My recent note touched upon how I have not had any pharmacological treatment of my Mental Illness for quite some time. This has come up here and there, and quite some time ago, I promised a post about my “medicine respite”. This is it.
Originally, I went off my meds for a variety of reasons, many of which were to be honest based upon being impoverished. Yes, I had MediCare part D, which made my medicine available for a small co-pay, but that was not nearly the only factor or cost in obtaining my medicine.
To get a prescription, I had to see a Psychiatrist. These visits cost out of pocket $50 a piece. Because I had no car, I had to take a bus. To take the bus, I had to have a pass.
Also riding the Bus took an investment of a minimum of two hours of time, and usually up to three or three and a half hours. The time was spent getting to the stops, waiting, the actual ride, and the same process on the way back. More than once, I got stranded because when I got out of my appointment, the routes I needed either initially or during a transfer had stopped for the day before I was able to avail myself of it.
Then there was the matter of actually picking up the medicine at the pharmacy. While at times, I was able to get a ride, mostly I had to ride a bicycle for about 30-40 minutes through a high-crime neighborhood to get to the pharmacy, and then the same amount of time (actually a bit longer, as I would be more tired coming back) to get back to the squalid little room I was living in at the time.
So the process of getting a prescription took 7 hours minimum over two days at about a cost of about $65 or so.
Because of my Psychiatrist’s penchant for micro-managing my life, and my occasional non-compliance with my medication, she would have me come see her as often as once a week — writing me a one week prescription at a time (no refills). So with an income of around $730 a month about $260 was devoted to getting medicine. Rent for my squalid little room was $400 a month. And the time spent obtaining medicine, added up to over a week out of the entire month pretty much devoted to just obtaining my medicine.
It should be clear why this situation was untenable. But this is only ONE of the points in the matrix that lead to the decision.
While there are others (such as what medicine was covered by my insurance, the efficacy of such, and the bureaucracy of obtaining it), the one worth mentioning is the actual intended effect of psychiatric medicine (side-effects aside).
There is no other way to put it, Mental Illness is a hell of a thing. While the politically correct thing is to not identify a person AS their illness, the fact of the matter is, with (at least MY) mental illness, the symptoms are expressed as, well WHO I AM. So any pharmacological treatment, in essences, changes my mind. It modifies my very personhood and identity.
While during the worst of my mood swings, this IS, believe it or not, actually the preferred path to take. But it is a hell of a choice, and it is a hell of a COST.
I know many of you reading this care and love me. But something to understand, Christopher ON psychiatric medication is for all intents and purposes a DIFFERENT PERSON than I am right now, off of them. While this medicine, in part, is to help prevent suicide (and other dangerous behaviors) being on it, IS a kind of suicide. The worst part of this, is that Meds-Christopher is AWARE of the change, and knows that the change is imposed on him. I gotta tell you, when I am on meds, I do feel like, an emotionally stable (if the medicine is having the desired effect) COPY of the “real” (unstable) Christopher. Many (but not all) times I feel like an inferior or “less than” copy.
So, let’s talk about imposition on the mentally ill. Medication imposes a different mind upon my brain, that is one level. Another level is that society imposes the medication on the mentally ill.
The usual reaction when someone (both friends and strangers) discovers I am mentally ill and not taking medication is “you NEED to be on your meds!” It seems to be an acceptable reaction from when someone has a psychotic break in public, to when someone even may just be casually annoying to state that “wow they must be off their meds”. I have even seen friends share posts from a Facebook post called “Mom is off her meds again” or similar. To me, I find this societal attitude very, very hurtful. The reason such attitudes hurt, is that such expressions imply that treatment in general, and psychiatric medicine in particular, is not to treat or address the suffering of the mentally ill, but as a mechanism of control so that the mentally ill do not inconvenience others. In short, that if one is mentally ill, then their health decisions are not theirs to make autonomously, but something to be imposed upon them.
It should not matter in my opinion, what other people think one should do about an illness, mental or otherwise. It is, like all medical decisions, that of the individual and their physician(s).
Being mentally ill, should not mean that one’s health decisions are up for public review, approval, or disapproval. Unfortunately in the society in which I live, it in fact IS. Not just by entitled individuals, but by the power of LAW. Let’s put it this way, the worst day to feel suicidal is a Wednesday. In California a statute enshrined in the title of a Van Halen album, 5150, REQUIRES that if an individual is “a danger to themselves or others” that they be hospitalized for a “72 hour observation”. This happened to me on occasion, but one that stands out was in the mid 1990s. Why? It happened on a Wednesday, and that evening I was committed to a County Mental Health hospital. When one is committed under a 5150, you actually have to sit before a Judge to be released. In this case, I did not have to go to a courthouse, the court came to me. Court was held in a small room at the hospital. “Court” here, not being a euphemism, but an actual legal hearing with a Judge in the room hearing it. But here is the thing, I should have gotten my hearing after 72 hours — which put that mark, late Saturday evening. They do not have Court on the weekends.
If you are suicidal on a Wednesday, you have AT MINIMUM a 5 day stay at a mental hospital ahead of you. If your doctors or the Judge are not convinced you are well enough, your stay can be much longer. But the point is, the choice is not that of the individual, at all.Now, I am not saying that involuntary treatment is never necessary. While at times, it is the correct thing to do, it should be motivated by compassion for the individual, not by the fear from others. I would like it to be understood, that it can really suck for the individual involuntary treatment is being imposed upon, and if it IS indeed necessary, a RATIONAL reaction should not be expected (like at all) due to the nature of the illness, the reason for commitment. When the inevitable irrational response is received, the individual (who figuratively and literally is not in control of the situation) should not be responded to with criticism, shame, or punishment. Compassion tempered by empathy and understanding, in my opinion should be the guiding principle for these interactions.
L. Christopher Bird
The Craic House
August 11, 2014