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My Adventures in Psychopharmacology

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June 2005
Lexapro, lots of Lexapro

Dr. Titrate recommended a consultant, and the consultant recommended a treatment program in Utah. It cost $450 a day and was not covered by my parents’ insurance. The next morning, I was shipped off to a remote campsite in the High Uinta Mountains. This wilderness program was designed specifically for drug addicts and alcoholics. Dr. Titrate had assured my parents that although I wasn’t technically an addict, the treatment would be beneficial.

But the field therapist—a recovering alcoholic in battle fatigues—and her staff of instructors didn’t seem to be in on the secret. They treated me like the worst kind of addict: one who was in denial. “Acknowledge your addiction, or you’re not getting out of here,” one of the instructors told me.

My attitude baffled the instructors, and I was routinely disciplined with silence and the withholding of hot food. When informed of my resistance, Dr. Titrate upped my daily intake of Lexapro again, to three times the normal dose.

I should note that I was over 18 and technically could have left the program at any time. But leaving was not really an option. Dr. Titrate had given my parents strict instructions: If I phoned and said I planned to come home, they were to say I wasn’t welcome. I would be stranded with no money in the mountains of Utah.

I had little to no contact with the outside world during this time. My mother and father had weekly hour-long phone conversations with the field therapist, who, in turn, had weekly hour-long phone conversations with Dr. Titrate. My parents could send e-mails to the center, but anything deemed “nontherapeutic” was withheld from me.

The letter that did get through was one they were required to write: an “impact letter” that I was to read aloud in group therapy. My parents later told me that it was the hardest thing they ever wrote. They debated. They agonized. They revised the text endlessly. They wrote that they were desperate that I be accountable for my life, that they had sent me to the treatment center because they had no idea how to help and this seemed the best option. They wrote, “Instead of taking responsibility for your life, you are foisting that responsibility on others. But the price is terrible. From middle school on, we have seen you struggle to forge friendships. But this is not the way to make lasting relationships. In fact, it’s just the opposite. We are terrified.”

I was terrified, too, but I didn’t know how to stop. My mental state still swung violently between extremes.

As the Utah program came to an end, Dr. Titrate’s consultant arranged to have me sent to a 90-day “aftercare” program in Southern California. This program, too, was designed for recovering addicts and alcoholics. To get in, I was required to “admit” my addiction in a phone call to the center’s director. After a tearful hour of trying to be honest, I lied and said, “Okay, I’m an addict.”

When I was released a week later, the Utah field therapist said, “I don’t think we can do much else for you, but at least you’ve admitted your problem.”



August 2005
Lexapro, Lamictal, Provigil, Wellbutrin, Cymbalta, more Lamictal

In California, I had a brief honeymoon. Now, in addition to a large dose of Lexapro, Dr. Titrate prescribed the mood stabilizer Lamictal and, for focus, Provigil, a non-stimulant used to keep narcoleptics awake. I went to twelve-step meetings, body-image meetings, risk-assessment, and love-addiction meetings. I did t’ai chi, I meditated, and I wrote daily “letters to God.”

But the honeymoon didn’t last. The Provigil made me faint and frenetic. I got dizzy and had frequent stomachaches. I experienced sudden, overpowering moments of terror. Whenever I refused to get out of bed all day (often) or refused to attend group meetings (even more often), I was grounded, which just gave me an excuse to retreat even further into myself.

I did befriend a girl my age, a recovering heroin addict who had been in similar programs half her life. Go through the motions, she told me, and no one will pay attention. Instead of letters to God, I jotted down Ludacris lyrics and dated them. She was right: Nobody noticed the difference.

I suffered panic attacks with greater and greater frequency. One attack was so frightening that I finally demanded to see a psychiatrist. He decided to start weaning me off Lexapro, replace it with the milder antidepressants Wellbutrin and Cymbalta, and increase my dosage of Lamictal.

Around this time, the Utah program mailed me a box of computer printouts—the e-mails my parents had sent that were deemed “nontherapeutic” and withheld. One was an article about cognitive behavioral therapy—a treatment Dr. Titrate had always dismissed. After I read it, I set up an appointment.


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