Wednesday, November 10, 2010

Frontiers Of Denial - Lesson 1: Self-Medication

As a card-carrying alcoholic bipolar bear there’s little anyone can teach me about denial. When confronted with a choice between the easy way and my way – well – do I even need to tell you which I chose? Frequently I was so defiant that – if you told me to turn left, I turned right simply to annoy you…and show you that I could. Demonstrating my will became more important than doing what was best for me. I paid dearly for this commitment to ill-considered independence.

There’s an old expression that goes – Anyone attempting to defend himself in a court of law has a fool for a client. There is no equivalent saying in the world of mental health but we sure could use one because acting as one’s own therapist – counselor – physician is rather like performing an emergency appendectomy on yourself while drunk. Sadly, however, the practice is common, as evidenced by the hilariously euphemistic phrase, self-medication.

In the rooms one meets so many people who have wrestled with clinical depression; alcohol abuse was their way of “self-medicating” and the results are horrific. But my most vivid introduction to the concept came as I attempted the trapeze act of managing manic highs, using pot and alcohol to hold onto that magic point of euphoria. Repeated crashes taught me that pouring booze and other drugs on mania is really pouring gasoline on a bonfire; one is in tremendously bad faith if one acts surprised when the building burns down.

To be fair, talk therapy, which is where the real action and healing can be found, is so time-consuming and expensive that insurance companies are squeezing it out of fashion. We have become overly reliant on psychotropic pharma to manage mental illness, and it is an imprecise science. Some meds are nasty, some have ugly side effects, some are not well understood, and many are expensive – even if one has coverage.

So, for the arrogant imbecile anxious to ignore the medical community’s collective wisdom, there are plenty of plausible excuses to avoid the obviously superior path of care and treatment under the supervision of a trained professional. Bipolars are absolutely famous for doing this; going off their meds when things improve and taking back their will, no matter the seriousness of their transgressions.

If you have a bipolar bear in the family complaining about side effects, it’s okay to listen seriously and sympathetically, but, it might be the first step on a road culminating in self-administered brain surgery. Remember that alcoholics are world-class liars and bipolars, especially those early to recovery, are amazingly accomplished in the art of rationalization.


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