Med Dread

Posted by fxckfeelings on September 30, 2010

There’s something about the decision to take or not take medication that makes people very reactive to feelings, both theirs and others, instead of just weighing the important stuff, like the risks, their symptoms, etc. The only good way to make medication decisions is to think about what will happen to you without them and decide for yourself what will do you the most good. Until the day others can feel sick on your behalf, their reactions to your own carefully thought out medical choices shouldn’t come first.
–Dr. Lastname

Given all my issues, I’m not doing so badly, although it’s true I have a $400/week speed habit. Even with that though, I’m doing well at a demanding, high-powered job, meeting all the overtime demands, and then, at quitting time, when I’ve gotten paid and don’t want to feel bored or alone, that’s where speed comes in. A few years ago, I had a crazy, manic mental breakdown and they started me on medication, which I’ve taken regularly, but I’ve been doing fine ever since, my mood is great, the speed hasn’t bothered me, so I don’t see why I can’t start cutting back on the meds. That’s my goal: to feel OK without meds.

Whether it’s bad for you to use speed or stop your bipolar medications depends a lot on what you believe you need for your future survival, assuming that you care about it.

Since I don’t think that’s a safe assumption, let’s assume you’ll at least consider caring about it after you read my response.

In the present, it’s fun to party, and a bipolar personality may give you more social attractiveness and more energy for completing all-night work assignments. As years go by, however, your party-going friends are unlikely to stick around when the weather is no longer fair, and employers that exploit your extra energy will be quick to outsource your job out-country as soon as possible.

After that, you will have nothing to hang onto when the speed runs out, you’ve got nothing to do, your party friends won’t see you without a door charge, and the bipolar crash hits, as it must, sooner or later, with all its usual force and fury.

You’ve been told that reducing bipolar medication and using speed may not hurt you right away, but they shorten your remission time and speed the day of your next relapse. The problem is, once you hear the first part of that sentence, you probably ignore the second half.

What you should be hearing is that other people want you to wake up and take care of yourself before it’s too late, because they can’t do it for you. Instead, what you hear is that other people want you to stop doing what you like to do and you wish they’d go away.

By “future survival,” I don’t mean feeling better, making the pain go away, or not getting caught. I mean protecting yourself when your luck turns bad, the jobs dry up, your parents are dead and gone, and the money runs out.

And don’t think I mean that your life will turn bad simply because of the speed or medication decisions—if only it were that simple, Nancy Reagan. Life turns bad on its own due to the prevalence of bad luck, whether you substitute speed for your medications or not. The question is, how well will you be prepared to cope with it when the next batch of shit arrives.

So, if pleasure is your goal and you’re living in the moment, which is common for people with your illness, then congrats. But if you’re thinking of living past tomorrow or even the week after, you need to wake up the guy in charge and consider what you’re taking meds for, pleasure, pain, and all.

STATEMENT:
Here’s a statement that offers you the protection you deserve. “It’s hard to put up with the exhaustion and stress of work, particularly without the relief and pleasure of speed to look forward to, but I want to be proud of the way I take care of myself, even if I have to endure pain along the way, because that’s what will get me through the hard times.”

I used to screw up a lot before I started taking Ritalin, and my husband always gave me a hard time, both for the things I promised to do and then screwed up and the ways I tried to cover up the screw-ups, but for the past 2 years I’ve been pretty responsible and honest. I think I’m still doing well, even when I stop Ritalin from time to time when I don’t have any projects that require steady attention; but recently my husband told me that I’m less available emotionally when I don’t take my medicine, and I wonder whether I should take it all the time. My goal is not to slide back to the way I was before.

Who knows what comes first: paying more attention to what people think because you’re hiding a screw-up, or hiding your screw-ups because you care what people think.

It’s no wonder that, even years after you get your screw-ups under control, you still measure how well you’re doing by how other people react. If you want to stop going around in circles, it’s time to stop.

As every married person knows, there’s a big difference between wanting to please your partner, and having to please him or her. Wanting to is healthy. Having to means you don’t feel you have a choice, your self-esteem is held hostage, and, ultimately, you’ve lost a sense of freedom you can regain only by the secret defiance of, you guessed it, screwing up.

It sounds like you know what the medication does for you, how it might harm you, and when it’s worthwhile to take it, regardless. You’re not starting or stopping it because you feel like it, but because you’ve measured the odds. That’s the mark of a good management decision.

That said, you’re allowed to forget about your husband’s feelings and use the same method to decide whether taking medication is necessary to being a good wife. Remember, no medication, including Viagra, is risk free. It won’t be good for your marriage if you take on that risk to please your partner, than because you think it’s worthwhile.

Define what it means to be a good-enough wife in terms of the time and attention you believe you should offer, not in terms of whether your performance pleases your husband—unless you feel your husband is the ultimate judge of your performance. If that’s true, the health of your marriage might have issues of its own.

STATEMENT:
Here’s a statement to protect yourself from being overly responsive to the feelings of your significant other, at the expense of your own judgment. “I’ve heard your concern that I’m less emotionally available when I don’t take stimulants, but I’m determined not to take them unless absolutely necessary, so I’ve looked hard at what happens to our relationship when I stop them. In my opinion, I no longer screw up on my commitments and I’m reasonably available, even if somewhat distractible. So I think we’ve got a good thing going, even when I don’t take stimulants, and that I should continue to keep them in reserve.”