Readers of this blog have demonstrated their preference for intimate sharing over intellectual musing. Abstract, reasoned posts garner few comments and occasionally prompt people to unsubscribe from WillSpirit. Reader involvement has waned of late, and I suspect that’s because many of my recent essays have been more philosophical than emotional.

But I need to write about metaphysics, the nature of knowing (technically, epistemology), and consiousness. Although its primary motive is helping others, my blogging nurses the wounds inflicted by past traumas and setbacks. Grounded spirituality supports my health, and philosophical essays situate my mystical aspirations on solid footings.

Several years ago I switched from a private practice psychiatrist to Kaiser’s mental health clinic. My new doctor offered two observations early in our relationship. First, she remarked that I was taking a lot of ‘garbage,’ by which she meant my half-dozen psychiatric medications. Second, she opined that my only hope for lasting peace of mind was to find a spiritual solution to the problems caused by my traumatic upbringing and devastating career loss.

Her contempt for my medication regimen shocked and alarmed me. I had trusted my prior psychiatrist and obediently taken all the pills she prescribed. It had never occurred to me that a different doctor would view the cocktail of potent drugs as excessive and dangerous. My new psychiatrist’s perspective forced me to realize that the dreadful side effects I’d incurred might have been avoided had I started out with more competent care.

Even more perplexing was the advice about spirituality. I’d attended Alcoholics Anonymous meetings for twenty years and had been trying to find a ‘Higher Power’ the entire time. After my transcendent experiences in 2000 (which doctors diagnosed as manic psychosis), I’d managed to sustain religious fervor for a few years. But the mystical resonance had worn off (indeed, the earlier psychiatrist had discouraged my exploration of mystical states). How was I going to find spirituality with a materialist worldview predetermined by my atheist upbringing?

Around the same time, I became friends with someone who had been active in AA for a long time but struggled with the Twelve Steps’ emphasis on God. Despite some moderating language in its Big Book, AA usually makes God sound like an all-powerful parent (i.e., Yahweh). Both for my friend’s sake and my own, I began writing blog posts to ferret out a transcendent path free of mythic and irrational beliefs.

I dovetailed this work with attendance at local Buddhist sanghas and retreats for over a year, and then a like amount of time training at a nearby Hindu center. Prior to this, my meditation practice had been developed in either Quaker or secular contexts (i.e., mindfulness classes at my local medical center). The former provided little instruction, and the latter ignored mystical implications. In contrast, Buddhist programs offered specific guidance toward deep currents of consciousness, and the Hindu tradition connected meditative states to cosmic love. As I progressed along these paths, WillSpirit essays helped me reconcile my spiritual insights with my understanding of biology and physics. The search was on.

My Buddhist and Hindu explorations overlapped with my study of Chinese Medicine as I prepared to practice acupuncture. Readers already know the outcome of that professional venture, but the schooling exposed me to Taoism, Confucianism, and other Chinese philosophies. These studies complemented my growing understanding of Buddhist and Hindu metaphysics. For the first time, I began to feel comfortable with Eastern mysticism. Blogging organized my thinking as I incorporated an entirely new set of philosophies into my worldview.

As many experts have asserted, it is easy to find parallels between Eastern philosophy and the counterintuitive reality revealed by modern physics (especially quantum mechanics). Similarly, although divergent in emphasis, both holistic healing and conventional medicine restore vitality to weakened organisms. WillSpirit became the platform on which I integrated newfound holism with the reductionism I’d absorbed as an undergraduate, graduate, and medical student.

You can see how blogging about philosophy has helped me mature. Since gaining insight remains central to my mental health, metaphysical writing will remain a key feature of WillSpirit.

Even so, I respect the needs of my readers. When I visit other blogs, I’m most touched when the writers reveal inner conflicts or neuroses that resonate with my own difficulties. I want WillSpirit to serve as a locus for kindred souls to gather and heal as one. Besides, just as philosophizing helps me grow, sharing my life experience helps me heal.

With that in mind, let me end by revealing how devastated I’ve felt during the past two days. After weeks of slow improvement, the neck pain that had so worsened around the time of my hospitalization returned full-force. I may have overstretched doing yoga, or maybe the intense pain and spasm happened for no reason. But until I broke down and started taking muscle relaxants and narcotics, I could barely move because of intense, stabbing pain in my neck, shoulder, and upper back.

This was bad enough, but the awful discomfort also had its predictable effect on my mood. I spiraled quickly into an angry depression, complete with specific plans for suicide. My thinking bordered on the delusional, as evidenced by my suggesting that my wife prepare for my death. On what planet would that be the right thing to say? I didn’t announce a definite decision, but I told her that my reserves were running dry and it felt like I’d lived long enough. I wanted the suffering to end, once and for all. Naturally, this greatly alarmed her and left us both shell-shocked for the next 24 hours.

As an alternative to suicide, I gave in and took pills. Narcotic pain relievers alarm me because of my past addiction problems, but they seemed preferable to sliding further toward suicide.

Where was my vaunted spiritual perspective during all this uproar? I must admit it failed me. I felt only sucking despair and lost my ability to mentally detach from pain. The agony worsened as I looked at my professional failures and troubled friendships through the lens of discouragement and self-contempt. I felt unable or perhaps unwilling to step back and adopt ‘The Watcher’ stance that usually saves me.

Today I’m feeling better. After a day of lessened pain and tension, I can now discern a spiritual light shining dimly in my heart. I can see the bigger picture, though the narrow view still tugs at me.

Maybe the philosophical posts are my way of sidestepping true emotion. If they serve avoidance, it’s no surprise they don’t engage readers. But I still think such writings help me. They don’t vaccinate me against despair, but they elaborate a spiritual philosophy that is independent of specific beliefs and resistant to doubt. Such a foundation makes it easier for me to accept my hardships with an open heart. Obviously, it sometimes takes time and even medication to unlock the gate, but I know where to find relief.

Hopefully, my readership will understand and forgive my putting personal needs first. Although the philosophical posts are often boring, they serve my psyche. I also realize that successful blogs usually stick to a single subject area; I appreciate my readers for indulging the obvious variability of theme (e.g., mental health, metaphysics, neuroscience). Long ago I promised to write the Whole Story. For me, that includes dispassionate contemplation as well as heartfelt intimacy. But the ultimate goal is to help us all discover paths to Peace of Mind.

In my own clumsy way, I seek to reconcile rationality with intuition, mind with heart, Will with Spirit. As boring as it often sounds, this is my best formula for Grace.

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.)

The post I planned to write today will come later.

For the past several months a counselor practicing Acceptance and Commitment Therapy (ACT) has been teaching me to expand my philosophy, and quit struggling against my hardships. My insurance granted pre-payment for twenty sessions, and I have completed 12 or 13 so far. My relationship with this clinician started at a propitious time, and dovetailed with my involvement in Bipolar Advantage, which teaches one to take a more positive attitude toward mood fluctuations. These two influences spoke to my gathering awareness that being frustrated and unhappy with ‘the way things are’ serves me poorly. They also bolstered my resolution to wean myself off as much medication as possible, a step made more essential when I awoke to the horrific damage psychiatric drugs have wreaked on my body.

This therapist’s work underlies much of what I write about accepting life’s deprivations, acquiescing to grief, and appreciating the sublime qualities of emotional distress. Knowing that outside of the sessions this person has kept up with my blog posts, and sends me insightful comments on how they relate to my individual story, adds to my feelings of gratitude. I wrote a letter (actually an email) of thanks this morning, and ended up sketching part of my core emotional landscape. Posting a slightly revised version of my message on this site offers my audience a view of my inner milieu, while at the same time publicly expresses my appreciation. Knowing that others share your experience can be very healing. I hope that one or more of my readers will resonate with my longstanding ambivalence about life, and also my growing desire for more engagement. ACT teaches, among other things, that while we all undergo times of distress and cataclysms of sorrow, we can remain open to common joy. Even more, during those shaded times when our days feel bleak and fortune has violated all its promises, it remains possible to enjoy being alive. Perhaps it is akin to loving one’s child even as he spits hostile words at you. He may not be pleasant, but he is still an infinite gift.

A large segment of the population staggers under a burden of emotional agony. If that were not so, investors in pharmaceutical stock would not be so well rewarded. No doubt people have always been afflicted by almost unbearable feelings, but in this era of education, abundance, sanitation, and comfort, I believe we can do better. Not that the pain will go away, but perhaps our appreciation of day-to-day reality can increase. Imagine a world where even in the midst of wage-slavery and fears of violence people relished being alive. Where they accepted their pain to the point that they had energy to fight against injustice. Where financial and material trappings became less important than human relationships and creative expression. The way to achieve this vision lies in opening up, ‘sharing experience, strength, and hope’ (as they say in Alcoholics Anonymous), and collectively learning how to thrive in the midst of a challenging world. I try to do my little part by deconstructing my rusted and creaking mental mechanisms to a behavioral health audience and handing on the tools and lubricants others have provided to help me get things running more smoothly.

This therapist gives me much in this regard. I publish this letter as a public statement of gratitude, with the prayer that programs and messages such as ACT will propagate outward into our culture, like the rings stretching away from a pebble pitched into a pond. Where the surface of my depression once looked as solid and impenetrable as a pane of glass, ACT shows that all pain has depth and rhythms, and that I can learn, grow, and even enjoy myself while exploring these textured realms. Of course, the ideal often lies beyond my grasp. My ability to take such a philosophical stance, and savor the warm sensation of blood pumping from my wounds, depends on practice and motivation. But I have been fortunate to meet someone who has had the patience to sit with me as I bleed, until I understand that unlike the blood that flows through my body, the blood of the soul is infinite. No matter how much I hemorrhage, I will always have the vital spirit to go on, if I choose. So much better than my previous experience in the mental health world, where the philosophy has always been to apply pressure and tourniquets. Sure, drugs can slow the rivers of emotion, but once you tighten the tourniquet the limb goes dead.

I place the letter here because it is more personal and less intellectual than much of what I write. I want to allow people to get to know what I’m really going through, rather than always hiding behind a facade of philosophy, analysis, and weak attempts at lyricism. Fact is, I am making progress, but slowly. I see the path ahead, but have yet to walk most of it. This message shows one footprint along the trail.

Dear [M],

I’m glad that my last blog post provided, at last, some good news in regard to my mental state.

Contemplating death as a solution has always seemed reasonable to me, given how my mother checked herself out of life as I watched. In the suicide hotline we always ask about prior suicidal behavior; I’ve only made a few weak attempts, none of which had a high likelihood of lethality. But suicidality has become a part of who I am. Even twenty years ago I was pretty sure I would some day kill myself. Obviously I have not, and may never, but I no longer feel alarm about thoughts of destroying myself. I think that attitude helps me support people who call the hotline in crisis.

On the other hand, I respect that such talk upsets others. I wish when in my worst moods I could censor my statements better. In particular, it is hard on Mandy to know how often thoughts of death go through my mind (not that I talk about it all the time, but it only takes occasional mention to make the problem apparent). Accepting that life brings pain, and that pain can be endured or even seen as a kind of beauty does not automatically translate into a desire to keep experiencing it. I am OK with that disconnect, but I am not so pleased that my ambivalence about life pollutes the happiness of those around me.

Back to today. Bottom line is I feel better, and happy to keep going. I truly do have a commitment to stay around for Mandy, and I would never leave my dogs unprotected. I even look forward to the future, no matter what it brings.

Thank you for paying attention, and supporting me as I work out a philosophy and mind-set that will carry me through the last several decades of my life. I need to have some kind of framework to both endure and see positive aspects to further declines in health, increased physical pain, and the probable loneliness that await me. Having a deteriorating neck that hurts all the time, and threatens the integrity of my spinal cord, plus knowing how few close relationships I have other than my marriage, does not give me a rosy picture for the future. I appreciate that ACT is not about convincing myself that my fears are unfounded (they aren’t), but rather gives me at least a glimmer of hope that I can survive the struggle. There is even that astounding suggestion that no matter what happens, my future can be enriching and full of adventure.

I look back at what I’ve written here and almost laugh at myself: this is how I think when my mood is more or less good (although I’m realizing my spirits are not as upbeat as yesterday). I don’t know how you feel about getting saddled with me for twenty sessions, but it has helped me that you have been so understanding. And I am thrilled that there is at least one person reading my blog who really ‘gets’ what I’m writing about. Of course, it’s not surprising that you do get it, since you taught me much of what I’m saying. What’s nice is that you’ve taken the time to read how I’ve been thinking about the acceptance philosophy. (You’ll note that I don’t do much with commitment, at this point. I need to more fully commit to staying alive before I can talk with any authenticity about fidelity to values, etc.)

To try to end on a positive note, I am highly motivated to search for reasons to stay alive, and to be glad I am. I want to build something more than a stoic fortitude to not abandon Mandy. Writing helps me feel good about breathing and thinking. Knowing that you (and hopefully a few others) find what I produce interesting makes it even better. In the end, creating something attractive and worthwhile out of tragedy and sorrow has been the task of artists throughout the ages. After decades thinking of myself as primarily a scientist, I now see that creative expression will be my salvation. That requires the knack of appreciating the heavenliness of heartache, which you and ACT have taught me.

Thank you.

I have no choice but to make this short (or what counts as brief for me): I only have one hand. Slicing broccoli normally doesn’t cause me problems, but as my mental condition deteriorates off Cymbalta, even routine tasks are becoming hard. The knife careened off the stalk I was skinning.

I like to put broccoli flowers in salads, and after I chop up the tops I always split the peeled stalks with Ralphy, one of our two dogs. Tonight the blade slipped as I was cutting off the rind, and I somehow managed to slide the tip of my left ring finger between the knife’s edge and the cutting board. The blade nearly sliced off the part of the figertip distal to (sorry for the medical term–’distal to’ just means ‘further out than’) the nail. My pain tolerance is high, but this surprised me with how much it hurt. The end of the finger obviously contains a dense network of nerve endings. Luckily, there was enough of an attachment remaining that after a long period of washing, and then even more time placing pressure to staunch the bleeding, Mandy was able to secure the little flap in place with an adhesive strip. As an operating room nurse, she would have preferred to drive to the emergency department to see if they could stitch the tiny piece down. As a former (ophthalmic) plastic surgeon, I felt that a successful job would have taken very fine suture and a high degree of skill. I did not think I would get that level of care for this minor problem, and a trip to the ED would only waste 3-4 hours driving, and who knows how long waiting to be seen. In the end, I would have come out with an adhesive strip–much like the one Mandy already attached.

Time was I never would have been so careless with a sharp blade. I prided myself on being able to handle knives, scalpels, etc., skilfully and safely. Now, ten years later, I am very much out of practice. My acquired ineptness with cutting instruments, combined with antidepressant withdrawal (which floods me with the distracting conviction that life is pointless, and also saps my energy levels) caused me to stupidly cut myself. So here I am typing with two fingers and a thumb on one hand, while I keep the other elevated to reduce swelling.

Before this injury, I had toyed with making my next post about the dreadful and permanent side effects I’ve suffered from taking psychiatric drugs. That would have been a big step, because I feel a great deal of shame. Yet doing so will ultimately help me heal and, more importantly, might serve as a warning to others. Maybe cutting off a part of myself was an unconscious way of putting off this decision. So, another time.

I would have a better outlook, increased energy, and sharper judgment if I went back on Cymbalta. But, mainly because of how similar drugs have wrecked my body, I just can’t bring myself to swallow that nasty little green pill. So I keep on in this deteriorating mode, hoping that things don’t get too much worse before they start getting better. I suspect my body needs to regrow a huge number serotonin and/or norepinephrine receptors, as per a post I wrote not long ago. Given how far I’ve sunk since I penned that essay, it seems like it could have been in another lifetime.

Mandy thinks I need to take a break from writing, and a number of other activities important to me, in order to give my fingertip the best chance of healing properly. Since my mood continues to take me to more and more maudlin and self-pitying places, that might be a good idea even without the finger issue. So for a little while I may spend less time blogging. If nothing else, I can concentrate on learning how to customize my blog functionality and layout. I have a stack of books on html, css, php, java, mySQL, etc, that I’ve been unable to devote time to because of the hours spent drafting posts and exploring blogs. I figure if writing never leads to an income, by acquiring programming abilities as I work on my site I will be in a position to look for work in computers instead. But to achieve that objective, the books need to be read.

Nothing as ambitious as success (either as a writer or programmer) will be attained if I don’t recover my emotional equilibrium. I can’t express how much regret consumes me when I think about how a therapist finally talked me into taking medications, and how I went ahead despite a lifetime of opposition to psychiatric drugs. My hesitation was born of watching my mother destroy herself with drugs given to her by psychiatrists, and now I have done exactly the same thing. Except that unlike her, I remain alive… Barely.

At age sixteen, I planned to hike the John Muir Trail with my friend Jack (not his real name, though why would it matter if the world learned about our teenaged foolishness 34 years after the fact?). I did eventually complete the trek, but a few glitches arose. The problems started after we rode a Greyhound bus north from Los Angeles. We boarded with a number of outdoorsy types just like us, carrying bulging backbacks and bota bags, who chatted the whole trip. There were mothers holding their small children on their laps, trying to calm them as they stood on mom’s jeans, riding to homes or relatives in small towns along the eastern Sierra slopes. One or two men in faded business suits sat near the back, a lonely type I always used to see on intercity rides. Are they salesmen? Fathers working away from their families? A contingent of older folks had also boarded; they shoved shabby suitcases overhead, and leaned against the windows to nap until Reno, saving their energy for the casinos. Like them, Jack and I slept most of the way, under the influence of pills I had borrowed from the medicine cabinet of an elderly woman whose garden I tended.

We awoke to disembark at Lee Vining, a minute hamlet close to Yosemite National Park and (coincidentally) not far from where I now sit. I swiped a bottle of rum from the local general store, being an ignorant but fearless young delinquent. Jack and I sat on the shoulder of the road with our spanking-clean packs, and shared the bottle down to its last swig. As we became more and more drunk (a process aided by the the Valium we’d taken on the bus) we kept our thumbs out over the road, until a young man in a yellow Porshe at last pulled over. The car looked new, and smelled like a shoe store with all its fresh leather. Jack, being smaller than me, squeezed into the cramped back seat, and I ‘rode shotgun’ in the shiny black passenger seat as we wound our way toward the high mountains. I don’t remember much of that drive to the trailhead. It must have taken over an hour, and we arrived after dark. Our benefactor abruptly dumped us with our backpacks on the side of the road. He had figured out right away that we were tanked (how hard could it have been?), and made it clear he regretted stopping for us. Although he may have picked us up to show off his new car, by the end he probably feared one of us would throw up on the carpet.

Wilderness at last! In the dark and moon-less summer night we looked around and marvelled at the narrow pines silhouetted against the stars, and the flat expanse that lay between us and the forest. Taking in the majesty of the mountains quickly got replaced by our exhaustion, bordering on coma. On the cliff’s edge of collapse, we decided that rather than thrash our way into the dark groves to set up camp, we’d do the easier thing and unroll our sleeping bags where we stood. Within minutes we were passed out in our bags. Funny thing, this cop car drove by and blasted us with a searchlight. I vaguely remember their P.A. system barking something about moving our camp site. It did not sound like a bad idea, but it would have been a lot of work. So we fell back asleep instead. As you might guess, that turned out to be a big mistake. When the police returned, they had little patience with our drunkenness. It also turned out we were camping in a parking lot, which was probably what tipped off the cops that we were not too sober. Within about thirty seconds they found the fifty joints of marijuana Jack had carefully concealed in his pack. Uh oh.

For the next ninety minutes we slammed from side to side in the back of a cold steel-walled van, trying to stay perched on the single steel bench. Hands cuffed behind us, we had little chance of holding on as the vehicle roared down the twisting road toward Yosemite Valley. Once we arrived the two officers, already divided into the good-cop/bad-cop routine that I learned about later, shined intense flashlights in our eyes and told us to get out. Dizzy from the drive and the booze, and blinded by the glaring white beams, we tumbled out of the wagon and more or less landed face-first on the oily asphalt. As the cops chuckled, we writhed our way to standing positions, hands still pinned behind us. They marched is in to the little jail and spent (what seemed like) most of the night interrogating us. What they hoped to get out of two high school kids is a mystery still, but early on I confessed the location of the rest of the drugs. I should have kept my mouth shut, since I doubt they would have found the stash otherwise. They thought everything had already been located, and their search of my pack had been cursory. But the ‘good cop’ won my trust, and I decided to help him out. Their whole attitude changed after I fessed up. Both became cold and efficient, and they went through every last rolled-up sock. By the time they unlocked our hands and pushed us into the four bed cell, the pleasant stupor of near-lethal intoxication had long-since worn off. As I lay on a one-inch thick mattress staring at the underside of the upper bunk, with the corridor lighting making the room almost as bright as day, the depressing fact of our arrest for marijuana possession began to sink in. I had ample time to contemplate this giant screw-up, and what looked like the end of the John Muir Trail adventure.

How stunning the view from the front steps of Yosemite Jail! Few lock-ups let you out into a plunging chasm lined by vertical granite, with a thousand-foot-high waterfall thundering to your right as you stagger down the redwood stairs. The photo with today’s post, taken recently, reminds me of what a glorious sight opened before me as I exited the jail. Sadly, Jack’s parents were not enjoying the vista. After driving most of the night from an L.A. suburb, they seemed a bit peeved. They hammered Jack with their anger and accusations, once in a while staring at me, eyes almost bleeding with contempt. This was not fun for any of us. Jack and I had been ordered to depart the park and not return for at least a month, if ever. Jack’s folks led us to their car like executioners loading horse thieves into a gallows-bound carriage. I worked to reinforce my defences for a drive south under a barrage of criticism, but before we took off my father granted a reprieve. We spoke for the first time since the arrest as I stood at a phone booth under an enormous cedar, the morning air pungent with a scent of damp pine needles. I gazed with longing across a vast meadow the color of limes, toward sheer rock faces that loomed above me despite the distance. My father could not be predicted under even normal circumstances, so I had no idea what to expect as I told him the story. Since the police had been unable to reach him the night before, I was free to slant things to make my behavior sound pretty innocent. Those arrogant park rangers had rousted us as we slept, just to harrass us. It must have been our long hair that made them decide to frisk us. They had no probable cause. I thought it best to leave out the parts about camping in the parking lot, or how we were so stoned we could barely talk. Knowing how furious it would make my stepmother if I ruined her summer by returning to L.A., my dad only surprised me a little when he suggested I stay in the mountains. “Keep a low profile,” he directed after I told him how the rangers had banned me for thirty days. Why not just leave the park via the trail, and commence backpacking by myself? The drugs had been confiscated, so he did not see how I could get into any more trouble. (Six weeks later I would talk to him from inside the Fresno County Juvenile Detention Facility.)

Sounded good to me. With a widening smile, I pulled my disheveled and ransacked pack out of the family car’s trunk, said goodbye to a brooding Jack and his fuming parents, and trudged off into the trees. I moved quickly, before any cops noticed I wasn’t rolling out the gate. The next two weeks gave me my first taste of adult freedom. Friendships formed easily among the shaggy young drifters hanging out in the walk-in campground (no cars allowed). With our down sleeping bags stretched out on beds of pine needles, we slept randomly grouped in an open grove of ancient conifers. We all wore the same uniform: plaid cotton shirt and blue denim jeans. We ate Fruit Loops cereal for breakfast, and then broke into groups to hike, or ride the open-air trams, or maybe swim in the freezing currents of the Merced River swollen with snow-melt. We drank lots of booze, once or twice dropped LSD, smoked pot day and night, ate slices of pizza outside the Yosemite Valley store, and pretty much created a ruckus wherever we went. Every day I got an adult to buy me a half-gallon of cheap chablis, which I passed around the campfire with my new pals. That helped get me past the obstacle that as a high school kid I was the youngest and most naive of this group of youths. Most of the girls I met in the park seemed far older than me (even past the advanced age of twenty), or else they were my age but kept on a tight leash by their parents or chaperones. I lucked out, however, and managed to spend one whole night with a college-bound girl I’d met that afternoon, but in my nervousness I drank so much I passed out with my clothes on. She still seemed to like me when we awoke the next morning, fully clothed but wrapped in each other’s arms. To my chagrin, she left the park that day with her tour group. So much for my hopes of ditching my virginity in Yosemite.

I struck up a friendship with a guy named Paul, who had no fixed address and worked odd jobs when he needed cash. He latched onto the John Muir Trail idea like a tick on a poodle, and we started collecting food for the first leg of the walk. He taught me that uncooked pasta, pankcake mix, Lipton soup packs, and dry salami fed you just as well as pricey freeze-dried dinners. He helped me get rid of useless items and employ the extra space in my pack for more food, so we could go further before restocking. He showed me that you can burn a camp stove on unleaded gasoline from a service station (back then they sold gas in Yosemite Valley, and unleaded fuel was still a novelty), which was cheaper than the less toxic white gas available in camping stores. Paul made me realize that Jack and I would have smacked into problems soon after starting, given how we planned our aborted trip with such ignorance. Shorter than me, but stocky, Paul’s curly hair was so blonde it looked almost white. He only shaved often enough to keep the stubble from turning into a beard. I thought he seemed worldly and street-smart. The night before we hit the trail, I called my dad and told him I was finally launching my adventure. To my surprise, he cautioned me to be on my guard with my new friend. A few weeks later I found out he had given me good advice, which of course I did not follow.

The next morning we pulled our weighty packs up on our shoulders, cinched the waist straps, and embarked on the 211 mile trail. The first day we spent climbing out of Yosemite Valley, past the roar of Vernal and then Nevada falls. Each is a thundering column of white water that kicks up a cloud of mist. The spray drifts over the trail to either freeze or refresh you, according to the day’s weather. Above and below both waterfalls the river tumbles steeply over enormous granite boulders, roaring loudly.

The trail started out crowded with visitors, so that we had to squeeze by balky children or stomp impatiently behind older couples breathing in heavy sighs as they made the ascent. Most hikers turned around so we saw fewer people as we approached the Valley’s rim, where the terrain opened out into large expanses of granite sparkling with feldspar. I watched the snowmelt-swollen river feeding the two falls surge in vigorous currents next to the trail. The icy, clear water swept through a narrow sluice that a glacier must have carved into the massive blocks of stone that formed the mountain.

This story forms a diptych, and one main panel of it happened as I attempted to cross the granite sluice through this muscular flow. For today, I want to skip ahead to the first night Paul and I spent on the trail. We set up camp in a grove of conifers stunted by poor soil layered on top of a hard pan of rock. That evening, as we sat with a Boy Scout troop around a toasty campfire (back then hikers were still allowed to burn open fires), we heard a loud thrashing and the sound of breaking branches. By the flickering light of the blaze I spotted a bulky shadow under the tree where I had suspended my sac of food. We all stood up, but only I rushed into the grove to find that my bag, and only mine, had been swiped by a bear. I had dutifully suspended it from a branch but underestimated the reach of a bear extending on its haunches. As an unrepentant petty thief, I suppose it served me right to get robbed by a wild animal. But it did not bode well for the success of my trip if I ran out of food in the first twenty-four hours, especially if it wasn’t me that consumed it.

I was young. I was stupid. I took off after the lumbering bear. It looked like it moved slowly, but that illusion came from its gigantic size. The animal’s gallop rapidly outstripped me as I sprinted in pursuit, screaming and throwing rocks. The moon was full by this time, two weeks after the dark night when Jack and I camped in the parking lot. So I dashed through the open forest in pursuit of the bear’s gigantic contour which I only glimpsed now and then, shouting at full volume. Somewhere along the way I pulled a thick branch into my hands, and I brandished it like a baseball bat. If I had caught the bear, if it had waited for me, or if it had headed back my direction, I would have swung that branch at its head. Which probably would have been my last living act. Luckily for me, after the bear paused to rip open the sack and rummage its contents, it loped onward and disappeared into the trees. Badly winded, I was relieved to see my food containers and torn ‘stuff sac’ scattered on an open face of rock the size of volleyball court. I gathered up my items: a can of spam had been punctured by the bear’s fangs; the box of pancake mix was ripped and dampened with slobber, but still held most of its powder. Cans of evaporated milk had rolled into crevices unharmed, but the beast had ripped open my box of brown sugar and licked out every single crystal. And I never saw the dried salami again.

Why did I take the time to put this really long story on my blog? Especially when I know that few people have enough interest to read all the way through such lengthy posts. As I said, this tale actually forms part of a diptych. The second part is short, and tomorrow or soon after I will publish it on the site. Both anecdotes show my courage as a teenager, and how blind I was to my own vulnerability. I suspect young soldiers at war have similar ‘bravery’. Generals count on their troops to act with little caution when engaging the enemy. I would have done well in a war, until my brashness got me killed.

I am different now. Very timid about risk, and ever-mindful of consequences. One advantage of my former bouts of hypomania, which medications no longer allow me, is that I would lift my blanket of caution. I would recover some of my adolescent wildness, and its creative impulses. As I pull myself out of my decade-long pit of despair, I want to recover some of that bravery. I’d like get reacquainted with that young man, who chased a three hundred pound fanged and clawed wild animal through a moonlit forest. Who never worried that the bear could have sliced his gut open with a swipe of its paw. Stupid, yes. But also bursting with vitality. Better to be alive in one’s heart and a bit foolish, than be dead in one’s soul and ever-so-wise.

Before antidepressants.

After 1 year on antidepressants.

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.

Back in March 2000, my moods got a little dicey, to say the least. On Monday, for instance, I might feel fantastic, everything looking like sunshine, my mind bubbling with marvelous ideas for the future. The (pejorative) clinical term ‘grandiose’ would have applied to some of my plans, like the one about founding a ‘museum of the human body’, which I envisioned filling a local decommissioned aircraft hangar. Mostly, though, I was just trying on new hats, given that my old surgeon’s cap needed to be tossed aside (because of worsening neck damage). My thoughts on Monday stood at the peak of optimism; from that vantage the future looked grand.

By Friday all that joy had melted into a sticky tar of futility. How could I go on? After a decade spent growing into a subspecialist in oculoplastic surgery, and only six years as a full-fledged independent doctor, it seemed unimaginable to start all over in a new direction. Words like ‘overwhelming’, ‘impossible’, and ‘catastrophe’ popped into my head many times an hour. The image of beginning as a peon/student in a new discipline looked ludicrous. Added to my career meltdown, I had to accept the fact that Mandy and I had moved out of San Francisco, where we had owned a very unique house that I adored. Now we lived in a brand new but unremarkable suburb thirty minutes away. Not surprisingly, our marriage suffered from the stress, loss, and fear. My whole life looked pretty hopeless.

In that latter frame of mind I returned to my never-completely-absent option of suicide, which I’d toyed with off and on since my first diagnosed major depression at age twenty. My mother, before she died (crippled with depression) when I was six, had a love of the Golden Gate Bridge and showed me pictures of it with wistful vocal tones and dreamy facial expressions. I believe she had imagined living in the Bay Area with my father, back before the divorce. In my mind, the structure became an icon for hope abandoned and dreams forgone. For many years I had considered it my gateway to death. With my world in fragments, its pieces careening out of my hands, I began to step closer to that door.

Then one day I experienced something like waking from a dream: I stood in my garage, loading a knapsack with weights, which I hoped would force my body to sink after I jumped. I had elaborate mechanisms in place to make sure the pack stayed strapped to my back in the face of the final impact’s devastating power. With a shock of clarity, I understood the gravity of what I was preparing to do. I stood with these implements of my destruction scattered around me, and suddenly I regained clarity. I made a decision to live. I called a friend who resided on the same side of the bridge as me. I drove to her house so she could take me over the span into San Francisco, where the mental health clinic stood on a busy street near my old neighborhood. I did not trust myself to safely make the drive across the ‘gateway’ alone.

Once at the clinic, I explained to the social worker everything that had gone wrong in my life, and how desperate I felt. With utter openness, I told her my detailed plan for the plunge, and about how I recognized that my life might end without some help getting back on track. She listened patiently, and then told me she needed to place me on an involuntary hold, a ’5150′ in common parlance. I did not object.

A few days later, I found myself in a dreary psychiatric unit with walls the color of butter and the same gray/white streaked Linoleum flooring I remembered from public grade school. The environment looked anything but cheery, but at least I felt safe. I knew this was the place for me right then. Not a single thought of going AWOL ever entered my mind.

My psychiatrist did not ask me whether I liked being in this place, or if I believed it was helping. He told me he wanted me to stay, and that he planned on extending the legal hold for another twelve days: I would now be on a ’5250′ confinement. I had no objection. I saw no reason to complain about this step. He told me there would be a legal hearing, but that I did not need to go. He did not tell me that California law mandated that a patient’s rights advocate visit me and explain my situation. He also never offered me the option of signing in voluntarily. This was also a California legal requirement. He just told me he felt I should stay in the hospital, that he was establishing the hold, and that there was no reason to go to the hearing if I wanted to remain in the hospital. So I forewent the hearing.

Upon discharge from the hospital ten days later, I received paperwork informing me that my right to possess a firearm had been revoked. By California law, I had to wait seven years before the restriction would be lifted. It was not until later that I found out the federal rule: no firearm possession for the rest of my life.

I do not like guns. So at the time the issue upset me only a little. I did wish someone had informed me of this major implication of the legal hold. Other than that slight sense of betrayal, I let the matter drop. Then, a couple of years ago, Mandy and I were alone in our little place in the mountains. The dense, forested terrain is fairly isolated; there is only one house on every five to twenty acres, and many of the houses are vacant most of the time. That night we sat in our den watching a videodisk, when a man’s face appeared at the window, looking in. Mandy screamed so loud I jumped up involuntarily. I went to the front door, and saw two young guys outside. One stood on our porch, looking in through the glass door. The other leaned against the house at the bottom of the steps; he wore a black sweatshirt with a hood over much of his face. Naively (stupidly), I went outside to talk. I guess my feeling was to show no fear. As it turned out, the man on the porch acted very politely, though his story was murky and shifting. He never gave a good explanation for how he had found his way so far off the road without a car, but he wanted a phone so he could call someone to pick up him and his friend. In the end, I gave them directions for the walk out to the main road. They left.

Mandy was terribly shaken up. We found out afterward that the kid with the hood had moved in with our neighbor down the hill a few weeks earlier. As near as we could decipher, there had been an argument between our neighbor and this young man, such that the kid and his friend were kicked out of the house. They had come to us trying to find a way out of the area; why they did not just tell the truth never became clear. Understanding the situation calmed me down, but my wife never felt as comfortable in our retreat after that. Events a year later amplified her fears: the same kid (allegedly) murdered our neighbor in his armchair, after they argued about turning down the music.

So now a gun does not seem like such a bad idea, but federal law bars me from possessing one. Even if Mandy purchased the firearm, my understanding is that I would be forbidden to use it. In an acute situation of home invasion, I would not hesitate to employ an available weapon to defend my family and myself. Still, it would be better to not have to worry about these legalities. Someday I will probably search out an attorney to help reinstate my rights.

My reason for telling this story, however, is that it highlights the question: how much does society trust those with a history of psychiatric issues? I’ve already related the story of how psychiatry training programs rejected me, despite my stellar academic record, quite likely because I told them the truth about my mental health history. In part, I believe this because shortly after I received one rejection letter I also heard from the state’s medical licensing authority. Nothing ever came of the contact, but it became clear that my divulgence of my emotional difficulties threatened my clinical license. (In some states a medical license can be revoked for the mere record of a psychiatric diagnosis, though in California there also needs to evidence of impairment.)

Now, there are no doubt situations where a person’s mental illness would make them a dangerous gun owner or an unreliable physician. But treating all people with psychiatric hospitalizations (and often those who just have diagnoses without history of institutional care) as potential hazards is discriminatory and encroaches on civil rights. There should at least be some kind of judicial review on a case-by-case basis.

From the story I told, do I sound like someone who should never, ever own a gun? I never contemplated violence against anyone else, and I sought help before doing any harm to my self. The situation was extreme, and I needed assistance, which I engaged and accepted willingly. I would have been happy to sign in to the hospital voluntarily. There was no need for the legal hold at all. (Sometimes psychiatrists will object that a voluntary patient might just walk off the unit, but the law actually prevents this; the clinician has ample time to institute a hold and prevent ‘absconding’ if there is reason to believe it dangerous to the patient or others.)

I would have fought the ’5250′ if I had known the long-term implications. It never even occurred to me that the involuntary detention would be on my record from then on. I certainly had no idea the government would forever rescind a right that, while questionable from a societal standpoint, is extended to every other citizen who is not a convicted felon. California law was violated both by not getting me connected with a patient’s rights advocate and by not offering a voluntary sign-in. It was a travesty all around, but I’m the one stuck with the consequences.

How many people get drunk on a given weekend and murder someone as a result? I would venture to guess the number is substantial. Yet we don’t prevent alcoholics from owning guns. Why should someone who is mentally ill be automatically considered an irredeemable danger to society? Obviously, the horrific campus shootings and other mass attacks terrify the public. After the fact, every one of these killers gets slapped with the ‘psycho’ label, though many have no such history previously. But considering every case of mental illness to be of equal danger to society is analogous to considering every person who loses control of his or her feelings from time to time a potential murderer. Yes, fits of rage can lead to homicide. But most people who get overwhelmed with emotion do not go on to kill. They may sit at home and cry, they may overeat or drink to excess, they may yell. But only very, very rarely do they assassinate their companions.

In a similar way, rare cases of mental illness lead to paranoid delusions of such severity and power that murderous acts result. But the large majority of people labeled psychiatrically ill harm no one. Admittedly, a small percentage does commit acts of self-harm, but only a miniscule number hurt others solely as a result of illness. (Concomitant intoxication or interpersonal conflict may lead to aggressive acts by a mentally ill person, the same as with anyone under those influences, but it is unusual for psychiatric symptoms alone to lead to unprovoked violence against another.) It is obvious that not all mental illnesses are the same, but society’s tendency has been to paint all psychiatric diagnoses equivalently, and treat us all as unreliable and hazardous.

We get our rights taken away as mental health patients, and few (besides us) even consider it a big deal. I really never cared about the gun issue before now. Never wanted a gun. The right to possess one mattered little. Now I see things a little differently. I believe it might be in my family’s interest to have a defensive weapon available in our sparsely populated neighborhood. Most of all, however, I am mad at how ‘the system’ treats me like an unreliable sociopath just because I was brave enough to seek mental health care.