The Sickness

I'm on a lot of drugs. I won't soften the language here. Most people would find the doses I need to just barely reach the level of being able to remember what I was even doing just moments earlier quite staggering. A medical student intern from UCLA was reviewing my case with my physician, was surprised that I'm on as many drugs as I am, and was absolutely certain the doses and the history were mistaken.

Then she met me. Within a fraction of an instant, on a time scale normally reserved for testing the resolution of clocks far more accurate than the infamous atomic clocks, she knew there was no mistake.

I take at least 60 mg of pure amphetamines each day. Some days I need as much as 300 mg. I had 600 mg once. It kept me out of prison, and saved several lives. I'm not joking.

I take around 5 - 10 mg of Lorazepam daily. This is more commonly known as Ativan. It's used in those doses to subdue violent inmates in mental health facilities. Sometimes I've taken over 100 mg in an hour. Again, it prevented much worse problems.

I take around 5 - 10 mg of Alprazolam daily. Xanax. Far faster-acting than Ativan. They're both benzodiazepenes. Technically, the Ativan can substitute for the Alprazolam. In practice, I need both.

At these dosages, within a week I was physically dependent on the benzos. Not addicted. Dependent. My brain rapidly fragments and implodes if I stop, and often if even I slow my intake of them. Within a week I can barely speak. After two, I can't breathe without conscious effort. I've never gone past that point.

The Amphetamines are much more insidious. I am addicted to those. Not a physical dependence, but a social dependence. I can't function without them. I become completely psychotic within hours of missing a dose. I become violent within days. I've never gone more than a week without them.

But the most insidious physical dependence I have is on Lexapro. It's an SSRI. It does for Seratonin what Amphetamines do for Dopamine. It slows the reuptake of Seratonin in certain parts of the brain so that it has more time to take hold of the receptors. Seratonin regulates the sympathetic nervous system, and is the backbone of the parasympathetic nervous system. The benzos regulate a much lower-level neurotransmitter called GABA, which is the primary noise filter.

Without the benzos, I rapidly develop DTs, lapse into a coma, and die. Without the SSRI, I slowly lose any ability to think, to move, to process, to function. The symptoms are very similar, but take much more time to become apparent.

The holidays are the worst.

I went from just before Christmas to well past New Years without the SSRI, and much of that time also without the benzos and the amphetamines.

I've been back on all of them now for just over a week. My best guess is that the changes are permanent. My brain has lost something. My psyche is fractured, cracked, not nearly as stable as it once was so many years ago when I first began treatment.

But at the same time, even with such complete devastation, I did manage to function much better than before. The pain was indescribable. It's pain. It's not pain. It's something incredibly wrong, yet not at all physical.

I related many of the events of the past two months to my doctor when I could finally see him. He was shocked I wasn't dead, or worse. And he was proud of me.

I've been seared down to nearly nothing. There is no more that isn't the bare essence of my "self". I'm completely exhausted. And yet still I manage to move forward, driven by the force that I've known was at my core even as a child. I cannot stop.