They would not admit me, first of all, at RUMC. The more-or-less explicit reason was that I was unwilling to say that I was a physical danger to myself. This was not so much a matter of pride on my part as a matter of honesty; I was in rough, rough shape, but I was not in danger of self-harm. So I left with my brother, who had come up from DC to take care of me, sedatives in hand, and proceeded to look for outpatient care. I remember walking out onto a Staten Island street and just thinking, what the fuck do I do now?
It was a wearying ordeal to get into treatment. Maybe I’ll write about it someday. But I am in treatment, now, and have been for four months. I am blessed with a great prescribing psychiatrist, thanks to help from my friend Katie Halper. Finding a working therapy solution has been much harder, but I have done some short-term CBT and I’ve Skyped with a psychoanalyst.
I am on a comprehensive meds regimen. I am on the largest dosage of lithium I’ve ever been on. I’m on olanzapine, an antipsychotic. Accepting that I need to be on an antipsychotic medication has been a key step, for me, and one of many ways in which this time has been different than the past. I am on fluoxetine (Prozac). I’m on Wellbutrin. I was on Lamictal but I had an allergic reaction and we had to drop it. I have prescriptions for Xanax for anxiety and Ambien for sleep. (Don’t worry, I consider avoiding benzo addiction to be one of my hobbies these days.)
One thing you learn: there’s no such thing as just the right level of concern. Like, you tell people you’re bipolar, and they think you’re kind of a moody fellow. You tell them you’re on antipsychotics and they think you belong in Arkham Asylum.
The side effects are what they are. I have tolerated olanzapine in a way I have never tolerated Seroquel or risperdal and for that I’m grateful. But, god, the hunger. The olanzapine causes hunger pangs, omnipresent and gnawing, all day, every day. If I’m not careful I could just write about the hunger for hundreds of words. Hunger in the morning and at night. Hunger right after I eat. Hunger that dominates my mental life. I went to a meeting at my union hall and they had pizzas laid out on a table. I took three slices and went and sat down and while I was eating one – while pizza was literally in my mouth – I began to stress about when I could go back up to get more, when it would be socially acceptable to get seconds. I Googled around about olanzapine hunger and I felt so validated to read other people, talking about 50 pound weight gain, about being forced off the drug by the hunger. One person wrote that it’s like having a hole in your stomach and that sounds about right. I have all sorts of little tricks to try and deal with it; I drink coffee and seltzer by the gallon. (No joke, I average 5 liters of seltzer a day.) Still I’m up 20 pounds since August. It feels like a war of attrition I’m bound to lose.
Other than that, the side effects are alright. I go to bed absurdly early unless I really fight to stay up. Some acne. My hands shake sometimes. I have to pee a dozen times a day. At first I had some verbal dysfunction but it faded, thank god. Mostly at first there was just the permanent sense of being altered, the familiar sense that I was a few degrees off from everybody else, a haziness. I no longer feel that way, usually. The question I guess is if it went away or if I simply got used to it, if I have a new normal. All I can really perceive is just enough of an increase in mental effort to do everyday things, just enough to notice. Writing. Writing is so much harder than it was.
There have been some other annoyances. The logistics, the travel, the time off work, the expense. I struggled with agoraphobia for months after, scared to be seen, scared of people. They tell me it’s pretty common with people who go inpatient and so I feel like it wouldn’t be unusual for someone in my situation. Anyhow, it’s much easier now, although I’m still frightened of being seen in a way I can’t quite express. I mostly keep my world small.
I’m sober. Occasionally I go to AA meetings but I am not really doing the steps; it’s partly the god and partly the submission and partly I’ve read the research. But it is profoundly comforting to know that the meetings are out there, so many meetings. You have to give credit to the 12 Step people on this: I can look on a website and find a dozen meetings in a dozen neighborhoods at many different times of the day. The whole thing is set up to make attending meetings as easy as possible. The contrast with finding a therapist is really stark. Anyway: sobriety’s fine. It’s been easy. I mean it sucks, but it hasn’t been difficult. I’ve been to bars with friends and not had any temptation. I just miss beer. I made a pot roast while it was snowing the other night and it felt criminal to not drink a nice stout. But I’m committed to sobriety and it has clear and direct rewards.
Everything with me is rituals and rules now.
Getting off of social media was easy too, although I’m sure it would have been harder had it not come with such dramatic upheaval. There’s this unusual feeling that no one is selling anything to you, off of social media. In this era we’re all constantly trying to sell visions of ourselves to those around us, electronically, and cutting that out of my life has left me with relationships that seem at once more natural and more deliberate. Do I miss it sometimes? Sure. I hate to give Facebook any credit at all, but without it things do seem a bit more lonely. There are people I miss. I have this permanent sense of not knowing what’s happening, partly by design; I am not really reading the news lately and tend to avoid takes like the plague. But socially, it’s tough. I have no idea what’s going on in people’s lives. And people are in touch and then they stop being in touch, and I never know why. Probably because of something I’ve done.
I thank god for my union. My strong health insurance, that’s thanks to the NYC public sector unions and how they’ve fought. My prescription drug benefit comes directly from my union. My generous sick leave days are thanks to my union. Had I exhausted them, I would have been able to draw from a pool of shared sicked days that others have donated, thanks to my union. My boss has been great about everything, very supportive, but if that had not been the case, I would have been able to rely on the muscle of my union, on the grievance system. I thank god for my union.
I’ve thrown myself into activism work with my housing rights group. It’s a wonderful radical, deeply pragmatic organization. Housing is such a primal need, and the people who work for housing justice in this city are some of the best I’ve met. My group is a great opportunity to be a rank and file activist, to just be a foot soldier. I do phone banking; I hand out leaflets; I get signatures. I do all the mundane brick and mortar political work, and it’s a blessing. I’ve also been working with my union whenever we have a meeting or an event. Our contract’s up; it’s going to be a hard fight.
I am lonely. I see people and they treat me differently now, and my heart rebels. But my head knows that it’s natural. I am different, after all. Still, when I interact with someone I’ve known and they’re just completely the same, when they treat me the same, it’s such a wonderful feeling.
I get emails, lots of lovely emails from sweet people who reach out to me. I sometimes have a hard time writing back. I often don’t know what to say. I suppose thanks will have to do. I do get other kinds of emails, occasionally. It’s still the internet. On the internet, all truths are crowd sourced, even the most personal and intimate. And so I get people who patiently explain to me what my condition means and doesn’t. I get accused of faking it. I’m told what my disorder can and cannot explain, I am lectured to about what I am accountable for and am not. I am told that my illness renders my political opinions illegitimate. It’s amazing, not only how many experts in bipolar disorder there are out there, but how many experts there are in my bipolar disorder. The question of my culpability for my actions when I am cycling is one that I will continue to turn over in my head for the rest of my life. And I have the advantage of being me. I will keep my own counsel on the nature of my illness. I don’t need any volunteer parole officers for my mental health.
Is the question whether I’m sorry? All I am is sorry. I am so sorry. I have such bone-deep regret. I live in guilt. And I am paying for my mistakes. I have once again set friendships on fire, driven off good people who trusted and cared for me. Not with one big thing but with a long, drawn out series of minor betrayals, my constant accusation and demands, all drawn from a frantic paranoia, my deep-seated fear that people who care for me are withdrawing their affection and, when it gets bad, my belief that they are actively plotting to harm me. I mistreated people who were unfortunate enough to be close to me. You chip away at people’s trust, a chisel here and a chisel there, and then they make the rational decision to cut you out of their lives. And then you have to live without them. Yes, I am sorry. I am so sorry. I’ve changed my life in every way I know how. I should know better than to say that this time is different. But this time it has to be different. I can’t go off meds again. I can’t do this anymore.
And so I’m more sure than ever that I need to stay away. Long experience tells me that, sometimes, that’s the only way to make amends, to make yourself scarce. There are projects I want to work on, longform stuff, if I am permitted. But there will be no comeback tour. I have lost my having-opinions-on-the-internet privileges. I enjoy being off social media; I’m deeply uninformed about the news cycle and couldn’t comment intelligently; I have lost the pathological compulsion to always be writing and sharing. But most importantly, I have to remain offline as a penance to the people who I have mistreated with my words. I have to give up something to show people I understand that my behavior was not acceptable, to sacrifice something in the name of accountability. Are all of the things people got mad at me about legitimate? No. There has been irrational hatred of me along with rational dislike. But I have lost my right to argue about that distinction. I have to be accountable, and the best way to do so is to permanently remove myself from online life. It’s not much but it’s what I have to offer at this time. Besides I was online for 9 years. Better to let other people talk, to let other kinds of people talk.
Sometimes I dream of another life, or really another me, a me who wasn’t at war with myself, and the things I would have written then. But I’m too old for that now. I can only move forward. If there is any virtue to getting to a place where you say, to another human being, “I cannot go on like this, and I need help,” it’s that the part of you that cares for the opinions of other people dies, and however briefly, you live unmediated. I would like to think I can access it again, in times of better fortune.
I’ll be alright. I have become acquainted with the quiet. Time for books, time for snow, time for the library, time for campus. Time, like the man wrote, to burrow deep for a deep winter.