Friday I saw Dr. Altman in the City. It's the middle of the seventh month where I'm solely on the Geodon. Now more than ever I understand it's crucial to be honest with him about everything. I learned the hard way after two decades living with the SZ that any unusual thought is fair game because it could be the result of the illness. For too long, I was loathe to use the schizophrenia as an excuse for my behavior, so when the troubling thoughts appeared, I told myself it was something I was doing that was wrong. In reality, the SZ had found an opening in which to insert itself. It loves an opening.
As my therapist, Max, has told me, "You have some control up to a point, but only some control." I did all I could before I needed to go on the Stelazine, and right now, I've done all I could on my own with the Geodon. I felt I was wrong for not being able to control it, and now I accept that it hasn't been easy, and I forgive myself.
Sitting in the chocolate brown leather chair across from Dr. Altman, I told him what used to go on in my head in the 1990s for five years until I started grad school. A troubling thought would pop into my head uncontrollably, and it upset me. I hadn't told my first psychiatrist because at the time, I hadn't connected the dots and realized it could've been brought on by the SZ. Now I know better.
When I said that sometimes it's still hard on the trains and in restaurants, he suggested we consider going higher on the Geodon, especially because I haven't experienced any side effects. When I was younger, it was a point of pride to be taking only 5 mg of Stelazine and nothing else. In reality, that was way below the maintenance dose. In 2003, as soon as I began seeing Dr. Altman, he raised it to 10 mg, and shortly after, I began having new troubling thoughts-different ones. As loyal followers of my blog know, in April 2007 Dr. Altman instituted a cross-titer from the Stelazine to the Geodon.
From the summer of 2004 until he switched drugs, I've lived with a subtle worry, as documented in Recovery Café: Robin and Chris, my inaugural blog entry of that series. Looking back, I can remember when it all started. In August, 2004, I was the featured performer at the Italian American Writers Association's poetry reading at the Cornelia Street Café, in the West Village. I had my fifteen minutes of fame behind the microphone. That night, I read the breakdown scene from my memoir, Left of the Dial. I ended my reading with a victory scene.
It's not what a lot of us would've done, and to this day, I have no idea why I chose to publicly disclose on stage. Exactly one month later-on September 11, 2004-I was on the bus and then the Staten Island Ferry going to the City to attend the poetry reading, and I had a mini-meltdown. Looking back, I realize that was the beginning of my recent worries. Yet again, at the time, I felt responsible for what was going on: if I tried harder, wouldn't the thoughts go away?
Fast-forward four years to today. In rational moments, I'm aware of what goes on and I can analyze why it's happening, so that is a good thing. I don't believe what my mind tells me. Yet the idea of a dose increase appeals to me because I could be free of the anxiety. Free. I like the sound of that: free. It's possible to be on medication and not have symptoms. That is the noble goal to strive for. I trust Dr. Altman with my brain. As long as I'll be able to still have my near-photographic memory and my mind is sharp and clear, I'm willing take the higher dose.
Why? As my psychiatrist told me, "Total symptom relief is the only acceptable outcome." Ironically, my friend Dmitri suggested I go higher as soon as I started taking the Geodon, as if he was Lucy in the Peanuts cartoon dispensing five-cent advice from a lemonade stand. The new drug had worked so quickly Dmitri believed that more of a good thing would be even better.
Anything that would make me "mellow yellow" I'm willing to consider at this point. When my friend Ana and I popped in to see a psychic, Sue, the woman told me, "Sometimes your nerves are on edge." The dose change could be the beginning of good things to come. Dr. Altman is a true professional-I intuited this at our first meeting-and I trust him completely. The truth is, for people with bipolar especially, and also for those of us who have SZ, the dose needs to be adjusted as we go along, based on our shifting needs and the subtle changes in our biochemistry.
A guy I met at Baltic Street, whose division I toured on my day off, told me, "A lot of psychiatrists believe if you're still on meds, you haven't recovered." That is sad if not scary: that we have to jump through hoops to be considered recovered. At the end of this blog entry, I'll link to one of my first entries, "Optimism and Hope for Successful Treatment Outcomes." It proves out that recovery is within reach. My contention is that for 95 percent of us, recovery is possible only if we take the medication.
At the 2007 NAMI convention in San Diego, I presented a poster session about recovery that talked about strategies for living well with a mental illness. A woman stopped by and asked me about the medication issue in not so many words, and I told her that I believed taking the meds allowed a person to recover. It seemed that was all the validation she needed for her choice to swallow pills.
The bottom line is, it's never too late to see improvements, and the tide could turn at any moment. My good friend Robin [the other expert blogger] believes it's not too late for me to reap benefits from a dose change. Even Ana suggested that it's still too early in the game to call the final results of what Geodon can do for me.
One thing I can tell you: I play to win. I won't give up. I haven't yet done all the things I've come here to do in this lifetime. Fly me to the moon if that will enable me to do them.
Published On: October 21, 2008