2024: an autopsy, pt 2

[princess bride narrator voice] where was I. AH YES. the pit of despair

I started having fun writing here and guitar solo’d for a while — if you want to skip to the cliffhanger from the last post, it’s under the paywall.

In my last article, I talked a bunch about drugs.

As a quick aside before I get into the really juicy stuff, I’m realizing now that I forgot to mention that even without going to California to do Ayahuasca, I did decide to stay off my meds. At least for a while.

I completely understand that there are lots of people who have had a super fucked up experience with psychiatry. I think there’s a lot of merit to the idea that a lot of the psychological suffering we’ve historically assumed to have a physical origin point in the brain is actually a lot more complicated than that. I think that the history of a lot of human knowledge and behaviour is super brutal and fucked up, including medicine, and especially psychiatry. Also, in addition to all of this, my experience with psychiatric medicine has been overall positive.

I get stressed out admitting to this, because social norms are complicated and depend on the orientation of a person in space and time and culture. While the overall global understanding of mental illness might be one thing, the social norms around mental illness in my own peer group are very different. Admitting I had a positive experience with psychiatry while entrenched in millennial post-hippie pseudo-leftist DIY-and-activist spaces can feel like showing up to a crust punk show in heels and a pantsuit.

Despite the fact that I may have a genuine love for crust punk music, be as politically aligned with the other attendees as can be expected given the normal variance in human thought and behaviour, despite the fact that being at the crust punk show may be the most authentic expression of what I’d like to do with my evening, or that punk is ostensibly about the rejection of dominant social norms in favour of an anti-authoritarian politic and mode of self-expression, and despite heels and a pantsuit being (in this thought experiment) perhaps what I am most comfortable and confident wearing to a social event, my presence in such a space with such an outfit is in fact a violation of the social contract. Maybe this is because all counter-cultural rupture eventually hardens into its own set of norms and regulations, which run the risk of reproducing at least a shadow of the structure of domination they initially sought to undermine. And perhaps, given the history and philosophy of punk, being in this kind of space dressed in this way may actually be a more philosophically rigorous expression of the punk ethos than everyone who seeks to earn inclusion by dressing like everyone else.

But try saying that to a sneering thirty-something being a good boy in his regulation all-black-and-patch uniform. He’s still gonna call you a cop.

I’ve written about this extensively in my book, so I won’t rehash it all here, but basically when I was 21 or so I went through a period of about three months where I felt focused, capable, smart, and sure of myself in a way that felt a lot more intense than these things tend to, for me. I didn’t seem to need to eat or sleep very much. I did not leave reality. Another reality simply descended on top of mine — in a way that made it difficult, if not impossible, to accurately weight my feelings or perceptions. None of this felt like a bad thing. It felt like the best thing that had ever happened to me.

And then, seemingly all at once — without a discernible trigger I was smart or self-aware enough to notice at the time — and still am not now — I hit a wall.

Once again, I did not leave reality. The meaning of my reality changed. Where I’d been seeing, everywhere, evidence of my fundamental connectedness, the plan God-or-whatever had for me, obvious messages about how smart and pretty and cool I was, perhaps smarter and more pretty and cooler than everyone else, perhaps the smartest and prettiest and coolest girl alive or to ever live — I suddenly saw, instead, irrefutable evidence of the malignancy of existence. The salience of this truth was eclipsed in certainty, by me, only by the knowledge that if I was not the most perfect example of this malignancy, it was only because I was — for reasons I could feel but could not articulate — its originating source. I never seriously considered ending my life, but I did understand suddenly why people want to do that kind of thing.

This precise tenor of misery lasted four months, until I got seen by a psychiatrist. As I have a family history of bipolar disorder, I was diagnosed with a probable case of “very mild” Bipolar II and given antipsychotics.

I don’t think these were the right drugs for me. I gained a bunch of weight, which I still haven’t lost. I had side effects that started mild and slowly mounted in intensity until, unable to contact my psychiatrist because the system is in fact imperfect and fraught with terrors, I weaned myself off of them, without medical supervision, in what felt like the longest and craziest psychedelic experience imaginable.

This also happened, though: one day I was crying and binge eating and having panic attacks all day, in a horrific mirror version of the universe in which everything was a sinister, cruel version of itself, in which the meaning of my every thought and feeling was malignant, in which I was afraid of parked cars and was pretty sure I was about to flunk out of school. I wasn’t hearing voices, so to speak, but my inner narrative was cruel and unyielding and never shut up. I couldn’t make a choice because my brain was a non-stop barrage of narrative thought, of a thousand competing priorities and expectations and judgements I could not manage or sort or make sense of or organize into any kind of measurable plan of action. Besides which, it was always already too late, and I hated myself. And I started taking medication and it was like that went away immediately. It didn’t solve all of my problems. It created a non-zero number of new ones. But within a year, I had graduated university with a ninety-something average, I had learned to speak French, I’d done a tree planting season, and I’d written and published a book. Even given what I know now, if I went back, I don’t think I’d do anything differently.

Three years later, I got a new psychiatrist. My new psychiatrist practiced something called collaborative medicine. He approached the DSM with a lot of skepticism. He was well-versed in feminist and anti-racist criticism of the whole practice of psychiatry. He encouraged me to think about myself not as someone with a mental disorder, but as a person who had qualities and habits and experiences which informed my behaviour. He encouraged me to think about which of these I actually liked and respected and enjoyed about myself, but may cause friction with other people or with the norms of my culture, and which actually caused me distress. Only this last category, he suggested, were symptoms.

It was suggested to me that my emotional responses — even big ones, which other people did not like — were not actually the same as being a bad person, and that as long as they weren’t violent or cruel they may actually be appropriate given the situation, and that its actually very healthy to cry when you are upset, and that when people treat you poorly you should get mad and tell them to fuck off and leave. It was suggested that while people do not understand how the brain works, we do understand that people suffer, and that they suffer in recognizable patterns, and that there are at least some people who actually care about that a lot, and very genuinely want to help. It was suggested to me that I could both lower the level of suffering I experienced and also hold the truth that there are probably also systems of power or legacies of trauma that have heavily contributed to my suffering, and that not only should I continue to address those things, but that addressing them might be more effective if I didn’t also feel like fucking shit all the time.