Clinical Confession

I think the objectification of the self as a patient under treatment qualifies as "outside," though the narrator may be biased.

Since I was begun on a new antidepressant last Wednesday I haven't cried, and have felt better in general--until this afternoon, when I began to feel fragile. This makes me suspect I should increase the dose of the antidepressant now lest I lose the effect, as I have so many times.... Oh, and I just remembered I forgot one medication this morning--Abilify!

That's not good, as one test of my sanity is remembering all the medications I am supposed to pour down my gullet. It's no secret and no shame, here: Lithium, Effexor, Prozac, Wellbutrin, Abilify, Adderall, Enalapril, Aspirin, Celebrex (and M.S. Contin on bad back days). Klonopin at bedtime.

Of course I am transitioning from Prozac and Wellbutrin to Effexor, the new antidepressant, why I am on three at present. I'll stop the Prozac and Wellbutrin on Wednesday.

I used to say to my patients that if they took no more than one pill per decade they could be considered healthy. By that criteria I can't be healthy, as I take two pills per decade. Still, an increase in medications also reflects a doctor's inability to properly treat a disease; doctors always add more in pursuit of the desired effect, whether it's to control seizures or blood pressure. But what is "mood?" And what are its normal variations? And are some destined to be lifelong melancholics like Eeyor?

Flowers for Algernon...you begin to come out of a depression and "smell the roses" when inexplicably, the normal mood retreats and you're left alone again in the shoddy outhouse of your mind. This is what I fear will happen to my Effexor response.

What must it be like for a person who's never seen a psychiatrist to read my blog? Monsanto coined the term, "Better living through chemistry." I can see a suspicion that people like myself just can't handle a little pain in their lives, and thus go running to the doctor for every little anxiety and mood shift. But it's not like that.

I didn't see a psychiatrist until I was 29, though I had suffered severe depressions since the age of 13. I had decided it was simply normal to be suicidal for six months at a time, that everyone must go through it.

I don't expect psychiatry to help me with grief over my daughter's death, or to give me the courage to take my former landlord to small claims court (which I'm doing). I just want to be normal, with normal sadness and anger and fear, the kind we all have. What makes me abnormal is my brain's ability to generate a persistent mood, whether the pit of depression or the peak of mania, for an extended time, a time long enough to damage my life and relationships. For a mood disorder to be worth treating, it must interfere with basic functioning. It must harm one's life.

How I do go on! So much for today's confessional. I'll end with a poem on depression, another objectification:

On the Left Brain

Sometimes I think my left hemisphere
swollen like some great infected testicle,
necrotic, convoluted and gray.
Its vein walls are thinner than the membranes
lizards use to shield their eyes
and inside blood flows so slowly
I consider it a miracle
that a single rational thought escapes.

The great vein of Galen sits
at the bottom of both hemispheres
like a distensible sewer line that eventually empties
through the superior vena cava
into the heart’s right chamber
where its effluent mixes with blood
from the bowels and extremities,
pools in the lungs, and, re-oxygenated,
races from the left ventricle
back to everywhere else.

I tell you this because
the dream engine that pulls the body
has no conception of itself,
and though dependent on blood
is blind as an infected testicle,
as my metaphors bear witness
and your brain understands


Not rated,

CE