Tag Archives: Mood swings

On Refusing to Take Medication

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I avoided medications of all varieties for much of my adult life. When I was 36, I had had too much of my depression and opted to start taking Prozac under the care of a psychiatrist at Redwood City Kaiser. I stayed on anti-depressants alone until I was 47 when I finally acknowledged my bipolar disorder after a suicide attempt and added mood stabilizers to the list of drugs that I was taking. Why did I go so long before I sought relief? Mostly because of a prejudice that had been drummed into my head by my mother, a registered nurse, who believed that medications should be avoided at all costs and that my depression and manic swings were character flaws. When I stopped listening to her, the quality of my life improved and I was able to be the person who I always knew that I was.

Many people feel that people who refuse to take medications should be forced to take them. They cite incidents such as a New York City man who went off his meds and started hitting people with a hammer or a schizophrenic woman who killed her baby in a fast food restaurant’s bathroom. The recitation of such litanies by certain advocates who favor forced medication is stigmatizing because the vast majority of people who go unmedicated don’t commit such crimes. Their struggles are worse than those of us who don’t take them, but it is important to understand their reasons for refusing.

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The Merry Month of Self-Murder

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The sky was open to Space and the world was green. The sun shone on the grass as only it can in January. But despite the pleasant weather, my brain filled with pessimism. For many years, I had answered the question “Are you thinking of killing yourself” with “Not the fast way. The slow way.” What I meant was I propelled myself towards death by eating badly and refusing to exercise. Eventually I would suffer a major heart attack and that would be the end of it. But on that January day I texted my last will and testament to my wife, sat down on a log, and began to study the veins in my wrist.

I bucked the statistics by my choice of time. The media gets it wrong; the holidays and the winters that follow are not the time when hospitals see an increase in the number of suicides: it is May. Scientists have not hit upon why self-murder spikes at this time of year, but they have made some observations:

Doctors first observed in the 1820s that suicide rates spike during late spring. Researchers have since postulated and tested all sorts of explanations for the global phenomenon, making this one of the most studied questions in psychiatry. There’s still no consensus, but evidence suggests it has to do with so-called sociodemographic factors. During the winter, many people go into semihibernation: They work less, see fewer people, and are exposed to less frustration and conflict. That all changes in the spring, when increased interaction with others and the stress of work may trigger suicidal thoughts. The theory is based on a couple of observations. First, the spring suicide peak is more pronounced among people employed on farms or in factories who experience greater seasonal variation in the intensity of work and social interactions. In addition, developing countries with a higher proportion of agricultural workers see more seasonal change in the suicide rate than do developed countries. The magnitude of seasonal changes in the suicide rate is more than 10 times higher in Uruguay, for example, than in Belgium. Researchers have also detected a smoothing out of the seasonal variation in suicides in recent decades as more people move from farm to office. (There are smaller peaks in other parts of the year. Cubicle workers are more likely to commit suicide in the fall than in the spring, as are mothers who send their children off to school in September.)

I am not so sure of this theory or of some of the others. Some link the suicide rate to the weather. The amount of sunshine in the day, pollen counts, and air pollution have all been indicted. But one thing that I think affects me heavily by the time May rolls around hasn’t been investigated: Daylight Savings Time.

Why? Because Daylight Savings Time interferes with our inner clock. It makes us wake up an hour earlier than we are used to waking up. It hits us like a hammer in March and continues its drumming through the Spring. The ones who are worst affected are those who are most susceptible to bipolar disorder: night owls.

Owls aren’t early risers like larks. A Lark doesn’t feel the shift much if he has to wake up an hour earlier, but for an owl — who already has a hard time getting up early in the morning — the moving forward of the clock is catastrophic. Six o’clock is taken over by five a.m. A whole hour is stolen and it is not given back until the fall. I have met few people with bipolar disorder who like Daylight Savings Time. It’s proponents, in fact, are few. But big industry — especially retail — like it because people are more likely to leave the house to buy during daylight hours than during darkness. Oil companies like it because people do more driving and more driving requires more gasoline. Despite the health risks, we keep this destructive institution for the profit of a few.

I know that my sleep is sucky at this time of year. When my alarm goes off, it wakes me out of a deep sleep that my body has made no plans to end for another hour. I am dizzy and depressed on many mornings. A gray malaise overcomes me. This darkening of the mood affects my thoughts and those thoughts turn increasingly to negativity and the belief that I am a burden to others. Wouldn’t the world be better off without me?

The cheap fixes I employ are to adjust my medications if the depression gets too deep and to seek out the help of my therapist more often. I stick to my clock, however. Millions of others are in the same boat. So why do we persist in this? Well, our country puts corporate interest over people. What is my life to them? I am collateral damage.

For Further Reading:

  • The Suicide Rate Doesn’t Peak During the Holidays. Why Does It Peak in Spring?

    • What Do I Do When I Am Manic?

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    I waste time. But not in the same way that I usually do it. I’m always up nights, twittering, reading, working on recent photos. My day ends somewhere between 3 and 4, at which point I go to bed, which alerts the cats to begin their trills of demand for food from my softhearted wife. I use a cocktail of Xanax, Benadryl, Doxepin, melatonin, and my nighttime anti-psychotics and mood-stabilizers to stall my brain into torpor. I sleep well and I sleep deep until about noon or one o’clock in the afternoon, an unconventional hour but one that I can manage thanks to my unemployment and insistence on afternoon appointments.

    If I am manic, I forget to take the meds until a later hour and do not feel their slowing until after Lynn has gone to work at nine. I lay in bed, staring at the pockets inside the sheets, groping for rest. Mania purposes me to a different set of activities, First, reading is impossible. My eyes fly over the words, ignoring the middles of sentences and barely noticing the presence of paragraphs. I have missed whole scenes and whole characters when I am in this state. For this reason, as my condition advanced in the late twentieth century, I read less and less. Volumes I wanted to peruse stood on my shelf for years, unopened and stinking of dust. There was no accomplishment during this time except as resulted from my strange habit of digesting dictionaries.
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    Did the Meds “Erase” My Personality?

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    The thing I don’t like about being angry is that it isn’t the me that I want to be. It’s a nuclear fireball, a complete eradication of the rest of my personality. For a few seconds, everything that I love becomes less than a memory. The witnesses to my explosion see a six foot six inch tall brute with a beard screaming at the top of his lungs and waving his arms about. Wouldn’t you be scared? Wouldn’t you keep that memory in your head purely for reasons of defense?

    These scenes came more frequently when I was soaring in and out of manias and mixed states. It isn’t hard to see that my anger could be tied to my suicidal inclinations. Because I could not and would not destroy the objects of my ire, I turned that impulse towards myself. One time too many it brought me to a place where I was studying the veins on my wrist. Beyond the eradication of myself that was caused by my disease, lay the prospect of self-annihilation as punishment or revenge.

    Maybe now you can understand my reaction that came while I was planting vinegar weed at the Native Seed Farm. I had done something stupid — I had mentioned my involvement in the Depression and Bipolar Support Alliance in a passing comment. Most people let it drop, but this one woman wanted to know more. What were the people like? Was I ever scared? And then the most stigmatizing thing someone can say about someone who takes his meds faithfully: don’t the meds erase your personality?

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