“We Don’t Do The Same Drugs No More”

I finally went to the OB-GYN last week. I hadn’t been since my post-partum check up, six weeks after my daughter was born. That was four years ago. The CNM scrunched up her face when I told her. “You haven’t had any lady care for four years?

It pisses me off that people are often blasé about the fact that men in their twenties and thirties go to the doctor pretty much never but women who don’t go the the OB-GYN every year are seen as irresponsible. “I thought the USPSTF changed the recommendation for pap screening from one to three years?” It was half question, half half-hearted explanation. That wasn’t why I hadn’t been in, but it made me feel better. “Plus, I’m not on birth control,” I added, realizing I hadn’t adequately justified my hiatus from reproductive health. That one hit a little closer to the truth of the matter. I stopped taking hormonal birth control the year before I got pregnant and never went back on, and absolutely relished the freedom. Yes, I realize that the pill that tied me to a doctor and flatlined my sex drive is the same one that liberated me and millions of other women. I can hold onto both of these truths at the same time. The CNM tucked her leg up onto the chair, tucked a chunk of pink hair behind her ear, chiding me quietly as she pulled up a new chart: “That may be, but you still need exams.”

It’s not like I’d been neglecting my health. I am in tune with my body to an almost freakish degree and I love medicine of both the Eastern and Western variety. Almost as soon as I went back to work after maternity leave, my stress-induced TMJ flared up. I tried acupuncture first, but it didn’t do enough to justify ducking out of work for an hour at a time, so I turned to an internist who was so cute I decided he would be my first-ever adult primary care physician. What I wanted was painkillers. What I got was a referral for PT that ended up being exorbitantly expensive and inordinately time-consuming and not covered by my insurance.

Later that year, I went back to the internist about a strange rash. I made big plans to tell him about my anxiety, too, but couldn’t find the words. I’d never told anybody how my chest tightened up every day when I left the office, or how my stomach roiled before I left the house. Was that anxiety? Was it bad enough to warrant medication or did I just want to get high? What I wanted was to get the ball rolling toward a prescription for Xanax. What I got was a diagnosis of stress-induced eczema.

A few months after that I huffed a chemical inhalant in the middle of my work day. I think the high lasted a few hours but it was hard to tell when it wore off because my head didn’t come back to my body. I remained in a dissociative state that the internet told me was called depersonalization for six days. I remembered that I had a primary care doctor and called his office to beg for an appointment. A different doctor in the same practice group squeezed me in. “Are you under a lot of stress?” he asked, shining a light into my eyes. I nodded. He asked me to turn my head from side to side. “Do you find yourself crying?” “Mhm.” My eyes welled up. What I wanted was somebody to tell me I didn’t have brain damage. What I got was instructions to come back for a full blood workup the next week.

I went to a therapist instead.

I went through a round of CBT.

I got back to running.

I got sober.

In short, I started to get right mentally, physically, and spiritually.

Nine months after I quit drinking, I ran a marathon. A particularly severe bout of post-race tendonitis drove me back to the primary care physician. I’d sustained enough strains and sprains in my two decades as a runner to know that ice and rest would do the trick, but the pain in my hip was bad enough that I figured I could benefit from talking to a physical therapist who specialized in running injuries. Of course, I never would have booked the appointment if I didn’t think I there was a chance I could also get drugs. In the few minutes it took to schedule an appointment online, the pink cloud that had been carrying me for months dissipated. I went from happy sober person, chirping away in meetings about how great it felt to be so present for my family during the holidays to walking zombie. I went from wanting to get better quickly to hoping for something serious–a fracture or a tear. I didn’t think about calling my sponsor. I didn’t think about what I’d do when the pills ran out. I couldn’t think about anything but the possibility of getting high again. I obsessed about what I needed to do to make it happen. The next day, I hobbled to the office and told the doctor with a straight face that the pain was an eight. I told him I could barely walk. I got him worried enough that he wrote out an order for an x-ray, which is when I knew the jig was up because there was a minuscule chance I might be pregnant that I couldn’t ignore, given how long my husband and I had been trying to have a second kid. The doctor sent me home with no x-ray, no drugs, and prescription for ice and rest. “Come back if it still hurts when you get your period.” Fuck.

Once you’ve developed a taste for pharmaceuticals, every doctor’s office is a street corner, every appointment a seedy transaction, every honest ailment immediately supplanted by symptoms of the most plausible path to opiate relief. And when you are sober, every ache is an invitation to go back out. It’s easy to pretend you’re not flirting with relapse because sometimes people need medicine. With my history, the question of how prescription drugs fit into sobriety should be black and white but when I try to hold a picture of my sober life still in my head, there is so much blank space I start filling in the gaps with gray. Of course, most doctors aren’t handing out controlled substances like candy anymore. When you are an ex-pillhead, that almost doesn’t matter. The possibility alone is enough to throw you off course. It’s easier to avoid doctors altogether.

So that’s why I haven’t been to OB-GYN. I can’t trust myself to go in for a pap smear and not drum up enough undiagnosable premenstrual pain to walk out with a low-grade narcotic that will start the slow unspooling of my life. If you jump through enough hoops, the drugs will come. That’s how, last month, I ended up driving myself away from the hospital at 2 AM on a Sunday with a clean bill of health and a unnecessary prescription for Norco tucked in my bag, mind racing with thoughts like:

“A tranvaginal ultrasound is a steep price to pay for a week’s worth of pills;” and

“I guess nobody ever accused a junkie of driving a hard bargain;” and, most importantly,

“What the fuck am I going to do when these pills run out?”

The next 24 hours were mental torture. I had drugs, but I also had a head full of AA, which means I am utterly incapable of convincing myself that taking even one pill (or drink) is not a big deal. I know where one pill (or drink) goes. I’ve been there before and it’s hell. There is no easy way back if you even get a chance to come back.

Of course I was going to fill the prescription anyway. I went to four pharmacies that day. One rejected my (extremely common and accepted everywhere) insurance. The other three were closed, two of them within thirty minutes of me showing up. By 8 PM I had nowhere to go but my usual Sunday night candlelight meeting. Somebody said something about their daughter and I remembered (for the first time in days) that mine was turning four soon and that if I took those pills, I’d be drinking or using or withdrawing on her birthday. I knew enough about myself to know there was simply no way I would not be a fucking mess. I went home knowing what I had to do, knowing exactly how good I would feel when I did it, but still unwilling. The next morning I woke up early and, without giving myself time to think the decision through, turned on the stove and stuck my hand with the paper prescription into the burner. The night before, a doctor friend had told me to just rip it up, which I guess would have done the trick, but I needed this thing gone. The burn was not clean; I was.

The unexplained pain that had precipiated my ER visit disappeared that day.

I kept the OB-GYN appointment I had scheduled a few days earlier anyway. I’ve been trying to have another baby for two years and have reached the point that I can’t pretend doctors don’t exist. The CNM asked me questions as she filled in my chart. “What was the first day of your last period?” “How many days is your cycle?” “Do you drink?”

I looked up from the paperwork I was working on and looked her in the eye and told her what I’ve before never told a medical professional because I was not willing to burn bridges I might want to cross later: “No. I haven’t had a drink since January 30, 2016. I have a history of substance abuse, mostly painkillers and weed. I can’t mess around with that stuff.”

“Congratulations!” she said.

When I left, I felt relieved. Not because I think I am finally going to get pregnant but because I finally have a doctor I can go back to without tearing  open my old wounds.

Need Versus Want Versus Deserve

One of my first big steps toward recovery was making an appointment with a counselor. Initially, I tried to find somebody whose experience spoke directly to my very special and unique circumstances. My first run at sobriety through a twelve-step program left me convinced that I was different (better) than the folks who needed God and daily meetings and inane “literature” to keep clean. In reaction to this, and in a simultaneous act of desperation and ego, I sent my first inquiry out to a woman who advertised herself as specializing in working with “high functioning” individuals seeking to address career-related anxiety. I considered it a bonus that she specialized in career transitions as I was convinced that the bulk of my problems emanated from my insanely high pressure job. I pretended that I liked the fact that she was herself in the process of transitioning from counselor to bona fide life coach, even though that struck me as if not a red flag, then at least a pink one.

I also searched for counselors That specialized in substance abuse, but not, like, serious substance abuse. I was only drinking except for that one time in February when I took what was left of the hydrocodone from my c-section because I was annoyed at my husband and spent the next day ransacking medicine cabinets until I broke down and realized I needed to get myself a dealer, a prescription, or into an NA meeting (they are right when they say you don’t realize you are an addict until the drugs run out). I pretended not to notice that many of the addiction counselors that I found online specialized in something called “harm reduction,” which is the clinical term for “drinking less, but still drinking (thank God).” I pretended not to notice the crawling in my arms, the way my insides lurched in anticipation when I read those words, which I took as permission. Nothing red about those flags flapping furiously in the wake of my denial.

In the end, the high end life coach didn’t have any openings and the addiction specialists worked across town and I ended up going with the first local counselor who saw clients late into the evening, because as a full-time working parent of a young child, that was the only time I had. I made the call from the back porch, whispering into the phone because I didn’t want my neighbors to overhear. I told her I was anxious all the time and afraid of falling back into old, dangerous habits. She told me she could help. I booked five days out and cried with relief into the cool autumn air.

By the time I made it to the appointment I was high out of my mind and couldn’t look the counselor in the eye. At her suggestion, we walked up and down Lake Michigan and I told her, in halting, unemotional tones, what was going on. I told her about my long hours and my toxic co-workers and my dead dog and my oppressive religion and my transgressive marriage to a non-Mormon and my clingy toddler. I told her about my expectation that I would be perfect in all aspects my life, explaining that it was not as unreasonable as it sounded because I’d pulled it off pretty well for 30 years. I told her how the anxiety started in my head and worked its way into my chest until I was on the verge of panic. I told her how the depression started in my chest and worked its way into my head until I was on the verge of tears. I told her I didn’t know what to do.

When I finished unloading, the counselor said a few things that stuck. She said that she was not surprised that I got high. She said that I was burning the candle at both ends for my family and my job but that I wasn’t doing anything for me. She told me I needed some new coping mechanisms. Together, we came up with an action plan that looked something like this:

  1. Go to bed early.
  2. Stop looking at my phone before bed.
  3. Exercise.
  4. Join a mom’s basketball league.
  5. Meditate.
  6. Start a blog.

That’s right. I paid a counselor $150 an hour to fix my brain and came out with a list of New Year’s resolutions.

As with any list of resolutions, this one needed a bit of tweaking. I never could muster the nerve to play basketball with a group of stranger moms, particularly since I had it on good authority that at least one of the moms was a former collegiate player, so I decided to train for a race instead. I never made it past the first meditation session using the Headspace app, so I ditched developing a regular meditation practice in favor occasionally reminding myself to breathe.

For the next few months, I treated this list like a prescription, and the items on it like medicine, because that’s what they were. I dutifully turned off the TV after a single episode of Walking Dead and went upstairs at 10 PM. I stopped asking myself if I had time to go to the gym and just went. I submitted a proposal for a blog on women’s issues to a local collective and forced out content for content’s sake. If you’d asked me before I went to therapy whether I had time for myself, I would have laughed. Sure, if you count trying to see how much work I can cram into my 25 minute train rides to and from work and playing LEGO with my two-year-old as time for myself. I wanted to read fiction and write essays and play music and run along the lake, but somewhere along the line I convinced myself that I didn’t deserve to do the things that made me come alive unless they were in the service of my employer or my family. I’d bought into the idea that women can’t have it all, that by having a good job and a happy family I was already taking too much, and that if I dared to ask for more I’d lose it all. By re-framing my dumb hobbies as mechanisms for coping with anxiety that was driving me to self-destruct, my counselor took want and deserve out of the equation. As she pointed out, I wouldn’t be able to do my big job or take care of my family if I went to rehab. I made time to read and write and run because I had to.

The other thing my counselor recommended is that I go to recovery meetings. She started with gentle suggestions, emailing me dates and times of meetings vouched for by her colleagues, meetings with professionals, other lawyers, women. After yet another lapse, one that left me so sick I was begging my husband to take me to the hospital and finally willing to do anything to stop ingesting poison, my counselor gave me the gift of telling me that it was time to get serious about finding a recovery community. I’d tried to stay sober myself and failed. I needed help.

I balked. I questioned whether I could call myself an alcoholic. I questioned whether I had time. When the memory of the last hangover receded into the distance, I questioned whether I still needed to go to what I perceived as the extreme lengths of taking time out of my busy schedule to sit in musty rooms listening drunks read from an outdated book, listening to drunks talk about their problems, holding hands with drunks, listening to drunks recite the Lord’s prayer. That’s how I described the experience of participating in AA when I was convincing myself I wasn’t sick enough to continue with the program. During these negotiations with myself, I discounted the way I felt every time I walked out of a meeting, which was always, inevitably, without fail, better than I felt going in. Meetings made me feel lighter, seen, renewed. The truth was that I liked stepping outside of my routine, which had become staid and soul-sucking. I liked listening to people work through their shit. I liked thinking about how to live a better life. I especially liked the drunks, who showed me that I was not insane, or at least that I was not alone in my particular brand of insanity. And oh how I envied people who dropped casual references to home group and who laughingly confessed to being kicked in the ass by a sponsor, which told me that I did want a recovery community, and badly.

As usual, as a woman, a Mormon, a mom, a martyr to the end, wanting it wasn’t enough. Want didn’t justify tucking my kid into bed early to make a 7:30 meeting for young people on Thursday night or losing an hour better spent billing to check in with a Monday nooners group. And, it turned out that need wasn’t enough either, at least not after a decade spent hiding from the truth, lying to myself about what it is that I really need.

A close call and a sobriety angel cleared things up. I posted a cry for help in an online group for women working toward sobriety. I owned up to needing an IRL community, and whined that I had no time to attend meetings. A serious wise woman weighed in.

First, she handed down some knowledge. She said, “For years, I used drinking to hold together an unsustainable life. Like duct tape. When I took alcohol out of the equation, something had to give.”

Next, she put me in my place. She said, “I have two kids and a high pressure job and I go to six meetings a week. Anybody that is not okay with me taking the hour a day I need to not drink myself to death can fuck off.”

In the end, she made me cry. She said, ” You deserve a life that isn’t killing you.”

She was right, of course. This is both obvious and revolutionary. Within days, I found a meeting that I loved, that I attend and look forward to as often as I can up to three times a week.

I deserve to take 30 minutes to run a few miles because I want to move my body, not because I need it to quell the anxiety that makes me slam doors and scream at my family.

I deserve a job that does not require me to sacrifice my sanity, my safety, and my health at the alter of the billable hour and client service.

I deserve an elevated life in which I deal in wants not needs, in which I do the things I like because I like them, not because I need them to cope.

I deserve to feel like I want to live instead of like I need to die. 

Anybody that is not okay with me doing what it takes to shape that life (including, mostly, myself) can take a seat.

What I Thought And What I Know About Depression

January blew in and out again in a puff of snow. Seasonal Affective Disorder and Postpartum battled it out in my head. I thought I understood mental illness because when I was a teenager I had a string of bad boyfriends and too many feelings and cried out loudly for help. I thought I understood mental illness because I lack impulse control. I thought I understood mental illness because even after I got a good boyfriend, I still felt sad. I thought I understood mental illness because sometimes I cry on the bathroom floor. I thought I understood mental illness because my aunt tried to kill herself and my other aunt lied about being on the pill because she wanted to get knocked up so she could move out of her parents’ house, and because my mom is a rock from a quarry of dysfunction. I thought I understood mental illness because my good friends are in therapy or on drugs. I thought I understood mental illness because my husband, the good boyfriend, is anxious. I thought I understood mental illness because I know depression is a disease and needs to treated. But I don’t understand this month-sized hole in my chest. And I don’t understand the static in my head. And I don’t understand waking up in the morning and rolling right back over again. And I don’t understand why the usual tricks like focusing on the positive! and giving it some time! aren’t enough to snap me out it. I don’t understand why I thought I’d be immunue. I don’t understand why I’m not immune. This month felt like a year and I hated it for taking me away from my child, my husband, my job.

I wrote the preceding paragraph almost exactly two years ago, in February 2014. Reading it for the first time since then I can’t figure why it took me so long to get help. I quit drinking that year in May, around the same time the weather turned, and my mood lifted considerably, but the blackness returned with the cold in December and I didn’t call a therapist until the following September after months of cycling on and off the wagon, in and out of anxiety, over and over again. The turnaround since then has been incredible. January 2016 wasn’t exactly a walk in the park, I still felt inexplicably sad sometimes, and I cursed the dark days, but I knew what was going on and I knew how to handle it. I didn’t always succeed, but I managed to be present for my family, my job, myself, and today I am happy even though it snowed and I didn’t see the sun. If you are suffering, please know that help is available.