“Have You Taken Your Meds Today?”
Alas, a question that us psych patients have heard far too many times – after all, one time is “too many” – from our nearest and dearest. However, it was no one near, nor dear, that, very bizarrely, popped the question to me the other day. An “anonymous” prank phone caller, after eerily listing off a list of women’s names in monotone (the caller, herself, was a woman) and repeating a phrase (it was that memorable) like a scratched disc, asked me:
“HAVE YOU TAKEN YOUR MEDS TODAY?”
What the %&@£? Since when are prank callers asking people about their pharmaceutical regimen? Likely, I thought, they are not, and this call was made by the type that would leave “trollesque” comments around here – it was the fifth call from the same woman that I had received within twenty-four hours, and during one the previous evening, my question, “Why are you still on my phone line?” (at first I thought it was a wrong number, with the weird list-off of girls’ given names… ) was answered rather ominously:
“WHY ARE YOU STILL ALIVE?”
Wow. The caller was not only very intoxicated, unless she always slurs her words that much, but also a creative genius. What a clever retort! Ironically, her question has some good answers, which I’ll get to later. After telling a few friends about the calls, that I found highly amusing, not scary, they convinced me that reporting what had spiraled into harassment to the police was in my best interest. I haven’t heard from my mystery caller since then, but to answer the former question, I have, indeed, been “taking my meds”.
In fact, I’m on a new pill since exiting the hospital, but there is one “med” that I have not taken for a few weeks now, and that, not stupid questions, is what I’ve been intending to write about for a while (I don’t care what anyone says – stupid questions do exist, very much so! ). First and foremost, I’ll share some big news: for the first time in over seven years, I am completely free from Effexor XR. If you have been reading this blog for some time, you know that for a long time I believed that I was permanently dependent on Effexor – and not to prevent depression, but to stop the physically and psychologically unbearable withdrawal syndrome that many experience upon ceasing to take this medication, especially if – like me – one has either (or both – like me) been taking Effexor for a prolonged period of time, or has been taking a particularly high dosage. I was on 450 mg, an “experimental dosage”, as all dosages over the recommended – and clinically tested – 375 mg maximum, are. 300 mg was the highest dose I had heard of anyone else taking, and people taking far less complained of an awful and prolonged withdrawal, many on the blog “Brainzaps: A Journal of Effexor Withdrawal“. My project, “APOCALYPSE EFFEXOR: REDUX“, demonstrated some of the horrors of withdrawing from the drug, when I made myself into my own lab rat and stopped taking the drug cold turkey to demonstrate to those around me, and whomever is interested reading on the web, how dangerous Effexor is.
I was certainly not the only one whining and zapping, and I encourage you to join the near 25,000 folks who have already signed the electronic petition against Effexor if you or someone you know (and now you do! ) has been affected by this jagged little pill, if there ever was one. I am, however, temporarily on Prozac (fluoxetine), at its lowest dose (10 mg) as this is a common method of preventing withdrawal symptoms if taken for one month, after Effexor is completely stopped. It took me slightly longer than a year to get to this point, and I still credit being on an opiate – methadone,which I began taking after my hysterectomy last May, when I found myself addicted to hydromorphone (Dilaudid), the strong painkiller that I’d taken to deal with the pre-surgical pain – with the fact that the withdrawal has not been too challenging physically, though no doctor has shared my opinion. I did taper down the dosage, about once a month, as well as interchanging doses over the course of weeks – for example, taking a higher dose every other day for the third week of the month, and every third day for the fourth.
There is no doubt that withdrawing from Effexor is complicated and frustrating. Once I was about half-way through the taper, I began having emotions and feelings – running the whole gamut, and, yes, including the first libidinous feelings I’d had without herbal assistance (speaking of this little helper that really did help me after I found a banner like this on another blog):). My newfound affectations – all essentially reactions to the world around me – not surprisingly, queued some overzealousness that became the source of trouble. I no longer experienced painful and bothersome “brain zaps” (the feeling of an electrical shock, from head to toes, running through my body, that occurred upon a simple turn of my head or landing of my foot upon taking a new step) when I forgot to take my daily dosage of Effexor, like I had at 450 mg, and even 300 mg. I began forgetting doses, accidentally at first, and eventually purposefully, finding that if I did so, I experienced far more along the emotional spectrum over the course of a day. In my own words, I felt far more “like myself” than I had in years. ”Uncontrollable crying”, a withdrawal symptom listed on the official label for the drug, came along with many of these emotions, but I could care less, as long as I could be more of me than I had been in years.
Looking back, now, this was a vast oversimplification, not to mention it was greatly influenced by others that I was spending time with. I told new friends – people whom in retrospect I had little in common with, and who had more interest in taking advantage of my kindness than in my company – of my years-long struggle with antidepressants and other psychiatric meds. They shared the opinion of so many people who have never had any personal experience with these powerful drugs: that they were evil personality-mangling substances that the clever avoid. Obviously, in their words, “[I] should just stop taking them!” Furthermore, when I thought that I was acting “like me” for the first time in years, I was really making some very lousy judgments and forming false and naïve opinions about friendships. I was gushy, and I was gushing all over the place. When I learned that one friend had been referring to me as his “sugar mama” (me? an income assistance recipient? ) I was furious. When I learned that the individual who informed me of this less than flattering title that had been used behind my back was using me as well, which became brazenly clear upon a barrage of text messages I received, begging that I let my bank account be used for some kind of sketchy transfer of funds, with the meagre reward of “up to 10%”, I fell into the same dark place I had found myself last summer, where, living in the city of Vancouver, I felt that everyone I met who took interest in what I had to say was secretly only interested in taking advantage of me in one form or another, usually financially or sexually, if not both.
After one particular week during which I had taken none of my meds, I finally started to feel the physical withdrawal. My brain was zapping and I felt very confused, not to mention the fact that my bank account was empty after I handed over the funds to the fellow – he promised me he would double my money by investing with a cousin who sold pot – who I would soon find out was laughing at my “generosity” behind my back.
I was also at a personal crossroads, and I was spent – I had survived a random assault over the Christmas holidays in Winnipeg, but I had not dealt with the ramifications of being raped by a stranger because of my skin and hair colour. I had simply run away, back to Vancouver. My sister had shunned me while I was visiting my hometown because of (as far as I understand her reasons) her dislike of the way I had behaved during the previous year’s visit, before my hysterectomy, when I was under the influence of high doses of Dilaudid. This had been almost as painful as being assaulted. At the same time, I had come to the realization that I had no real interest in attending law school – an alternative to grad school that my dad promoted, and which offered me the opportunity to compete, in my family’s eyes more than those of anyone else, with my sister’s plans to attend medical school after she finishes her undergrad degree. I was terribly afraid to break the news to my family, that I was once again living “aimlessly”. So, I didn’t – I told my dad that I was writing the LSAT (law school entrance exam), when I was really in the throes of some serious self-destruction.
It was self-destruction for the purpose of self-destruction, not for fun, though some may have trouble understanding this. I knew that, delving much deeper into the lifestyle of drug addicts on Vancouver’s Downtown Eastside than I had ever planned when I decided to do some “participant observation” style research in the neighbourhood for personal, journalistic and sociological research purposes, that I was putting myself in a great deal of danger, not to mention throwing personal ethics to the wind. My original goals were definitely accomplished – I gained great insider’s insight into an ignored, marginalized community, and how it survives and functions, but at a great cost – I wasted the money awarded to me for “pain and suffering”, a result of the horrific car accident that drove a wedge between me and my long lost, and finally found, Aunt Ruth – another source of trauma I had been hiding from – and failed to use it to pay off the bills and loans from family and friends that I had promised would be returned, including that for my kitty’s expensive surgery. I threw away my own dreams of travelling abroad to volunteer in a poorer country, which I hoped to do once I’d gotten that cheque.
I was consciously turning myself into the monster that my sister, blatantly, and the rest of my family, more discreetly, believed I was. I was truly hell-bent on self-destruction.
When I grew tired of my company – notably, the women who all seemed to believe that accepting rather violent sexual advances from men was not something to complain about for the mere reason that this was the Downtown Eastside (ooooh, I’m sure there is no rougher neighbourhood on the planet! ) - I had spent a lot of money on drugs, but much more had gone into the hands of individuals who had spent much longer than me in the area, and whose main source of income was ripping off “tourists” like myself. When I checked myself into a medical detox facility, from which I was quickly sent to the psych ward at Vancouver General Hospital for possessing what seemed like a fabulous idea at the time: my wish to jump off the Lion’s Gate Bridge (yes, the bridge that separates North Vancouver from downtown Vancouver is replete with those horribly tacky lion statues that some folks feel the need to position on their front porches, and this alone would have made such an event incredibly tragic) in the blood soaked jeans that intake staff did not even notice, having tried to attack myself with a piece of glass from a pipe I broke the evening before, I left a “friend”, G., a young homeless man from the drug scene, with my personal effects, including my phone, which he pawned, my keys, which he lost, and my bank card, which I had not planned on letting out of my hands, having made this mistake only a week earlier.
Before giving him the card, with which he could access my bank accounts, I had tried to transfer him a large amount of money using Western Union. My request was declined. I was down to the very last of my money, and I was caught in the middle of another “double your money” scheme, plus he “needed” money for groceries and other necessities that went along with housesitting. Over the years, I’ve learned that sometimes hope can be one’s worst enemy. Deep down I knew he was not going to come through for me, salvaging this last little nest egg, tiny in comparison to what had already come and gone. It would have been more logical to buy a whole lot of freaking scratch n’ win tickets with the funds. But I was desperate to believe in someone and something. When I explained that I was most likely over my limit, it being a Sunday and the bank counting all activities Friday through Sunday as one day, he became irate and paranoid.
“Fuck, you’re difficult! How come you’re just telling me this now, huh? You knew this would happen all along!”
“No I didn’t,” I protested, and this was the truth, “I cannot foresee everything that’s going to happen all the time, I just remembered the rule about weekends, and the fact that I’m going in on Sunday [to detox, this being the appointment time I was given a week ago, when I had something worth speaking of left in my account and entered this arrangement with him, my friend, the one who had told me to watch out for all those other bad characters that ripped me off all along]. Why would you think I’m trying to rip you off, after everything I’ve done. How many envelopes of cash have I given you? How many?”
He just shook his head. Going into detox was a death of sorts, as I knew my life after this institutionalization had to change. The only other option was a life of crime, and hanging out with addicts who were likely to “nod off” in the middle of any conversation, even if you told them you were moving to Africa or that you had terminal cancer. I did not want to end on a bad note, and I found myself writing down: “savings” and my six digit PIN, the contents of my chequing account having been donated to a complete sociopath who had spent time in prison for permanently disfiguring someone by sticking their head in a deep fryer – a feat that he wore like a badge, and used to manipulate people in his line of work the very same way one uses a university degree on a resumé to get a job – the last time I had gone through exactly these motions.
“It’s not like I’m going to clean you out or anything,” he said in a softer tone, looking downwards.
“I know, I know,” I stammered, nervously. In that same place where I knew how this story was going to end, I was terrified of all of these people – they all knew one another and could well have all been in cahoots with each other.
He had already nearly told me to take a hike earlier that morning when one of my actual friends, back in Winnipeg, managed to have the Vancouver Police track us down to his cell phone, when he dropped me off in a filthy “hotel room” with hot pink walls that had been written over in black permanent marker, yet not with one poetic phrase. I lacked a sharpie marker and I was so furious with myself for ending up in this position that I sent some friends a goodbye message on Facebook and broke a glass pipe and spent the wee hours of the morning trying to find an artery, to no avail. I still lost enough blood that my blood pressure was low for two weeks and I could not stay awake – I nearly drowned in a bowl of soup offered to me before I left detox for the hospital. None of the staff could figure out why I was so weak, they just assumed I had snuck in some contraband and I was on the nod. What a wonderful health care system we have here in Canada – I managed to hide the open wounds on my thighs from all nurses and doctors, even in the ER where I slept in the hallway for 24 hours, and where I had to wear a hospital gown.
My hospital stay itself, exactly two weeks long, was very uneventful, albeit one thing – the addition of Seroquel XR to my meds, and the further decrease of Effexor from 75 mg to 37.5 mg, the smallest dose available in pill form. I came down with the worst case of “gastrointestinitis” (the best diagnosis the entire staff of doctors, nurses, and therapists that worked on the ward could come up with, even though the vomiting and diarrhea did not abate until I took an antibiotic… I think a fellow patient was more accurate when he looked at me and said, “Now you have the superbug!” ) I’ve ever had a few days into my stay. As soon as I had kept down one tray of solid food I was released. I attacked myself with a razor blade promptly after being discharged. However, I was still incredibly weakened, and this was not working. By morning I was throwing up again, and I called my dad for the first time in weeks. My physical illness, whatever it was, did me a favour that way – I had no will to do anything but the hardest thing of all: call the one person I had left in the world that might still care about me, and beg for help.
Another two weeks later my dad arrived in Vancouver to help me pack up the apartment that had once been home. I had destroyed that feeling long ago, and the place did nothing but make me depressed. One weekend, long ago now, before the money came, and before a series of men in the business of ripping off women who cannot come back and beat the crap out of them got their dirty hands on it, two “friends” had spent the weekend at my place and had made a mess cooking pancakes that I did not eat. I was home so infrequently after that, as I went back downtown with the two and my ICBC settlement cheque arrived the following Friday, that my formerly pleasant abode decayed for the following two months to a near unlivable state. I had opened my big mouth about the money on its way to one of the aforementioned acquaintances, making the foolish assumption that she would uphold some sort of code between women and keep it to herself.
Apartment buildings on the Downtown Eastside – the only buildings in Vancouver that rent suites, or, in most cases, rooms, for $375, the equivalent of the amount that British Columbia income assistance allocates for housing – are very much like dorms at a boarding school or university. I will elaborate on this when I write specifically about the area in my “Among Hungry Ghosts” series, the title of the series of articles based on this excellent book by physician and author Dr. Gabor Matê, who has worked as a doctor and activist in the neighbourhood for over 30 years and wrote the book, . For the sake of the current discussion, one parallel facet is that gossip spreads like a virus, and this woman, D., certainly did not keep her promise any more than G. kept his word regarding the safekeeping of my cash and belongings. The man who bragged about the deep fryer incident took advantage of my physical dependence on methadone, and made sure that I was physically well without having to journey back to my own neighbourhood, which seemed like climbing a mountain at the time, only instead of a beautiful summit, I had to face the ruins of my life-not-so-long-ago. Make no mistake – I take full responsibility for the, to be frank, stupidity of my actions – from the moment I sat down with this fellow, I made a conscious decision to self-destruct. However, when I think of him, the word evil is the first that comes to mind, and I do not think I have ever before used this word to describe someone, thinking it is dogmatic and trite. He preyed on women like me, all along pretending to be a confidante and talking trash about other men who do the exact same things that he does to an extreme.
Phew. That’s enough darkness for me, today. In the end, I knew that this was not my life, and I was exiting one way or another. By the grace of my Goddesses and guardian angels, not to mention my dad and my Auntie, down here on Earth, I made it to detox and the hospital before I made it to death; I made it to a bug that was certainly super before I made it to Hep C or HIV; and I found my way to a new home before I found my way to a new hovel.
I ended up surprising myself in many positive ways. I found the strength to tell everyone -
i cannot be anyone but myself.
And there is only one of me, and she’s not half bad, so I better be her, not someone else’s version of her, whether it be that of a sociopath, or that of my dear father. I will suffocate any other way. I will also suffocate if I try to go at it alone, because, if I’ve learned anything, I’ve learned that everybody needs somebody. What a shame it would have been had I turned my back on my wonderful Aunt, after so many years apart, and after she accepted the idea of having me and my dad, her brother, in her life again. So right now I have two people in my family and my new home is with my Aunt in British Columbia’s breathtaking interior. And I only wished to have one, so I am tempted to use the word “blessed”. The three of us are a force to be reckoned with My dad is even learning new tricks all the time.
And I have taken my meds, but I am free of Effexor. Seroquel XR – a low dose of it, but nonetheless – has come as a huge surprise. It is true, the more I learn the less I know, as I never thought I would say “yes” again to a doctor’s offer to give me a drug classified as an antipsychotic, even if also “approved to treat bipolar disorder and depression”. Had I not been in such a desperate place – unable to sleep or relax or bathe – and then there was breathing - I would not have given it a chance. And I believe it is helping right now. I do not believe I’ll be taking it for the rest of my life.