Drugs of choice

female head In 2008, in a boring-looking room, a psychiatrist gave me a diagnosis I could have done without. She made an assessment, asking me many questions, and after 88 minutes concluded I had ‘a lesser form of bipolar affective disorder’ (bipolar type 2).

Somewhat shocked, but definitely terrified, I looked at my 15-month-old daughter, and began to fret. Then the processes of grief kicked in as I thought I was being told I would not be able to think well.

In one phone call with this doctor, I said, ‘Hey, you should research open “addiction” self-help groups. We’re all like “that” in there,’ meaning that mental health was an issue for almost half of us – hardly surprising as those rooms are full of people in early addiction-healing, not to mention hepatitis C, HIV and other BBVs. She proceeded to suggest I keep taking vitamin D, as it is helpful for people with depression.

I didn’t mind the upswing of my newly-diagnosed condition, but the lows often left me suicidal. Try as she might, this poor clinician couldn’t get me to take drugs for the bipolar 2 –it didn’t help that the psychiatric profession are not sure whether it requires medicine anyway. According to a fellow living with BP1, the main difference between BP1 and BP2 is that when, for example, I think I’m super-woman on a well-day, my ‘sane brain’ will let me know that is clearly not true. I was ‘lucky’ – my diagnoses left me with enough connection to reality (as we know it) to protect me from the excessive sex, retail therapy, and other behaviours that often bedevil people living with BP1, getting us into terrible debt, not to mention STDs.

I was already taking low doses of opioids for chronic pain and SSRIs for the suicidal phases of my illness. The idea of taking another medicine was hardly attractive, and let me say there were people in ‘the rooms’ who were dubious about my decision not to take drugs for the BP2, but it took me nine years to finally ‘research’ whether lamotrigine actually stabilised my moods.

To this day, I’m unsure whether it did but I, as ever with unpleasant psychoactive drugs, took the lowest possible ‘clinical dose.’ I was in 12-step and we didn’t do those kinds of drugs, right? Wrong. How many of us have utterly ignored the one page in ‘the big book’ about how when a professional advises us to take a medicine, we should seriously consider it. After all, they are trained to know better than many ‘recovering addicts’ when a drug is necessary or not. Lots of people ‘in-recovery’ or not take psychoactive medicines for mental health care, chronic pain and so on. So what’s the problem? Several.

When you live within a community whose narrative is anti-psychoactive drugs, and you’re enduring countless illnesses, lack of paid employment and sleep, your own thought process will struggle to remain grounded in fact and reality, as most people know it. Then there are the infrequent ‘amateur psychologists’ who will tell you that you should not take tramadol, SSRIs or anti-psychotic medication as that is a relapse. To be fair, anyone in those rooms who knew me knew I was the last person to advise not to take psychoactives therapeutically as a passionate proponent of harm reduction, but most didn’t know me at all.

The only groups I regularly go to now are full of people navigating similar dilemmas. Some opt to take the prescribed medicines, some opt not to and use other tools (yoga, vitamins, meditation) to cope, and a few like myself do both. One thing’s for certain. As we age, some of us will hurt, creek and often be challenged by illness, drug prohibition and socio-economic deprivation. Therefore it is our job as responsible citizens to ensure we do whatever it takes to ensure the highest possible levels of self-care.

Andria Efthimiou-Mordaunt is an activist at ACT.UP London, actuplondon.wordpress.com. This article is in memory of Mary P.

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