- © 2007 Canadian Medical Association or its licensors
I'm perverse.
A few years ago I fell ill, of the mental sort. Marital breakdown and professional stress were interrelated triggers, but it was felt that I was suffering from an actual disease, and I was treated accordingly, being referred to a psychiatrist who felt medication was indicated.
I went through all of the usual stages of denial. At first, I thought I wasn't ill at all, just undergoing “stress.” Much of this denial was banished when the psychiatrist told me that I was perhaps the most depressed patient she had ever seen. Then I played with my medication, debating that it wasn't really necessary, so I took it on and off until my psychiatrist divined that and challenged me, point-blank: “Do you want to get well?”
I did. So I took the drug faithfully, and I got better. But there was a price: on the medication, I feel like sludge, I feel like my thoughts are slowed down, I feel like I am interpreting the world though a dark filter. Torpor is the word I use when I'm feeling really resentful that I have an illness that requires treatment.
So, about a year ago, I pushed and pushed to get the psychiatrist to let me come off the drug. I told her about the side effects, I emphasized that I had been relatively well for 6 months. She relented, but with misgivings, and, not surprisingly, I got sick again within weeks.
So I've been back on the drug again for a year. And in her office a few weeks ago, in the midst of the interview, she shocked me: “Do you think it's time we tried to taper you off the medication?”
I didn't push, I swear. I didn't moan about the side effects, in fact I had become rather resigned to them. This took me rather by surprise.
At first, I wanted to do a little victory dance. I settled for throwing my arms in the air. But after the initial reaction, I grew rather more circumspect. I asked her if she remembered what happened last time, how I went off the rails rather quickly, how I burned through whatever marital good-will I had accrued up to that point after a very long dry spell, how it took months before I could work as a doctor again. She acknowledged all this and said that, in her professional opinion, based on my mental state, that I was ready. This time.
Then things began to get strange. My thoughts ran something like this: if I stop taking the drug and get sick again, it will mean I have tried to taper off twice, and now I'll likely have to be on the drug for the rest of my life. That means a lifetime of sludge. Yet, if I continue to take the drug for just right now, I'll be left with the illusion that the drug is just temporary and can be withdrawn at any time. So, I concluded, I want to continue taking the drug so that I can one day not take the drug. Does that make sense?
In the end I've decided that I am going to try to taper off just because I hate the drug so much. I want to be rid of it. Another part of me loves what the drug has done for me, and knows what can be lost. This time, though, I won't hold on until the bitter end, refusing to call my psychiatrist because that means going back on the drug. If I start to get sick, I'll call her before the losses start to mount, and I won't think in terms of the rest of my life. I'll think in terms of today.
— Dr. Ursus