Enough

There is a merry-go-round inside my head where I sit for hours each day, spinning around, past, and between the question: what do I want? More specifically, what do I want to do with my time given the things that I must do and how I want to do them and what I feel will give me the greatest chance at happiness or, looked at another way, the best possibility of a living a life of which I am proud and with which I am content, more often than not.

The answer to date: I have no fucking idea.

First, let me acknowledge the uber first-world-problems nature of this question. I have a choice. I have so many choices in terms of what I might do and when and how I might do it. I don’t have to work a full-time job. I could probably get away with mostly volunteering. And, while I do have three small children, I also have a lot of help with caring for them. I am a full-time mom — we all are — but I do not provide their minute-by-minute care day in and day out (praise be).

Counterpoint: money and time and help do not fix anything unless you actively use them to make your life better, like really better in a sustained, worthy, purposeful way.

Currently, I spend my not-immediate-mom-or-other-household-related time at work. I don’t love my job but going to work, even a few days a week, flips a switch for me that says I am useful, to my family and others, I am earning money to pay (some) of my family’s cost of living, I am using the graduate degree I spent years attaining, and pursuing the career I’ve spent over a decade building. Which would all be great, except that going to work is also a massive trigger for my anxiety and depression, so much so that I’ve had to take two leaves of absence in the past three years, one that lasted over a year, and the other of which started after I sent an email asking for leave from a hospital bed in the ICU. Obviously, work is not the cause of my illness(es) but working, especially since my twins were born, has been a major precipitating factor in some of the very worst periods of my life.

And yet, I keep going back, like some punch-drunk boxer who thinks if she just keeps getting up, keeps staggering back to the center of the ring, that somehow she won’t get knocked down again. This time, it will be different. I will take on less, take more breaks, only do certain kinds of projects for certain people, work from home on Fridays, and so on and so forth, as if it’s all a matter of (illusory) work-life balance and not life and death.

But it is a matter of life and death and on the days I can hold that truth steady in my mind and heart, I know I need to quit. And yet, god damn it, I am not a quitter. I refuse to concede defeat. I can do this, this thing where you do all the things and be happy more often than not. I see it being done all around me. All of the lovely lives with make-up and fashionable clothes and eyes that aren’t red from crying, with children who get haircuts and use cutlery and probably don’t have to listen to their mom begging them to please just stop because she can’t, she just can’t right now (or ever). Women with multiple kids, full-time jobs, and husbands who work long hours and travel and, yet, somehow they just can, when I can’t.

I understand that comparison is the death of joy. That I don’t know other women’s lives. But the idea of quitting my job tears open in a me a wound of profound sadness and shame. A wound I want to plaster over as quickly as possible and by whatever means so that I don’t have to feel that pain. The pain of failure.

It was not supposed to be this way. I am not supposed to be this way. Somewhere along the way something went terribly wrong and it must be my fault. This is how it feels when I think about quitting.

But, in actuality, quitting my current job is, at its core, accepting that my life is the way it is and that I am the way I am and that working is not helping me create a life worth living. It is doing the opposite. It is taking the hard parts of my life and making them harder and taking so many of the good parts away.

My life is just as it is and was meant to be for a million different reasons none of which can be changed because they already happened and were themselves a result of a million things that came before. I am failing my life only to the extent that I am choosing not to live it in the way I know will best protect me and provide me with the most happiness. Not walking away from a form of work that continues, for whatever reason, to break me because I am afraid of doing the wrong thing is not merely ironic; it is heartbreaking. I am breaking my own heart.

And I have had enough. I will turn 40 years old in two weeks and I am no longer willing to live my life worried about what other people might think, or, more importantly, what I might think about myself because I can’t tell the difference between what I think I should do and what I actually want. I have to find my wants, to listen and feel for them every day, until I have one in my hand and then run with it, as fast and as far as I can, before I can convince myself it’s not real or good or right. I have to learn how best to love myself so that I can embrace a life that grows that love. I need to quit failing myself by pushing through rather than pulling back to my center. Because I am enough. And I have had enough of my own bullshit. It’s time to get off the merry-go-around, to do the terrifying, first right thing.

ABC DBT

This past winter I decided to break up with my therapist, which was a terrible idea except it wasn’t. It was terrible because breaking up with your therapist is the WORST. It’s like breaking up with a really good friend, someone you have an established relationship with, who knows all of your deepest, darkest shit, and who has invested time and brain power in helping get said shit sorted out. And then you break up. I chose to break up based on the hope that I might find a friend I liked better and who liked me and who might be able to help with the sorting more effectively.

There’s no real good way to find a therapist, at least I haven’t found one yet. My insurance company directory is entirely unhelpful because most mental health care providers don’t take insurance. The system is prohibitively complicated and costly, in terms of time and resources, for sole practitioners, and even groups of therapists, to become certified as “in network.” So there’s Google and Yelp and Psychology Today and word-of-mouth and referrals. I found my very favorite therapist in the whole wide world through her ad on Psychology Today. But eventually she broke up with me because I was too crazy. I mean, she made a very thoughtful, professional, and kind decision to recommend I seek treatment from someone with expertise in bipolar disorder and even found me someone with such expertise, but samesies.

Still, she is my very favorite and if I couldn’t have her I wanted to know who she thought I should have. She gave me two names. One had a waitlist, the other is my new best therapist friend since January.

I like my new friend for many reasons but a huge plus has been the fact that she is a DBT therapist. DBT, or Dialectical Behavior Therapy, is a modified form of your standard, white bread Cognitive Behavioral Therapy developed in the 1980s to treat people with Borderline Personality Disorder (BPD). It has since been expanded to treat all sorts of disorders, including mood disorders like bipolar. It’s also super helpful with substance abuse and suicidal ideation, so I’ve got my bases covered.

DBT involves working with both acceptance and change through the principle of dialectics. Dialectics, in really basic non-philosophical terms, means two things that appear to be opposites, or at lease contradictory, that can both be accepted as true or reconciled in some fashion. My favorite starter example from DBT is: (1) I am doing the best I can, and (2) I can do better. These are both true. For me and, I’d wager, for most of us.

DBT is chock full of these seeming conundrums that are actually simply true. Two which are particularly apropos to me are the concepts of active passivity and apparent competence. Active passivity means I work really hard to get other people to make decisions for me. Apparent competence means I am really competent at certain parts of life and, therefore, appear to be competent at most parts, when in fact I am not competent at all. Fun!

DBT has four major components or “modules,” which are core mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. You had me at distress tolerance. 

Tolerate distress? Yes, please. Sign me up for how to do that because I have a zero tolerance policy when it comes to distress, particularly distress related to my marriage or my children. Also, my job and body image. Pretty much bad tolerance all around. Lucky for me, this was one of the first modules covered in my DBT skills group. 

To start, I was a bit dismayed to learn I couldn’t just distress tolerate my way through daily life, but was supposed to use my skills only for significant emotional crises. Apparently, living at crisis-level anxiety all the time requires making significant life changes. Go figure. Still, I have a lot of significant emotional crises and the skills I’ve learned have come in quite handy. Some also make great party tricks.

For instance, there is the TIP skill (DBT loves it some acronyms). The T in TIP stands for temperature. It’s based on something called the mammalian diving reflex and is a way to calm down quickly. So, if you’re having a panic attack, or want to impress your friends, grab a big bowl, fill it with ice and water, make sure your fitness tracker is working, hold your breath, and stick your face in. Stay down for at least 30 but as close to 60 seconds as you can get. Assuming you are a mammal, your heart rate will drop immediately and your parasympathetic nervous system will be activated, further prompting a relaxation response. It works. I’ve tried it. A number of times. Obviously, its not always possible or convenient to stick your face in a big bowl of ice water but when it is, do it. 

Another, less intense but perhaps even more useful distress tolerance skill is STOP. Now, this is probably going to sound really simple but in my experience it is not simple at all. It is not easy to do it or even remember to do it when things seem to be going to hell in a hand basket. But I try. 

For example, I have a tumor in my shoulder. A very small, very benign tumor that really, really hurts a lot of the time. I have not had surgery yet because my insurance company sucks (double bird salute Empire BCBS). In the mean time, I have been prescribed Valium, both for my anxiety and for the muscle spasms associated with the tumor. I was prescribed 3 pills a day but taking that much was really messing with my depression, among other things, so I decided to cut back to two. Except holy hell it really hurts.

So, this was my crisis. Pain. Physical pain and all of the emotional and psychological pain that I like to pile on top of it. A pain hamburger, with the works, plus fries. When it hits, and all I want to do is take that third pill, I try (not always successfully, but more often than not) to STOP. I stop, freeze, just stand there in the middle of the room half way to my prescription bottle. I take a step back, mentally and sometimes physically, from where I was going and from the overall situation. I observe, what I’m feeling, thinking, doing, what’s going on in my environment and with the people around me. I also think about my options (I know, cheating with the two o’s). What might I do do instead of taking medication that could possibly help me feel better/less overwhelmed/more able to get through the rest of my day? Finally, I proceed mindfully. I take all the inputs, thoughts, feelings and I choose a path that seems right.

My favorite/least favorite distress tolerance skill is radical acceptance. Again, radical acceptance is deceptively simple. Basically, you accept life as it is. But by that I mean you really accept it, mind, body, and heart, not only as it is but also as it is not. You accept reality is not and cannot be something else. There are no shoulds with radical acceptance. There are no whys or if onlys or buts or what ifs. What has happened is not reality. What might happen is not reality. Reality is the present moment, the present minute, and it is what it is. Period.

You must accept reality because (1) you have no choice and (2) it is the only way forward. You can only effectively live your life grounded in what is real and true and present. Flailing around because what is real and true and present isn’t fair or right or something you can handle because-you-just-can’t-with-it-right-now-so-please-make-it stop won’t work. It is just flailing. Even if reality isn’t fair or right or something you can handle, it is still true. And the only hope you have of changing it is to start from that truth. Otherwise, you’re just titling at windwills.

I struggle with radical acceptance. A lot. I like to tantrum about life, the big parts and the small. For six years, I have been having a low-grade panic attack because I have failed to accept that my house cannot be as clean as it was before I had children. I am currently failing to accept that returning to my job is is negatively affecting my mental health and my relationships. Instead, I show up each day conviced that its me, not them, and if I can just be better it will work out.

Once, I spent about six weeks not fully accepting the fact that I had two newborns. I kept talking about how much easier things would be if there was only one red-faced, screaming banshee attached to my chest or failing to sleep through the night until finally my mom took me (gently) by the shoulders and whispered-screamed, “There are two. You have two babies and, unless you plan on taking one back, you will always have two. So stop. You are only making it harder.” And I was making it harder, with my constant imagined scenarios of easy outings with a single stroller, or god forbid, a baby  bjorn, instead of a truckload of gear requiring two sherpas and a donkey. So, I stopped. And, eventually, it got better. It was still really, really hard to have two newborns, but at least I wasn’t living side-by-side with the imaginary world in which I had only one. It was hard, but not harder in comparison to what wasn’t real.  

There is so much more to DBT than distress tolerance. So many modules! So many skills! I go to therapy for three hours every week: one hour individual therapy and two hours group. I have skills homework due each Monday. I complete a diary card with approximately 15 categories of how I’m feeling and what I’m thinking on a scale of 0-5 every night. I talk to or text my therapist throughout the week. I am often exhausted of my own thoughts and feelings and distress and tolerance of said distress (or not). But it’s helping. I feel better in the sense that I see more of what’s happening and I can name it and be less judgy and instead give myself some grace and a better place to settle and regroup before I try again. I get up. Then I get knocked down, or I knock myself down. I get up again. I accept that this is my life right now. I am doing the best I can and I can do better. 

Girl who hikes

Until very recently, I was not a girl who hikes. I was a runner and a yogi, activities that fit easily between drop-off and pick-up, around work schedules and naps. Hiking does not fit easily. It takes up room. It requires planning and packing, maps and mountains. It requires gear, appropriate gear for the conditions as I, painfully, learned prior to purchasing crampons (and you can just eff off right now YakTraks because NOT the same thing). 

I started hiking this past fall. I read a book about anxiety and the author suggested that anxious people need to plod more, run less, and to do so in big, quiet spaces, with more trees and less other people. While I did not love all of the book, I will forever be thankful for the part about hiking, because she was totally right. Hiking gets me. It takes me out of my ordinary life, kicks my ass, and sends me home feeling calmish and more capable of doing All the Things Needing to Be Done.

At first, I thought hikes would be a time to think big thoughts, answer hard questions, sort myself out into a nice little bento box of wants and needs and goals and plans. Trying to do these things will hiking is the worst idea ever. Spending four hours in my own head attempting to sort out all my shit is the seventh, or eighth, level of Dante’s hell. Hikes are for doing the opposite of this. Hikes are like meditating the right way.

This past January, I went on a yoga and meditation retreat where I learned that everything I thought about meditation was wrong, which was very helpful and worth the price of admission. I thought meditation involved solitary, silent, furious focus on finding the damn answer to the big life question. Turns out meditation is the pre-funk.

Meditation is the often, but not necessarily, solitary and silent focus on bringing yourself back to yourself, back to the breath at your center; literally, the goal is to breath in and breath out and to notice the inhale and the exhale and to not get distracted (for too long) by anything else. In my experience, it is basically impossible. Still, I try. Because if you can get to that place at the center of you, THEN you can stand there (or sit in a lovely lotus position that defies physics and my hips) and ask the big life question and, possibly, give yourself a wise answer. This is like hiking the right way.

First, you get all your gear: your map, your water, you bars, your gators (for the two feet of snow), your crampons (NOT YakTraks), your poles (again snow), sunscreen, hat, gloves, phone, small plastic bag with toilet paper, etc. Then, you drive to the mountains. There, you lace up your boots and you go.

You go for as many hours as you can possibly squeeze into your insanely busy schedule. If your me, you go hard, because the faster and steeper the terrain, the less able I am to have a chat with myself about whether returning to work part-time will provide sufficient personal fullfillment to outweigh the shitstorm that will rain down on our family of five as a result of the change in my schedule and flexibility.

Instead, I breath, I count steps, I try not to kill myself but catching a toe on every third rock. Sometimes, I chant a mantra I learned at the yoga retreat. It’s sanskrit so it doesn’t have obvious meaning, although I know what it means. It’s more like humming, or singing the chorous to a song over and over again. It helps me not focus on anything else.

Generally, it takes me at least an hour to settle in and just hike. Of course, my mind keeps jumping around, waiving its hand furiously like a small child who really needs to tell you something. But somewhere between my boots hitting the ground and around the fifth mile mark, the inhale and the exhale become the primary acoustic. I start to lose the busy, anxious, just-fucking-hold-it-together me and find the me me. The me whose existence pre-dates kids, husband, career, college, medication, diagnoses, Amazon, cars with CD players. The old-school me with nothing but time and myself to take care of.

This is the me I trust to provide the wise answer (except with regards to cigarettes, hair color, and boys). And though it doesn’t happen everytime, when the answer does come it feels like magic. Like I have succeeded in pulling a rabbit out of a hat I didn’t even know I had. And that is why I have become a girl who hikes.

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Me at the top of a very tall hill (9700 ft but can’t say moutain, because Colorado).

Reboot

Um, hi. It’s been awhile. Like maybe a year-and-a-half while. Which is totally my fault. Obviously. I stopped writing. And I probably worried some of you, and I am so sorry. I’m okay. I’ve been (mostly) okay since my last post in the fall of 2017. I’ve had a couple of really not okay moments and I will get to those eventually, but for now I wanted to try and explain why I stopped writing and why I am starting to write again and how I hope you’ll be interested in reading.

I stopped writing, largely, because I started to feel better and I felt less and less like talking about being sick. I didn’t have to think about or feel my illness every minute of every day for the first time in over a year. Continuing to blog about it felt counterproductive.

While I could have written about getting well, frankly, it felt boring and also more like purposeless navel-gazing than writing about being sick. Writing about being sick felt like it might be helpful; it made some meaning out of the madness (pun aboslutely intended). Without that larger purpose, I felt lost in terms of what to write about or why to write it.

I also had a bit of a shame hangover (hat tip, Brené Brown). I shared a lot on this blog, about my mental health, my guilt/fear/shame as a parent, partner, and human, and my struggle to accept and make my way through life as a person with “late onset,” or at least late-diagnosed, biopolar disorder. I was broken when I started this blog and I stopped writing when I had reassembled enough pieces to feel capable of moving forward from not exactly where I left off but close enough to be my life.

And I did move forward, and I do, but I’ve also taken like a million steps back and fallen once so hard I almost died. But I didn’t and I’m okay but not always or in the way that I’d like to be. Being well is a struggle, every goddamn day, it’s a struggle. And I’ve found some things that are really, really helpful to me. Also, things that are particularly unhelpful. I’ve got some thoughts and ideas and tips and tricks and questions and answers and questions without answers that are still useful to ask. I’m back at work. My oldest is about to finish kinder and the twins will start pre-K this fall (?!). I am the ringmaster of the shit show that is our family of five. I’ve started taking epic hikes and gone to two meditation retreats and one in-patient psych ward and my weekly pill organizer could kill a horse.

I am okay and not okay every day and most often at the same time. And I’ve been thinking I’d like to write about that. That it might be helpful to know that getting better is always just that and sometimes it involves getting worse, at least for awhile. I have absolutely no answers to Any of the Things, but I can point them out and write about them in a way that might make them more approachable, less scary, sometimes funny, and always shared. It’s not just me and it’s not just you and none of us can do this alone.

So, if you’re not still totally pissed at my for disappearing for 19 months, please come back. I promise I’ll write as often as a mentally-ill, working mother of three kids six and under can, which I hope is often. XOXO, A

Acceptance

Acceptance is often discussed as the final stage in a variety of different emotional transformations or processes. Acceptance of the loss of a loved one, acceptance of divorce, acceptance of a chronic illness. And there are other common stages that come before acceptance, including disbelief, denial, anger, and sadness.

For me, having twins has been such an emotional transformation. And, at least according to my therapist, I have yet to accept that my life has changed as a result of having two babies. This lack of acceptance is allegedly the cause, or at least part of the cause, of my ongoing struggle with severe anxiety about just about everything, but particularly everything related to being a mom, the mother of three, including 9 month old twins.

Looking back, my disbelief stage didn’t last long because, you know, science. It was undeniable that there were two of them from about six weeks on. But denial, denial and I became good friends. So long as I didn’t think about it too hard, I could almost pretend that the pregnancy wasn’t happening, even when I was throwing up four times a day and eating my (ever-increasing) body weight in potato chips each week.

When I wasn’t busy pretending it wasn’t happening, I was angry. Mostly at myself. If I hadn’t needed fertility treatment, if I had been more normal, more healthy, more like a woman should be, we most likely would not have had twins. They don’t run in my family or my husband’s family. We could have had just one. My God! Imagine what just one more baby would be like instead of two. [Side note: Two newborns, and even two not-so-newborns, is so much more than one baby. It is exponentially more baby.]

My obsession with what might have been got so bad that my mother finally confronted me. She said, unless I planned on giving one of them away, there would always be two so there was no point in thinking about any alternative. She was right and, eventually, I willed myself to stop because it made me so sick with envy and shame.

Before my first son was born, I had been deeply ashamed of not being able to get pregnant. Now I was ashamed for, in some sense, not wanting one of my babies, for feeling angry and sad instead of elated and hopeful. Even after the babies were born, perfect and healthy and big enough to come home from the hospital right away, I still felt sad. Sad and overwhelmed and incompetent and scared. Eventually, all of these feelings coalesced into a general, ever-present feeling of anxiety.

Anxiety – a feeling of worry, nervousness or unease – follows me around now like Winnie the Pooh’s little black rain cloud. Sometimes it grows so big I have a panic attack (like I did this past weekend, at home with three small, sick kids on a rainy Mother’s Day). Mostly it just hovers in the background of my days, making my heart race a little too quickly, my mind focus on the lows rather than the highs, my sleep restless, my concentration poor, my marriage tense.

I work four days a week as an attorney and I come home every work night to two babies who are either the happiest or most furious babies I have ever seen (sometimes both and always seemingly at random). I take over for the au pair immediately but also need to change, set the table, make dinner for my husband and older child, etc. Sometimes it works out; sometimes it doesn’t. By the time dinner is done (food strewn everywhere except my toddlers stomach), it is time for bath and books, which usually involves some bathing and book reading but mostly feels like a game of whack-a-mole, except instead of whacking the moles, we have to try to diaper and dress them and keep them from maiming themselves. Then baby bottles and toddler back rubs and trips to the bathroom until finally, blessedly, the kids are asleep. Sometimes my husband and I take time to cuddle on the couch; sometimes one (or both) of us needs to catch up on work. Regardless, within a few hours at best, we are also in bed.

As I write this, none of the above seems that difficult. In fact, it sounds like it should be the best part of my day. But it’s not. I often spend the period between work and bed feeling so anxious, so overwhelmed and inadequate, that I want to cry. Or drink. Or runaway. I don’t understand it and I can’t seem to fix it. I sometimes numb with whatever is handy to avoid it, which only makes me feel like a worse parent.

Weekends feel even harder. Constantly trying to entertain and tire out the  three-year-old; fitting in two naps plus assorted feedings, diaper changes and activities for the babies; husband wants to play tennis; not to mention all the chores that keep our house and clothes clean, our fridge stocked, our bellies full. I get through it, but that’s about all I do, which only makes me feel worse. I feel anxious and sad about feeling anxious and sad. Because apparently even my feelings are wrong.

I like my job and I love my family but it’s an effing lot to deal with day in and day out. And despite the overwhelming evidence to the contrary, I still haven’t managed to truly accept that I can’t live my life the way I did before I had children, or even when I had only one child. I joke about lowering my standards but I haven’t really done it. Not in any significant way. I don’t know how. Also, it scares me. If I let control of any one thing slip away, how do I hold on to the rest? If I’m not constantly vigilant, constantly planning ahead, constantly trying to anticipate and meet our family’s needs, who else will do it? I am the mom after all. Isn’t this what moms do?

I know I’m not alone in feeling how I do about being a mom. But I also know many moms are able to navigate their daily lives with more gratitude and joy and far less anxiety than I have. At nine months postpartum, my anxiety about mothering seems to have become a mental and emotional habit, a self-fulfilling prophecy. From the moment we found out we were having twins, I expected it would break me and so it has. But if my expectations were different, maybe my reality would be, too.

If I can accept that I am a mother of three, now and forever — that my to-do list will never be completed, that my house will not always be clean, that my days will be unpredictable, that I will be pulled in multiple directions, that I will disappoint or hurt or not be present for one or all of my children (or my husband) at (many) points along the way, that I will not be able to control the outcome, that much of my planning will be pointless — then maybe my anxiety would dissipate. No more little black cloud. Because if I don’t have unreasonable expectations to fail to live up to, then I don’t have to spend my days fearing failure.

So that’s the goal: to accept that my life is not and will never be the same as it was or what I imagined it would be. It will be different. It is different. And I will have to learn to be different too.

Wish me luck.

Sometimes 

Sometimes the bad feelings follow the good so quickly it makes my head spin. One minute I’m fine, better than fine, nearly myself again. The next minute, I’m an anxious, tearful mess, only looking for whatever might numb my feelings quickly enough so that my family doesn’t notice. 

What the hell is going on? I’m so fucking tired of this bullshit. It’s been six months since the babies came. Enough with the postpartum shit already. And yes, I was crazy before the babies, but not like this. Never like this. At least not for such a sustained period of time. I don’t know what to do. I feel like we’ve tried everything. I’m scared nothing will work. I’m really scared.

If I was unmedicated

I would probably be dead.

But if I wasn’t dead, who would I be?

I’ve been medicated for OCD, depression and anxiety off-and-on since I was 18. If I had decided not to take those little pills at any point in the past nearly 20 years what might have happened?

Would I have graduated from college? Law school? Would I have even gone to law school? I was going to be a Russian history major after all, until I had to drop out of my first undergrad and learn to eat again.

Would I have met and maintained my now nearly 15 year relationship with my spouse? Meds helped me make it to and through my new college. I even made friends, who eventually introduced me to Matt. So without meds we may never have met.

But there have been times, particularly when I have tried lowering, changing or even going off my meds, that our relationship has faltered. Does this mean that unmedicated me would have left, would have wanted something or someone else? Or is it just that unmedicated me is impulsive and destructive and likes to blow up as much of her life as possible just to watch it burn?

I honestly don’t know.

Similarly, I am not sure that I would be a mother of three but for my meds. Having children is terrifying and I’m already afraid of my own shadow. Putting my heart out into the world like that? Taking on that vulnerability? I’m not sure it would have been possible but for my medication.

So, assuming I had stopped my meds somewhere along the way (and hadn’t died) what would have happened? Would Matt and I have broken up during or after college? Would I be living alone now, no kids to hurry home to after work?

I guess what I really mean is, has my medication helped me to be me–the me that I would’ve been even if I’d never taken it; or is my medication a factor in my fate? Has it determined the course of my life in a significant way?

And if it has determined the course of my life, does that mean I’m not really me? The me I would be if I had just let it play out the nature-nurture way, without the chemical assistance.

Questions without answers I suppose, except for that one at the beginning. If I was unmedicated, I would probably be dead.