The medication that Doctor Wu prescribed for my anxiety was called escitalopram, or Lexapro.  When I looked up the side effects and found they included dizziness, drowsiness, weakness, sweating, feeling anxious, insomnia, dry mouth, loss of appetite, nausea, constipation, yawning, weight changes, decreased sex drive, impotence, and difficulties having an orgasm, I decided to give it a pass.  When it comes to mental health, too often the cure is worse than the disease.

Trephination, an attempt to get at a brain disorder by knocking a hole in the skull, goes back eight thousand years.  Another early treatment involved bloodletting and purging, as it was believed this could restore balance to the four humors of the body, black bile, yellow bile, blood, and phlegm.   Possibly the first electroshock therapy on record was the Roman Emperor Claudius applying an electric ray to his forehead in the first century.   Did these practices spring from the minds of physicians or the Cenobites from Hellraiser?

Things didn’t get much better in the 20th Century.  Henry Cotton, a psychiatrist and medical director at the New Jersey State Lunatic Asylum in the early 1900s, believed that mental illness resulted from infected parts of the body and began by removing patients’ rotting teeth, before moving on to their tonsils, parts of the stomach, small intestines, gall bladder and the colon. 

Shock therapy is another treatment that was widely practiced at one time, and in retrospect appears barbaric.  Insulin shocks were meant to induce comas.  Metrazol shocks resulted in violent seizures.  Electroconvulsive shocks sent electricity surging through the brain.  All of these were designed to drive out the madness, but might be compared to blowing up your house to get rid of the mice.

One of the most gruesome, and infamous, therapies is perhaps the lobotomy, where connection to and from the frontal lobes of the brain are severed, in an attempt to eradicate bad behaviors.  The most famous example of this in media is the lobotomy performed on Jack Nicholson at the end of One Flew Over the Cuckoos nest.  The bad behaviors may indeed vanish, along with the personality and memories of the patient.

Medications that have been used to try to treat mental illness over the years have included opium and morphine for sedation, toxic mercury for mania, barbiturates for sleep, and chloral hydrate for psychotic episodes.  These days commercials for new pharmaceutical drugs flood the television airwaves day and night.  The side effects in the disclaimers, like those of Lexapro, rival the symptoms of the worst diseases. 

In 2008, in the midst of a creative high, and subsequent depressive lows, I did a few weeks of outpatient treatment at Kaiser, my goal just to make it to the end of the school year when I could resign with a little dignity intact.  Using vodka to try to manage my moods had resulted in a sickening dependency, and if I began to detox during the day the fumes emanating from me could stink up a room.

During this time, I was prescribed two medications for bipolar disorder, Depakote and Seroquel.  Depakote, or Valproate, is largely used to treat epilepsy and bipolar mania.  Seroquel, or Quetiapine, is an antipsychotic medication prescribed for schizophrenia, bipolar disorder, and major depression.  For three months I quit drinking, stuck to my medication, and went to the YMCA everyday to lift weights, swim, box, and practice martial arts.  For a while I felt pretty good.  The fact remained, however, that I hated my job and had been thoroughly shut down in my attempts to do anything with my music.

When my depression returned, it came back ten times worse.  I went to a weekly class at Kaiser where a young intern showed us deep-breathing techniques that might be helpful.  Nothing helped.  One night, driven as if in a state of trance, I walked across the street to a Rite-Aid pharmacy and bought a liter of Jagermeister.  The relief I experienced upon drinking it straight from the bottle was profound.

At the end of the school year, I quit my job, cashed out my pension, and moved to Central America to become a scuba dive master.  What followed were some of the most beautiful, happy experiences of my life, so I’ve learned to heed the advice of others with caution.  Sometimes the problem is you, but other times it really is the situation.  Western society, in particular, has created conditions that can be degrading and damaging, especially for the most vulnerable citizens.  In some cases, medication may be necessary, but other times you just need to get the hell out of Dodge.

Nothing helped Vincent Van Gogh.  Few believed in his talent and he had to rely on his brother for money.  At the age of 37 he shot himself in the chest and failed, even at that.  He missed his heart and lay in bed for three days before finally succumbing to the self-inflicted wound.  Now he is one of the most inspirational, celebrated artists in the world.

At the asylum in Saint Remy in France where he’d committed himself, Van Gogh’s treatment largely consisted of cold-water baths and long walks in the country.  By now I’d gone a month without drinking, suffering through deep depressions in a stifling hot pop-up camper in my Mom’s backyard, but finding I could break free of them by going down and jumping in the cold ocean, then walking along the beach until I reached the point of exhaustion, when I wasn’t being crippled by gout.  I decided to stick with that regimen, instead of trading one addiction for another. 

Depression and anxiety, I could live with.  Impotence by Lexapro, never.

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