The article in today’s NY Times- The Problem with How We Treat Bipolar, was so very close to home. I read it and reaching the final period, I could not decide if I was going to throw up or cry, or maybe a bit off both. Not so much because Linda Logan so accurately painted the picture of mental illness and hospitalization, but because she nailed a piece of this puzzle that nobody seems to understand. Losing the self. It gets tossed aside, jettisoned. No importance in the clamor to find the right drug, or the right treatment. I understand how important stabilization is. I “know” that. But I know it always comes with a price. Every new pill, a different size, shape or color is a stepping stone on the path away from who you are. The electricity that ran through my brain left me farther from the self I knew than any of the chemicals I ingest daily, and have swallowed for more than 20 years. My response to this article was so visceral in part because there is no time to mourn the loss of the self. No therapist has ever said how do you feel about what has happened to “you”. It isn’t about the you that is lost. It is about the you that was raped, sodomized, abused. The you whose family fell apart, or the you who lost her mother. It is not about the you that feels the shadow of her former self. The one who goes to doctors because she cannot remember the names of the people she knows. Only to be told there is nothing wrong with her brain. No, wait. There is something wrong. This is not alright. Sadly, it is okay. It is perfectly fine in the pursuit of stable and not hospitalized. It is sickening because there is so much loss that is part of the status quo. I try not to look back anymore. What is there to see? Myself, lost and gone. The pain is so searing, so difficult, why would anyone want to look back? But it isn’t that easy. There are reminders every day. In the words I can’t spell, or the words that skitter away at the corner of my conscience, as I pull together a sentence with such effort. I know who I was. I can see her in my mind’s eye, the ECT didn’t erase her. I wish it had. Instead I am left to my frustration and anxiety in a world that is not of my creation. The walls painted in hues of seroquel, trileptal and modafanil. It is not the architecture or design of my chosing. Years have passed and it shifts. But it never returns to where it was. We cannot return ourselves to their virgin form. The self we were before it was touched by so many hands, and so many medications.
I remember a care free young woman. Sure, a bit wild and high-strung. One that lived out on the edge, a lot of the time. There was no adventure too grand, or too small. Friends surrounded me. Where my family fell short, I had people in my life. I could create without calling it to me. to write, paint or sculpt was like breathing. Where is she now? Where did that self go? Friends? none to speak of, save one or two that matter. Create? aside from this year spent blogging I don’t. Have not in years. Adventure? There is no adventure because I can’t manage to get beyond this gate without anxiety tearing me apart. I have shrunk to a mere speck of who I was. But I am alive. That is all that seems to matter. Even if it means living in a bombed out shell of your self. Is this the healthy patient they seek so doggedly? The one that is finally stable, or the one that is so fractured by the process they no longer care.
The most difficult aspect of this issue is that each time our illness rises up, and our lives start to come apart we face a cross roads. We can accept the treatment, whether it be a drug, or something else. We are in a debilitated awful place. It is in that moment, when our judgement is far from good that we are offered our salvation. There they sit, so sure they have the answer. We numbly nod and take the pills. Desperate to feel better. Yet it is a double-edged sword. That acceptance is actually another departure. We move farther from who we were. The loss engraved beside all the others in a soul now full with the marks of our journey. There is always that hope that this will be the one. This will be the treatment that makes me whole again. It never is. It offers only another rung on the ladder going the wrong direction. Years pass, and rung after rung we move farther away. The distance impossible to reconcile. There is no going back. It never is discussed or even acknowledged. When they talk about relapse, and how bipolar is so difficult to treat, they may want to take into consideration the trauma to the self the treatment course entails. How can anybody live with that loss when it is never addressed? We would not expect a diabetic to keep coming back for amputations as their circulation fails without addressing what they had lost already. It is no different. You cannot hack away pieces of a person and never note it happening. Nevermind, why is it acceptable in the first place? Is this what it truly means to be treated for mental illness? That we lay ourselves bare on the chopping block of psychiatry? There is no other field in medicine where iatrogenesis is so widely accepted. How can it possibly be okay? and what of the millions of people who come to harm each and everyday the world over in the pursuit of wellness. More often than not, so ill they cannot even truly consent to treatment. But worse yet, are never told what will happen.

Would I, at 20, have blindly accepted that first white pill, if I had known this road it would set me traveling on? I know what my answer would be.