WillSpirit!


∞ Where Mental Skills Heal Mental Ills ∞

A former physician writes about mental health and recovery using insights from life, science, and spiritual practice.








  • Red_Exclamation_DotDisclaimer
    • Dear Visitors:
      Although I trained and practiced as a physician, my background does not include formal instruction in psychiatry beyond basic medical education. This journal presents ideas about treatment philosophy, but must not be considered therapeutic advice. Abrupt changes in one's psychiatric medications can trigger profound cognitive, emotional, and physical symptoms, including suicidal thoughts and actions. Consequently, pharmaceutical agents should not be increased or decreased without supervision by a mental health clinician.

    • ON THE OTHER HAND, your brain belongs to you, and your opinion counts. If you decide that changing your medication regimen will serve your best interest, then I believe your providers have an obligation to help you try to achieve your goals. I want everyone to be educated about their options, and do what will be most helpful for themselves. No one should feel pushed around by dogmatic and/or limited viewpoints, whether those of psychiatrists, anti-psychiatry advocates, or myself.


My Life as a Doctor on Disability

birdintree

Since I started this blog at the end of May (and ramped it up in July), most of my posts took on a rhetorical style. In college (UC Berkeley) I took a year of Rhetoric rather than Freshman English, for reasons I no longer remember. Ever since then, it has been hard for me to write without composing an argument. My guess is that readership will not be attracted to an endless column of that stuff, as much as I enjoy logical analysis of issues.

While I cannot change into someone new, as much as I sometimes wish it, it is important for me to also be ‘real’ in this project. So what follows gives a brief sketch of my current lifestyle, at least as I lead it when in the Bay Area.

After waking up early, I sit at my computer for an hour or more looking at any comments that might have come in, writing responses, and visiting blogs. Then my wife and I walk our two little dogs: Emily, a chihuahua-dachshund mix, and Ralphy, who is some version of a poodle. Both weigh 10-11 pounds, and are the cutest dogs in the world (but it’s possible I’m a little biased). Some days I also go to an AA meeting a few miles from home; it’s a daily meeting, and it is one of the few places I’ve made friends as an adult.

After the dog walk, Mandy and I usually go to the gym. This takes us to noon, or a little later. The afternoon I often spend running errands, though I prefer to have time to write. That is one of the reasons I prefer living in the foothills (where we spend 1/4 to 1/2 of our time); it presents fewer distractions to my writing.

Mandy usually cooks dinner, and I either do the clean up alone, or with Mandy’s help. I actually prefer to do it by myself because, truth be told, Mandy does 90% of the housework; I have never been one to assist much. I feel guilty about it, but evidently not enough to pitch in on a regular basis. That’s another reason I like being up at our mountain place: there is a great deal of work to do outside, around the land. That way I can contribute to the function of the household, since I am poorly motivated toward cleaning and doing the indoor work.

In the evening we typically watch a rented movie. Then I do one of two things. If I am feeling OK, I spend more time at the computer. Unfortunately, very often I get depressed as the day ends, and I retreat to a dark room, curl up in a ball, and try not to think. I focus on my body and its sensations in order to escape the torment of my thoughts. Not a pretty picture, and obviously not one I am proud of, but there it is.

When I am writing, my guilt about not helping around the house gets alleviated slightly. Since my surgical career ended in 2000, I have spent six months in graduate school, three months teaching high school, and eighteen months doing public speaking for the California Department of Public Health (about childhood lead poisoning). I’ve also done some volunteer computer programming and other unpaid work (including a little recent work as a mental health patient advocate). But you can see how I do not have any earning capacity. For now we are coasting along OK, but someday an income will be needed. Since I have crashed at every endeavor since my surgical career ended (due to neck problems), the only thing I have left is writing. Although it may never pay actual money, at least it feels like work rather than mere laziness.

Writing as a living is obviously a very, very uncertain thing. Especially for someone with so little background in the field. I have what I think is an interesting story to tell, but whether I can tell it in a compelling way is an open question.

Believe it or not, those eight (rather short) paragraphs sum up the better part of my current life. It is simple, uncluttered, and sometimes boring. The difference between what I do now and what things were like back when I had a clinical practice is impossible to overstate. Back then I worked fifty hours a week (half of those in the operating room), fixed up our vintage house in San Francisco on the weekends, and spent the rest of my free time either sculpting or reading about sculpture. I was busy as hell. I felt productive and proud of myself. I was probably a little arrogant.

In those days I had minimal spiritual sensibility. I tended to see things from a materialist perspective and gave almost no attention to the murmurings of my heart. Stress consumed me.

Which is better? For all the loss, grief, depression, and defeat, I am now a more enlightened, understanding, and humble person. Admittedly, I sometimes take the humility thing too far until it borders on humiliation. But most of the time I see myself as a better person than before. (I admit my wife might have a different take on things.)

So that’s my story. I don’t know if anyone will care, or even read this far into my post. But I want this site to include some of my real day-to-day experience, rather than just arguments. Besides, I see now that my opinions about mental health topics sound naive compared to what I read on other blogs, where similar topics have been kicked around for a long time.

Lately, I’ve been battling a low-grade conviction that life is s**t. My grip on living has been slipping, and I find myself dreaming of the long fall off the Golden Gate Bridge, just like the old days. (When I was in the hospital, the therapists grilled me about why I was fixated on the bridge, when as a doctor I could–they thought–easily get my hands on some pills to die painlessly. My answer came down to what I mentioned in another post: my mother loved the bridge before she died. It seemed to represent something to her, even as she faded into the mists of depression back in Michigan.) That’s why I gave in and boosted the Cymbalta again.

Since the dose increase, my mood is perking up. Of course, I pay the price of diminished sexual responsiveness and the discouragement of losing ground in my project of breaking free of pharmaceuticals. But at least the nagging feeling that life just isn’t worth the trouble has lifted–sort of.

I’d like to end on a better note, but that would not be true to my current condition. When I started this blog my hope had been to show everyone a path to freedom out of depression: I actually believed my progress exemplary enough that I could begin to teach others. Rather predictably, however, I’ve slipped back into the pit, though fortunately not too terribly far. I have every expectation that things will look bright again before too long. I even have hope of feeling connected, once more, with the cosmic resonance that I feel at my calmest times, especially when surrounded by arrow-straight pine trees and dozens of birds, whose clicking, chirping and trills remind me of God’s voice.

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Do Medications Limit Spiritual Growth?

Mandy has an eye for God in Nature.

This is another addition to the ongoing conversation between me and Marian at Different Thoughts.

Believe me when I say that it pleases me to the core to know that you have attained a place of peace and connection with the central currents of creation. I am very happy that you have found your suffering to be a path to such a healthy and profound axis. I do know of St. John of the Cross and believe wholeheartedly in the concept of suffering leading to wisdom. At my best, I have found myself in such a state of grace.

Unfortunately, I am not there right now. It has been an impossible condition to maintain, as you said. Right now, the suffering just feels tiresome. I experience the world as a place that doesn’t fit my psyche, like I should have been born on a different planet. I’ve been trying meditation, retreats, groups, reading spiritual books, attending mystical services, hanging around people with values I respect, finding those who believe in deeper realities. Yet that state of grace is outside my reach, for now. I don’t mind that, because I don’t expect life to always be bliss. But I do get very exhausted having no energy and no enjoyment. That is the feeling the pills reduce.

I don’t like the medications. I think they are my enemy. But one way or the other, my brain is now adapted to them, and the pain (withdrawal symptoms?) I feel when I cut back too quickly gets to be too much if it goes on for more than a month or so. That’s when I raise the dose again, in order to catch my breath before the next attempt at reduction.

But for my part the drugs do not feel deadening. The antipsychotics did, but not the antidepressants or the mood stabilizers. They just don’t have an effect on my sense of reality that I can detect, except that they take away the experience of my days as exercises in pointless pain. I am not talking here about existential suffering, awareness of the aching heart of human tragedy, or connection with the streams of sorrow that run like lifeblood through the history of humanity. I am talking about dull, meaningless pain that I get sick of and can reduce with a chemical. Am I happy about needing to do that? NO. Do I feel weak for resorting to the pills? Sometimes. But I do what seems like the right thing for me, for now.

At the same time, I don’t believe the medications block me from spiritual awakening, or connection with divine consciousness. Our brains are biological. I suspect there is a non-material spirit too, but the organic matrices of our brain play at least a large role in our experience. If you add a foreign chemical you alter the biology, but you do not change the brain into something entirely new. I don’t think every chemical has the effect of blocking spiritual growth, though some might. I have not found the drugs to be a barrier to spiritual connection. In fact, my peak spiritual experience in life, which far transcended anything else that’s ever happened to me, and was very similar to what the saints describe, actually occurred while I was on Effexor and Depakote. I don’t think those drugs did anything to cause my epiphany, of course, but they did not prevent it either.

It is also important to remember that some spiritual traditions actually employ chemicals to foster spiritual enlightenment. Even the Roman Catholic church incorporates wine in its services. I know, at present the little sip of wine at communion is purely symbolic. I strongly suspect, however, that the early church founders did some actual drinking as part of their rites.

My point is still the same: each person is unique, and every path is different. I am relying on chemicals right now because I am trying to make my transition off the drugs without killing myself or making my wife miserable. And yet, I have had many days (not very recently, but not all that long ago, either) when my spiritual state was such that everything made sense and suffering became irrelevant: I was on a higher plane. I know that condition exists, but I can’t be there all the time, and as long as I’m living an ordinary existence I want to try to enjoy it.

I am glad that you have found your way to union with the grand consciousness. I fully respect that for you that has meant clearing your brain of pharmaceuticals.

Not everyone can reach union, whether they take medications or stop them. And for those that do, not everyone will do so the same way. There are many paths to God. For some, drugs may slam the door. For others, they may open it. For me, they do neither. My path to the heart of creation is open sometimes, and closed others, without regard to how much medication I’m on. It may have to do with lunar cycles, or simply with some variable rhythms in my body. Or perhaps I just try harder sometimes than others. But I am absolutely convinced that it is possible to get there now, or at least sometime not too long from now, and I don’t need to wait until every last psychiatric medication is out of my system.

Please understand that my ultimate goal is to be drug-free. So I embrace your philosophy on its basic level. However, I am not sure if I will ever achieve total freedom from psychoactive agents. It would be very discouraging if I thought that I would never experience God as a result. Fortunately, I know that to be false. I have before and will again experience the divine touch; I will feel in my innermost self the purpose, beauty, and power of suffering. In the meantime, I choose to live my life with a little less of the dreary kind of pain that is about as enlightening as pounding my thumb with a hammer.

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