Maybe my story is more about medicating than it is about alcohol abuse/addiction. It’s both things, of course. But self-medicating with booze was very real and insidious and so has been my journey with therapists and psychiatrists over the years. Beginning in college and now, seventeen years later…
It started in Boulder with Dr. Katherine Bryan, a psychiatrist at the University of Colorado where I was an undergrad. She put me on Wellbutrin and Adderall. I was drinking heavily and seeing Matilda Grace, an off-campus therapist who I’d been going to for a couple of years for my, sometimes severe, depression. I would show up to her office still drunk from the night before and she would look the other way. I remember her sitting cross-legged, barefoot on an ottoman with a mug of tea. Her office was dark and felt subterranean, though it was above ground. I wrote her checks each week and walked out sighing with relief that I could go home and be hungover in peace. I barely remember what we discussed. I know we talked about my pain around my dad and step-mom ad nauseum. We talked about my low self-esteem, weight issues and binge eating disorder, but the alcohol was skirted around. I would be lying if I didn’t say I’ve felt resentments for her…the years of taking checks, but making no real difference. Although maybe she did. Maybe she did make a difference.
Dr. Bryan was Dr. Bryan…a petite woman, in her sixties with dark salt and pepper hair and glasses with black plastic frames. She had a raspy voice and was a smidge abrasive, quite different from the soft-spoken Matilda who shot darts of empathy at me from her watery blue eyes. Dr. Bryan was from Long Island and recommended a psychiatrist friend of hers to me when I moved to Manhattan after graduation. I don’t remember his name and only visited his office a couple of times. It was on the Upper East Side. He sat behind a huge teak desk. He was balding, wore glasses and was intimidating in the dense silence. He gave me plenty of refills so I didn’t have to be there much. He knew I paid out of pocket for our brief fifteen minute meetings. He must have given me a deep discount. I saw one of his students for talk therapy. She was extremely kind and her office was down in the Financial District, which was closer for me to get to — just a short subway ride from my apt in the Alphabets. Jennifer was a student at NYU, getting her master’s degree and needed practice hours. I don’t remember how much she charged me, but when that became too much for my barista salary and I told her I was going to have to end therapy, she told me to keep coming. She saw me for free and told me I could pay her back, “someday.”
I felt guilty for years for not repaying Jennifer, but slowly she slipped from my mind.
She never sent me invoices or requested money. I wonder where she is and why she kept seeing me. I arrived in NYC on way too much medication. I was taking 450mg of Wellbutrin (the max dose) and 30 mg of Adderall. This left me spinning around the city, propelled down the streets and avenues by an anxious force that sped through my heart and mind. At the time I was still drinking, so the booze helped. The hangovers slowed everything down while the meds pulled me from the mental and physical sludge. But when I quit drinking six months later I’d worked myself into a semi-breakdown. I had what was maybe a panic attack, although it didn’t feel that dramatic, it was more like an acute downward spiral that left me feeling like I was swimming in cement. I called into work at the cafe — I was supposed to work the evening wine bar shift that night. The idea of smiling and talking to the regulars, of being shiny and social left me paralyzed. I talked Reese, my roommate, into calling Calvin, my boss at the time, and telling him I was sick…that I was having some kind of meltdown and couldn’t come in. I remember crying in the shower and deciding there, in that bathtub in our apartment on East 11th Street, that I would quit drinking. That, that would stop my mind from racing and give me direction. That was fall of 2005.
Fast forward fifteen years through many more shower epiphanies, through Denver and the various psychiatrists I saw there, to now. I’m in Arizona seeing Dr. George Garrett. His office is in Scottsdale with a long wall of seamless glass that looks out on mountains and palm trees. He’s down-to-earth and casual with me as we talk to one another through our face masks. I want to ask him if it’s harder to make a diagnosis only being able to see half of a patient’s face. But I don’t. He’s funny and honest, which I appreciate and lets me have input about the direction of my treatment.
When I first go in I am only taking 150mg of Wellbutrin. His first suggestion is to treat my ADD, which he doesn’t hesitate to diagnose. I wonder if I’ve been trailing off in my stories and looking out the window too much or if it’s because of my prior diagnosis. So we start there with 30 mg of Adderall. I go back three weeks later and we add in 2.5mg of Abilify, which is meant to influence and enhance the Wellbutrin. I don’t want to take more Wellbutrin because it makes me anxious, so I’m hopeful to try something new. Abilify is an anti-psychotic, but is used at low doses and in tandem with antidepressant drugs to treat depression.
In the past I’ve always been given Prozac as an add-on to my Wellbutrin when 300mg wasn’t cutting it — back in my drinking days. Prozac always made my mouth numb, so I’d stop taking it. I’ve always had an aversion to SSRIs, I don’t know why. A primary care doctor in Denver put me on Effexor once, which was the single worst medication experience of my life. I was honest with her about my excessive drinking, which baffles me further because Effexor can be a blackout drug. People will continue operating like normal lucid beings, while internally their memories have shut down after their second glass of wine. Effexor marked a destructive period for me.
I was in a very dark place when she put me on it — suicidal ideations — deep, thick greyness.
But life with Effexor was no better, just less memorable and when I finally sucked it up and found my fourth psychiatrist in Denver, she weaned me off of it as slowly as possible, but I still experienced the debilitating side effect of sensations of electrical pulses shooting through my veins and sometimes even my brain as my body withdrew from the medication. It was torture and left me feeling deeply hurt and resentful of the medical system in our country.
The nightmare experience with Effexor and the primary care doctor followed two other bad psychiatric experiences I’d had in Denver. One was with an older psychiatrist who worked in Cherry Creek, an affluent neighborhood in Denver. She was condescending and mean, once demanding that I put my coffee down before answering her question. I was not to be holding a beverage when speaking to her. The other was with a psychiatric nurse who worked in the same neighborhood. Linda was a nurse practitioner so she could prescribe meds. She was my boyfriend’s therapist at the time, but agreed to see me for medication management. This is a moral conduct grey area, since she wasn’t doing talk therapy with me it’s technically permissible. When I found out much later about a dark secret my boyfriend had been keeping, it was impossible for me to not resent the time and money I’d spent seeing Linda, knowing that she knew what was going on behind my back in my house. She knew that something was happening that would directly affect my well-being when I found out and yet, she said nothing.
So far, present day, I feel better and hopeful. I have faced almost two decades of psychiatric drug treatment and am hoping to maybe, finally be at a place where I can have grace with myself.
I’ve told myself the trite cliches, “you wouldn’t shame a diabetic for needing insulin, would you?” But still, the shame and questioning have persisted. None of my close friends have taken prescription drugs for their mental health. My partners have understood and been supportive, probably because they have mostly been medicated as well. I wonder if having uninterrupted medical care with a psychiatrist long-term would have built a foundation of trust that I could have surrendered some of my worry to? It’s such an odd thing, to think I have worried about the morality of my medications while simultaneously abusing alcohol and recreational drugs, but I did. Was it the social acceptance? Needing daily medication has always made me feel weak.
Neither of my parents are on them, though my dad self medicates with a fervor reminiscent of Hunter S. Thompson. My mom is so resistant and distrusting of the pharmaceutical industry that she refuses to take her thyroid medication, instead treating her disorder with a myriad of supplements, oils and food restrictions. And yet, when I went off of my medication this past spring for a bit she discouraged it. Maybe it’s my own stubborn frustration and desire for control that makes me rebel against the need for medication. Needing a drug that requires a DEA license makes me have to play the game with the gateway white coat and then the pharmacy all while trying to silence the constant worry of being uninsured. There’s a reason why the majority of mentally ill people with lower socioeconomic standing are living under bridges.
Paying a psychiatrist $375 pisses me off, then I swan dive down into the next layer of emotion which is guilt that I can. It’s not fair that money is the difference between being professionally medicated or medicating yourself with over-the-counter or out-of-the-baggie substances. Vodka and heroin or pharmaceuticals? Sometimes they feel eerily similar, which is why I have tried to meditate, journal and exercise my way out of medication — always unsuccessfully.