Altered States

By Susan Madrak

With all due respect to Peter Kramer, I had no sense of well-being from Prozac. But I did love the sense of fuzzy disconnection, of isolation. And although I wasn't overtly depressed when the drug was prescribed, I soon grew to depend on, even cherish the thick, wooly cocoon between the Prozac and my emotions.

I STILL REMEMBER the first time I got drunk. I was sixteen, and my feet seemed quite disconnected from the rest of me, as if they were off on an adventure of their own. I fell in love with that sensation of disconnection.

It was the beginning of a lifelong relationship with altered states.

"Neptunian," astrologers call it. Diffuse boundaries, a shifting sense of reality. In its more exalted form, oneness with the universal consciousness. How magical, to drink a potion or take a pill and leave the mundane form behind. I hated pot, but give me a Qualude or a hit of blotter and I was good to go. With Neptune in Libra conjunct the ascendant, these transcendent little excursions were second nature to me. (Just call me Alice in Wonderland.)

As I got older, I left behind recreational drugs and moved on to the prescription kind. I took Fiorinal for my chronic sinus headaches but discovered the kick it provided allowed me to clean my house in a way that wasn't possible without it. Sinus surgery eventually cleared up most of the headache problem and when I stopped taking the Fiorinal, my then-undiagnosed Attention Deficit Disorder (ADD) burst into full bloom.

First came Ritalin. The little yellow pill was a rekindled spark; I was functional. I could stay awake, focus, and otherwise be a productive little cog in the wheel. (I always say ADD is a disease of capitalism.) After a few years, though, I developed severe Tourette's-like facial tics. My primary-care doctor insisted he had just the thing for the side effects, but I said no, I didn't want to add another layer of chemistry to my system. So he switched me to Prozac; he said he'd read somewhere there were good results with adult ADD.

With all due respect to Peter Kramer, I had no sense of well-being from Prozac. But I did love the sense of fuzzy disconnection, of isolation. And although I wasn't overtly depressed when the drug was prescribed, I soon grew to depend on, even cherish the thick, wooly cocoon between the Prozac and my emotions.

The side effects from the Prozac were debilitating. I was exhausted in the extreme; I soon developed numbness on my entire left side, as if someone drew a line down the middle of my body. Lingering fevers and chills, night sweats and dizziness. I stopped going out, I was too tired. Somehow, I dragged myself to work in the morning, stayed awake on the job enough to keep my paycheck, and went home each night to crash on the couch. I'd wake up at eleven p.m., brush my teeth, and go to bed.

Part of me loved it. I knew the Prozac was causing all these scary symptoms; I was foggy but not stupid. I'd even weakly protested to my physician once or twice; he told me it wasn't the drugs, and sent me off to a neurologist, an infectious disease specialist, an MS researcher.

Everything came back clean, and the doctors told me told me it wasn't the drugs. Of course not.

I knew better. But I didn't really want to let go of that lovely cushion. How could I? I didn't care about anything, and I liked it. It felt safe, in a way I'd never known in real life.

Finally, a concerned friend dragged me away for a four-day camping trip. She suggested I stop taking the drugs for the weekend - "What do you need ADD drugs for while you're here?" The next morning, I woke up in my tent and I felt… better. A little less fuzzy, a little less numb. No fever, either. Each day brought a noticable improvement, and by the time I went home, I'd made a decision: No more Prozac. It took six months before the symptoms were gone.

And so I went unmedicated for a few years, until I had a sleep study done to test for apnea. I didn't have sleep apnea, but it turned out I did have narcolepsy.

"Narcolepsy?" I said to the doctor, skeptical. "Come on."

The neurologist explained the likely connection between ADD and sleep disorders: "It's very possible that, once we treat the narcolepsy, your ADD will improve." He suggested a new drug, Provigil.

I just loved Provigil. I felt wide awake, with no buzz. I had no trouble sleeping. The main problem was the price: almost $400 a month. I'd moved in the meantime, and my new neurologist eventually suggested "we" try Adderall instead.

Talk about between the rock and the proverbial hard place! I'd taken a job in a chaotic company where my job description was re-written every week. I was having severe focus problems and worried about losing my job. I didn't want to take any more drugs (especially amphetamines) but damn it, I had to pay the bills. So with misgivings, I agreed.

Adderall kept me awake, but not focused. Still, awake was an improvement over my usual semi-slumbering state, so I kept taking it. (I could afford it.) I remember grinding my teeth a lot; I'd wake up with an aching jaw and a headache.

I lost my job anyway, and with it went my insurance. I went cold turkey on the Adderall and had my first real experience with withdrawal.

I didn't get it at first. I thought, hey, you lost your job, your ex-husband is dying, you have no money, no wonder you're depressed. No wonder you're sleeping in the same clothes for four days and staying in bed. It was when I started thinking about, um, sort of accidentally falling off my balcony, that I knew something was actually wrong. So I did a little Googling.

"Oh," I told myself, scrolling through the results. "Amphetamine withdrawal. Suicidal depression. Oh, right."

It was a hard, cold winter but I chose not to fall from the balcony. Instead, I started standing off to the side to observe myself wrestle with all these complicated feelings -- unfiltered, unmedicated. I learned I'm not as fragile as I always feared; painful emotions aren't going to kill me. I didn't twelve-step my way to sobriety; I didn't find Jesus. (Never lost him, far as I know.) It's just not that dramatic.

It's only that, for the first time in a long time, I'm not deliberately altering my brain. (I still take Sudafed and Claritin for my allergies, but other than that, the only pills I take are vitamins.) My caffeine is limited to one or two cups of tea a day. I don't exactly like not buzzing through the day, but I'm resigned. I deal. If I'm depressed, I let myself be depressed. If I'm sleepy, I sleep. I don't pop a pill to change it. I'm living in the moment instead of bending it to my will.

I always had this little fantasy: If I ever developed a terminal illness, I'd smooth my transition to the next plane with LSD, like Cary Grant. But lately, I'm leaning more toward the traditional version, with loved ones gathered round the bed.

Because however it all turns out, I want to give it my full attention.++

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