Are We Men or Are We Mental?

As a person who has been considered by the medical industry, big pharma, and an ex-wife as having a few mental disorders, most imagined by the power of suggestion, I feel qualified to speak about psychiatrists.  I have seen one shrink in my entire life and that was at least three yeas ago.  I remember that he upped a bipolar drug to an ungodly dosage which I took faithfully for about six months before seeing a psychologist who told me I was not bipolar.  I already knew that but buoyed by the psychologist’s prognosis, I decided to quit taking the bipolar meds.

Before I get to the meat of this essay, I gotta tell you that that I never thought I was crazy.  Maybe horribly depressed, but never psychotic.  Why horribly depressed?  Me?  Mr. Funnybone?  Maybe it was because of the way I was treated as a boy.  Yes, we can all say we got hit, spanked or suffered corporal punishment.  I suspect, though, most parents dished it out reluctantly.  I never spanked my kids so I understand the reluctance.  My parents didn’t like each other.  They were angry punishers, complete with wooden spoons, belts, hands, palms, fists, whatever was handy.  I was ducking a lot, not successfully for the most part.  What the Nurse Practitioner told me was that I suffered from PTSD due to the punishment my parents dealt.  Yes, I am vigilant and notice everything.  I remember being amazed that I could drive down the same road every day with the same person and notice when something was different.  The other person, who had been down the same road with me for the same amount of days, did not notice.  It floored me.  When I was told the reason I noticed every thing was because I was waiting for the next whack on the head, it sort of made sense.  Vigilant.  Like a wolf.http://www.wenatcheeworld.com/news/2013/feb/13/wolf-photographed-near-ardenvoir-probably-just/

Now, my parents are dead.  They died young at 75.  My dad died in 2005 and my mother, uh, a couple of years after that.  Both died of disease.  Dad, lung cancer.  It’s an awful way to go.  People have such hope that they will try anything and everything to buy time.  My dad stuck around because of his wife, who could not bear to let him go.  Even though my dad told me several times he was ready and very tired of chemo, he stuck with it.  That is love and devotion.  

My mother, alone, never remarried.  She died of Amyotrophic lateral sclerosis.  http://www.alsa.org/about-als/what-is-als.html  It was very ironic for her to come down with this disease as she had been one of the most active people I knew.  She was involved in everything, Kiwanis, Meals on Wheels, and many community activities.  To have a neurodegenerative disease was the most unkind thing God could have done to her.  Maybe it was the twenty years of dating a married man.  I don’t know.  Doesn’t matter.

So, my roaming along point is that my parents died younger than the family average on both maternal and paternal sides.  My guess is that because they didn’t figure out they didn’t like each other until after they married, they carried a smoldering resentment.  I, being the oldest, was the obvious target.  Consequently, I was on the lookout for the unseen hand coming down to whack me on the side of the head.  Vigilance.

That’s over and done and I should be able to deal with it by now.

Ok, let’s get back to shrinks and other people ill equipped to judge mental disorders.  I read an article in the New York Times today about the new DSM V coming to a bookstore near you soon.  The article was written by Gary Gutting, Professor of Philosophy at The University of Notre Dame.  http://opinionator.blogs.nytimes.com/2013/02/06/the-limits-of-psychiatry/  He questions the way a diagnosis is made by the psychiatrists.  He calls them “moral judgements.”  The short of it is that Gutting says shrinks use a moral compass, or societal norms, to make decisions on disorders.  From my experience, I must agree.  I was only asked questions.  It was on my dime that I had a psychological exam by a Ph.D psychologist.  I took a 550 multiple choice exam, the Minnesota Multiphasic Personality Inventory.  I was also shown pictures.  Then the pictures were hidden and I was asked what I remembered from the picture.  I was also given other memory tests such as counting backwards and forwards using multiples.  2, 4, 8, 16, 32, 64 and on as far as I could go.  It took six hours.  It was supposed to take 8 hours but I did the MMPI much faster than other mental defects.

I got the results and it looked like I was ok.  I guess the test is designed to rule out certain disorders and not really diagnose.  So, I was poorer yet no closer to understanding what the fuck was going on.  My prognosis:  poor life management.  Bad marriage.  Two people together because they don’t know what else to do.  Love lost, gone with the advancing years that harbored disagreements, differences in child rearing, differences in a personal approach to life.  I won’t put all the blame on that because I’ve always been a handful but being trapped, so to speak, makes one anxious.  Subconsciously, I knew what was happening but in the real world, I didn’t want to face it.  Too much to consider.

I was introduced to the big pharma end of mental disorder by a doctor who thought we should find out why I wasn’t sleeping well.  I had already done the sleep test.  You know, the one where they hook wires to you and then hook those wires to a computer and then say, “Good night!”  Yeah, like I’m going to sleep with all that shit hanging off of me.  Like anyone could.  I think if they could, they don’t have a sleeping disorder.

That led to a Nurse Practitioner with a specialty in psychopharmacology.  I swear no tests were given me other than a few questions.  Within one hour I had three diagnosis: bipolar disorder, PTSD, and Chronic Anxiety.  Boom!  Just like that.  I think I was relieved because, one, someone had put names to what I was feeling, and two, I could stay in the domestic situation awhile longer.  When you know, though, deep down in the bowels of your soul, that whatever it is that you are doing is only a temporary fix and that sooner or later you will have to deal with the certainty of outcome, it doesn’t help a whit.

My first Nurse Practitioner moved to Texas to be closer to her sister.  I was moved to the current Nurse Practitioner I am seeing.  Or was.  I don’t think I’ll go back.  We’ve accomplished next to nothing in four years.  She immediately diagnosed me as being ADD Without Mention of Hyperactivity.  (So, if it is without mention, why mention it?)  That brought Adderall, amphetamine salts, into the picture.  Things got ugly quick.  They stayed that way.  I was quick to temper but just as quick to subside.  It was a horrible roller coaster ride.  I was told by the “dealer,” my name for the Nurse Practitioner, that I may have to take them for the rest of my life.

As an itinerant musician for many years, I used and abused many forms of stimulants.  At first it was crosstops.  I would take a few before a gig and then count on being told to quiet down. (I play drums.)  Although I first used cocaine in 1971, it wasn’t until the late 70’s and early 80’s that I got into it as part of my lifestyle.  Performing and partying, staying up for a couple of days at a time, life of the party, crashing hard, sleeping, eating and then at it again.  I look back and think that I probably should have died a couple of times already.  I guess something or somebody wants me alive.

So I knew the drawbacks of using stimulants but I took them anyway because I was prescribed them.  I thought they worked.  I got strung out and stayed there, losing weight and not eating.  All this because someone trained with a certain point of view thought I needed them to cope with my life.  This is what Gutting talks about.  Should we go on using the “moral compass” as a guide to medicating our troubles away?  I think not.  I am still a strong believer in testing.  If a disorder has symptoms and those symptoms are identifiable, then I would hope that more than just a few questions would determine whether someone puts poison in their body every day, three times a day.  Yes, there are people who need these medications.  My brother takes lamictal for bipolar but he is no more bipolar than I.  As he says, he likes the way it contains his emotions.  I thought that was why he rode a bike.  Anyway, the meds do all the heavy lifting for him as far as that goes.  What I have found out is that, yes, the meds do the heavy lifting but to continue to do so you have to take them every day.  If you quit taking them, there will be hell to pay until you learn to do the heavy lifting.  I’m learning to do the heavy lifting.

The inevitable divorce has come and gone.  Even after the divorce was announced, I continued to take Adderall, Clonapin, and Trazadone with an antidepressant thrown in to smooth out the edges.  I quit taking the lamictal after being told by a trained professional that I was definitely not bipolar. (As mentioned, I already knew that.)  In addition, my dosage of Adderall was upped by 20 mgs to 80mgs a day, 20mgs over the recommended adult dosage.  I was cruising, baby, zoooom...

As the separation entered its second year, I knew I was strung out but went with doctor’s orders.  I entertained the thought of how to get off this shit.  I knew that I depended on the boost given me by the meds.  I took the first dose at 7:30AM and then went back to sleep.  By 8AM, I was up and blasting away at whatever.  I took two more doses later in the day.  When it was time for bed, I took the Clonopin and Trazadone to get to sleep.  Classic dysfunctional cycle, yet prescribed.

Someone found me and realized I was not in good shape.  My Christmas present was losing the Adderall.  It was magic.  The bottle of meds just disappeared.  God must want it that way.  I am glad for it.  Probably saved what is left of my life.

So whose “moral compass” was being used to determine whether or not to medicate me?  My then wife?  The Practitioner?  Me?  It is something to think about.  If indeed one uses a moral compass, then many assumptions must be made by the professional.  What input did I have other than answering questions? Of course we count on professionals to know more about the situation than we do.  I know more about teaching than a doctor does.  I formerly assumed that when prescribed a medication, the doctor knew what they were doing but it isn’t that way.  YOU must ask the pertinent questions.  Find out what the side effects are.  If possible, look the meds up online to find out what the long term effect might be.  Remember, clinical trials are performed on a very tiny portion of the population so the effects may differ for you.  Yes, a particular drug may have the desired result for you but the side effects may make that the lesser of the evils.

Ask the doctor who’s “moral compass” are they using to come up with a diagnosis.  You might have to remind them of the Hippocratic Oath.  

Life can get pretty hectic at times and it is up to each individual to decide how to walk their path.  Take care of yourself.  Don’t always leave it up to others.  Realize your strengths and your limitations.  Listen to yourself and listen to your body.  Trust yourself.