When Medications Go Wrong

For years, I’ve pretty much been medicating myself.  I take my scripts home and medicate how I see fit for my situation.  I realize that makes me medication non-compliant.  The trouble I come to is my trust in doctors.  I have been burned so badly before that I find I have a lack of faith in them to know how they are really treating me.

When I was in my teens, and being treated for Major Depressive Disorder (misdiagnosis – strike one), I was put on high doses over a slew of medications for years with little result (overmedication – strike two).  I suffered extreme side effects, with little done to relieve them.  I took Zoloft in increasing doses over a three year period.  I continued to complain of extreme fatigue, anxiety, motion sickness, and periods of flu-like symptoms.

The doctor’s answer?  More medication.  It came to a head when I found that if I sat still for too long, I would drift off to sleep.  Sitting in school became impossible, and I was sleeping fourteen to sixteen hours a day.  Eventually, I was put on 300 mg of Zoloft with Provigil to combat narcoleptic symptoms.

It was at the doctor’s suggestion that I continue to exceed maximum dose and go to 350 mg that my mother finally put her foot down.  “Put her on something else.  We’ve put three years into this, and it clearly isn’t working.”  And much to my doctor’s chagrin, I was switched to Lexapro.

Wrong answer.

Immediately, I started to have dissociative symptoms.  I recall laying in my room, laying on the floor, and staring at my ceiling in the dark.  My mother stood in my doorway, just observing me.

“What are you doing?” she asked.

“Nothing,” I answered blankly.

Yes, I was finally awake.  But, every moment was torturous.  I lost my sense of self, and started to drift away.  My memory began to fragment, and I sunk into a deep, desperate depression.  I was frantic and crazed, while feeling numb and blank at the same time.  I became paranoid, and started to assert that everyone was doing things against me.  They were intending to harm me, and I started to give meaning to harmless comments and phrases.

I attempted suicide several times in the first month.  The cutting became so bad that I was doing it in rather public places.  I was caught one time at my boyfriend’s house, and I had a dull exacto set ripped off of me and immediately chucked into the local creek.

We were unaware of all of the side effects at the time, because all of the medications I was placed on were brand new.  When a pharmaceutical representative left her office prior to my visit one day, it became clear that I had become an experiment to brand new medications.  I was taking expensive, largely untested medications for her financial benefit.  Strike three.

I had gained thirty-five pounds over a six month period.  I was 4’11” and 165lbs.  That put me at a BMI of 33.3, and in the obese range.  And despite all of my best, and even worst, and unhealthy efforts, I still couldn’t manage to get my weight below 145lbs.  I was starving myself on 900 calories a day, and I still hovered around obesity.

I couldn’t afford my medication once I was kicked off of my parent’s insurance, and I just decided that since it failed to ease my symptoms, I would stop taking the medication entirely.  They failed to mention that if I attempted to stop the medication cold, then I would be stricken with the worst withdrawal I had ever known.  It was a good thing my parents had been through this before with my father, because they knew how to ween me off.

It took me years to get the rest of that weight off.  But, by then, the medication had already done long lasting damage far worse than just weight.  I had begun to develop a drinking problem.  I had engaged in risky sexual behavior due to hypomania.  And it sent me walking with bad eating habits.

After that, I distrusted doctors and medication entirely.  I had lost faith in mental health treatment.  I was left with a feeling that I didn’t have a disorder at all, and instead, it was just me.  I was convinced that I wasn’t treatable.

It took a lot to make me realize that I was in desperate need of treatment.  I had taken psychology courses and was suggested by several psychologists in my college to have bipolar disorder.  I knew my behavior wasn’t “normal”, just as I had always suspected.  It took the my marriage, my depleting mental health of my husband, and the birth of my son to encourage me to start treatment again.

Three years, four doctors, and a another slew of medications later, and here I am, again the victim of overmedication and bad medication choices.

Recently, I stopped my Abilify.  Admittedly, it was because I noticed an interaction between the Abilify and my weekend consumption of alcohol.  I started to find that I would fall asleep soon after taking it on Friday’s while we drank.  I decided that I would just stop over the weekend, and continue during the weekdays as normal.  But, eventually, I just forgot to take it at all.  And soon, I started to notice an improvement in my worsening condition.

Suddenly, I was able to think again.  I started to feel more like myself.  I became more aware of what I was thinking and feeling, and I finally started actually living in the world around me.  It actually felt like living again.  And that’s when I noticed the weight I had put on.  I had fell victim to Abilify’s weight gain, among other things.

I can blame the dissociative symptoms on Abilify.  It had created an emotional flattening, and I started to dissociate from myself and my world.  It had robbed me of my ability to write and care for my family appropriately.  I wasn’t feeling, so I wasn’t caring.

The anxiety?  Well, I recently started to run out of a supply of Wellbutrin I can’t really afford right now.  I started to cut back to make ends meet, and I discovered that was starting to subside.  Other than rebound depressive symptoms, I was feeling better.  It didn’t matter to me anyway.  I was still going through crying jags, whether I was taking the Wellbutrin or not.  The difference was between whether they were loaded with distressful urgency to cut or not.  I decided that I would prefer to keep my near streak of four months without cutting.

I don’t blame my doctor.  He’s an old school doctor who works off of the biological model and treats symptoms.  I have declined therapy several times, though my requests to be seen since have not been honored.  All of my symptoms point to mild psychosis in general, aggravated by extreme life stressors.

I blame myself for not listening to myself and taking action sooner.  Treatment happens on both ends, and I have not been holding up my end of the bargain.  I have not been mood charting, and I have not been notating subtle symptoms.  It has become abundantly clear to me since my extreme meltdown and psychotic break during the summer that I had been probably Bipolar 1.5 all along.

Though I don’t experience full on mania, I do experience mild psychosis, practically all of the time.  I have not been pressing the issue about invasive thoughts, paranoia, “The Voice”, or any of the mild hallucinations that I experience.  Only when I had my break did I bring it to my doctor’s full attention.  And I was met with extreme medication.

Personally, I’m at a loss as to what to do.  I’m damned if I do, and I’m damned if I don’t.  I noticed last night that “The Voice” has returned, even if it’s benign (right now).  I don’t want to be overmedicated, and I can’t risk gaining anymore weight.  The weight is worse for my mental health than anything else.

And it completely screws up my bodily function.  Now, I’m experiencing weight related problems again.  My knees and back hurt.  I have acid reflux near to the point of anorexia again.  Sexual dysfunction is destroying my sex life, my self-esteem, and hurting my marriage.  And I’m back to full on social anxiety, because I’m too self-conscious to function.

But, at the same time, I’m aware that I need some kind of medication.  While, for now, I’m better off without it, the day will come where I am asked to step up, and perform at a higher function.  My family, including Finn, has been very great about my general lower function and picking up a lot of the slack for me.  However, this won’t last forever.

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Just Snap Out of It

Society has developed some seriously bad attitudes toward mental illness.  It’s no surprise.  We see it attached to the stigma of it.  We’re treated like lepers, as if this were a terribly contagious thing.

Depression is no exception.  Today, a lot of people have been discussing the topic of the “Just Snap Out of It” phenomenon that occurs out there.  Honestly, there is a saying out there about how if a person hasn’t experienced it, then they can never truly know.  A person who hasn’t experienced clinical depression, either in the form of MDD or BP depression can never truly know it’s depth and breadth.  It is an all encompassing monster that claims every last bit of life and any possible joy that can come from it.

Having Bipolar Disorder, I am a person who naturally experiences some sometimes pretty obvious mood swings.  And the attitudes toward it are so completely off.  I have never had a person treat me poorly while I was in a manic episode.  Not one.  Not even when the plainly awful behaviors were showing.  Each person seemed to find it charming, amusing, or interesting.  Even when there were moments where I was so out of control that I was scared out of my wits, not a single person around me seemed to notice that there was something absolutely wrong with it.

No, my energy and spirits were high.  I would act impulsively, and people would take it as spontaneity.  I’d be overly, annoyingly chatty, and rudely interrupting others, but they took it as being outgoing.  Everyone seemed to think that was a sign that I wasn’t depressed anymore.  They seemed to think that it was some kind of miraculous recovery from “being like that”.

People only seem to take notice when I am depressed or mixed, like it’s some kind of disease that I choose to be afflicted with.  And the comments are absolutely endless, because everyone seems to have their own opinion about it.  It’s as if they consider themselves to be the authority on depression, anxiety and sadness in general. I will constantly hear phrases like, “Get over it” and “Get a grip” as if just snapping out of it were an option for me.

Meanwhile, people without mental health diagnoses start flinging clinical terms around, like they had some true application to their fleeting, shallow emotion.  For instance, “Oh, I’m so *bipolar* today”, instead of just saying that they are moody, or women arbitrarily making a comparison between PMS and Bipolar Disorder.   Or “I’ve just been so depressed lately”, to reference a little bit of discontent or sadness.

It’s not cute. It’s not funny. No one with those diagnoses thinks that it’s witty that someone is taking a serious clinical term with so much guilt and stigma that it could bring down a religion, and applying it to their BS, frivolous emotions!

It does everything it can to minimize those conditions.  It puts it in a light that we have some kind of real control over it.  As if it were something that a person can just “snap out of”.  It implies that a person chooses to be disordered.  It also puts a shameful connotation of attention seeking behavior.

Yeah, it’s the life, let me tell you. If I were doing anything for attention, it wouldn’t be this. It would probably be something more hilarious, like plastering myself with an obscenely worded banner and rollerblading through Downtown. Depression isn’t newsworthy, but that sure is.  Or maybe I’d be doing something a little more productive or noteworthy, like finding a cure for cancer.  But no, my depression is just that interesting that I would choose to gain that much needed attention from people I don’t even know or care about.

I have to wonder if the general public has to be so naive that they would actually be jealous over it.  So much emphasis is put on the “just get over it” ideals, as if that were possible. If I could will myself out of this state, don’t you think I would do it already? It would be more logical to think that I want to reclaim my life and be a productive person.  But no, according to others who are ignorant enough of mental illness, I am perfectly content to have disordered behaviors.   Sure, who doesn’t love ignoring their kid because the voices just got too loud? Personally, I love gripping my ears and screaming, “SHUT UP! SHUT UP! SHUT UP!!!!”

And as a result of this blatant ignorance, I am really starting to believe that some are just plain jealous.  Because, they seem to think that those with disorder aren’t being responsible for their emotions and behaviors that result.  I certainly have quarrels with wanting to thrust a sense of selfishness and entitlement out there, because it’s what I have to do to take care of myself and my own in this world.  It’s those same people that shove themselves and their ideals down other people’s throats, only to make them feel bad. Misery loves company, and we’re perfect targets, right?

The point is this.  If a person is out there reading this and getting offended, it’s time to take a step back and think hard.  Is it so fair to be so judgmental?  Isn’t it about time to take a look from another perspective?  Does a person with a congenital disorder choose to be symptomatic?  It would be an entirely different story if I were refusing treatment, but like anyone else, I am keeping my appointments and taking my medication according to doctors orders.  We don’t blame someone for their symptoms when they have a seizure.  Why should this be any different?

Let me assure everyone.  If could have snapped out of this disorder and been a “normal” person, I may have done it, instead of living this ongoing nightmare.

Blog for Mental Health 2013 Badge Voting

The new year of 2013 is coming upon us, and quickly.  Last year, I started Blog for Mental Health 2012.  For those that are unaware of what Blog for Mental Health 2012 was, I’ll fill you in quickly:
Many people who suffer from mental health disorders do so in silence.  And prior to many of our own blogs, we may have done just the same.  By taking the pledge to Blog for Mental Health in the year of 2012, we celebrate our own voices that speak up in our own unique ways.  We pledge that not only do we blog about mental health topics for ourselves, but for the inspiration of others to raise their voices and tell their own stories of their own personal experiences with mental health disorders.

For more information about Blog for Mental Health 2012, visit the page.

I fully intend on continuing this pledge and tradition into the new year of 2013.  Therefore, I’ve gotten started early on the design for the Blog for Mental Health 2013 badge.  Last year, it was created solely on my own.  But this year, I’d like others to participate in selecting the official badge to represent the pledge.

The nominees are:

#1

#2

#3

#3

#4

#5

If you have any suggestions for combining badges, they are quite welcome.  Let the voting begin!

PS:  Please visit the comments section for additional badges that were created after the first run.

Liquid Courage and Tablet Saviors : 30 Days of Truth

Day 20 : Your views on drugs and alcohol.

“Drugs are bad, m’kay?”

Or are they?

There is this long, Nancy Reagan-induced diatribe about the dangers and evil of illegal drugsSay no to drugs.  This is your brain on drugs.  The war on drugs.  Above the influence.  Don’t drink and drive.  Prom promise.  Those of us that are Reagan babies and older, through the boomers, are well aware of the presence and negative consequences of drugs and alcohol.   And despite the heavy dialogue, many people have personally experienced their own battle with substance abuse and dependence.

Alcohol had torn my life apart at the seams.  As with any addiction, it starts off as a recreational activity.  It’s a part of popular culture, especially in the younger age groups.  In my youth, drinking was cool.  Truthfully, it was a fun escape from the drudgery of daily life.  That was at seventeen.  Within a year, I started to find solace at the bottom of a bottle.  Coincidentally, that was the same year Smile Empty Soul sang:

I do it for the drugs.

I do it just to feel alive.

I do it for the love that I get from the bottom of a bottle.

Bottom of a Bottle – Smile Empty Soul

By the time I was in college, I was seeking out opportunities and excuses to drink.  A set of rules existed which meant to separate alcoholics, the loathsome bunch that we perceived people like our own parents to be, and recreational drinkers.

  1. Never drink before 5PM.
  2. Never drink alone.
  3. Never drink without occasion.
  4. Don’t drink before or during work or school.

As I gained my own freedom with my own apartment, the rules started to change.  In private, I could do what I liked.  I could deny everything and anything when I failed to be under the limelight of public scrutiny.  I began to use alcohol as more than a crutch; I started to abuse it completely as a coping mechanism.  That’s when alcohol and I started our sordid love affair.

The environment in my private life began to change.  I have spoken about it many times in various posts like Decent into Hell where I described my addiction as:

The last days of that relationship are blurry; my memories are obscured by the drugs and alcohol intoxicating my mind.  The days blended together in a ritualistic, self-medicated loop, work.drink.sleep.work.drink.sleep.sleep.drink.sleep… suspended in agonizing slow motion.  The silence was deafening in the deep, dark hours of night, still, cold, indifferent.

I had become a functional alcoholic.  I never drank before 5PM.  There was always an occasion, even if it was a day ending in “Y”.  And I certainly was not without company to share in my intoxicated merriment.  But there is a solid difference.  Every waking moment I did not spend at work was with a glass or a bottle in my fist.  I had gone far beyond the point of mixers, and mostly beyond the need for glasses.  It was me, a bottle of Bacardi 151 sans the filter, and a bottle of Gatorade to chase.

I wrote in Love the Way You Lie:

At that point, the seeds of alcoholism were taking root.  I violated my own rules of drinking.  It’s 5 o’clock somewhere!  I’m not drinking alone if I’m drinking with my boyfriend.  Hair of the dog, best way to cure a hangover.  If I’m still managing to get to school and hold an honor’s average, I’m not drinking too much.

Liquid courage and comfortingly numb.

It has always been my vice, and holds the looming, unending threat to assume control and ruin my life. In another 30 Days of Truth piece entitled, Control, or Lack Thereof, I went into a full exploration of recent recreational alcohol use and the negative impact it created in my life.

Flip that coin.

Drugs have revolutionized my life.

People neglect to realize that they are consuming legal drugs daily.  It becomes painfully obvious when you sigh over exorbitant copays at the pharmacy counter, like many people with mental health disorders often do.  But, instead of calling them “drugs”, we call them “medications”.  Did you know that Wellbutrin technically has the same chemical composition of a methamphetamine?  And that benzodiazepines work on the same receptors in the brain as alcohol?

So here I am, with my uppers to wake me in the morning, and my downers to put me to bed at night.  It would be illegal and detestable if I were using meth and boozing away.  Instead, it’s under the supervision of a doctor, as a controlled substance, in a convenient little pill.  Don’t get the wrong idea.  I am only likening the effects.  The supervision of the doctor is safer, and the medications are regulated by the FDA.  And as a result, I have most of my functioning back.

And I wouldn’t have it any other way.

Little Shades of Grey – Domestic Sexual Assault

Trigger Warning:  This post may contain triggers that would be hazardous for readers who have a history with sexual assault and crimes of that nature.  It is strongly advised that children under the age of 13 and those that may suffer adverse affects from this post take care and use caution while reading,.  Reader discretion is advised.

In the previous post, Little Shades of Grey – Sexual Assault by a Lover, there was a representation of statistics and a personal account concerning sexual assault and rape.  Unfortunately, that incident was not a sole occurrence.  In fact, it was just the first.

Some women are still stuck in the old mentality that there are just some things you have to do to please and keep your man.  I grew up with the idea that sometimes, I would have to perform sexual acts I did not want to participate in, or I’d have to engage in intercourse when the mood and / or time was not right for me.  It was the nature of being a woman.

Dozens of grey rapes, my mind came to put a term to it, so I wouldn’t actually have to relive it. It was the attempt to free myself from the haunting memories. But, it wasn’t enough. Dozens of times I said no. Many times he reminded me that if he wasn’t “gettin’ it from you, then I’ll get it somewhere else”. Bullied into it, by a man who preyed on my deepest vulnerabilities.

How many times had I thought we had a fantastic night only to wake up to a surly, dismissive, apathetic day?

I started to realize that there were no fantastic nights. There was cheap booze, little white lies, and completely carnal fucking.

The first instance with Avi was not even a full year after the incident with Beck.  It didn’t register, because it was just so subtle.  He lovingly and eagerly asked.  I was too ashamed to tell him the truth about what happened.  I was anxious at the idea of disappointing him, and I went along with it.  It was just that one time, right?  I could satisfy him and then say no.

Then, there is the mentality that no doesn’t really mean no.  For many women, myself included, there is a disconnect between mind and body.  While my mind may be shouting, “NO!”, my body may not be complying.  It’s confusing for a woman, and encouraging for a man.  Men, but societal rules, are accustomed to the chase.  Often times, men get the wrong signals.  And for a predator, that is a perfect excuse for inexcusable, despicable behavior.

To some men, no doesn’t mean no.  No means, coerce me.  No means, harass me.  And that’s exactly what I experienced.  There was no changing my mind, or else I was a tease of a girlfriend who deprived my boyfriend of sexual gratification for my own kicks.  There was no saying no, or my will would be broken down in one way or another.  Finally, not complying with his wishes was grounds for threats and dismissal.

“If you don’t do it by choice, then I’ll just have to take it by force.  But you’d like that, wouldn’t you?”  I shiver and tremble at that phrase.  In my mind, there was nothing worse than losing control of my situation.  What I didn’t realize was that sex and sexual acts were no longer my own choice.  I was, for all intensive purposes, a victim of continual sexual assault and grey rape.

Sex is often a mechanism for control.  And seeing as how I was also both a victim and abuser in other ways, it was the perfect arena for him to gain back control.  Though I would disagree, and I would put up a fight, he would always eventually win.  Nothing scared me more than another full on assault.  Maybe I thought I had the control by consenting.  It’s tricky to know.  I described a bit of it in Decent into Hell.

Just say yes, you little masochist.  

Addictions leave you little choice.

Help me tighten these chains.  Is that my voice?  My mind screamed to be released, for me to take the free ticket to ride and go.  But my heart without it’s limbs could not be freed from it’s vice.

The pleasant memories melted into the form of nightmares.  There was a double edged sword, turning the pleasurable jabs into horrific stabs.  My monologue’s narrator was raspy and exhausted.  Playful smiles turned to sinister grins just as loving chuckles morphed into maniacal laughter.  The blaze pushed forward, engulfing everything in sight.  It seared my flesh, leaving nothing but brittle bone.

In a domestic relationship, it becomes harder to define rape. It becomes even harder to convince others that the sexual contact was not consensual. Worse, is the probability that one will have to face their assailant in the wreckage of the aftermath of reporting.  And that’s possibly why so many sexual assaults and rapes go unreported in those situations.

There are deviant sexual acts I was forced to participate in that I am still ashamed of.  I recall my first threesome.  I consented to it under the pretense of defensive sex.

For those of you that are unfamiliar with defensive sex, it is a sexual response to an emotional manipulation playing on the insecurities of sexual performance and satisfaction.  It is an attempt to avoid abandonment and ease fears for some.  I recognize the manipulation in my own mind now.  And I realize that I had engaged in this behavior and played into his own hand.

The focus of the threesome shifted to a twosome, only involving me as a third party observer.  And I recall watching, thinking I had been tricked into watching my ex sexually gratify himself as a show of force.  As if he was proving to me that other women wanted him, and I was apt to lose him at any time.  I was ashamed at the manipulation.  Later, when my friend and I lost touch over it, I realized it was also an isolation mechanism, enabling all forms of abuse by removing me from third outsiders.

I could have never seen it coming.  Like other forms of abuse, it creeps up and becomes the new “norm”.  Also, it has devastating effects on emotional, sexual, and romantic dynamics in future relationships, again, like other forms of abuse.  This is just as real and horrifying as any other form of abuse, though it is far less recognized.  However, it should be recognized for what it is, and women should be educated and informed about the possibility of this type of hidden abuse.

With or Without You : 30 Days of Truth

Day 15 : Something or someone you couldn’t live without, because you’ve tried living without it.

Most people would prefer to choose a certain special someone or an object to contain all of their affections.  Though my relationship with this is troubled, I have found it to be impossible to live without it.  Even if it’s so hard to live with it.

Medication.

I have made the attempt several times in my life to live without psychiatric medication.  My first was a psychiatric evaluation when I was thirteen, and I refused treatment.  What thirteen year old has the intense desire for repeated therapy visits and pesky medicine?  As a direct result, my symptoms progressed, and I wound up my own cutting board.  When it became concerning, no one was willing to take me back for actual treatment.  Instead, I unnecessarily suffered until I humiliatingly revealed myself and my wounds to an outsider.

The next time was in my late teens.  After being medicated for nearly five years with no result, I was ready to give up on $60 co-pays for a medication that just gave me heroin-like withdrawal symptoms when I forgot to take it.  (That was also the first time I became strongly inclined to start carrying medication on me in clever, cute containers).  I spent a gratuitous amount of time on weekends in a different county, an hour away from my home.  The bus services were shoddy at best, and if I forgot to take my medicine on Friday, then by Sunday morning, I was violently shaking and vomiting in front of my relatively new boyfriend.

This new boyfriend, Avi, convinced me that there was absolutely nothing wrong with me.  The medication was doing more damage to me than good.  It was a waste of time and money.  Psychiatry was a joke and a con for cash.  It would be in my best interest to get off of the medication.

The funniest thing about that was the fact that I became irreconcilably depressed when I weaned myself from the Lexapro, an SSRI.  I required way more than my typical six hours of sleep.  I could no longer party until dawn.  And mostly, my only desire was to scream and cry my eyes out.  After you’ve been hypomanic for so many years, having a crash like that was epic.  Coincidentally, it coincided with the very first cliff fall in our torturous relationship.

And resulting in that choice, I developed functional alcoholism prior to the legal drinking age in the United States.  It took several abusers, victimization, abject poverty, and becoming an abuser to take me down into the depths of a bottle.

I found that I had even given up on self-medication.  When Xan and I got together, it became obvious that he suspected I suffered from addiction.  Though our relationship was certainly not new, our courtship was brand new.  In order to not put him off, and make a show of my own self-control, I slowly ditched the bottle.  I was so addicted that I found I had to be intoxicated to make love to him.  At least a little.

A few years later, I started treatment.  I had managed to remain sober, however, I had completely lost control of myself.  Several months into treatment, I ran into every medicated person’s greatest fear.  My medical coverage was eliminated.  Every pharmacy reported the same thing; Lamictal costs a fortune, and if I can’t afford COBRA, then I sure as hell cannot pay for it from pocket.  I found myself soliciting every pharmacy within a 10 mile radius for assistance.  Finally, one came through for me.  But, not before I suffered cruel withdrawal symptoms.

A similar withdrawal happened over a holiday.  I was unable to see my Pdoc before Christmas, and he had taken vacation through the New Year.  The office had a policy not to call in medications, so I had to make an appointment to go in.  Catch 22.  For four days, I laid there writhing in bed.  Xan took charge, and I had a refill that same day.

The very last time was one of my own poor choices.  That is exactly what mania does – it gets your hooks into you and tells you dirty little lies.  I had decided to attempt to wean myself from medication slowly so that I could prepare to attempt pregnancy.  I did so alone.  Instead of consulting a doctor, I went ahead.  And instead of getting off of medications, I had psychotic breaks the likes of which I have never been remotely acquainted with.  The result was more medication and a lesser likelihood of having a second child.

I have been without by force, by accident, by coercion, and of my own volition.  Like it or not, I cannot live without medication.