Saturday, December 11, 2010

My diagnoses: Depression Anxiety Panic Disorder PTSD Scoliosis Ankylosing Spondylitis Fibromyalgia

I wrote this for Lester Grinspoon, but can't seem to find a way to get it to post to his wonderful website,

When I was six my family moved from Mexico to New York, a much anticipated move, joyously awaited because my mother, a native New Yorker,had wanted nothing more for many years than to return to her beloved city, to her family and friends. In New York my mother's happiness and relief to be "home" quickly dissipated, she found a changed city and a dispersed circle of people who were not as she remembered them,  whose lives had moved on without her. She was angry and hypercritical of everything and everyone, especially my father, my sisters and me. I was very homesick for Mexico, lonely and a little lost as the new kid in school, because between first and fourth grade we moved several times to try to find a place my mother would be satisfied with and I went to four different schools.( All in all, with my parents moving every year, I went to 13 schools in 12 years.)

When I was seven years old my father had a fit of rage one spring evening, because I'd talked back to my mother who had been railing at me for hours. He kicked and beat me very severely for telling her, in a whisper, to shut up. I walked with a limp and could nor run or play sports at camp the summer after that.

When I was eight I was playing alone in Riverside Park in Manhattan near our home and I was grabbed by a stranger, pulled into the bushes and raped. I thought I would be killed but the man released me at last and I ran home. I threw my ruined and bloody pants down the building's trash incinerator chute and acted innocent when my mother wondered what had become of those pants. I didn't want her to know.

I was simply terrified of letting my parents know. I think this is when I fell into my first really severe depression. I cried myself to sleep every night for a year.

When I was nine one of my sisters, who is 13 years older than me, came to visit and and spent a night in my room. She noticed the crying and got my lonely secret out of me. I begged her not to tell my parents but of course she did, assuring me that I was not the guilty one, that I had done nothing to provoke the attack and that the man who raped me was a very sick and damaged individual who had probably been similarly abused as a child. Her words were very important to me and I think her intervention in part made it possible for me to grow up in one piece, and not hate all men or fear sex as an adult.

After my sister left my parents turned on me. My mother called me a slattern and a slut. Mind you, I was nine years old. My father kicked and beat me again, and this time, as I attempted to escape his blows I ran for the building stairwell. My father followed, grabbed me at the top of the stairs and in my efforts to get away from his smacks and kicks I fell down that flight of concrete stairs and could not move when I landed at the bottom.

My father picked me up, carried me to bed, and there I stayed for several weeks. There was blood in my urine and I was bruised everywhere. Eventually the family doctor was summoned, after the bruises abated... he noted an elevated white blood cell count, heard from me about the red urine, and thought I might have nephritis. I don't remember ever being medicated for that, so he must've decided I didn't. Since then every time I've had bloodwork done a high white blood cell count has been noted.

In my early thirties I reported a chronically  aching back, shooting pains in my hips and a stiff neck to my family doctor, who noted scoliosis in my spine. He said," If you think this hurts now, get ready, it's going to hurt more as  you age.You can expect to be using a wheelchair in a decade or so"  He retired that year and I was without a primary care physician for some time.

The next several doctors I saw were not too concerned about my back. They thought my pain could be mostly psychosomatic, and that seemed to make sense, as I'd been through a failed marriage, a divorce and the very painful, unexpected break up of a subsequent relationship. The diagnosis of stress and depression as a rationale for my painful symptoms seemed to make sense then  because, after all, I was now a single parent, dirt poor, alone, under considerable stress and certainly very sad.

I humbly submitted to that diagnosis and agreed to try a varied series of psychoactive drugs to address my depression and anxiety. Nothing seemed to make much difference. I was very physically reactive to each and every drug I was offered. And this has been true of me with pills of any kind all my life. Gastric distress, cramps, nausea, diarrhea, constipation, dry mouth,"floatiness" , welt-like hives and rashes that lasted for months were among the side effects I endured. And my back still hurt, a lot. I didn't feel much of a lift in my depression, but talk therapy with a counselor effectively helped me to deal with my past, be present for my children's sake, and to try to plan for my future. The first therapist, who I loved, we related so well, moved away and subsequent counselors were of the opinion that fullblown happiness or success were not necessarily pragmatic goals for me. They characterized me as chronically depressive. One therapist suggested it was ethnic sadness... something about being Jewish...

But if I took my meds regularly, and if I could just function well enough to work, and to cope with the challenges of parenting teenaged boys without becoming suicidal, that was enough. The counselors, even that first, nice one I liked so well, advised me to lower my life expectations. Never mind going back to college, too stressful, or getting a drivers' license, since I had a fullblown panic attack when I first tried to take the test. I couldn't afford a car anyway, so why bother learning to drive? (I learned anyway,and had a car for a while, in my forties, which made me probably the oldest person in the state to operate a vehicle on a learner's permit.) The psychiatrist warned that stopping medication could quickly lead to suicide for me and he advised me to stay on my SSRIs and ativan or something similar for the rest of my life, probably. My hepatic system suffered, my gall bladder was removed, I got fat, had a permanent rash and was always mildly depressed, but that seemed better than being suicidal, after all.

I disclosed to my therapists and psychiatrist that I was using marijuana when I could afford to (not often) and experiencing significant relief from both the physical pain and my emotional burdens while stoned..
The psychiatrist helped me look online for possible adverse effects from the interraction of pot with my meds... we found none, but he advised me not to smoke pot anyway. The therapists I saw ( I kept trying to find one as good as my first)  were of the opinion that smoking pot would impede my ability to deal effectively with my emotional problems. Whatever! The last counselor I ever saw suggested I try methadone for my pain, she'd heard great things, and she wanted me to enter a drug treatment program to deal with my marijuana "addiction". I was aghast. Against medical advice, I stopped using ativan and Serzone, stopped seeing the silly methadone touting therapist,  refused drug addiction treatment and said goodbye to my shrink and that whole paradigm of medicated mental illness.

Depression, if things are really sad, I've decided, is a natural and maybe even healthy response. Depression that lifts when things get better is normal, not an ethnic quirk or a disease. Good, organic homegrown pot is enough of a mood elevator and pain management tool for me, when I can wield it, to see my own way toward improving my lot and experiencing real, lasting happiness.

In search of new answers I started seeing a new primary care person in my early 50's, and she referred me to a rheumatologist. He was good, and thorough. He ordered bloodwork, looked at an MRI of my back and gave me the double diagnosis of Ankylosing Spondylitis complicated by fibromyalgia. For a year I dutifully tried every med he tried to help me with, without good results. I am hypersensitive, it seems, to pills of any kind. I've always known that narcotics make me puke. Codeine no good (blech I feel nauseous just thinking about it.) NSAIDs, bad..Sulfa drugs, steroids... fuggedaboudit!
With my rheumatologist's full sympathy, I decided to lay off the meds again.

Here's what I do about my diagnoses now: I'm in a relationship that stabilized after some rocky stretches, and is now usually very pleasing and good, I have good friendships, I adopted a couple of cats,I stay in touch with my wonderful children, (my eldest is now at Harvard Extention taking pre med courses! and my baby is married, a medeival scholar who is graduating this year and entering the Peace Corps with his wife.) I eat healthy food, I excercise moderately and meditate, and if I'm really in acute pain I use only over the counter ibuprofen, which is tricky, as it sometimes backfires and causes all the old icky side effects to flare. Beyond that, though it's terribly pricey and hard for me to obtain with any regularity, pot has afforded me, when I can avail myself of its gentle assistance,  profound relief. Side effects... less money, more peace. I am physically comforted and uplifted, capable again of laughter, of creative thinking, of joy and pleasure in my sons, my partner, in my surroundings, my work, my volunteerism, my music, my art, my friendships. I may be self medicating  for my physical and psychological issues but I have to add that pot does much more than just medicate or sedate me. Pot has given me back my self, my love of life, my sense of hope and of wonder, of spirituality, of belonging to my world, and I get the sense when I partake that I am being helped by a powerful, compassionate green ally, my helpmeet and relative in the web of life.

Of course I can't afford to have much of that, and dare not grow my own, but when I have pot, I can report affirmatively that my pain levels are manageable, I remain in good spirits, and although in many ways my life is  severely restricted by both illness and unrelieved poverty, my life still is sweet, no longer examined, and very much worth living.

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