Q. Where would you like to be?
A. In a safe place.
Q. Is there something about your present place that is not safe?
A. What kind of a dumb question is that? Of course there is! Why else would I wish I were in safer place?
Q. Could you be a bit more specific, please?
A. What do you mean?
Q. What is it exactly about your present place that is unsafe?
A. That’s a good question. Let me think about this for a while.
Pause.
A. Well, it’s like this. I can’t exactly say that I’m in an unsafe place, at least not with respect to many of the other places where I’ve been. When I slept on a pile of cardboard in a high-crime district, I was considerably more unsafe. Yet at the same time, if I took care of myself, and I did the right things, I felt that God protected me.
Q. And if you did not take care of yourself, and did not do the right things?
A. I sometimes got burned. He protected me insofar as that He spared me my life, and saw to it that I didn’t suffer as much bodily harm or psychological damage as a lot of the people around me. But I was hit enough — and hurt enough, hard enough — to get the message.
Q. That message being?
A. All over the Book of Proverbs — for starts. But I’m afraid we’ve drifted from the point.
Q. And what’s the point?
A. The point is that, even though I’m living in a nice one-bedroom apartment in a secluded area with good neighbors, lots of protection, and a couple of locks on my door, there’s something about the place I’m at that isn’t safe. It’s not my physical spot that is my biggest concern. It’s my mental spot — where my head is at.
Q. And where’s your head at?
A. All over the map, man. I still dwell on a lot of the situations from my past, people from my past — from my homelessness. The people who tried to help me, even though they didn’t quite really get what my problem was, and so they couldn’t really help. And not only them, but the people who tried to hurt me, and who sometimes succeeded. And not only them, but —
Q. But whom?
A. My friends. The people I miss. The people who were in the same boat as I was. People who, for one reason or another, had lost their homes. We bonded together. We prayed together. We watched each other’s backs. We were there for each other, whenever somebody was down, or hassled, or messed with in some way. It was powerful. And that bonding, that love — I miss it.
Q. But isn’t there love in your life today?
A. Lots of it! Don’t get me wrong. But it’s a different kind of love.
Q. What makes it different?
A. Context.
Q. What do you mean?
A. See, I don’t have the same issues here. And the people I hang with, they don’t have the kinds of issues I had back then. Most of them never have. So when we share our love with each other, it’s on an entirely different basis.
Q. Is that a bad thing?
A. Not at all. It’s just that — I sometimes feel alone. As though my own specific experience, the particularly powerful progression of my life that has shaped me, is too weird for anybody to relate to. So while I may not be surrounded by people who blatantly want to hurt me, the ones who want to help me don’t quite know how to help. Or maybe I don’t let them help. I mean, I gotta admit, my pastor helps. My lady friend, she helps — though it’s not her job, and I sometimes feel guilty. I should be helping her, supporting her. But I’m not. I’m still on disability, and all screwed up in the head. So I turn to the therapists, to the doctors, to the system. And I find that —
Q. That what?
A. They totally don’t help. It happened just this morning even. I go to the therapist, and I think I’m advocating for myself, and I’m finding once again that I really like the guy, and I’m thinking it’s all good — and then, at the end of the session, it all comes down to the same old thing. That same old useless, worthless band-aid that can never really stop what’s bleeding inside.
Q. What same old useless, worthless band-aid?
A. Lithium.
Q. Lithium?
A. You heard me. No matter what I do and where I go, it all comes down to lithium.
Q. Why do they keep wanting to put you on lithium?
A. Because they’re boxing me into a box and not listening to my real issues. They think they know something more about me than I know about myself, because of their credentials and alleged expertise in their field. But how can they know me, if they’re not listening? They think that just because it’s well-known that those of us who are quote-unquote “bipolar” don’t like to take our medication, it means that I’m in denial, and I’ve got to take their medications. What a bunch of malarky. They might as well have told me that just because people are bipolar don’t like to walk across a pile of hot coals, then I’m in denial, and so I better walk across a pile of hot coals. Think about it! Do they think I’m stupid?
Q. I son’t know — do they?
A. Probably not. But I sure think they’re stupid, if they think that after all I’ve been through, I’m going to turn around and start believing anybody who wears a badge. And I won’t! Because I already know what’s going to happen That lithium won’t have anything to do with clearing out all of the garbage that is related to years of living on the streets. Which of course is the part they never listen to — the main part. The important part. And you know what else it will do?
Q. What?
A. It will destroy all the things that are good about me. The things that I waited years to be able to get inside and do – and that now I’m finally doing — because I finally got myself inside.
Q. What things? What things are good about you?
A. Dude! My piano playing! My speaking! My writing! My playwriting! My songwriting! All of that good stuff that I so delight in finally being able to do will be trashed and shot the hell if I take their lithium — just like it’s been trashed whenever I’ve taken any other psychiatric drug that those bastards have never ceased to cram down my throat! I lost a $50.000 annnual income in 2004 because of a psych med! And do those money-guzzling mainstream, medical monsters give a damn? Do they care? Do they care about Andy?? Do they???
Pause.
Q. Do I detect a note of resentment?
A. Listen, I’m sorry I got so pissed off. But now you understand how hard it is to keep going back to that damn clinic and trying to advocate myself. When they throw their crap back at me, I explode. I hate those medical bastards so much for what they did to me all my life – you don’t even know how much I hate them. All of them.
Q. But aren’t you — stigmatizing them? Lumping them into a box? Much as you yourself dislike being pigeonholed, can’t you find it somewhere inside yourself to be more open to them? To forgive them? To give them another chance?
A. There’s a big difference between forgiving them and just swallowing any damn pill they stuff down my esophagus.
Q. Then what are we to do about it? Shall we adjourn until next Tuesday, and give you a chance to get your bearings?
A. Sounds like a plan. I’ll need about a week to cool down.
Q. May I be excused now?
A. You may. Thank you for your time.
The Questioner is silent.
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Eden in Babylon 
I’ve seen the best and worst of meds. I’ve seen the ones I carefully selected after multiple trials and errors (and say, learning I have more than just depression and a genetic intolerance to SSRIs, though multiple psychiatrists dismissed both at first). They have been lifesavers, though mostlt because I actively pushed for the right ones instead of accepting whatever I was just given. I’ve also witnessed psychiatric meds used as tools of abusive control of the developmentally disabled and been the only one who worked out that one of those people subjected to that “overmedication for control” was having a toxic reaction to those meds that was life threatening. His doctors themselves refused to listen when I first tried to explain the warning signs. They only believed when it became nearly too late (and even then I think largely because I refused to let them reach for a cognitively lazier and less unpleasant think about explanation.) I’ve become a de facto expert managing my own and someone else’s meds because I’ve seen it be life or death if I don’t, but I’m not anti meds themselves. I’m very anti bad medical management of meds. I’ll say they can be amazing if you find the right ones, but they sure as heck aren’t going to be the magic bullet for trauma from years of something like homelessness all by themselves. Also, trust your instincts if a med has dangerous side effects. Lithium isn’t even the only med to treat bipolar. You deserve a doctor who at the very least works with you among multiple options to see if there is one that could work for you. As I said, psych meds are serious and I’ve witnessed first hand when they are overdispensed and red flags ignored medically.Saying “take this and only this” with no autonomy or voice for the patient is the opposite of trauma-informed and patient-centered care.
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Rarely have I taken a psych med that has helped me in any way. Before I was 51 years old, I blindly took any pill they gave me, just because they “wore a badge.” While I am not anti-psych, I do feel that we all have the right to deal with our illnesses in any way we find most effective. From what little I know of you, having leafed through your blog the past few days, I am certain you agree. Although I admire the tenacity with which many people (particularly those who suffer from severe Depression), commit themselves to trying different medications, or combinations of medications, over a lengthy period of time until they find the ones that are best for them, I don’t find that at this stage in my life, at 65, I have the energy to experiment with my otherwise unusually healthy and fit, long-distance running body in the fashion that these doctors recommend. In fact, I find their recommendations insulting.
While a lot of this is “my stuff,” there is also a spiritual perspective that perhaps my partner is a bit more in tune with than I. Our minds were designed to function in accordance with their individual, divinely drafted designs. Since I have stopped taking bipolar meds, all the strengths I have — the five strengths that I linked to toward the end of my post — have become considerably stronger. My light shines far less dimly than it did when it was doused on psychiatric meds. The downside to this is that I also tend to be more effusive than earlier, and at times more explosive. But my feeling is that these are defects in my character that I need to work through without the aid of meds, because that is where personal growth really occurs. If I thought I were growing, improving, becoming a better human being, and then the meds were removed from me, where would I be? Probably worse off than I was before.
Again, this is not to say that one cannot make the choices they feel are best for them. If that means one needs to take a whole cocktail of psych meds, as a very close family member of mine is presently doing, that is their choice. In some cases, this regimen keeps people who suffer from Severe Depression from suicide. But I myself am not prone to such tendencies, and the extreme tendencies I am prone to are not helped by psychiatric drugs. My own experience.
I guess, in a way, I’m practicing my advocacy once again. I need to get my hypothyroid medication, and that is a measurable, quantifiable disease. If I don’t talk to these people at the clinic, and inform them that I feel I have a right to this medication without cow-towing to all their other b.s., I’m just going to have to find another clinic. And the other local clinics, while they will accept my low-income insurance, won’t have any qualms about taking me to collections if and when I won’t be able to pay the bills. I’ve got a stack of bills I can’t pay from the clinic where I am already, and they’ve promised not to take any of their clients to collections. So that’s a big factor. Health care doesn’t come for free.
Thank for your detailed note. Again, I admire those who have the perseverance to stick with a concerted psychiatric medical plan to manage their mental conditions. My preference is to apply my perseverance in other areas. Take care and God bless.
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I’m thinking this must be a common dilemma Andy for those who are bipolar and gifted – dilemma in being told to take them and not wanting to because of past experience of them affecting who you really are. I know I’ve heard a couple of very clever literary ‘celebrities’ talking about this. Not on the same scale, but I’ve had bad reactions in my youth that put me off only to find something that did help later on when my midlife hormones kicked in and exerted very much unwanted effects. Anyway, you stick to being you – I’m in your camp!
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Thanks, Lynne. There really isn’t anybody in my life today who wants me to be any different than the way I am right now, except for — like I said — more-or-less off-the-beaten-path kinds of issues that relate to years of having lived on the streets, stuff relevant to a code of conduct that doesn’t apply to normal everyday indoor reality. And that kind of thing is not in the DSM-V. It’s not in the psych books, and while it helps to talk to counselors about it, when they start to recommend these medications, I have to remind myself that not one person in my life, including myself, and certainly not my partner, wants me to dim the creative light that they see clearly shining so luminously, and that light under the bushel of psychiatric drugs. This includes my pastor, my friends like you and Lauren and Jan and Jacob, my fellow peer counselors at the Recovery Center, and even my therapist, until he gets on this medication kick and becomes a turn-off.
I think it’s because there are aspects of the behavioral health paradigm that get hung up on the notion that unusual psychic conditions have to be regarded as BAD and diagnosed as DISEASES to be treated, rather than accepted as being natural, healthy conditions that are intrinsic to the individual’s spiritual or creative path. In my case, I’m not about to dim that light. It just baffles me that I can’t seem to get normal medication for a low thyroid condition without somehow always sidetracked onto that psych med path. I gotta just find another clinic, that’s all there is to it.
And hey – if G.F.Handel hadn’t have had a certain 24-day “manic episode,” the world would not have The Messiah and its Hallelujah Chorus. True, the creditors were knocking on the door after he squanderered all his Opening Night royalties in glee, but in the long run, in the big picture, what is more important? Nowadays no doubt they would have locked the guy up in some kind of psych ward and confiscated his music notation software just the way they always did to me when I lived in California and the laws related to such matters are quite a bit different. In California, a person has the right to “5150” a close friend or relative, and I myself was “5150’d” at one time by a person who misinterpreted something I wrote on a Facebook timeline, and claimed to be my friend. All of a sudden there were three Oakland city cops knocking on my door, and before I knew it I was being hauled off to a psych ward. That kind of thing is not as likely in North Idaho, you can’t just be hauled to a psych ward on hearsay. In the psych ward they would invariably confiscate my laptop (because it could be “used as a weapon”) and if I were in the midst of a musical project, it basically was a standstill until I could weave my way through the behavioral health bureaucracy, get out of the damned psych ward, and start composing music again.
All I can say is thank God I moved to Northern Idaho, where the laws and general social customs and mores work much more favorably toward the individual, and one is less likely to be ostracized, stigmatized, or institutionalized simply because he doesn’t “fit into the box.” Strikes me as highly ironic that California has this self-image of being so “progressive,” but that’s a red flag right there. Usually the ones who make that claim the most conspicuously are the least open-minded or progressive of the whole lot. Ah but I digress.
The clinic is an anomoly up here. I’m sure I can find another doctor who will get my my hypothryoid medication without my having to go through too much extranea in the process. Sometimes, one just has to rise above.
Thanks again for all your support. God bless.
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