Wednesday, November 25, 2015

A Writer on Living with Depression

It boiled down to this: I decided that my life, as I had known it, was over. I was never going to get back to the job I had when I was 25 years old, making $65,000. I was never going to get married and father children. It was time to put a fork in those dreams—I couldn't reclaim them. That me was dead and done, and I was reconciled to that. - Philip Dawdy, on his mental illness

A decade back, Philip Dawdy wrote an article for the Seattle Weekly about Rodney Plamondon's mental illness, and his own.

We post portions of his article in case they may provide perspective for people with disabilities related to his. Note that Dawdy finally resorted to a solution which went against much of the medical advice for people with his condition. While he claims that this worked for him, what he did was risky, and may well be the wrong approach for most others in a similar situation.

Dawdy begins:
He was in the hospital the day he learned he had been elected to the Phi Beta Kappa Society. Rodney Plamondon looked for a while at the letter that told him this. He was pleased. He was the 22-year-old son of a long-haul truck driver. Rodney's future wouldn't involve driving a Kenworth.

This was good. He had dreams. He had aspirations of doing graduate work in the classics at an Ivy League school, of teaching after that. Or entering the Foreign Service. Getting into that honorary society wouldn't hurt his chances at either.

Rodney put the letter away. He had more pressing concerns.

He was, on this July 1984 day, in the psychiatric unit of a hospital in Boise, Idaho, his hometown. He was newly diagnosed as a paranoid schizophrenic. Rodney hadn't the slightest idea what this diagnosis meant for his world, but he knew that his life had changed dramatically.
Dawdy goes on to describe the effects of orthodox [drug] treatment on Rodney:
Rodney is still staring at the dark walls of the tunnel. In the past year, he's been in and out of psych units in Seattle eight times. He's lost pretty much everything—his furniture, his computer, his cat, and every scrap of fiction and poetry he had written over the past 20 years. He takes Haldol and Clozaril twice a day—powerful antipsychotics. Rodney sleeps 12 hours a day on average, sometimes 15. On his left cheek, there are flakes of skin where the pillowcase has rubbed him.

Some days, when he leaves the building, he looks as though he's been mugged and beaten. Those are his good days. Other times, the bad days, he's too paranoid to step outside.
"It happened to me that way, too," Dawdy wrote,
a psychotic break out of the blue during a twentysomething life that had been shaping up quite nicely. It was difficult to build a new life out of that. There were many, many setbacks. That's the absurd deal of mental illness: You get taken most commonly in your youth, when life is just beginning to gel. You get an illness that, in many cases, is so disabling that it strips you of the psychological and practical goods essential to a decent existence. Often you get kicked right out of the mainstream, no matter how solid a citizen you were before it all went bad.

What are you going to do about that?

You have three choices: kill yourself, lead a featureless existence, or fight back and extract some measure of revenge on that which laid you low. Rodney and I rejected options one and two. Option three is no cakewalk. It takes years of determined effort before you see light at the end of the tunnel, and as you feel your way along, you've got to do it all on blind faith that something good might happen. After 15 years, I'm finally beginning to see a faint glow.
Dawdy describes his eventual realization dramatically:
You will stay awake at night and gnaw on that problem, probably for years. You'll likely struggle with some level of suicidal tendency. You're broke, mentally, physically, and financially. Some in your family and circle of friends have cut off contact. Rodney hears from his father perhaps once a year, usually by letter (his mother died in 1987). You wind up hating yourself because these consequences seem thoroughly logical.

What makes things dicey is that what you've got is episodic. You can take your meds and keep appointments with every doctor and social worker under the sun and yet, nine months later, bam, here comes another round of mania. Hello, locked psych unit. Goodbye, job and apartment. Stabilize. Repeat.

I was beset by the same cycles during my 20s and 30s. Meds followed meds, 16 in all. Breakdowns followed breakdowns. Nothing seemed to work for very long. I lost jobs at a healthy clip.

Amidst this whirl of disorder, I learned three crucial things. One, I wasn't going to kill myself. Second, I had far more power over my fate than any doctor ever let on. Third, the existentialists weren't joking: The world is truly absurd.

I'd like to claim that one night I was visited with a revelation about how to grapple with this. It was a far lengthier process.

It boiled down to this: I decided that my life, as I had known it, was over. I was never going to get back to the job I had when I was 25 years old, making $65,000. I was never going to get married and father children. It was time to put a fork in those dreams—I couldn't reclaim them. That me was dead and done, and I was reconciled to that.

That kind of truth will set you free. It will free you to take the kind of risks you'd never take if you were trying to realign yourself with the life you once lived and the goals that once got you out of bed each morning.

Also, it freed me to be pushier with my doctors about what meds and how many of them I would take. I couldn't, for example, tolerate the amount of sleeping caused by antidepressants. My doctor reacted as if no patient had ever bossed him around before.
Dawdy's decision was to endure bouts of depression instead of taking antidepressants at the recommended level. "I can't approve of this, of course," his doctor said.

Here's what he lives with:
When I get my semiannual visits of depression, I can't leave my apartment for days at a time. I can't listen to music of any kind. It all becomes grating and metallic—not even Mozart can punch through that mental pea soup.
Dawdy reflects on our society's treatment of the mentally ill:
As a country, we've spent the past 40 years trying to figure out what to do with people like Rodney, for our sake as well as theirs.

In the 1960s, he'd have been confined at a state mental hospital. That isn't too humane and costs a fortune, so we've mostly backed off that reflexive reaction to the chronically mentally ill. By the mid-1980s, people like Rodney were being pushed onto the streets. We tried to de-institutionalize them on the cheap and failed to provide housing. Oops.

But soon after, all the Prozacs and Risperdals came onto the market. They were a better deal than restraints in a state hospital or the old psych meds like Thorazine or the hazards of the streets.

And that was that, we figured. The meds are a cure, and we're saving money by not hospitalizing these folks. Let them live among the rest of us and go to work in the morning and pay bills in the evening. Let's get as many of them as we can off the public dime.

So what's next for someone like Rodney, assuming he's reasonably lucky and stabilizes? The way things are now, probably not much.

Are you going to hire him? He's barely worked in the past five years, and frankly, the man is too smart to find much satisfaction in pushing a broom in an office building. Will your family take him in? His own family has spent the past 20 years spurning him. Want to marry him?

You know the answers.
I once worked with a nice guy who had Tourette's Syndrome. I was sitting in the break room with him when he suddenly said, "Hey [n-word] fat [n-word]." "Huh?" I said. He looked at me in surprise. Touretters are often unaware of their involuntary outbursts.

I ran into him in a Toys'R'Us years later. It was explained to the other customers that he wasn't in control of what he said. Many of them refused to accept this. They thought it was just an excuse to get away with unacceptable conduct.

What would it be like to have your id broadcasting to the world without your control?

Philip Dawdy's solution to his mental illness, if it actually was as he describes, is anecdotal. He does not, for instance, seem to imply that it would work for Rodney.

But public understanding and acceptance toward the afflicted can make life workable for many. The customers who took a moralistic approach to the guy with Tourette's weren't making anything better for anyone.

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