Life Is Chaos And So Is Dinner

Like, if you go on meds and that happens, it's not because whatever's going on with you is jut Too Severe or that you're doomed or only people with Other Illnesses get to have meds that make them feel actually good and you have to settle for "miserable but somehow so hollow I no longer care about the misery" and be grateful you're no longer actively suicidal or whatever.

if i don't take this pill i spend the day as a dirty, inept husk, a sad sack of well-meaning but futile intentions just sapient enough to be dimly aware of everything im unable to be.

The person I was when I was very depressed did not feel like the real me. That was a version of me that was very ill. The "real me" is the me that is able to dance at stoplights and make art and enjoy food and laugh at jokes. And for now, I need pharmaceutical help to get back there.

The seventies had a much more limited menu of psychiatric drugs, many of which were harsh as hell. The antipsychotics were notorious for causing tardive dyskinesia, to the point where "weird twitchy body language," became an indicator of "crazy" in our movies—that's not because they were confusing schizophrenia with something like Tourette's (although precious few writers bother to find out much about Tourette's), it's because for a bunch of people, their ability to manage psychotic episodes was dependent on drugs that would give them lifelong tics if the dosage was the slightest bit too high, or sometimes if it wasn't.

What it also had—what I saw slowly changing during my lifetime—is the idea of a doctor as an authority figure rather than the doctor as an expert whom you consult for their specialized knowledge.

Listen, though. Listen, I was a kid in the eighties, and I had multiple health problems even before third grade, starting with multi-strep-infection festivals of pain every winter (this was eventually traced to a large sinus cyst, but not actually fixed until my twenties). You have that many strep infections, they give you antibiotics, that's just the way of things.

When I take antibiotics, often enough, all it does for me is give me a rash. I remember my mother taking me off the Pink Goop Of Yecchhh (this was when I was too young for pills) and bringing me back in to the doctor to inform them that I was reacting to penicillin. And I remember the doctor absolutely browbeating her about trying to diagnose me with something without medical backup, about taking me off the medication before I'd gotten an appointment, and finally grudgingly offering to try another antibiotic instead.

(As it happens, I also react to all penicillin drugs, even the ones they thought I wouldn't, and all sulfa drugs, even the ones they thought I wouldn't, and the only safe one that they commonly prescribed was erythromycin, which I despised, as the stomach friendly versions were not there yet. But. That's not the point, or not the point exactly.)

When I had my kids, one of 'em ended up with a very familiar little bumpy rash while being treated for an infection, and I went in to the pediatrician prepared to fight for my life, because I remembered how hard this was. And the pediatrician nodded, and said, "Your instincts are good, this looks like penicillin reaction to me. We've got some alternatives…"

Because doctors, although they can still be overbearing and arrogant, cannot take completely for granted that they are the ones in charge.

Which makes an enormous different in psychiatric treatment especially. Because there's a ton of nuance. You can go in and say, "Look, I can tell this is working at raising my mood but I'm also jittering out of my skin, can we find a relative drug or just chop the pills in half?" Or you can say, "I mean it's fine on one level but I don't feel like myself, can we try a different thing?"

When a doctor is an authority figure who tells you what to do, who decides when you are sufficiently fixed and what you look like (and feel like) when you are yourself, you cannot trust psychiatric medication.

god this tickles me