Me, My Psych Meds and My 12-step Recovery

 As I sat in my jail cell I had to question the admonition I got from an old-timer at AA meeting I frequented. “If you trust your Higher Power enough, you don’t need psych meds.”

Really? How well did that work for me? Prior to my psychotic break I wore my sobriety well. I had married the love of my life. My IT consulting practice was netting me a mid-six figure income. The custom house we bought and furnished was paid in full.

Funny thing about alcoholics. When things are going well we want to fiddle with the recipe that got us there. Why do I need meds? After all, I have been symptom free for years. I have never been manic in sobriety. For some reason the under-utilized abacus in my head couldn’t (or wouldn’t) do the math that me plus meds equaled sanity. That old-timer’s advice started to resonate. After all, I was a Higher-Power-trusting kind of guy. Never did it occur to me that maybe there was power and inspiration behind the development of the medications that kept me sane.

A salesman at heart, I broached the subject of discontinuing meds with my wife–my wife who had never known me symptomatic. “I’m doing fine,” I said. “Just look at all these articles I found on the web about managing symptoms with vitamins and exercise.” I closed the deal and by August of 2009 I was med free.

All was well until it wasn’t. In November of that year my wife was hospitalized with COPD exacerbation. Talk about the need for a lung transplant and end-of-life-planning marked many of our conversations with physicians. Up went the anxiety level.

As the stress level began to rise, the amount of sleep I was getting decreased proportionally. Funny thing about bipolar I disorder, nothing triggers mania like lack of sleep. Or so I learned later.

Around January or February of 2010–the timeline gets a little distorted… a little racy–my response to my wife’s health condition was to pick up more clients, sleep less and work more. One of my clients, a large county government, went under investigation by the state’s Attorney General. The subject of the investigation? The contents of a database I maintained. The state wanted the unvarnished data. The county wanted it “scrubbed.” Stress bombs were being lobbed at my increasingly fragile state of mind.

Somewhere in the spring of 2010 there was an audible snap. Distinguishing the seemingly real from the false got a little tricky. Paranoia replaced anxiety. Clients began pulling me into meetings to explain why I was sending late night emails about Russian cell-phone hackers and suspicious activities on the part of my co-workers. Apparently, my explanations were none too satisfying. First there was a mandated two- week “vacation.” A week after I returned I guess no improvement was noted as the County Manager’s personal security detail escorted me from the premises. My monthly billing dropped by 75% at a time I was spending and gambling like, well, like someone in the midst of a full manic break. The bank accounts were drained and the credit cards began to max out.

My wife reminded me of a promise to resume medication if she ever deemed it necessary… and she was definitely in a deeming-it-necessary mode. Funny thing about psych meds, the maintenance dose that had worked so well for years really wasn’t up to snuffing out full blown mania. I resumed my meds, but it was like trying to battle a raging forest fire with a squirt bottle.

By May, loved ones were more than a little concerned. That came to a head in the aftermath of a pool party/cookout gone awry. For some reason I thought our guests needed to be greeted by the entire content of my garage spread across the front yard and folding tables piled high with $3,500 dollars’ worth of random magazines, toys, household goods, and an inordinate amount of Febreze from a 2 a.m. Walmart shopping spree. Twenty-four hours later there was a late-night visit from the local police to take me to a 72-hour psych hold my wife and daughters had arranged.

Agnosognosia. A Greek term for lack of insight. The medical profession has reserved it to describe the phenomenon of people in the throes of mania denying that they are manic. I had it, but good. Four hours into my psych hold I pretended to be asleep and then put on a very calm front for the psychiatrist who had just come on shift to make the rounds. By hour six I was released, and my wife and daughter got a tongue lashing from the doctor for wasting her time. I delighted in that, but not once did it occur to me that if I had to consciously act calm, maybe things weren’t quite right. Life at home got a little more strained.

Five days later I agreed to be hospitalized. Then I reneged on my promise and decided to storm out of the house to underscore how healthy-minded I was. As I packed, among other things, a two-and-a-half-foot tall Buz Lightyear action figure, a cloth “green screen” for shooting videos and manipulating the background, and a folded American flag, I decided to also pack an unloaded .22 pistol that was going to be the centerpiece of a yet unscripted cellphone video masterpiece. As I turned from my dresser to the duffle bag I was packing on my bed, my wife entered the room. The gun was pointed in her direction. She didn’t see a budding videographer; to her it was a little more “assaulty-ish.”

A half hour later I was cleaning the pool at an unoccupied rental house of ours where I had decided to camp out. Not five minutes into it, I noticed a helicopter directly overhead. In my paranoid and delusional state, I assumed the helicopter was there to film me in all my glory. Turns out, as a very real S.W.A.T. team encircled me, I wasn’t so delusional after all. My mugshot made the front page of our major online newspaper… in all my glory.

Over the next six weeks in jail my symptoms subsided, my marriage was repaired, and I got a felony assault charge reduced to disorderly conduct. (I really couldn’t argue that I had been a little disorderly.) Still, I had one full year to learn how difficult it is to stay employable until that felony disorderly conduct was reduced to a misdemeanor. I am now very sympathetic towards sponsees who are trying to get back on track following incarceration.

You guessed it. If I am still sponsoring, I am still active in AA. It may not be for everyone, but it works very well for me. Now that I have double digit sobriety, however, one thing has changed. I have no qualms about pulling aside people who disparage the use of psych meds in meetings. I share my story and explain rather firmly why they might want to reconsider that position. I am also not shy about sharing in meetings about an article from AA’s Grapevine magazine published in the 1970’s when groups were first wrestling with the subject of psych meds. The home group in that story? Well, it arrived at a position that still holds true to this day: If advised to take psychiatric medication by a physician, you should not take one more, nor one less, than prescribed.