I was nine when I began reading prescription labels. My mother kept the lithium in a slender cabinet beside the refrigerator. Either of my two brothers or I could have grabbed the bottle when reaching for the salt. I appreciated the cadence of the word, lithium. I repeated it with a breathy whisper.
I remember my mother disappearing, and I remember visiting her in the hospital, not far from our home in San Diego. We dropped in on Sundays, though our appearances were brief. Mesa Vista looked like a tiny village from the highway, with squat buildings and chain-link fences around the perimeter. Inside, the hospital’s ceiling was low, and we met her in a wide room with beige carpeting. She was in a baggy dress, or was it a gown? Her hair was unkempt, a feral mess. But she was thrilled to see her boys.
Board games were stacked on the table—Monopoly, Clue, Sorry!—but I only wanted to play bingo. The wire globe, with its hand crank and perpetually tumbling balls was mesmerizing. Do my brothers remember this? I was enthralled.
After an hour, my father drove us home. I knew we would be back soon, but she was sad to see us leave. On the way back, we often stopped at McDonald’s. I always ordered Happy Meals.
Five years later, I was at a friend’s house when my father called to say he was picking me up. It was an emergency. The reason was unclear, but I was intrigued. We weren’t going home, he said. We were going to stay at the Residence Inn—a hotel that looked like a condominium complex. For how long? I asked. A few days, my dad said. That was fine with me. The hotel was in the parking lot of a new shopping center, which was a coup. The room had a kitchenette with an electric stove and a microwave. We were practically on vacation. When we asked my father why we were there, he muttered something about our safety. My older brother seemed concerned, but I shrugged. I had my Game Boy, and the movie theater was across the street. The Mask was on the marquee.
The pills were curiously small, and the name was strange: like it belonged in a carnival with clowns and kewpie dolls. I left them alone and never asked my mother why she needed them. I was in middle school, and she would occasionally bring me to her appointments with Dr. Ettarri. His office was like a set, a photograph of Freud’s library. A Tiffany lampshade, degrees on the wall, a chestnut leather chaise. The topics of discussion? Always my private matters. Anything my mother had gleaned from my journal or the notes she found in my jeans. Marijuana and making out were at the top of the list. Is this even legal? I wondered. Why am I being interrogated? You’re not my psychiatrist. I was dragged here. But I didn’t protest. When I acted contritely, they were appeased.
As a Berkeley student, I learned that the index is the most important part of a textbook. Once you find the subject you’re searching for, you can instantly flip to its page. You’re an investigator, prowling for meaning. My research yielded the precise results I wanted. With its soft zee and Germanic finish, Zoloft felt like a perfect fit.
I went to the university clinic and described my symptoms to the nurse: hopelessness, anhedonia, lethargy. I had memorized the terms and definitions. I knew what I was doing. The causes were anodyne. A break-up. Loneliness. A new environment, five hundred miles from home. And, as I mentioned, a family history of bipolar disorder. I suggested the treatment, even the dosage. Checking the nurse’s notes, the physician agreed. I walked back to the dorm in the autumn twilight, relieved. I fingered the bottle of meds in my pocket, a salve. I had found the solution. Everything would be fixed.
The summer after my sophomore year, I worked in a video store in La Jolla. I stocked shelves with new releases and rewound tapes for minimum wage. On my days off, I wasted my remaining hours with Brandon and Rich, a couple of guys I went to high school with that never left home. Their company was constant comic relief. A refined routine. They rarely worked, yet they always had enough money to gamble and buy weed. Mexico was less than an hour away, and Baja was their retreat. They sprinted to the sportsbook and drank cheap tequila on the main drag. I only joined them once. We crossed the border and strolled down Revolución in search of a generous pharmacist. We found a shop that was small and tidy, sterile. A man in a white coat was standing behind a glass display case with boxes of pills. The labels were all in Spanish, and for a minute, we stood there perplexed. I told the pharmacist what I was looking for and asked the price. Ochenta, he said. Sesenta, I replied. He agreed.
After a bucket of Pacificos, we made our way back to the States, our pockets full of silver sheets and turquoise tablets. The agents at the border let us pass without question.
College was over, and I thought the world needed my help. I found work on the swing shift at a shelter for teens—runaways and homeless youth. The counselors were hardened and wise, the residents wary. One cackled whenever he saw me. He gave me a nickname, too: College boy.
Though I eventually earned their trust, my anxiety was beginning to spike. Panic emerged out of nowhere. We gathered in a circle for weekly meetings, and I rarely spoke, consumed by dread. I excused myself often, seeking refuge in a bathroom I frequently mopped. But there was no relief when the workday ended. My thoughts were disintegrating. I became obsessed with the suburban façade of strip malls and tract houses. I was quickly losing clarity.
I needed a familiar antidote to calm the rising terror. One I had seen in my family’s kitchen cabinet but never taken. I booked an appointment with a psychiatrist and suggested the prescription that had helped my mother. He obliged. But instead of alleviating the symptoms, it exacerbated them. I began seeing waves on the freeway and the curtains in my bedroom fluttered—flashbacks from an acid trip I’d never had. It became a waking nightmare, so I ended the regimen abruptly. I headed back to the clinic once again.
I left California that summer, driving 3,000 miles across the country and landing in Manhattan. I enrolled in graduate school at NYU, intending to become a counselor. My agoraphobia had subsided, and the visions were gone, already in the distant past. I still felt bouts of deep sadness, but I could manage. Insomnia was the latest disturbance. I stared at the ceiling until I could no longer hear what was happening outside. The barking in the street, the whistling fireworks. After a month of sleeplessness, I sought help.
I can’t recall who wrote the prescription. I believe it was a man, but the details are fuzzy. I told him about the fatigue and exhaustion that made a day of work nearly impossible, and he gave me Zolpidem. Another pill with a funny name and clever commercials. The sedative worked, but I was drugging myself into a dreamless stupor. Every morning I woke up confused and nauseous. When the bottle was empty, I asked myself: Do I need this? I never saw that doctor again.
Three years passed, and I was between interventions. I was working for the city library, and my coverage was abysmal. Few psychiatrists accepted my insurance, and the one I found was running a pill mill. Young degenerates filled the waiting room, desperate cases like me. As I filled out the registration forms, I felt like I was pledging to a nefarious cause. But I was convinced I had no other choice.
My name was called, and I ducked into an office littered with pharmaceutical advertisements and medication samples. A stocky, silver-haired Ukrainian man asked me what my problems were. I rattled off a list of symptoms: irritability, paranoia, ruminative thoughts. I was a diagnostic conundrum; I could fit into any category. After a smattering of questions, he recommended Wellbutrin, an antidepressant that one of my Craigslist roommates had taken. Fewer side effects than an SSRI, he said. I was willing to take a chance.
Within a week, my insomnia had returned, and I was writing maniacally into the night. I believed I had a brilliant idea for a novel; the chapters wrote themselves. Shortly after that, I gave up on the Wellbutrin and began dabbling in narcotics. A bump of MDMA off a barfly’s finger seemed like a fine idea. I was also newly single, so I spent the weekends seeking a date for the night. I had rarely been successful in the trendy Brooklyn bars, but I felt more confident than ever. I was enjoying the escapades, soaking up the pleasures. But I also knew I was a mess, and I wanted to find the right treatment.
This was a mistake. I knew this as soon as the charlatan recommended it. I had failed to mention the sleepless nights and hypergraphia, the anarchic designs. Amphetamines were not the answer, but they prolonged the party.
I would pop one and snort another before I went out on Saturday night. One morning I woke up on a stranger’s floor after a dance party. Another night I got bounced from a local bar for trying to steal a tip. I now recall the episodes with a flash of joy and regret: moments captured in time and never reenacted. I had finally succumbed to the depths of my disorder. I didn’t need a doctor to diagnose me; I realized I was bipolar. A friend confirmed it for me. She was a social worker and duly concerned, but I was still having fun.
An acquaintance told me about Lamictal. We played soccer together, and he regaled me with his own stories of decadence. I felt ready to try another tact and wanted to settle down. My recklessness had yielded a book and a slew of bad habits. A realignment was in order. The doctor explained that Lamictal was primarily an anticonvulsant used to treat epilepsy and approved for bipolar disorder. I was amenable to anything that would rid my skull of its insistent tremors and tidal waves.
Days after my first dose, I felt more grounded, far less frantic. My thoughts were clearer. It wasn’t magic or pseudoscience, some remedy found on a wellness blog. Pharmacology saved me: a drug that blocks sodium channels and steadies nerve membranes, controlling neurotransmitters like aspartate and glutamate. It worked like gangbusters.
I expected side effects to set in, having coped with so many over the years: sexual frustration, bloating, and tension headaches. But there seemed to be none—unless I missed a dose. On those days, I staggered to work, half-blind, and crippled by intoxicating nausea. If a bedside reminder was all I needed to keep my head clear, I could certainly deal with that.
Once or twice a week, I take a milligram of Ativan to calm my nerves. I tell my friends it makes your feet tingle. A pleasant sensation, any time of day. I cannot resist the temptation. It’s a remedy for a hangover and an answer to a humdrum afternoon. Perfect for a three o’clock meeting on a Monday. I have tried other anxiolytics, like Klonopin and Xanax, but I believe this is the ideal course. It pairs well with a long movie or a book. It’s the only drug I want to take.
After two decades, I’m still popping pills with breakfast every morning. A nutritious meal of eggs, coffee, and a cylinder of compressed powder. I wouldn’t call it delicious, but it keeps me alive, somewhat healthy. I no longer have unexpected symptoms. I have persistent indications, constant reminders wherever I go: spells of paranoia that last from midnight until dawn, a tendency to avoid certain streets where I’ve shriveled in panic. They make me shudder with fear. I frequently ask myself if I’ll depend on these drugs for the rest of my life. When I have raised the point with psychiatrists, they have all offered a variation of the same platitude: We will wait and see. They’ll stay with me until a new malady arises, or a good doctor says I’m cured.