Those Damn Pills: A Rant

I'm passionate about the need for treatment, but I don't think most people realize how difficult it is to coordinate all the meds that are necessary to keep a bipolar person stable. Many of us—perhaps most—must take a "medication cocktail:" drugs to avoid mood swings, drugs to counteract the side effects of those drugs, drugs to ameliorate the side effects of the side effects, etc., etc. I mean, come on: I have a J.D. and it takes all my mental acuity just to know which meds need to be refilled when, which should be taken in the morning and which at night, which must be taken with food or on an empty stomach, and annoying little details like whether grapefruit juice is safe. It's mind-boggling, and you need an advanced mixology degree to prepare the perfect cocktail—which is only arrived at by months, sometimes years, of trial and error and constant, ongoing tweaking.

People often ask me (doctors, especially): Why do you need to be on all these drugs? As if it's a whim, or a joyride, or something that I choose to do because it makes me high. That's because they usually see me when I'm functional—when I can still get out of bed and am competent enough to remember or care about my appointment. They're merely spectators, on the sidelines of sanity. They don't know about the fiends that visit me in the night, and the heart-rending and humiliating loss of control over a life I have no choice but to live (except, of course, when I'm suicidal).

Without the drugs, I'm a mess. Or as my psychiatrist once put it bluntly: "a menace to society." That was back when I was still drinking. Back when I didn't take the myriad of warnings on the medication labels seriously. Back when I considered the "Don't mix with alcohol" proscription as a suggestion, not a mandate.

Doctors don't tell you all these lovely things when they rip off that scrip and send you toddling off to the pharmacy. Pharmacists don't, either. It's up to you to read the Patient Information Leaflet that sometimes comes with the pills, sometimes not. It's written in tiny, frequently unintelligible clinical-ese, with a list of potential side effects that quite often includes cancer and death. It takes blind faith in your doctor and the health care system to swallow that innocent-looking capsule and pray that your nose doesn't fall off.

In the end, faith and hope are the key ingredients in any medication cocktail. Faith in your doctors and hope that this last little pill will finally, please God, take the pain away and make you feel normal—or at least, like everyone else. If you're bipolar and you believe in Western medicine, you are conscripted into the religion of psychopharmacology, whether you want to believe in it or not.

End of rant, my next dose is due.