An Odd Price To Pay
I woke up on December 9, 2006 and decided to try sobriety again. The night before, I had attended a party and, predictably, drank so much that I didn’t remember the party ending, my walk home, or a subsequent conversation with somebody in which I apparently said very offensive things. My second go at sobriety would be my final one.
Within a month of sobering up, I crashed psychologically. Or maybe it was emotionally? Whatever it was, I lost control of my stability completely and ended up in counseling. I went hoping for a silver bullet but the counselor wisely made no such promises. One day, he very gently encouraged me to consider the possibility of antidepressants. “It is up to you…” he said after patiently listening to me describing an empty world. “…but you need to think seriously about doing this.”
The counselor worked at the university I had returned to after three years spent doing social work, a profession that manages to makes drinking even more appealing than it already was. Getting antidepressants meant getting a prescription from student health. This was doable, I figured, especially after failing – or perhaps passing? – a depression protocol designed to give the medical professional interpreting it some vague idea of where the patient believed himself to be. “It isn’t so bad,” I said, handing the survey back, hopefully. She looked at the document and made a face, “Well, this isn’t great.”
It probably wasn’t. Although I continue to believe that the day one decides to get sober is the best possible day to make that decision, that doesn’t change the broader challenge of unbalancing a life by removing the answer to all of its questions. Alcohol was the solution to good days and bad days and even-keeled days. Alcohol made every math problem easy, because every combination of numbers added up to drinking. Without that answer though, suddenly everything added up to nothing. That was was my sobriety in the first few months..
I was prescribed Prozac in the mildest possible dose, per my request. I had witnessed the use of antidepressants and was terrified of their side effects. In college, a woman in the next town who was battling what had been described as a mild depression walked into traffic within days of starting a round of the medication. As a social worker, I encountered client files with underwritten directives to, “Never remove child from antidepressants!” Plainly stated, I was terrified of starting to take them.
I looked at the bottle on my sink and I thought about it for a day or two. Then I began.
Hot Food
I first encountered serious hot food in junior high school. I asked the Asian Garden to emphasize the Spicy in its Spicy Shredded Chicken and the cook complied, delivering me what was then the hottest thing I’d ever eaten. But I giddily ate it all. Then I tried the same stunt at a Thai restaurant in Washington DC and the cook complied again, this time intending to teach me a lesson, delivering me something that was almost hot to a degree that still makes me nervous. I got through maybe half my dish. The cooks and the waitstaff took turns laughing at me. But I continued, with Chinese and Thai and, eventually, with my favorite: Indian food. The hotter they’d make it, the hotter I’d eat it.
Hot food has to be earned. Most restaurants won’t make it for a customer the first time he asks for it. It is far easier to make something hotter after the fact than it is to cool it off for an overwhelmed customer. Disappointment can be fixed with a few hot peppers or a hot sauce. Go to a restaurant enough times though and one scoop of cayenne pepper can become two scoops. It is a badge of honor to achieve this level of familiarity with a beloved restaurant kitchen.
At some point, I passed a threshold for consuming hot food in which it wasn’t simply a good meal: it was literal ecstasy. Runners sometimes talk about something they call the runner’s high, a euphoric feeling that sets in after exercising. I don’t know anything about this having never experienced it myself, but the descriptions I’ve read seem to mirror my response to hot food. If the food was hot enough, I broke out into a huge smile and then started laughing as I ate. This happened like clockwork. The people who ate with me regarded this with a detached bemusement. It might have appeared to be a ridiculous affectation. It certainly was an outlier to my generally sour demeanor.
In my mid-20s, just before this period in my life that I’m describing, I ended up cooking in an Indian restaurant. We sat down for a family lunch at 11:15 every morning, just before the doors opened for customers. Those meals always featured whatever was on the buffet, plus family foods from the back – this often included a hot sauce. The family’s cooks figured out my physiological tell. They used to run the sauce by me, waiting for a response. They took great pleasure in getting a sauce to the point where I would stat giggling. “Ahhhhh, there it is!” they’d say, pointing at me.
This euphoria went on for years. Then it didn’t.
Prozac
I took two months worth of Prozac at that lowest possible dose. The world seemed to smooth slightly. The bad days were no longer as all-consuming as they been before I had begun the medication. This was a good thing. I went in for a check-up.
“How are things going?” I was asked, and I said that they were better. Not great, I emphasized, but more stable.
“That is very good news,” the medical professional told me. “This is why you should up your dose.”
I balked at this initially, but weighed the situation as best I could. Things had been bad, I thought, and then I had listened to medical professionals and things had gotten better. My fears had been misplaced; the Prozac had helped, after all. Maybe more would be better. I agreed to the increased dosage.
I remember very little of the next month. I stopped sleeping almost entirely. When I did sleep, my dreams were so vivid that I confused them with reality. I would attempt to act upon dreams as if the responsibilities I had accepted within them were actual obligations. I often caught myself wondering if what I remembered had ever actually happened. On several occasions, I based my interactions with other people upon these dreams leaving both of us confused. I also occasionally came to while driving, having gotten myself to some part of town and having no memory of the how it happened.
After three weeks of this, I called the medical professional who had prescribed the doubled dose. I explained what was happening and was told that this was normal, and that the medicine was uncovering genuine mental instability. I was encouraged to come into the office for a check-up. When I went, I was told to continue taking Prozac, and to add Seroquel, an anti-psychotic, to the cocktail. “What you have is underlying bipolarity,” I was told, “And that’s emerging now that you’ve stabilized somewhat. This will help with that.” I was given free samples in a brown paper bag. I put the bag in my car but did not open it.
After another day, I called my counselor and explained the situation, including the second prescription, cautiously, as if I was doing something wrong. “Maybe this is what is supposed to happen?” I said, dumbly, and he cut me off. “Stop. Immediately. Go back to the lower dose today. And call student health and speak to somebody else. Call them now. If they don’t answer, call me back, and we’ll call somebody else.” His tone was much more forceful than when he was suggesting the Prozac. I recognized in it a seriousness that was not to be ignored. I called student health and when I explained my situation, I was told that they could easily get the woman on the phone who had recommended the Seroquel.
“Not her,” I said. “Anybody else.”
I spoke to somebody else and they echoed the counselor’s instruction. “Lower the dose, and get in here as soon as possible to see me. Don’t take anything else.”
I threw out the free samples and returned to the lower dose. I stabilized again. After another six months, I quit the Prozac, and have not gone back to it.
No More Hot Food
It was my oldest daughter who noticed it first. “Why aren’t you laughing at your food anymore, daddy?” she asked me, when I complained yet again of food not hot enough to elicit a reaction. “You don’t laugh like you used to.”
This gave me pause. I had not laughed in quite a while, I realized. Had I even giggled? I tried to think back to the last time it had happened and remembered once in an Indian restaurant in Pittsburgh, a meal we had after a spur-of-the-moment decision to go on a roadtrip. When had that been, I wondered, and figured out that it had been at some point during that summer. Nothing more recently. I had been frustrated with how bland the food had been and I railed privately against restaurants that knew me better than to make my orders mild.
The euphoria has never returned though. I know the food that I am eating is hot but that is all it is. It is no longer a gateway to somewhere else. I do not have a good explanation for this. Perhaps it was the medicine. Perhaps it was an odd side-effect of sobriety. Perhaps it was a huge coincidence. I know that I miss that feeling, although it has been so long now since I felt it that I can scarcely remember its particulars. Maybe that though is for the best. I have to imagine it would be harder to have lost it if I could remember how good it was.
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(I received substantive editing assistance from Maribou, Tod Kelly, Aaron Warfield, and my friend Renee.)
That could not have been easy to share. Thank you so much for doing it anyway.Report
Yes, a very interesting and soul baring piece. Well done.Report
Good God that kind of malpractice is infuriating. Not the fact that they doubled the dose: in and of itself that may not have been a problem for most people who weren’t you – but when you described your symptoms, they not only acted as though that was normal (when clearly, you were describing being HIGH AS F**K, only not in a fun way); but they essentially tried to sell you on a diagnosis of newly-discovered, more-serious mental health issues.
Under some circumstances, we’d call that ‘gaslighting’.
I briefly tried a different antidepressant years ago when I was going through a rough patch, and my experience was much the same as yours as described here, as far as being extremely-confused, yet finding it difficult to care about that. Couldn’t remember where I’d parked my car, no short-term memory at all, “reality vs. dreaming” and “who exactly am I talking to right now, and about what?” became…highly questionable, and emotionally I just felt numb, which was (to me) worse than feeling bad.
I likened it to the coming-up phase of a particular popular recreational drug, but without that drug’s fun/clarity phase ever kicking in, and I quit it pretty fast.
I would never tell someone who needed SSRI’s not to take them (I know too many friends and family members for whom they were lifesavers), but I would caution them to monitor themselves closely, gradually and conservatively titrate dosages, and work closely with a physician who is trustworthy, perceptive, and readily-accessible in case of weird effects.Report
The numb part is probably the only part of that that is normal. “Numbness” is a common symptom of the upswing from the bottom of depression (where the bottom is relative). Everything else sounds like very serious side effects.
And you’re right, the bullshit “bipolarity” diagnosis, and dismissal of easily recognizable serious side effects is infuriating.Report
RE: numbness being normal: probably true, but in my case at least I found it far more disconcerting and “unpleasant” than being down had been. Kind of like what I imagine Cotard’s to be like? Being in pain at least lets you know you are still alive – if I wanted to play pop psychologist, I’d speculate that’s what Sam’s spicy-ass food used to do for him when he was in a bad way.Report
Oh, I definitely understand how unpleasant it is. I don’t blame you for finding it worse than being down.Report
Great piece Sam, truely great.Report
Thank you for sharing this.Report
Thank you for sharing, that was really powerful.
I’ve had my issues with sobriety myself. Ironically, I never really started drinking until after I got over depression. But my depression was highly related to being a gay teenager in a very socially conservative environment, and the moment I got over that (feeling liberated/accepted as part of the gay community in the SF Bay Area) is the moment my problem with alcohol started. So, thankfully, I escaped the horrible consequences of being over-medicated on antidepressants. Because my first boyfriend and one of my good friends have both had issues with that. I’m glad that you didn’t hurt yourself, someone else, or worse.Report
Sobriety can be strange. An addict’s quirks can be bugs from the abused substance or a feature in the underlying personality. Addiction is like a glacier; it leaves scars in the landscape after it melts away.Report
Like the others, I’ll say thanks for sharing this.Report
I’ll add to the chorus. This was a great piece, Sam. I really loved it.Report
I also liked this piece.Report
By the way, if you were experiencing depression, you would likely have been experiencing low dopamine levels. Eating spicy food releases dopamine, so what you could have been experiencing with the spicy food before was a sudden spike in dopamine levels. If prozac has “normalized” your neurotransmitter levels, this may account for the surprising lack of euphoria you’re now experiencing with the eating of spicy foods.Report
This was really good, Sam.Report
Your kind responses are noted and appreciated.Report
Hey, I’m super unoriginal because I really liked this as well.
I also found the hot food thing fascinating. I’m often that guy who asks them to make it hotter after being warned by the server and sometimes the owner not to, only to usually find it’s not hot enough. I think it’s a Canadian thing. Food is never hot enough here for me. Happily, I’m going down to the Southern states for a month and a bit very soon and will be sampling whatever I can get.Report