The essay I’d written for today will be delayed. It was another piece about the unreliability of belief, based on the work of the late physicist David Bohm. I wrote it two days ago but postponed publishing because I’ve decided that sending out entries more often than every three days imposes on readers’ inboxes. Apparently this policy risks what happened today: a topic that sounded interesting before now seems less vital.

So what is ‘live’ for me today? Self doubt.

Thankfully, I’ve gotten pretty adept at accepting the big hardships. Physical pain, failure, and grief feel quite acceptable to me. They even seem to instruct me in wisdom. I can embrace them. On the other hand, right now nothing momentous is bothering me, yet I’m feeling bad about myself.

My life strikes me as eminently comfortable. I live in a lovely area with many nearby trails. The wetlands restoration outside the neighborhood gate is nearing completion so there are more waterways, marshes, and birds in view. I have time to enjoy the natural beauty and also to exercise and meditate for long periods every day. My life right now is nearly without stress: no business to fret about, no medical problems in need of attention, no family issues.

So what’s to complain about? The same thing that has come up for me over and over since my surgical career ended twelve years ago: aimlessness.

What is the point of my life if I have no gainful occupation? Can I find satisfaction merely from blogging? Why have I proven myself capable of working in so many fields while also demonstrating my inability to stick with any of them? How am I going to justify my existence now that professional endeavors no longer seem feasible?

In high school my mediocre performance and chronic delinquency pointed to an unpromising future. But as my senior year approached I found a passion: biology. It grew out of a lifetime interest that dated back to time with my grandfather, who showed me the insides of fish and chickens he prepared for meals, taught me how to cultivate mushrooms, and enlisted me to work in his vegetable gardens. My father had encouraged the curiosity by buying me the Visible Woman and Visible Man models. I’d tried to incubate quail eggs and had loved the nature classes offered at the camp where I spent six weeks every summer. First in Boy Scouts and later with friends, I’d gone on many camping and scuba diving trips around the Los Angeles area, which is rich with natural beauty once you get beyond the freeways.

As high school drew to a close, I found biology so fascinating that buckling down and doing homework suddenly seemed like a great idea. Before long I was at UC Berkeley earning nearly straight A’s. Ecology was the subject that most fascinated me, and I planned to become a marine biologist or some other species of naturalist. But all subjects piqued my interest, and I took a tremendous variety of classes. Soon, I was singled out as possessing strong analytical skills and was shunted into an honors physics sequence tailored to a select few of the most promising students. My father only seemed impressed by this latter turn of events, since he considered biology a ‘soft’ science. Overly influenced by his opinion, I abandoned ecology and decided to pursue neuroscience through graduate studies in biophysics.

Thus began a long, meandering career search in which I seldom felt myself on the right path. Faced with a future spent poking microelectrodes into nervous systems, I became bored and discouraged. I’d also broken up with my high school sweetheart, and my grandfather had recently died. My first major depression hit. A therapist convinced me to go to medical school, largely by telling me how much he wished he’d had the grades for it himself.

Learning about the human body did, in fact, fascinate me, but the practice of medicine terrified me. I did not have the proper attention to detail, and I continually worried about forgetting important steps in clinical care. At the same time, I found the eye remarkably beautiful and decided to specialize in ophthalmology largely on aesthetic grounds. Little did I understand that my choice would place me in one of the most detail-oriented subspecialties. After learning to perform cataract surgery and many other procedures, I decided to pursue further training in ocular oncology and then in reconstructive surgery. These fields offered slightly larger margins for error, and so seemed better suited to my personality. Plus, I liked the artistry of facial surgery.

I got a great job after my training, working at Kaiser. There were no administrative duties and lots of autonomy in patient care. I thrived. But my neck was not up to the strain, and as the pain increased my old fears resurfaced. During a manic episode I made a hasty decision to simply abandon my hard-earned career, rather than doing something smarter like reducing to half-time.

This led to an immediate collapse of my psychiatric health. After a couple of years spent recuperating, I began graduate study of biomedical computing; that lasted about two years before blowing up when the professor I’d planned to train under moved to another state. Then I taught high school biology for a term. After deciding that the life of a high school teacher wasn’t for me, I found a job with the California Department of Public Health teaching physicians about childhood lead poisoning. The work was fun and took me all over the State, but when it started to stress me out a bit my psychiatrist persuaded me to quit (which I think did me a disservice). For a time I looked into studying entomology and took some college classes in preparation, but that direction seemed too far afield after so much training in medicine. I next spent a couple of years preparing for graduate school in psychology, working as a volunteer counselor, but when the few institutions I applied to rejected me, I gave up. Through an informal internship, I then learned to work as a patient rights advocate in mental hospitals, but the pay seemed far too low. Finally came the acupuncture venture, which longterm WillSpirit readers already know about.

Do you get the sense that I’ve pursued a lot of different disciplines but abandoned all of them? I do. Ecology, neuroscience, biophysics, ophthalmology, ocular oncology, reconstructive surgery, bioinformatics, high school teaching, public health, entomology, counseling, advocacy, acupuncture, etc., etc., etc.

My hobbies have been similarly sporadic. Just as I was getting some recognition from local sculpture teachers as a figurative sculptor, I gave it up due to neck problems. Poetry periodically grabs me, but I usually get tired of it before too long. I’ve written some memoir pieces that instructors really liked, but I never follow through to create a sustained text. For some reason I keep the blog going, but probably only because it’s so easy.

Whew. That’s my long catalogue of aborted vocations and avocations. In the last few days I’ve spent time with a number of friends, each of whom seems really committed to his or her career path. Why have I never found a road worthy of ongoing effort? Why do I always seem to find reasons to change directions?

I have no good answer. It appears my personality permits me to be a Jack of all trades, but a master of none. This is intellectually fascinating but professionally suicidal. Back in college the professors seemed unanimous in their belief that I was headed toward a stellar future. What went wrong?

Clearly, part of the problem is that I’ve been too easily swayed by the opinions of others. And I’ve often chosen directions that made logical sense but had little appeal to my heart. Other times, I’ve ignored obvious limitations and pushed myself to tackle fields that were too stressful. I’ve acted impulsively and in the face of challenges have quit projects entirely rather than effect more nuanced changes. So I suppose there are lots of reasons, but most of all, there’s been a lack of staying power.

Given that I’m blessed with reasonable financial security, fairly good health, and endless free time, you’d think I’d feel happy even without employment. Instead, I’m working hard to prevent my psyche from beating up on itself about my inability to sustain a career. The only remedy seems to be meditation, which allows me to stop thinking about what’s happened and imagining what might have been. So I’m practicing intense mindfulness as much as possible, including while driving, walking the dogs, and swimming.

Just a week or two ago I felt beyond all this; I was ready to commit myself to spiritual growth and abandon the pursuit of worldly success. Circumstances seem to be forcing me to look at my situation despite my resolve to turn my back on career obsessions. Perhaps I need to better understand what went wrong before I’ll be able to accept it. Or maybe this productivity-oriented culture simply makes it difficult to find relief from this angst. In the end, of course, I must simply embrace my life and myself. But apparently I’m not quite there yet.

Sometime back I promised a post about how one’s attitude changes with drugs. When I quit Cymbalta almost a month ago, I quickly lost my confidence, started to feel tired and discouraged, and decided life did not have much value. I fear that without my strong connection, devotion, and commitment to Mandy I would have succumbed at last to the suicidal tendencies that have dogged me since my first major depression at age twenty. Yet not long before things had looked pretty rosy to me.

At present I am coping with some medication-induced injuries that will never leave me, even though I’ve quit the drugs that caused the damage. I find the destruction visited upon my body demoralizing and infuriating. But before stopping the Cymbalta, it seemed like my grip on the situation had improved, and I had hope that with a little time and meditation my distress would abate and I would settle into a more-or-less calm acceptance. Not long after my final dose of that drug (I continue to take several others), the problem started looming large again. I felt, once more, like my life had been destroyed. Given that my passion for breathing (and all the other essential components of human life) has always been lukewarm, suicide started to look like a logical and acceptable solution. How much grief, defeat, and loss can one person take?

As I’ve implied, my agreement with myself and Mandy is that I will stay around for our relationship. So although I had a well-worked out plan for my demise, I never set a time frame and just waited out the foul emotional weather. In just the past day or so, I have started to feel more like I can continue to live without merely gritting my teeth and wishing for natural death. Life has begun to look worthwhile again. Mandy and I have more frequent affectionate moments, I smile more often, and I feel like my energy has returned. Today we happen to be enveloped in smoke, due to a supposed ‘controlled burn’ that escaped its lines and is now raging in Yosemite. Every few hours the wind shifts to carry a thick cloud of particulate haze into our region. If we did not have so much air pollution, I’d be outside catching up on all the chores I neglected as I fought my way through this withdrawal. It feels good to recover the desire to be productive. I hypothesize that my brain is building more serotonin and norepinephrine receptors to compensatefor the reduced levels of those transmitters that followed stopping Cymbalta. (See this discussion about what is probably going on.)

My optimism would be greater if this had not already happened once. About two weeks after cessation there came a previous time of relief from the whirlwind, but it only lasted five or six days. So I will not be surprised if the curtain descends again. But right now I am feeling better, and I won’t spoil it by predicting another setback. This is how I ended my post back at the time of the last break from despair: “What I’ve written so far is the introduction to my real topic: the relationship between the chemicals that traverse my brain and the ‘person’ that the organ produces.”

For a number of reason I never got back on-subject. Today I am going to try to tackle, in a small way, the relation between chemical changes in our brains and the people we think we are.

In my opinion, it comes down to something like different vantage points. I wrote during the last storm break about how my little house in the hills would be invisible to a passenger in one of the airliners that regularly stretch contrails above me. I live my drama down here in the trees, yet those in the aluminum tubes soaring overhead have no clue about my problems and discouragement. They just don’t see my world of concerns. When I am medicated, it is like I am flying in the stratosphere. I observe my anxieties glide beneath me, but they look tiny and far away. Sometimes they get obscured by the pretty scenery, and I can almost forget they exist. But when I stop the drugs, I land flat on my belly on the August-baked earth, and gasp for full breaths in the smoky air. The pharmaceutical agents become the proverbial ‘rose-colored glasses’, that make a dim world look bright.

If they worked as well as I describe, I’d have to ask why one should fight the way I do to end my dependence on the medications. But if you look through pink-tinted lenses long enough, you no longer see the pink. Your mind adjusts and everything starts looking the way it did before. So then you are no longer jetting through the upper atmosphere close to the speed of sound, and instead end up bouncing along at ground level in a dilapidated truck. What’s more, even though the chemicals no longer help as much, the side effects continue. That is why I stopped Cymbalta. It helped my mood a bit but the benefit diminished until it no longer seemed worth the heavy cost in adverse reactions (primarily anorgasmia). So I stopped taking my daily green pills and have been fighting to regain my footing ever since.

If my entire opinion about whether to live or die hinges on a chemical called duloxetine marinating my brain, the question becomes, who am I? The suicidal man who feels life has dealt so many injuries it no longer warrants engagement? That is to say, am I ‘really’ this troubled person who emerges upon cessation of the drugs? Or am I instead the (slightly) bubbly soul that can discover benefits even in raw wounds and festering infections? Am I ‘in fact’ the wry middle-aged guy who emerges when the drugs (occasionally) work perfectly well?

Or am I both? Or neither?

At least I now recognize that my feelings change. It used to be hard for me to see that my attitudes shift. If the world felt awful, I believed in an unshakeable way that my feelings at that moment accurately summed up the nature of life as it had always been. On the flip side, if things looked cheery, I had a hard time remembering how it felt to be depressed. After years of gyrating feelings and world-views, I now recognize that tectonic shifts have repeatedly rocked my inner environment. My ability to predict eventual good feelings even when I am mired in deep depression has improved. I have recollection when I feel rotten that life once seemed fun, and vice versa.

As that sort of memory consolidates, I start to appreciate that my feelings are transient little things that have no direct relationship to outside reality. They are my internal filters, and not firmly connected to either the external scenery or my actual ‘self’. The same person (me) and the same life (mine) can look ashen through one set of spectacles, and sunny-yellow through another. I am the person behind the glasses, or even further back: behind the eyes. Possibly the real me looks through yet another screen: the brain. Some believe that our true selves have no material biology, but exist as ethereal spirits. I don’t go quite that far, but there is no question that somewhere separate from all the opinions, all the filters, all the moods and feelings, sits a person who is protected from the storms, and watches with a wise and tolerant eye as all the hurricanes and earthquakes and volcanoes thunder over the landscape. I’ve mentioned Acceptance and Commitment Therapy (ACT) before, and I am touching here on ACT’s core assumption.

I am not the earth’s tremors, or the volcano’s blast. I am not the wind or the sun or the rain. I am the ‘self’ that observes all the changes, all the weather, all the thoughts and feelings. But this is so easy to forget. It is as if, while watching a movie, I confused the events on the screen for things in real life. If I think that somehow my identity is that of a scared and lonely man, hemorrhaging and forlorn, I am overlooking the fact that at other times, with different chemicals in my blood, I feel like ‘someone’ entirely different.

It could be that I am nothing more than a memory stream. A dynamic album of photographs that keeps adding page after page after page. My identity cannot be pinned down to any particular image, not even the most recent ones. Instead, to get any sense at all of ‘me’ as a stable and defined entity, you have to look at the entire book as a unit.

By changing my drug regimen I am not creating a different person. I am just turning the page, putting in new pictures taken through different lenses. What I think and feel today is just an addition to my identity, not the summation of it.

Does this make any sense at all to others? I know these ideas are not mine alone, and no doubt writers more eloquent than I have stated something like the same point of view with greater clarity and logical support. But this is what I meant to bring up two weeks ago, during my previous respite from the Cymbalta-withdrawal nightmare that has been my ‘reality’ since August first. I am aware of some texts I need to read that touch on similar streams of thought. When I get more information, a wider perspective, and time to digest, I will return to this subject of self and how it relates to the turbulent currents of mood, opinion, biochemistry, and experience.

For now, I am glad of the break from the pain. It feels good to expand again, and fill my wings with blood the way a newly metamorphosed moth pumps itself up before taking flight into the moonlit sky. For now, at least, I can nourish myself again, and savor the nectar of daily life.

(Click here to link to a nice video showing a moth feeding on nectar.)

I am almost sorry about yesterday. What a discouraging post! I say ‘almost’ sorry, because my goal here is to be honest about what goes on in my world, inside and out. I don’t want to hide my moods; certainly not the positive ones, but not the depressed ones, either. If I don’t watch it, my text drifts into the arid desert of analysis and logic, and away from the messy emotional compost that nourishes my more heartfelt writing. Personally, I find too much issue-dissection boring. Life is as much about what the heart feels as what the brain thinks. States such as passion, affection, sorrow, euphoria, fury, and desperation often look disorganized and senseless. If I am to be authentic, and open about my inner experience, sometimes I will sound wretched. (Another reason I’m not too regretful is that I received such nice, supportive comments!)

My feeling life gets tossed about by frequent typhoons of sadness and despair. Although the cloudiness alternates with brighter moods, including pressured winds of optimism and plans that soar high above firm ground, I never venture far from the shade. Until recently I called my storminess ‘bipolar disorder’, and my bleakness ‘depression’. At this stage in my life I find it more helpful to consider myself a bit temperamental, mournful, and sensitive, but to pitch the illness concept overboard. Whatever you name what I’ve ‘got’, however, I am never long on an even keel, and I spend a lot of time in the stagnant duldrum of hopelessness.

So if I am going to write with feeling, which makes more interesting reading than pure logic, there will be times when things sound a bit unhealthy. Self centered. Whining. Self pitying and immature. I hope the less uplifting posts will alternate with essays that climb toward ecstatic observations on the spiritual underpinnings of biology, or pieces that animate the possibility of utter contentment in the face of chaos and loss.

I could make the decision to censor ‘ugly’ material out; I could make myself always sound spiritually fit and possessed of wisdom. But I have given this thought, and my goal in this blog is to tell a story of life. Not just my own history, though that forms the basis of most of my ideas, but the larger story of life as a damaged human being. An injured person may have days when everything ‘falls into place’. On such days every insult, each wound, and the countless pangs of grief, are recognized as openings rather than cuts. The awareness blossoms that such fenestration widens the eyes so they can see more beauty, and expands the heart so it can offer more love. But most of us with hellish memories also suffer times when the vision clouds over, and the heart cramps into a lonely knot of muscle, unable to accommodate more than the thinnest stream of blood.

Even Jesus, we are told, had moments of doubt in the garden of Gethsemane. My spiritual development is as close to that of Jesus (or the Buddha’s, or Gandhi’s, or Mohammed’s) as a flea’s heart is to an elephant’s. So for me, at least, perfect and perpetual equanimity remain out of reach. I suspect this to be true of all but the most determined and fortunate of those who are raised deprived, assaulted and hated instead of nurtured, protected and loved. When children suffer overwhelming losses, they grow up with infinite feelings of want. When they are attacked, they learn to expect the worst. And when despised, they learn to hate themselves. Such lessons take a lifetime to unlearn. On the best days, one gets blessed with a radiant comprehension of life and its full panoply of emotions. One understands that joy, love, anger, and grief are just different directions that the same wind blows. One feels the uneven but never-ending currents of time, space and fate flow like God’s blood through the mind, body, and soul.

But there will also be days when it all looks like a lump. At those times the injuries seem too great, the loneliness too imminent, the joy too sparse, for life to be worth living.

I have my saintly moments. But they are not as common as my darker days. I am not offering a cure in this blog. I am not presenting my path to recovery as a method others can follow and find salvation. That would be a lie. My path has not proven to be direct and unerring in leading me to peace. My commitment to well-being wavers, and sometimes I just break down and cry.

That is the story I want to tell. The entire canvas, including the splattered and shredded edges that often get hidden when one uses an elegant frame. This is my life nailed to a tree. It is not hanging in the Met, or bound in the rare books section of a major library. It is a mess. But it is sometimes beautiful, often interesting, and it is all I have to offer.

My aim is not to lead people to think I always view life as a precious jewel, which I certainly don’t. Or that I am living the perfect story of recovery, which will never be the case. I choose instead to present the days as they strike me, the ideas as they arise, and the emotions as they crash over my bow.

Yesterday I was a shipwreck. Today I feel more like the transom of an ancient wooden fishing boat I once found on the beach in San Francisco. The varnish had at one time been shiny, and the wood had formed part of a stout and working vessel. What I found had turned into a labyrinth of splinters and warps and cracks. The paint that once proudly announced the boat’s name could barely be deciphered. But that piece of wood had an elegance it had never known when it was still functioning as a beam across the stern of a trawling watercraft. Time and catastrophe had etched it with a fineness that it seemed to want to share with me. So I took it home and put it in my garden.

This is my transom. It is wrecked, and not all of it will be beautiful. But I want to share it with you. Feel free to place it in some corner of your garden. Let the moss grow over it, and let the ants move in. Or burn it and toast marshmallows. It is my gift to you and to the world, if you want it. It will not always be attractive, or even inspirational, but I will try to keep it authentic.

So I don’t apologize for whining, even though I’m embarrassed. Yesterday, I was a lonely and discouraged child. Today I am an inept but enthusiastic poet. I am sometimes enlightened. I am often discouraged. But most of all, I am alive. And good or bad, upbeat or down, this blog is helping me stay that way. I pray that it helps you, too.

Well, it’s out. I whined a few posts back about how catastrophically awful I felt this taping had gone. As often is the case with me, things do not look as bad as all that. I’m actually satisfied enough with the outcome that I am putting out a link to the show, in case you want to watch. It includes an interesting discussion about what it means to live successfully with bipolar conditions. Do we fight like hell to avoid all symptoms of mania and depression? Or can we learn to tolerate our wide ranging emotions (or could we even consider them ‘gifts’?). My little bit comes near the end. Up until that point, I just sit motionless. Like a houseplant. But once I get talking you can actually see that I am a living human being. I am so habitually constrained in my emotional expression, that as the taping was in progress, the little animation I display made me feel like I was losing it emotionally. Too passionate. Too voluble. Too much. Now I see that I look pretty normal, or possibly a bit flat in my affect. It’s a good lesson for me: maybe I could let out a lot more feeling without coming across as out-of-control, or melodramatic.

Wow! There are so many mental health blogs to read. It’s enough to make an insecure manic-depressive jump off a cliff. How can I possibly stand out in such a throng?

Oh well. I’m used to being put in my place. If this past decade had a purpose, it was to teach me humility.  Where once I could tell people I was an oculoplastic surgeon, all I can say now is that I have started a blog. Well, who hasn’t? I’m trying to show up in mental health circles on the internet. I read the successful blogs about the subject. (I’d read less successful ones, but how do I find them?) Since I always think I have something to add, I post lots of comments. I keep plotting a direction for my own work.

As I write my comments, It seems inevitable that one of my insightful observations will attract attention, bringing readers back to my own site, but no luck so far. Maybe the comments aren’t all that insightful after all. Inevitability inevitably fails.

It’s not easy being a psychiatrically ill former physician (is it easy to be any kind of human?); I feel like people should take me seriously, just because I was once successful and my history is fairly unique (you’d probably agree if you knew even half of it). But in this society the question often is simply, “what have you done lately?” Watching my past glory fade into my current obscurity hurt for a long time, but not anymore. I now feel happy to be free of the pressure to compete. It is a pleasure to be an ordinary human, and not worry about trying to be better than others.

On the other hand, I would like my message(s) to get out. If I could get someone to listen, I think I have important stuff to say about mental illness and psychiatric care. Maybe my experiences would help others. Maybe they could avoid my mistakes, and reach happiness sooner. Nothing would please me more than having someone struggling with mental illness derive benefit from my history.

Believe it or not, I used to think it would be kind of cool to have a bipolar I diagnosis. So much more interesting than ‘mere’ depression. It pleased me when I started to come out of my manic psychosis/religious ecstasy and I realized that I was now officially manic-depressive. I had always read about bipolar artists and writers, and I was happy to join the club. Pretty naive, don’t you think? I now realize that many people are frightened and turned off by mental illness. I understand that it looks like weakness to others (even though I know it takes strength to survive the storms of emotion that come with bipolar disorder). I see now that it might have been better to hide my psychiatric problems. But I already  told everyone who would even half listen about my religious ‘delusions’, my hospitalizations, medications, and so on.

Since everyone around me knows the story, whether they wanted to or not, I figured I had nothing to lose by starting a blog. So what if the whole world knew my story?

It is now obvious that the whole world could not care less. There are so many bigger problems, more famous people, and better writers. Not to mention more than a hundred million blogs! (Or is it two hundred million?) What’s a poor former surgeon to do?

Keep writing. Keep hoping. Keep living.

I am prepared to fulfill my mission–to bring light to others with mental illness. But will anyone ever hear me? What can I do to make it happen?

Keep writing. Keep hoping. Keep living. My new motto.

Years later, we now know that the SSRIs do not exceed the older drugs in effectiveness. Compared with ‘tricyclics’ (the older antidepressants), drugs like Prozac have different side effects, but not fewer. Perhaps the only real advantage of SSRIs in treating depression is that they don’t kill you if you take too many. Tricyclics are notoriously lethal in overdose.

So the dust has settled, and SSRIs no longer look like wonder drugs. Worse (from the standpoint of the drug companies) most of the patents of the original SSRIs have expired (long acting preparations and other alterations may still be available only in branded forms). So the pharmaceutical industry needed to move on to something new.

Enter the ‘atypical antipsychotics.’ They are ‘atypical’ because they work differently from the old antipsychotics. The old drugs were essentially dopamine blockers. The class had been discovered because of an herbal folk remedy for insanity, from which a very effective anti psychosis drug was isolated. It turned out that it worked by blocking the effects of dopamine in the body. This led to the ‘dopamine hypothesis,’ which postulated that schizophrenia results from excess dopamine. That idea was eventually proven too simplistic, though there is little doubt that dopamine is one of the neurotransmitters that goes awry in psychotic illnesses.

Atypicals, however, are less specific for dopamine than the older drugs, having widespread effects on serotonin and other neurotransmitters. (They also may be more discriminating in which of the body’s several types of dopamine receptors they target.) The prototype was clozapine (Clozaril), which had tremendous antipsychotic activity, but life-threatening side effects. Working from the structure of clozapine, researchers created the other atypical agents. These include: olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify), and risperidone (Risperdal).

Unfortunately, I have taken all of them (except clozapine) at one time or another. I have had only one episode of so-called psychosis, which was relatively short-lived, but the psychiatrist who followed me during that period continued the atypical antipsychotics long after my spiritual euphoria had resolved (religious ‘delusions’ and ‘hallucinations’ were my only psychotic symptoms). She continued the atypicals because the drug companies started promoting these agents for mood disorders. The pharmaceutical manufacturers first succeeded in expanding the scope of the agents for non-psychotic mania. Eventually, they began touting them as helpful augments in intractable depression. These potent ant highly toxic agents are being used more and more for such reasons (Abilify, in particular, gets promoted for this purpose).

When I took them, they mainly felt like strong sedatives. Sure, they helped with agitation. They made me feel like I’d been hit with a hammer.

Problem was, they had terrible side effects. Well-known problems include incredible weight gain, increased cholesterol, and diabetes. I got the first two, and was well on my way to the third by the time I finally quit the drugs. There are other side effects, it turns out, when these drugs are used in combination with different classes of psychiatric medications. I won’t go into detail right now, because I am still getting up the nerve to talk about how these drugs have harmed me: it is a very sensitive subject for me.

My point right now, however, is that these are hazardous drugs. Their side effects are far more dangerous than, say, those of the SSRIs. Given the escalating epidemic of obesity and ‘metabolic syndrome’ in this country, we really should question whether these drugs are good choices when so many people already have trouble controlling their weight. Especially since the evidence for the effectiveness of atypicals for mood disorders is not all that convincing.

Addendum:
Here is a link to a good site to check out if you want to know more about the controversies surrounding atypical antipsychotics. I also just came across an article about the problems with big Pharma and atypicals (with reference to a recent major legal settlement involving Zyprexa) on HuffPost by Dr. LLoyd I. Sederer. My thanks to Liz Spikol for her The Trouble With Spikol blog post summarizing the article.