The Medicated Self

Pills 1

Today I learned that it was my new medicine that causes the tremor in my hands. I felt my own relief viscerally, right between my shoulders, where I had carried my worry with me in silence. Shaking hands aren’t great. They never mean something good.

So it was a strange comfort to know it was simply some of the medicine that keeps me even, calm, engaged. The stuff that somehow takes the suicidal thoughts (“ideations”) and turns them down to a low whisper, easily ignored. Chemicals that help me find sleep somewhere away from the violent nightmares – so brutal, dizzying, incomprehensible. That used to be every night and every day. Without medicine, it still would be.

There is, I understand, controversy over vaccination. It doesn’t make much sense to me. Then again, I’m rather biased: several pills stand between me and a desperate, hollow existence. Not insanity. I’ve never been psychotic. I admit to more flashbacks – without medicine, I mean – a more bent reality folded at sharp angles with the past. Certainly I collapse underneath intense suicidal thoughts. That’s not psychosis. But even if I were psychotic and there was medicine to keep me here with you, wouldn’t we both be grateful? I am grateful. So grateful. I can walk into a classroom without smiling against a current of perfect inner terror.

I am, genuinely, happy to see my students. That means the world to me.

People often worry – and I myself worried – that these medicines would split me apart and take me away from myself. I worried I’d be someone else. Someone not-me, and maybe I wouldn’t even know. I’d become a controlled neurochemical concoction that would wander along in life without feeling. Unable to remember. Like from a sci-fi movie. Or, uh, that one movie with a crazy Natalie Portman in it. No, the other one.

Let me explain, though. What a self is, and what neurological change means. Let’s try to think it through.

Throwing pills at a problem does not resolve it. That’s an odd place to start, but it is the most relevant to my own experience at the moment. Medicine calms things down enough in my head so that I can start to grapple with what bothers me – the memories, the hurt, the deep distrust – instead of, say, ruminating all day over which knife to pull across my throat.

I did not understand that those kinds of thoughts meant my brain was sick. I did not know these were symptoms of a problem I could never think my out of, could never overcome by sheer will. The brain can get sick with all kinds of things, just like every other part of our body. It is a scary and a helpless feeling.

Once I slammed my head against a wall until it ached, desperate to feel something different than dread. I wept, shaking and confused, as it offered no relief. I hardly realized what I was doing.

Was that me? Yes. Yes, it was. That was me, that was real, and that still lives in me.

Still, I don’t think I abandoned myself by taking medicine that allowed me to breathe, to have a solution other than ramming my own skull against a rough wall. That person, that self, had disintegrated into an extremely limited and painful existence. It does not betray pain to allow other feelings in, I learned. In fact, it helps throw pain into real relief, helps me understand it.

I am not someone else.

A theologian named Bernard Lonergan explains that what is spiritual in us is the awareness that knows, feels, decides. The someone who asks and understands. That is me. We are also material creatures with bodies that are fundamental to ourselves. Like the foundation of a house, our bodies fundamentally make the house of knowing possible, but that isn’t the same as knowing itself. In other words, we aren’t just neurons. We are the conscious knowing, the someone, of those neurons – which is, really, quite radically distinct from neurons.

This is a helpful way to explain that, while the brain can get sick, giving it medicine isn’t becoming someone else. It is helping us to be more richly ourselves. If the foundation is cracked, it’s very hard to build a good house. The self is wounded. Fixing the foundation, bandaging the wounds, deepens our experience of who we are. Not the opposite.

I have been able to become a better someone. The same, and better. Someone more. One who can smile and mean it, and yes, can still cry. Every feeling remains available and real. I am not numb, not at all. In fact, I feel even more. It’s amazing how much more room there is in me for all that now that I don’t think of knives all the time.

It is still strange, I won’t lie. As my doctor and I fiddle with medicine. Sometimes I feel a bit like a neurochemical thermometer: nudged up and down with each new dose. I am still haunted by problems, like days when I wake up entirely convinced life is not worth living. Once a comedian said of his own severe depression: “There are just days when I want to throw myself in front of a bus made of knives.” I know what he means. Those days come and go. I am aware now that they can come and go at all.

I would not recommend taking medicine without also attending therapy. Once there’s room enough to feel, a lot of things get serious really, really fast. Having someone to talk to is extremely helpful as that stuff comes to light.

Not every medicine works. The first dose made my head hurt like hell and did nothing else. The next made my stomach ache as if stabbed. It didn’t do much, either. Weeks stretched between each try. It takes weeks for the medicine to take effect, to shift the brain’s chemistry. The side effects, damn them, are much faster. Still, I’ll never forget how it felt to realize I wasn’t thinking so hard about killing myself. I felt a breathless, dazed relief. As if someone had finally taken a boot off my neck.

Thus the tremors. A new experiment. It’s alright, as long as I don’t drink too much caffeine. It’s funny, almost, to have my hands affected. I’m not sure why. Sometimes I laugh when no other reaction seems available. I wonder what it’ll be like to draw on a board, and I laugh. (I hate doing that anyway.) It’s an odd reminder that this isn’t quite normal, my existence. That, yes, my stability is artificial – since it literally requires something artificed, something made. None of that makes me not myself. It doesn’t take away my gentle, determined, and challenging experience of life. All it means is that I need help to have that experience.

Help isn’t so bad, though. It’s another form of grace.


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