In Response to Comments on Previous Post

As usual, the comment discussion led to lots more writing – enough to make a post. Here are some points.

More than one person commented on the “pain” expressed in the last post. That surprises me; actually, despite being numb, at least things are stable. I wouldn’t have thought to describe things as terrible pain; if anything, this is the best I’ve been since stopping my wonder drug. Not good, and scary, but I’m not batshit crazy.

Aqua wrote:  To be mentally ill in ancient times and in pre modern times, was to be recognized as being behaviourally “different” just like now, but now we have different labels than before. Sometimes, maybe it was better, but many times it was downright awful too (think “witches” and all the burnings and drownings that too place. Sometimes it was better..I am sure being a Shaman has its perks.

Bearfriend says: It occurs to me that your inability to cry may be linked to medication? That they are making you unable to really experience any emotions at the moment. Of course, this can happen without meds as well. Once you are on the conveyor belt of psychiatric treatment it is very scary to contemplate stepping off.

Inside that statement is part of the problem for me: if I had not presented to any psychiatrist ever, I would not be considered mentally ill at all. My closest friends never guessed (though weren’t surprised when I told them, either), I function in society and the workforce well enough for enough of the time, I’ve not hurt anyone else, my behavior, while sometimes strange, has not been to the point where it can’t be smoothed over with apologies and a little bit of lying after.

If I were not in the medical field, but rather in a more artistic field, I would probably be considered entirely normal – well within the range of commonly found temperaments in dramatic fields. In high school, when all my friends were the freaky kids, I was among the most “mainstream” or “normal” of them all. And none of them turned out too bad. I just made the stupid mistake of trying to fit in into a world and social class that I am not especially suited to.

Once, I tried to explain this to the former shrink. (I might actually have written this before.) One of the biggest scams in medicine is back surgery for disc pain – it gets no better results than just waiting three months, and has horrible complications. Huge numbers of people come out of it with worse pain, urinary or fecal incontinence, leg weakness or gait problems, and other things. With a friend who is now specializing in rehabilitation medicine, we once joked about “Top 10 Things We Learned in Medical School” and one of them we both put down was, “NEVER have back surgery.” I explained to the shrink that essentially, I walked into his office healthy, and came out extremely ill and disabled, just like those people. If I had never walked in in the first place, I would not be “mentally ill.”

That has been one of the hardest things for me. I think that in a lot of ways, asking for help and getting it (sort of) makes things worse, encourages you to be “sicker” because all of the sudden, that gets you attention and a legitimate role as a patient. When I had to cope alone, the fact is, I did.

Bearfriend is right about another thing – that once you are in, it is nearly impossible to get out. I can’t leave for two reasons, mostly. One is that since I now have an “illness,” I keep getting promised symptom relief or improvement. That is a pretty strong motivator to keep being treated. The other is that now I am not just me, I have “manic depression” which now will be with me forever, and is a serious disease (even if I am more lightly stricken) that needs medical treatment…forever.

There was another statement in the comments about meds not helping. I just wanted to clear that up – for me, meds actually had me 100% symptom free and totally normal for about four years. During those four years, I didn’t see a psychiatrist at all – just got refills from the GP every few months. Then I had to stop taking it, and since then, my entire life has gone to hell. I do believe in at least some psychiatric medication because I was so helped by it at one point.

About my analogy of psychiatry / psychodynamic theory to religion: one of the most influential books I have ever read is Carl Sagan’s The Demon-Haunted World. Though I talk about myth and magic and stories and destiny, I don’t quite believe in those things on a practical level. Rather, they are a human construct that is very good for describing many aspects of the human experience. In day-to-day reality, and in medicine and politics, I am a rationalist.

Psychiatry is a belief system not supported by evidence. It is basically an unprovable science. It is similar, in that aspect, to myth – sometimes a good analogy for some parts of the human experience.

The problem comes when one uses that as a basis for medicine, for intervening with people’s lives, or presents it as a science. For example, one can be damaged in the anal stage, and according to theory, become either overly fastidious or super messy. Or may turn out fine. So what is the value of the theory? It is a non-predictive science, which means it is a belief system. (And yes, I know that it explains by delineating a whole set of reaction styles that cause the difference – but there is no way to tell why which person would react one way, or to prove that those reactions are the cause of the outcome. It is a post-hoc theory.)

It’s sort of like how one could say, “There is an omnipotent God who created the earth and the universe and controls all occurrences…” I suppose it is plausible, but it is NOT science. It is non-testable and non-predictive. Knowing that “fact” gives you no assistance in predicting what will happen, or even really in understanding what already happened…therefore, not science.

And I have often said, if I were to choose for myself a belief system about human nature, despite the secular appeal of psychodynamic theory, I certainly would choose a kinder, happier one than the one offered by psychiatry. If I am going to believe in bullshit, I may as well believe in bullshit that makes people happy.

Incidentally, this new shrink happens to be a very devout practitioner of religion, but also is classically psychodynamically trained. I think this is overall good for him, because it gives him a  belief system to compete with psychiatry. He isn’t a fanatic Freudian who believes that psychoanalytic theory explains everything and is the one true doctrine of human nature, because he has another belief system that also explains everything and claims to be the one true doctrine of human nature.

The more paradigms you understand and have in your arsenal, the better-equipped you are to be able to take part of one and apply it when it seems relevant, without being a slave to it and bending the rules to make facts fit your doctrine.

On the last post being hard to write: I wrote it, with great difficulty, fishing out words. Often, I found a word that fit by meaning and connotation, but it didn’t often have the right sound or rhythm for the sentence. (See: “emissary or oracle” – I ended up writing both because neither was quite right, oracle was maybe closer, but neither had the right rhythm, I wanted something like “channel” as the verb but couldn’t make it fit in that grammar; “misfortune” – wrong word altogether, but originally I had used “tragedy” twice there, so it had to go; “tenebrous” – not dark enough connotation; “farcical” is just not quite the right word, not enough ridicule in it; “adamantine” has the right connotation but the absolute wrong rhythm, that should be a hard, trochee word.)

On the other hand, I thought I wrote for about 20 minutes, but when I finished and looked at the clock, nearly an hour and a half had passed. So maybe there was some real writing, hypnotizing “flow” writing in there. And there is a bit that I terribly like, that did come to me sort of from beyond and is fanciful.

* * *
Another quick note – when I logged back in, I glanced over some search terms people are using to find this site and a few that I didn’t quite expect are showing up a lot. Unfortunately, WordPress doesn’t seem to register the whole search term if it is over a certain length, so I’m left trying to guess what someone searched for with “what role does medicine have to play in <blank>” or “are psychiatrists who yell at their patients <blank>,” and  the enigmatic “im getting signs that are pushing me to <blank>.”

But a lot of them are coming up with things like, “How to tell my doctor I self-harm” or “how to tell my doctor…” or “what doctors say about…” many different things related to mental disorders.

For those people, I hope this site has been helpful in demystifying what the doctor really thinks of you, and what to say or not say, and shows our limits and some of the biases common in the medical world.

* * *

Finally – thank you to anyone who comments on valproate and how it makes you feel. No one fucking tells you ever what meds will actually make you FEEL like, and it sounds like maybe valproate is one that looks worse on paper than in most people’s practice.



  1. Hi,
    re: what valproate makes you feel like sounding worse on paper…I take Tegretol now…for the last two years. Have you ever read its profile. It sounds so scary I am amazed anyone ever tries it…but I was desperate. I have absolutely no side effects. Go figure.

  2. Sara.
    I was here too.
    I am sending you lots of love and hugs.
    I take Valproate. I am good with it. I know, so much bad stuff is written about it. but i like it.
    take care gorgeous. xo

  3. a more thoughtful post to come later, but a quick note on valproate: i was on it for a while and had no side effects. i stopped it because i have pcos and didn’t want to risk making it worse, but as far as i or my doctor could tell, i didn’t experience any side effects at all. not bad!

  4. I think I stumbled onto your blog via ‘the secret diary of a manic depressive’ a blog very different in character to yours but, like yours, very well written. You tell your story in a wonderfully empathetic way, as do all good writers, and I envy you your talent while sympathising with your problems.
    You say that in the world of the artist you may be less conspicuous,your differences more acceptable. Really, it doesn’t matter what world you inhabit. You are an artist and an all-round intellect. I know that everyone who can put two words together thinks they ‘have a book in them’ but you really have what it takes. I reckon you should continue to hone your skills and maybe write with a view to becoming a published author. You have nothing to lose.
    Sometimes I feel a little voyeuristic on these sites because I do not have mental health issues as such (although some of my friends and family might disagree) just an interest in human behaviour and the workings of the mind. It is completely obvious to me that in many instances the manic depressive personality(?) has the compensation of huge artistic creativity which makes the rest of us look like drones. Good wishes to you from Sydney, Australia

  5. Hey,
    Does this mean you found the Dr. with the color in his name? He sounds quite similar to the one i had and miss (and actually left a pathetic voice mail to last night…wanted to hear his voice). Anyhow, he was quite religious, however very much trained in psychodynamic, cognitive-behavioral, supportive, etc.


  6. I have learned to expect very little, and to treasure the times when I’m well on my own. I keep it simple now, just lithium, sometimes a little Seroquel for sleep (50 to 100mg). I make every bipolar’s mistake: I play doctor with my meds. Have to because I have no health insurance.

  7. I think that if you suffer from a mental disability, it isn’t always necessary to see a psychiatrist. I have manic depression and I see a Social Psychiatric Nurse once a week an d she helps me very much with the real day to day problems that I run into, but also with coping with the disability itself. I see my psychiatrist once every two months to discuss whatever big issue is on my mind and he does not do Freudian analysis and I don’t know any psychiatrist who still does as Freud has been proved quite wrong a long time already.

    Also, it seems to me that if you have manic depression, it should be your job to be as well informed about it as you can and to become your own expert about your own disability, specifically the one that you suffer from. You must be aware of the different cycles that a manic depressive person goes through and how that affects her behavior and emotions, yet you write about it as if it is all a big mystery and I see no understanding of it on your part. You should make yourself your own project and stay away from psychiatrists who analyze and get with a therapist who gives you practical help. and emotional support. You only need a shrink to prescribe the medication, not to analyze if you still wet the bed when you were 5 years old.

    I’ve educated myself about manic depression in general and about mine specifically and I can tell you a lot about myself that is to my own benefit. I think you need to recognize all the different cycles there are and which particular one you are in and they are not just up and down. Be proactive and not a victim. If you take the lead, you will suffer less.

  8. Sara,
    I’m glad you spelled out the problems with disc surgery. I had two herniated discs in my neck, and had fusion and laminectomy done. The laminectomy has caused much more pain, weakness on my right side, and neuropathy for the last 10 years.
    In my lower back – I have multiple problems in L5-S1. I’m managing with periodic cortisone injections. I will never have surgery there. Never! I was told that when you start getting incontinence issues from the disc you should consider the surgery. Ironic to know it can cause incontinence.
    I’m so glad you started posting again – I was worried since you stopped!

  9. Cat- I’m really sorry you went through all that. I’m sorry for everyone who gets hurt by medicine.

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