Can Meds Keep You Sober?
I need certain drugs in order to stay sane. And no one’s going to tell me I’m not sober because I take them.
I've always been depressed. Back when I was a little girl growing up in LA, still playing with dolls, I felt that psychic emptiness, that quiet despair, that self-loathing that William Styron, Sylvia Plath and others have written about so poetically. By the age of 15, I had a budding eating disorder and, by 19, I’d had my first full-blown nervous breakdown: I couldn’t eat, I couldn’t sleep I didn’t want to be around people. I cried constantly and, when I wasn’t crying, I just felt dead inside. I had a heavy feeling in my chest, like some enormous beast was sitting on me. My therapist at the time refused to put me on medication because he thought I need to “work through it” with talk therapy.
I still managed to graduate Magna Cum Laude from Emerson College but I was gaunt and bony and had a haunting look in my eyes. At 21, living back in Los Angeles, a new psychiatrist put me on Prozac and although it was far from perfect, it was a big improvement: I stopped making myself puke every week and the depressive episodes where I would hole myself up in my apartment, not answer my phone and sleep for 18 to 20 hours a day went from lasting a week to lasing three days. I stopped Googling “noose knots” and wondering if the shower spigot could hold my weight if I decided to exit this world.
Anti-depressants don't make you happy—they make you, if they’re working effectively, undepressed.
In my time, I've gone through the medication merry-go-round: on Prozac, onto Zoloft, onto Effexor, onto Cymbalta, back onto Prozac, add Wellbutrin, add Abilify, add Geodon, add Seroquel and on and on ad infinitum. I would switch meds because they would either stop working at about six months or they would never work in the first place. The anti-psychotics, like Abilify and Risperdal, that doctors added to “boost” the sagging anti-depressants always made me feel slow, tired and hungry or just emotionally shut down. I wondered if that’s how normal people felt or if was an overly medicated, robotic zombie cut off from my destructive but inspiring spirit.
As any good psychiatrist will tell you, antidepressant medication is an art, not a science. A medication that does wonders for one person can make another person agitated—or, almost worse, do nothing at all. Everybody’s chemistry is different so you have to be willing to go through the trial and error of finding the perfect recipe for you. One thing is certain: if you don’t need medication, it will do nothing for you. If you do need it, you will feel a change—anything from mild to profoundly life-altering.
When I was 24, I discovered crystal meth and it did for me what I thought Prozac should have done: lifted my depression, gave me confidence and induced a sense of wholeness. I used to call it “Prozac with wings.” By 26, I was in my first rehab and nobody ever thought about taking me off my medication. My depression was not a result of my drug abuse or a life well torn apart. It predated my addiction. It predated everything.
Yet my situation is unique because I developed epilepsy at five years of sobriety. I was living in Paris at the time: one minute I had a baguette in my hand and the next I was prone on the sidewalk, shaking in dog shit. After trying half a dozen anticonvulsants, my doctor and I settled on Phenobarbital, the only drug that would control my seizures without intolerable side effects. Of course, when I came back to the States and got a militant sponsor, she made me try all the other medications again before she'd let me stay on the pheno. The side effects of those others were vicious, which means that if you saw me 30 pounds overweight or balding or so sedated I couldn't remember your name—well, it was surely during that period. I know that Phenobarbital is a Barbiturate that was used by Elvis, Marilyn Monroe and Judy Garland to dire consequences. I also know that pheno is one of the oldest anti-seizure medications in the world. I am still on Phenobarbital and I have been seizure-free for almost four years.
Not once do I think that being on either my psychiatric or anti-seizure medication is breaking my sobriety. Anti-depressants don't make you happy—they make you, if they’re working effectively, undepressed. It's not the same thing. If it were, I wouldn't have shot coke on top of Cymbalta or smoked meth while I was on Prozac. And I will echo here what many people have said before me: mental illness is a disease just like any other. Would you ever tell somebody with diabetes to stop taking insulin and do the steps instead? Of course not. Alcoholics Anonymous is not Christian Science—or it shouldn't be. But I see plenty of people in the rooms, some with double-digit sobriety, that are obviously suffering from untreated mental illness. These people often feel guilty and ashamed that they need meds to feel normal, that their enlightenment through the steps is not sufficient. Although it says very clearly in the Big Book that “we work closely with the men of medicine” (i.e. doctors) and “that we have no opinion on outside issues” (and I consider mental illness an outside issue), I see many people who choose to inform other people that being on SSRI’s means breaking your sobriety—that you shouldn’t “take anything that alters you from the neck up.” Many people in AA do not buy into this widespread fallacy, thank God, and those people know that mental illness and/or clinical depression is a separate issue (a medical issue, in fact) from alcoholism. Unfortunately, many people do not take medication until they get to that crossroads of suicide or relapse. My hope is that the tide is changing and that we can encourage alcoholics to seek treatment for depression and other mental illnesses early on.
I was recently considering changing sponsors but during my first conversation with the woman I was thinking of asking, she said, "You are on a lot of medication."
"Well, I'm a lot fucked up," I answered.
"You should really try to get off some of those, starting with the Prozac."
"Thanks for your time," was all I responded.
She kept saying, "I don't want to play doctor.” To that I say: Well, honey, then don't.