Before (I Have Known Pain)

These days, most of the time, I feel pretty calm. The mind gets wound up, sure, and sometimes there’s anger or agitation or sadness, but all in all, underlying it is a feeling of peace.

That wasn’t always the case.

Twenty-plus years of depression, anxiety and more

Mine was not a transient depression or anxiety disorder. Over the course of 22 years, my brain was given more than a dozen labels, including soft bipolar, borderline and PTSD – my last psychiatrist finally summed it up as a “rip-roaring mood disorder.” I was “hard-wired” for depression and anxiety because of my family. We had a genetic serotonin deficiency going back three generations on both sides, I’d tell people. And maybe we did. Or maybe we just thought too much.

Suffice it to say I know what it’s like to collapse in line at the cafeteria because my legs have turned to jelly. I know what it’s like to pull myself 25 feet along a hallway by my hands, in front of gawking strangers and acquaintances, sweat pouring over my body, because my legs just won’t work. I know the choking feeling, the black spots that precede the feeling of having a black cloak placed over me from behind, the chest pain of panic that mimics a heart attack.

I know what it’s like to lie in bed, staring at the ceiling, without enough energy to decide whether to lie on my left side or right. Unable to think, and not particularly able to care that I can’t think. I know the blankness that exists beyond tears, which indicates that hope has left the premises.

I know what it’s like to think obsessively about dying every single day, to have suicidal thoughts intrude on every aspect of my life. To want it to be over. To this day, I can’t hear the Sugar Ray song “Fly” without remembering how my mind changed the lyrics to: “I just want to die…”

I have known pain.

Everyone who experiences clinical depression and panic believes their pain is the worst ever, and nobody else – especially nobody who has ever gone off medication – can possibly understand. But I can. It feels like another lifetime, but I can.

I took a veritable pharmacy of medication

When my panic attacks landed me in the university emergency room repeatedly in the late 1980s, I started taking imipramine, a tricyclic antidepressant.

At the time, I thought the attacks were totally random, but they weren’t, at least not wholly: I was 22, and all around me, my friends were dying. I had committed every aspect of my life to working with people with AIDS. My classes, my research, my social life, my volunteer work, my job—all of it had to do with AIDS which was, at the time, an illness that killed people very quickly. These attacks, I now see, were my body’s self-protective response to emotional overload.

I tried to go off the imipramine a few times, even after I burned out and ceased working on AIDS-related projects, but I couldn’t function without it—at least, not in the way that was expected of me—and I always wound up taking it again.

A few years later, Prozac was introduced, and my similarly-medicated friends and I went starry-eyed over the fact that its only (known) side effect was weight loss. I was quickly taking the maximum dose, and it did have another side effect – diminished libido. So I began taking Wellbutrin, too. The combination ‘worked’ for almost two decades. There were a few times it didn’t seem to be working, but the other medications I tried were a disaster (I remember one, in particular, called Remeron that left me no happier but in a fatigued stupor and ravenous enough to devour the entire city of Toronto). So I’d go back on the same combination, figuring it was better than nothing.

In 2005, I’d completed a manuscript that had been five years in the making. I’d won a large writing competition and quit smoking. But my savings had run out; my part-time film critic job wasn’t enough to support me, and I panicked. I left the entertainment industry and my community of artist friends in Toronto, and I moved across the country for a job as a corporate storyteller. It was the first job I’d ever had in the business world.

The beginnings of a breakdown…or breakthrough

The office was beautiful – stunning – a two-story all-wood, natural-light building overlooking a quiet cove in the Pacific. It was filled floor-to-ceiling with books, and writers were at the top of the organization. I’ve never, and probably never will again, see a place that so deeply valued writing. The office was open-concept, the kind that exists to promote collaboration (but in reality, promotes distraction). It was a brilliant sales tool for clients who were wowed by how “creative” it looked, but it wasn’t so effective as a workplace, especially for a highly sensitive, introverted writer who hadn’t worked in an office in more than a decade. Within a month, I’d started smoking again.

The job was a dream – an exhausting dream, but a dream nonetheless. Flying around North America, staying at luxury hotels and resorts, eating the best foods from renowned chefs, researching enough on a variety of topics to have written a Masters thesis every couple of months, coming up with creative visioning questions, helping people who all said “I’m not creative” uncover their creativity – it was all-encompassing and, at first, deeply rewarding. I felt Successful with a capital S. My mind was in heaven.

After less than 2 years, though, I was in my doctor’s office, saying yet again, “I’m not feeling good. Something’s not right. I think the meds aren’t working any more.” She sent me to a psychiatrist, the best in the city, she said.

This woman was the best, all right. She was a psychiatric equivalent of a neurosurgeon, pinpointing with laser precision the areas of my brain – and personality – that were flawed, damaged, wired incorrectly. And she knew just the pills to fix it, so I could go back to working 90 hours a week and trimming the edges of my personality so that I could fit in enough. (I mean, creatives are supposed to be weird, but there’s a limit.) Except…many of the meds didn’t work. So we tried other ones. Topamax. Seroquel. Ritalin. Celexa. Dexadrine. Cymbalta. I had to take a bus down to a Target in Bellingham, Washington for one, because Health Canada hadn’t approved it. But then that didn’t work. So she raised the dosage. And again. And again. We agreed I was an ultra-fast metabolizer, or maybe my numerous brain flaws were treatment-resistant. There were pills to sort out my mood, to help me focus, to keep me from freaking out, to help me sleep, then to help me get up in the morning. Then there was the topical gel to help with sexual side effects, but it caused acne, so there was also Accutane – a former chemo drug – to combat that. It made my hair fall out.

I stayed up for days in a row. I couldn’t sleep – which was seen as a sign of depression, and not of being on enough prescription speed to help a hedgehog win the Kentucky Derby. I went into blackouts and woke up with fully composed (and frightening) emails, my cursor hovered over the “send” button. I woke up with cigarettes burning precariously on the edge of the ashtray.

The final meltdown(s)

And then, one day in 2007, in her office, I lost it. I started crying and couldn’t stop. She suggested I take a medical leave of absence from my job, and I did. For six weeks, I lay in bed unable to do anything. Occasionally, I’d get up to go see the doctor, and she tried giving me more, better, different pills.

With two decades of therapy under my belt, I had volumes and volumes of knowledge about myself, of intellectual tools with which to navigate life. I was certain that the remaining issues were entirely biochemical. My brain didn’t fit the standard, and it was a simple matter of poor wiring; pills could fix that.

Of course, the doctor – a petite blonde woman with a grim face and no-nonsense stride, wrapped in J. Crew – never hesitated to point out my personality flaws, like being direct or socially naive. We also had several memorable conversations about sleep. When I told her my natural cycle was to be more awake and creative between 10pm and 2am, she told me point-blank that wasn’t possible. It was another sign of a flaw in my brain, that my body didn’t adhere to normal circadian rhythms.

Her pills kept me alive at a time when I didn’t have the emotional or spiritual resources to keep going, and for that, I am grateful.

She told me once, with a curt laugh, that if I ever went off meds – after all she’d done to try to find the right combination that worked – she wouldn’t allow me back in her office.

By 2008, we’d finally settled on a cocktail of Adderall XR (90mg, which is three times the maximum recommended daily dose), Cymbalta (120mg), lamogratine (150mg), Strattera (80mg) with .5mg of clonazepam as needed, plus androgen gel and Accutane. I’d been laid off from my job and was on Plan G, a special type of emergency psychiatric prescription coverage, so I didn’t have to pay the thousands of dollars a month these pills would otherwise have cost me. The plan didn’t cover Adderall, so the doctor kept giving me “free sample” cards from the pharmaceutical company.

This cocktail sort of “worked,” meaning I didn’t fall into the deepest chasms, but it became clear that no amount of medication was going to make me feel “normal”, or better than “meh”. So, on my own, I began using self-hypnosis audio, brainwave synchronization tracks and doing energy work (guided by books and audio).

Convinced that the next breakdown was only a matter of time, I was in the process of applying for Person With Disability (PWD) status, and my psychiatrist, my therapist and my GP were all firmly behind me.

“I wish I could get off meds,” I’d say, “But I’d kill myself.” At one point, I journaled, “I may have a ‘sick’ identity, but at least that’s better than ‘pathetic.’”

Life painted me into a corner (for my own good)

In January of 2010, the psychiatrist told me that she could no longer give me the “sample” cards. I’d moved to an island 60 miles away, and I’d been having trouble getting over to the mainland to pick up the other samples I relied on (shockingly, my new GP didn’t have the same veritable pharmacy warehouse in his office).

At some point – I forget exactly when or how – I came to the realization that I would have to go off these medications. There was no other option. I was facing close to $2,000 a month in prescription costs, and I barely had enough money for rent and food. I couldn’t go on the government plan, because I hadn’t filed the tax returns that would determine my eligibility.

I knew that I couldn’t go off these meds cold turkey, that I would have to taper, and that Dr. X would in no way support this decision. I was afraid to tell my new GP, afraid he’d say I was too crazy and somehow force me to stay on meds. Looking back, this very fear seems odd, but in the moment, I was terrified of being locked up.

I counted out the pills I had left and began searching desperately for other ways to heal my brain, to keep myself from hurting myself.

Don’t try this at home (seriously)

By tapering, I thought I could avoid withdrawal. I was wrong. For at least a month, I vomited thick, brown gunk so often and so profusely that I sometimes had to stand in the tub, because the toilet couldn’t hold it all. This wasn’t food; I wasn’t eating that much, and it looked…well, really, it looked like crap. Literally.

I looked at every book on neuroplasticity and self-healing I could find. I listened to every spiritual talk and book I could download. I tried techniques and games and practices and processes and everything that could possibly help heal my brain. I began creating a toolkit that blended Buddhism, energy work, cognitive reframing (feeling sensations without assigning labels/stories to them) and coming into my body.

When things became intense, I listened to a playlist of spiritual talks – mostly Eckhart Tolle –  I’d created, called “transmutation”; at night, I listened to a sleep track with subliminal affirmations I’d recorded myself.

It seemed clear to me that what I was puking out was negative energy – veritable demons that had been stuck in my body for decades. Every time more came up, I thanked it for leaving me. I have since learned that people who drink ayahuasca have a similar “purging” experience before the workings of the universe are revealed to them.

About a month later, I experienced the rapture of being alive, and that changed the way I perceived my brain.

Image credit: FREESTOCKS via Unsplash