Your Very Creative Youth
On Going Off (my meds)
a photo essay w/text
The gyrating ball of anxiety is pleased to meet you.
Six days into the cut-back, that is, the planned titration off my psych meds, I awoke to a dark weekend. Even before I opened my eyes, everything was despair. Everything and everyone was wrong, was doomed, and most especially me. I had a project for the weekend, and I like to have projects. If anything cheers me, it’s a project. This one was to fix up, tighten-up, sand, paint and stain an old bench I’d bought for my backyard. But the idea of going to the lumber store or the paint store or the hardware store, or all three, on a Saturday, struck me as an outrageous cliché of the white life of a gray-haired very late middle aged not quite elderly man on a Saturday, doing his little busywork project before having a backyard BBQ where he can discuss details of his new bench or else his upcoming hip replacement, so happy, so satisfied with himself and his life, because little projects to prettify your backyard are what life is all about. You might as well wear a safari hat and listen to NPR all day while driving around in your Volvo station wagon. Also I felt a strong sense of my inferiority before any man who would know about lumber, hardware, paint or stain. (Benches, I knew, being a big sitter all my life.)
I came down to a kitchen piled with the dishes I hadn’t done the night before and was overcome by a feeling that I live my life in squalor, that my house was squalor from front door to back. I noted once again the steadily lengthening crack in the kitchen ceiling and tripped over the kitchen floorboards where they buckle. My wife saw no reason to indulge my morning bitterness and pushed back at my complaints, then implied my sour mood might be related to my titration project, which just made everything worse. Not that it could be related; it had only been a week, and I was still taking the meds, just smaller doses; there were still lots of psych meds in my blood. But how could I blame her for declining to indulge me? She had been indulging my moods for 30 years. How exhausting it must be at times. I spent the day feeling completely separate from her, convinced the feeling was permanent, and feeling outraged at being, at feeling misunderstood, like some disaffected teenager full of unfocused rage against whatever. I hated who I was, who I had become, who I had not become, I hated what I was doing, everything I did or had done, and was suddenly, totally convinced that my current book project was an absurdity destined for pathetic failure, which it may well be, but that’s not the point. At that moment, I was sure It would be the anti-culmination of an anti-climactic life.
Self portrait with horns
All this happens while your resentment grows stronger with every morning gulp of water pushing down yet another capsule or tablet or pill, the white one, the yellow one, the Confederate-gray. Also you are in and out of therapy, which sometimes has helped and other times has been wasted time and pain and effort and energy, though perhaps not enough effort on your part. But there were times you were just uninterested in the work therapy requires, and that lack of interest and energy were a sign of how depressed you were, and you felt guilty toward the hard-working therapist, the hopeful therapist, that person trying to be optimistic with you, or trying to argue you up or down, as if they could ever prevail in a debate with you about what you deserve to feel.
This dark mood was depression, not titration. On the contrary, it was the reason for the titration. Despite being on prescribed, staggering, off-label dosages of multiple anti-depressants for over a decade and a half, that I still was capable of waking up to dark weekends, still had daily stretches of deep despair, still was forced to fight through debilitating self-consciousness, insipid doubt and guilt, and a steady gut feeling like sadness and grief, to get through every day, to find a way to be a little kind, occasionally polite to others, and productive, was making me crazy.
The only pale comfort I had, more of a distraction really, was in finding meaning in my pictures, even as the better ones tended to cause me stress and doubt. Were they any good? Should I edit them? Am I over-editing? Will they ever see the light of day?
As I titrate down, that is, as I come carefully off my psychiatric meds, these images, all recent, nevertheless seemed to me to trace my experience of the last twenty years on certain prescription drugs that may or may not have helped or hurt me. Or my possible experience. I really don’t know for sure. I have been on the meds I’m eliminating for so long that it is hard to know what their effects are or to remember what, if anything, their effects once were. Or who I once was without them. All I can recall is the initial optimism the introduction into my bloodstream of a new medication used to bring, how you would be certain a new med was working long before it possibly could be, as many take a couple of weeks to take any effect. It’s not even necessary to name them, and maybe not wise, though I have listed them in print in pieces I’ve written in the past, for publication.
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When the medications came into my life, I wanted to lean on them, hoped to be freed from the heaviness that is one physical symptom of depression, and so to soar. In the glow of their coming, I made plans to attack life with a rare energy, with a new and ravenous hunger for experience, for knowledge, for discovery. But the truth is, if I have had experiences over these years, and I have, if at times I have seemed to be hungry, I haven’t often felt the hunger. I have gone along with others just for experiences, I have picked up and even retained some information and knowledge here and there, mostly through repetition, or because I had to in order to survive, or to get paid. I have aspired for things, aspired to accomplish things, but only ever because I thought I should aspire or accomplish.
But the truth is, in spite of any possible appearances to the contrary, I have led a life of fear, fear of tomorrow, of my mood tomorrow, or tonight, for that matter, or an hour from now. Regularly, I have retreated in the face of the threat of an emotion, painful emotions of course, but even sometimes pleasant ones. I have declined to approach any and all purging, cathartic emotions, if those things exist at all outside of drama and literature. I don’t know what closure is. I feel I carry everything that ever happened in my life on my back.
Through aging, through a kind of growth and slight self-knowledge gained, through incremental acceptance, and despite my work writing about victims of violence and the aftermath of violence in Oakland, I have been able to arrange my life in ways that allow me frequently to avoid, to ignore, to look away, to run away, from confrontation, from circumstances of others’ deep sadness, from witnessing the infuriating. Nothing unique about these behaviors, necessarily, though my engagement in them has been perhaps more thorough, calculated and profound than yours. The moods and deep depressions have taken a toll, though. Whatever boon avoidance has given me speaks to the ineffective medications, I think. I think it says that, though cowardly, I have taken care of myself amidst their failure to take care of me.
It is not that my med-spiting mood swings have been wild so much as that they have been not in my control. Within them, though I might sleep or brood or growl, I can contain my behavior, my commentary, even my face and body language, when I think about them, and keep within the realm of politeness and harmlessness. But even if I can sometimes have some influence on their modulation and intensity, I can’t control the advent of pain or the appearance of the negative thoughts and feelings. But I am grateful I can control anything and maybe the medications were my lever of control, and maybe when they are gone from me I will struggle more. I’m worried about that.
I think about the meds and whatever good they might have done me when I see people on the streets who have lost touch with so-called reality, so many of whom perhaps once had lived stable or at least more stable lives, enough to maintain a medication regimen and to live day-to-day in a kind of assisted normalcy, but then that stability slipped away, for whatever reason. and in many cases there was no opportunity to go off your meds gradually. Just, suddenly, you are out of them and they are no longer part of your morning. Soon you ache like you’ve got the flu. It’s hard to rise and hard to move forward. For me, even on high dosages, day after day, year after year, the anxious weight I feel in my gut, in my diaphragm, my middle, sometimes in my arms and legs, increases, the size of the knot of anxiety grows and swells and infects everything it touches. The inner heaviness is followed by the thoughts, the self-lacerating thoughts that go with the gyrating gut weight, the awareness, the awareness of the hopelessness of this very moment, never mind all the hopeless moments to come. This one is bad enough. What do I do now? What in my past have I done to make myself not feel this way anymore? Is there anything I can do? Is there some food I could eat? A movie? Nicotine? A book? Should I get high? Get drunk? Get out?
But nothing changes anything, and you find yourself burning up on a hot day unable to find a place of shaded safety, of comfort, and there is no hope for change and you look for a messenger to take the word out to the world that you are done, emptied, emptied out, out of everything and might be going out of business. But no one can really understand the message you give them, or its urgency. Nor do they ever really understand the favor you are asking, that it was a message you wished them to relay. And it is not a thing you can do yourself, and so it is a task that never gets done, and eventually you get what you could call a small respite where a day or a morning comes when you can function with ease and almost enthusiasm, even roll along well, but the whole time you are looking over your shoulder and afraid to look too far ahead and you don’t want to live in the moment because the moment itself is haunted by past moments and the days and moods to come.
Lately, before I began the titration, a new physical-emotional hybrid sensation has appeared. It feels like a momentary inflammation of the ball of anxious weight at my center, a swelling that feels like a reminder I don’t really ever need that I’m in pain and pain is my forever companion. It is as if the anxious ball itself is malignant, as if the anxious ball itself is glowing hot and anything it touches will burn a moment. Then this momentary pain itself subsides but the memory of it lingers, the reminder has had its powerful effect. You will not forget. And then you begin the wait and the watch for the next inflaming, the next swell, like watching the waves when the storm itself is only a rumor.
My therapist and I talk sometimes about joy, or I do, how I can’t recall the feeling, though I have felt it in my life, and am aware of one or two events over the course of the last 20 or so years that might have merited the feeling of it. Were the drugs the thief of joy? And if I can’t say I have felt joy for many a season, I can’t say I have fallen into the blackest darkness either. Though I am certain that I have gone closer to the black darkness than I have gone to joy, I wonder if the drugs have been my protector. It may seem like a ridiculous question but how can I know for sure: have the medications, or should I say, how much have the medications dampened my emotions, limited them, restrained them, harnessed or held them back, good and bad. And is this thieving and protecting related to the dearth of creativity? And hell, would I be able to describe those extreme emotions anyway, even if I felt them? And if after the meds are gone the black darkness comes, who will I answer to? And if the darkness comes will there sometimes be joy to balance it?
In the meantime, there is this nagging belief completely unsubstantiated by personal study that all along the medications have not only failed to lift you but have held you back. I guess a doctor would tell you that these meds do represent a trade-off. If you wish to avoid a chronic feeling of crippling sadness all day every day, you might have to give up a few things, like shitting, sleep, sex and writing fiction. Surely you have come to blame the drugs for your battles with being overweight. You have blamed medications for your bouts of insomnia. You have blamed them for constipation and erectile disfunction. But mostly you have blamed them for a peculiar, personal sense that you have lacked creativity since your very creative youth. Others will say your nonfiction was very creative, that your sense of humor is a source of constant creativity, as is the obstruse way you see the whole world. You have a unique perspective. You are a unique, creative product yourself. But you can point to the timing, first to falling into the deepest depression you’ve experienced in the early 1990s, the fading of inspiration, the coming of meds, which helped lift you out of the deep depression, the last story you wrote for years (“Punch-Up”), then the years of a kind of creativity, creative nonfiction, but it was not the same as creating stories from scratch. How it coincided with the rise of the medications, but that was the trade-off maybe, as you felt better, more confident, hungrier for life, and while you missed that struggle with and satisfaction at finishing short stories, you still got your fix as a writer, and you got read! Still, the void you would look into when you thought about short stories was vast and very empty and you kept hoping it was true that this was a vacuum created by whatever these medications were doing to your brain and your soul. So always there was the dream of coming off the meds, that you would lose weight and start imagining stories again, stories you could write, while thinner. That the words would come to you.
And now after years of discussion and threatening to leave the meds behind, you have begun the titration, with the advice of a psychiatrist, which is your privilege, unlike those people struggling without medication on the streets, coming off cold turkey, which brings on more than the physical symptoms of withdrawal, but sometimes hallucinations and suicidal ideations.
But you can do it gradually, under the supervision of your (admittedly disinterested) psychiatrist. Not like the guy that came up to you that sunny spring day at the lake and began spouting gibberish. White dude, dark hair, 40ish, fit, you could tell that not that long ago he had had an expensive haircut but now his hair was shaggy and long. He wore stylish horn-rimmed glasses, but there was also this: he had long thick hairs covering his right earlobe. His left was also hairy, but not so much as his right. I thought it was a sign of his break with life. I think it was a thing he had probably kept an eye on. Maybe in happy times his wife would joke with him about it, or his kids or his big sister. But now that he had broken with reality, with daily life, he never even thought about it, like the traffic light he ignored and almost got run over as he ambled towards me. It was probably a miracle he still had his glasses, which were thick, and I wondered what a person living on the edge of reality, on the street, with severely poor eye sight, would do if he lost his glasses. He was living on the street somewhere, and I wondered was someone looking for him, checking in with him occasionally, and how hard it would be to see.
As for me, I think I am about half way to being off these things. The days are not much harder than before. I feel bloated, occasionally shaken, pessimistic, but none of that is that new either. I am having some gastro-intestinal issues. I am dubious that this coming-off will create any of the fantasy changes I had fantasized about it creating in my fantasies.
I do have new short stories and poems, but they were written before all this began. The poetry I have been writing has been squeezed out, not based on inspiration. But I am grateful to be writing it. I am sleeping better. I feel fatter than ever. I am leaving this paragraph intentionally disorganized because I think it reflects the current state of my brain. My appetites for unhealthy things are a worry, as I do think that, if these meds were doing anything positive, they were curbing some of my urges. Only they were also curbing appetites I want to have, my curiosities, for my creative pursuits, for approval.
So I allow that continuing to take the meds as prescribed may have kept me off the streets all these years. If they have never raised me very high, or never freed me of my pain in a way that allowed me to raise myself very high, it's possiblethey have served as a net, a bottom higher than my natural bottom. In their absence I might find new depths of pain they had preserved me from. And maybe in that potential fall I will find some clarity. And maybe in that clarity I will find ideas, germs like I used to store in my brain like so many acorns waiting to be eaten or born. - J. O'Brien
I feel bloated.