Being Mentally Ill Sucks

There's a lot of things I don't like about dealing with mental illness, the main one being that you are miserable and tend to make everyone around you miserable as well (to some extent, obviously everyone is responsible for their own feelings, etc etc), because 1. you are suffering and this makes them sad; 2. you are unable to fulfill your usual responsibilities which at best inconveniences others and at worst seriously harms them; and 3. you are suffering, which makes you unpleasant to be around. This is true of any illness though.

The difference with the suffering of mental illness from a physical illness is that 1. it is even less quantifiable than physical illness (with no visible symptoms or objective criteria to even demonstrate its existence) and 2. there is no effective treatment. If you are in terrible physical pain, there is a wide variety of amazingly effective drugs (thanks epidurals for making labor almost pain-free!); if you are in terrible emotional or psychological pain, people tend to recommend stuff like diet changes, getting more rest, or "relaxing". I have given birth, had appendicitis, and had multiple episodes of kidney stones, which are supposed to all be quite physically painful, and there is no question in my mind that the pain I felt from all of these, while certainly bad, was nowhere near the level of suffering I have felt from my mental illness.

Connected to the lack of effective treatment (at least in the short term/crisis mode) is the generally abysmal state of mental health care. Singapore does not win any awards in this regard (our insurance, as is quite typical here, does not even cover any form of mental health care, including drugs), but as a modern, first world country and destination for medical tourism does have a number of specialists, specialized drugs and the like. I am highly literate, well able to advocate for myself and pursue the best care, and have enough money to afford whatever care is necessary, and it still is a struggle to get treatment even of a minimally effective level. Part of the problem is that the vetting of mental health professionals is spotty, in that many of them, while possessing the proper academic credentials, have very poor people skills (which is a BIG problem when treatment relies on the provider's relationship with the patient).

Couple that with the very real stigma of mental illlness (I always have to debate how much to tell people), and it makes having mental problems absolutely exhausting. I absolutely understand why so many people do not treat theirs (in my opinion, a majority of the world's population would benefit from the right drugs and/or therapy): it is very expensive, time consuming and not very gratifying.

I have been spending a lot of my time (and money) on searching for the right drug combination, which among other things has made me gain around 20 pounds. This is in addition to attending therapy sessions twice a week. I think I am finally starting to see some progress, and have tentatively found the right drug combination, but it is heartbreakingly slow and so frustrating.I suppose I should be grateful that I have the time and resources to pursue all avenues though, and focus on the positives in my situation rather than on how I would like things to be different.

Drugging Myself

Another blogging hiatus, thanks to my continuing depression. Whenever I am depressed, I tend to withdraw from all activity (especially of the social sort) in favor of laying around thinking about death, aimlessly skimming stupid articles, and playing game after game of Memory. I finally had to bite the bullet and go on Zoloft. 

I am hugely in favor of psychotropic drugs: in fact, I often wonder if the entire population shouldn't take them in one form or another (better living through chemistry! can't wait for the pill revolution). Certainly I would have advised anyone else in my situation to get on them ASAP. 

Despite my theories, I am not consistent and was extremely reluctant to get medicated. It seemed like a personal failure somehow (I felt unreasonably pleased with myself for being drug-free). But in the end, I was not improving and my depression was negatively impacting my family, and B in particular (I was pretty successful in putting on a front for R: but this meant all the accumulated drama got dumped on B as soon as she was sleeping). So off I went to the psychiatrist (of which there are only about 20 in the entire country of Singapore, the culture here is strongly biased against all forms of mental health treatment).

I started a week ago and am now starting to feel considerably better. I expect in a few more weeks I will be almost back to normal (historically, SSRIs have always been quite effective for me).

Intervention Is the Best Show on TV

B and I aren't television watchers. We don't actually have a signal because we don't pay for cable (the Internet is good enough for our purposes). Sometimes there's a show I get into (Sherlock, Downton Abbey until it started being embarrassingly awful with romantic singing in the aisles and so on); B likes more gritty shows (Breaking Bad was the latest), but for the most part we never watch it.

There is one big exception though: Intervention!! B and I are obsessed with this show. He has been downloading episodes for me onto the cell phone, so that I can watch them at the gym, and suddenly I am consistently exercising for the first time in years. We animatedly discuss every episode in detail.

The plotline of Intervention is simple. It's a reality show. They find an addict (generally their families have written in, asking for help), film them going about their daily business (they know they are being filmed but aren't told the real reason why), then stage an intervention: all the family/friends/loved ones of the addict gathered into a room, asking the addict to go to (free, paid for by the show) treatment. Virtually all the addicts go (though many later start using again: the show provides the latest updates of their lives).

Each episode follows the same arc: description of the addict's original personality, great potential and/or success (sometimes this is a bit of a stretch); the development of their addiction; and their eventual life destruction (being a homeless prostitute is not uncommon).

It's a fascinating show: the emotional drama, the depictions of the extremes of human behavior, the family dynamics, the glimpses into a side of life most people never see...The fact that it's all real (if of course edited for dramatic emphasis) makes it all the more gripping.

As someone interested in parenting and psychology in general, it's especially interesting. I wrote elsewhere about addiction and its causes: this show is like a perfect case study. Many addicts (at least half) have seriously screwed up and traumatic life events (stuff like being raped at age 10 by your estranged father when you went to meet him over the summer).

Virtually all of them have dysfunctional families (often to the point that you can't believe it: everyone knows they are being filmed, so what you see is them on their good behavior!) The addicts come from many different backgrounds, but usually are middle class, with outwardly average, apparently normal relatives. It's both a powerful demonstration of how badly heinous parenting can ruin someone's life, and of how much dysfunction, abuse and generally mind-boggling behavior lurks behind closed doors.

Sometimes I think everyone should be required to go to extensive therapy.

Marijuana: A Cure for Drunk Driving?

In the latest research on marijuana use:

To date, 16 states have passed medical marijuana laws, yet very little is known about their effects. Using state-level data, we examine the relationship between medical marijuana laws and a variety of outcomes. Legalization of medical marijuana is associated with increased use of marijuana among adults, but not among minors. In addition, legalization is associated with a nearly 9 percent decrease in traffic fatalities, most likely to due to its impact on alcohol consumption. Our estimates provide strong evidence that marijuana and alcohol are substitutes.

Source: "Medical Marijuana Laws, Traffic Fatalities, and Alcohol Consumption" from IZA Discussion Paper No. 6112 November 2011

This really isn't a surprise to me at all. The main reason to do drugs (assuming you aren't an addict) is that you want a break from your current mental state, whether it's to relieve stress, have fun, or just experience something different.

There is considerable evidence that humans enjoy altered states of consciousness and seek them out for their own sake, though the methods used differ (running, fasting, drug use, sleep deprivation, traveling, mediation, and listening to music being just a few). In other words, alcohol and marijuana do basically the same thing for their users: it's not surprising that they are interchangable (though it's a pity marijuana isn't legal as its negative side effects are fewer). (Just a disclaimer: I prefer alcohol to marijuana so this is more of a theoretical opinion.)

Progress:
--Exercise: 30 min. walking.
--Diet: Breakfast: Toast with peanut butter and jam; bread with mayonnaise; Snack: Frappucino, packet of gummy bears; Dinner: Pasta with tomato bacon sauce; Drinks: Chocolate soy milk
--Other: Did not drink 8 glasses water; one frappucino consumed.

Drugs and Alcohol

I did a lot of drugs in my youth (ages 19-maybe 25?). I was pretty catholic in my drug tastes too: drugs I took included marijuana, cocaine, speed (meth), LSD, mushrooms, laughing gas, opium, various prescription drugs used recreationally (vicodin, percocet, and codeine among others), and some more unusual ones like dextromethorphan (a primary ingredient in cough syrup), hallucinogenic cactus, and morning glory seeds. Of course I drank alcohol and tried cigarette smoking (briefly; I didn't want to get addicted). In fact, the only popular drugs I didn't try were heroin (although the opiates are basically the same chemically) and Ecstasy.

And you know what? I really enjoyed it. Taking drugs provided me with all sorts of positive and interesting experiences. I never developed any kind of addiction problem, never did anything I really regret, and never ran into any serious trouble. If drugs were legal, I would probably still do them (assuming childcare was lined up). I particularly regret that LSD is not legal, because I found its effects so interesting. (It also is not addictive and does not cause any physiological problems: American drug policy is not at all rational.)

This is something that people tend to ignore when discussing the "drug problem": drugs are a lot of fun. That's why people do them in the first place! They are fun because they reduce your inhibitions; allow you to perceive the world in another way; give you a break from your own psyche; and affect your mood positively. Many other things usually approved of by society do the same thing (running, breastfeeding, meditation, traveling, even eating): drugs are just quicker and more efficient.

I consider drugs and alcohol, caffeine, and tobacco as one and the same (the only reason they are not always classed together is an artifact of our stupid drug policy). Alcohol, caffeine and tobacco are drugs, and the reasons to use it are exactly the same ones for using opiates (heroin, vicodin, etc.) or amphetamines (meth, etc.). There is no (mental, moral, physical) difference between having a couple of drinks after dinner; smoking a joint; popping a few pain pills; snorting a line of coke; or having a cigarette. The effects of the drug might be different (like whether you become sleepy or energized, or aggressive or affectionate), but that is all.

Some people do develop addiction problems (and some substances are more addictive than others: why I was always very careful with tobacco). But in my opinion, addiction has very little to do with the actual drug. Addicts probably have some sort of genetic predisposition to addiction.

However, having known a lot of addicts (both in my family and in my drug-taking days), I believe psychological factors are the key to addiction. I have never met an addict (as opposed to a recreational user) who didn't have: 1. significant mental health problems (prior to the addiction); 2. a dysfunctional family (usually pretty severely dysfunctional, and the more dysfunctional, the worse their addiction was); or 3. at least one, and usually more, seriously traumatic experiences in childhood/youth (rape, witnessing significant violence). Actually most of them had at least two of these factors.

I read Katie Granju's blog, which I enjoy, but I find her posts about her son's addiction (he died of a drug overdose about a year ago) seriously annoying. She has frequently referred to his addiction as "a disease", but the reality is, addiction is not a disease that just descends out of a clear sky and "could affect anyone".

People are addicts because they are in intolerable emotional, psychological or psychic pain, and drugs give them a release from it. There is no other reason, for her son (Henry Granju), or anyone else. The fact that she has not addressed this, focusing instead on drug supply issues, is both troubling and socially damaging. (Henry, like many addicts, wanted the experience of being high rather than a particular drug, and took whatever drugs were available in pursuit of this: I have seen many other addicts just turn to alcohol if street drugs weren't procurable.) If she really wants to help other troubled youth, she should advocate for decent mental health services (not available for most, especially if you are poor), preventing child abuse and crime, and providing parents with the necessary resources (psychological, financial and physical) to do a decent job.