Dope About Dope

There’s an aspect of my life I don’t write about much here. In fact, I think I only discussed it once, and then briefly. Six years ago I had a major crisis in my path that led to an ugly snowballing of events, both outer and inner, culminating in about two years of severe depression. I didn’t seek treatment during that time for a number of reasons. The main one was pride. I felt ashamed, and most especially I didn’t want anyone puzzling over why a Buddhist monk would be experiencing mental illness. I didn’t want to admit to mental illness. I also had no health insurance and little income and thought I couldn’t afford treatment. And I had simply sunk into the inertia that depressed people sink into. I had reduced my activity to the absolute bare minimum necessary for survival. I rarely left my room, forget the house; I didn’t answer the phone or emails; I considered it a great accomplishment for the day if I showered, or cooked a meal. All experience was processed by my mind through a negative filter. Anything I could think to try was doomed to failure, I thought, so why even bother? People’s conversation, their jokes especially, felt physically painful to me. I spoke in a low monotone, never looked anyone in the eye. Nothing was funny and I had a hair-trigger temper. My thoughts fragmented and I frequently could not call up words I was searching for. And I slept. Oh Lord did I sleep. Fifteen hours at a clip was normal. Waking at three in the afternoon feeling as though I’d never gone to bed, and returning to bed an hour later. Spending so much time in bed, my body felt atrophied, my back constantly aching. I did nothing for my temple. I did nothing for anyone.

Two episodes changed this. The first concerned my dear friend Anne. She has her own history and was the only one I trusted to be empathetic, and the only one whose calls I would take. She finally exploded at me, asking who in the fuck did I think I was to put others who loved me through hell because I couldn’t wrap my mind around taking medication that might help. Did I think I was somehow superior to her, who had been on every medication under the sun since she was in college? She nailed it as just another facet of my arrogance. I had nothing to say. She was dead right.

The other episode was an unavoidable family reunion in Maine to celebrate my mother’s 75th birthday. After a couple of days, my sister Sarah sat down in front of me, peered into my face, and asked, “Who are you, and what have you done with my brother?” Some time later, my whole family intervened. They wanted me to cancel my return flight to Arizona, and get help right then and there. I somehow persuaded them to let me go back, but promised I would seek out the right healthcare professionals.

Remarkably, I honored my promise. I engaged a psychiatric nurse practitioner (with prescription privileges) and a therapist. I started taking a medication called Zyprexa. This helped almost right out of the gate, but as time wore on, stopped alleviating symptoms and created some havoc. I shifted to Paxil, an elephant dose. Then I really started to feel better, with virtually no side effects. It was like someone had gift-wrapped my nearly forgotten life and handed it back to me.

Something about my initial engagement in the Mongolia project seemed to alter my chemical makeup. I cut the Paxil dose in half. That was just right.

I’m telling you all this because last Sunday I finished a bottle and went to find what I thought was my last one. I don’t know how I lost track, but there was no last bottle. I looked everywhere. I was out. How could I let this happen, you ask? The answer is simple. I’m an idiot. And right now, I am literally off my meds. Thanks to my other sister, the ExpressMail cavalry’s coming, though, so don’t worry.

All seemed fine for the last few days, really. I was quite glad. The nastiness of Paxil withdrawal is the stuff of legends and lawsuits. But after an intense outing with F.I.R.E. to a countryside prison today (which I’ll get to in a minute), I went wobbly this afternoon and crashed. Better now, but still a bit dissociative and dizzy and writing all this to fight my urge to withdraw.

When you take meds for mental illness, you’re regularly confronted with the question, “Why don’t you try to get off them?” First of all, if they’ve asked that question, you can be sure that that person has never gone through such illness. Get off it? No one asks the diabetic why they don’t just kick the insulin. I'm a little in love with my Paxil. I’m not kidding. Just about everything I’m enjoying about my life today would be impossible without it. And I’m terrified of relapse. Writing the above brought back such intense, awful memories that I had to stop typing a couple of times to control my tears. I hope you don’t mind my indulgence too much. I really needed to confront some of that tonight.

A good counterbalance today, though, in the You Think You’ve Got It Bad Dep’t, was visiting this prison. I’ve also written a little about how participating in KPC’s Prison Program was one of the most meaningful things I’d ever done and I’ve been itchy to see something of Mongolia’s prison system. Today I had my chance.

Meredith from F.I.R.E. again teamed up with the FPMT folks, who themselves coordinated with Mongolia’s social service agency, for this visit to distribute warm clothing, soap, and some Dharma items. We got started early, and it was plenty cold. No more than 15º with a stiff breeze when we left to load boxes at the warehouse.

The facility (named, in a poetic flight of fancy, Prison Number 429) lies about 40km outside of Ulaanbaatar. No one wants to go there because it also functions as a hospital and primarily a TB ward. The social worker told us the last visit was some Christian group in 2002. Here’s the view as we approached. I was disappointed to learn that we would not be permitted to visit the maximum security wing on the hill, but it was an eye-opener nonetheless:

This prison could not have contrasted more with American facilities. The Mongolian State provides little. The barracks have no heat and whatever the prisoners have in the way of clothing and food almost all comes from their visiting families. Security was totally laughable, but Mongols rarely try to escape, I’ve heard. Some of the more exemplary prisoners are given the task of tending the prison livestock in the fields outside the gates and they always come back!

We loaded into their rec room, which consisted of one pool table and a display with dusty pamphlets from World Vision on how to prevent spreading TB. The guys were brought into the hall outside and made to squat. This is their means of crowd control. That and the occasional lash with a stick, a bit more intimidating than the granny in my courtyard.

We were introduced, and then they let five guys in at a time. We had jackets, sweaters, pants, socks (including the effing clown-colored toe socks which Meredith would not leave at the warehouse like I begged her to – I’m really sensitive to the indignities prisoners have to suffer but she insisted they wouldn’t add to them; I disagreed but was overruled), hats, gloves and some shoes. Here Meredith loads a guy up:

The state of some of their clothing, with the Mongolian winter approaching, was occasionally shocking. This guy had no socks, and just these plastic sandals:

Ten of the inmates had been selected to receive warm boots; I think they have outside jobs:

This handsome fella put his Dulaan-knit hat right on. We handed out about 85 of your wonderful hats – you Dulaan knitters made a big difference to these guys, whose heads are all shaved, and who had no such hats:

Ani Chantal gave each man a protection cord blessed by the Dalai Lama on his most recent visit. She also left Dharma books in Mongolian for them to read:

As we left, these guys were in the control squat, but in a surprisingly chipper mood, waving goodbye to us. You can see more of the Dulaan hats here including, unbelievably, one in the front row that I tried to cull, adorned with a knitted daisy! Maybe they'll dig the toe socks, after all...

As we left, I asked Meredith to take this photo of me. The reason is I’m wearing the hat that my boys at Roxbury Correctional Institute in Maryland gave to me as a gift before I left. I’m going to find some way to get this to them, wearing their hat at a Mongol prison:

And finally, as we drove home, I was struck by the intense chilliness of this Mongolian steppe-in-winter vista, even at the end of October:

Thank you all for letting me share all of this. It really helped tonight.

Comments

[Bolor]

Thanks for sharing... (sounds cliché, but nonetheless). Glad to hear help is on the way and, truth be told, we all have our own demons to battle with... and keep in check hopefully just like you.

BTW, them lads sure look happy!

[Nancy O]

May peace be with you! Your battle is exactly like mine, although mine culminated in a hysterical mental breakdown in my kidney doctor's office. I know what you have been through, and you are always in my prayers, even more so now. I hope your calvary arrives soon. The work that I do for Dulaan and for other charities helps keep me focused and on track (well, that and a little help from Celexa). Thank you for sharing this with us, and thank you for allowing me to help others.

I love the pictures, the smiles and the love you can feel make it all worthwhile.

[Angie]

Adequate words of comfort escape me. Hang on, many, many are thinking good thoughts for you. I'll knit some man sized Dulaan hats for prisoners.

[Bessie]

Thanks for sharing a tiny part of the interesting story of your life. i think those who share their hardships publicly bless the rest of us -- as the truth of pain is freeing to all of us. and we all have pain; more often than not unspoken. As for what you're doing, such as visiting forgotten prisons in mongolia and giving out warm clothing, seems like you are up to good; it's inspiring. take good care -- especially until your package arrives.

[Faith]

Thank you. I'm glad putting it all down was able to help you a bit, and I'm sure it will help some of yuor readers, somehow, as well. I know it helped me.

Best.

[kmkat]

I too went through the horribleness of depression, post-partum in my case, but as I had always been at least mildly depressed, that episode was a doozy. Thank heavens for psychopharmachological miracles. After 16 years on the meds I've never been happier. Life is good.

Your analogy with the diabetic and his/her insulin is a good one. I like to consider the advice, "Just snap out of it" re: depression as akin to telling someone, "Just change your eye color." Can't be done, we were born that way.

Thank you for putting this all out. Mental illness affects so many of us.

[Kittie]

Thank you for sharing. From the bottom of my heart. Knowing there are others out there who suffer like you do can help in so many ways when you are sliding down that slippery slope.

And seeing people who are so much worse off than you will ever be, and knowing you in some small way helped them, is a blessing that can't be described.

Just...thank you.

[Sis Laura]

I think it was incredibly brave of you to post this particular entry. I am one of the few that witnessed you at your worst (in Maine) and it was extremely painful to see. Maybe your writing so openly about what the vista looks like from the eye of a person in deep depression will help others to seek help without shame. Thank you, my dear brother.

[nephew paul]

hi! i don't really have mutch to say. i'll start typing something worth reading when i read something worth typing. hee hee. so, just stopping in to say hi. better than a long distance phone call. wow, am i running out of things to say.now i'm just typing in random words to fill up the little box provided. using the email thing on the side, you now know how to reach me!

xoxoxooxx

paul

[Konchog]

Ah, thank you all so much. One potential Paxil withdrawal symptom is easy weepiness, and ya'll done gone and triggered it.

kmkat -- I'm going to remember that eye color comeback. Good one.

Paul, you rascal, keep writing!

[minnie]

i completely understand. while i am not on anti-depressants myself, my youngest child is. and it's been a roller coaster. in fact, his doctor decided we needed to up his medication in mid may, and he had several major episodes that ended up with him being hospitalized. we switched medication as quickly as we could. he's doing well on this medication, and if things continue to go well, he'll be home in a few months (he's in theraputic foster care, and this, his second placement, seems to be working, thank goodness)

and thank you for showing the hat pictures. i didn't see my hats, but that's ok, just knowing that we've warmed these men (prisoners or not), and maybe brought a little peace and happiness to their lives is enough

[sheila]

Bless you, Cuzzin Tom, for the work you do, and I'm going to be sending larger hats too for the guys. Thanks for posting this today, I'm sure it was hard to live thru again.

[rho1640]

Well, heck, I have this enormous hat I didn't send because it is too big for even my huge head (going to try felting it this year so maybe it will be a bit smaller) but I think someone there might have fit is and it is just blue and white (good men color)

I think that guy in the sandals will be thrilled with toe socks :D You never know they may become the new in thing there.

I've actually been thinking about talking to my docs about getting back on meds - I'm tired of pretending to be happy - does that make sense to you -- my problem isn't sleeping too much -- it is exactly the opposite - I have insomnia which is ridiculous. My brain is exhausted but it won't shut down for me to sleep - it is kind of like the energizer bunny - it keeps going and going and going. Wish it had some good thoughts on making some money to supplement retirement or something constructive at least.

And thanks for sharing - look at all the people who understand and wrote and imagine how many won't write that you will help by your post - we all go thru things for reasons - even horrible things - maybe you had to go thru that to be able to help someone else by writing about it.

And now that I have rambled out a book to you I will go sit and quietly read some more
;)

[Rinchen Gyatso]

I have panic attacks occasionally, but was having them a lot while in Japan and for several months after I came home (I taught English in Japan from March '04 to March '05). I was terribly overworked, wearing lay people's clothes (which for me was symbolic of being a failure as a monk), and was completely cut off from any Dharma community. Odd, being that Japan is ostensibly a Buddhist country. Anyway, I was in major denial about the attacks, during some of which I actually collapsed and passed out, especially when the doctors I started seeing upon return from Japan all basically said to me, "What's a Buddhist monk having panic attacks for? Don't you know how to meditate?" That was painful. I stopped seeing doctors.

It didn't help that I was under-employed in a boring jog and living with my parents again in my mid-thirties. Now that I'm out of mommy and daddy's house and doing something worthwhile (going for an M.A. in Buddhist Studies in CA), I don't have them as much and they're not as intense. I never did go on medication, but I've only had one since coming to school here and it was not so bad. So, perhaps this is a little selfish, but I'm glad to hear I'm not the only monk with mental health issues. I feel like I can admit to being human...something I find lay people, Buddhist or otherwise, don't always allow us to be.

Cheers to you, mate.

With palms together...

[Ani Dara]

Just coming by to grab your addy for a hyperlink in this week's Mandala Messenger (get ready for lots of new visitors) - and WOW. Soooo glad your sis is hooking you up with the meds. Promise to stay on top of them this time, we're counting on you!!

[Melinda]

Thanks for the picture, and for the story of your depression. I resisted meds for years because I thought it was wimpy, but I now have a relationship of slobbering gratitude with my prozac. I'm lucky that the first thing I tried worked, and continues to do so without side effects. I'm lucky that I'm sane and happy enough now to work on helping other people.

One of my hats MIGHT be in that picture, but it's hard to tell since brownish-gray hats just aren't as distinctive as hats with daisies.

[Robert]

Konchog, I applaud your courage to deal with depression and come to Mongolia where your work is needed, but help is hard to come by. Please let me know if there is anything I can do.

[Konchog]

Melinda -- For some reason your phrase "slobbering gratitude" gave me the laugh of the day.

The rest of you -- in these comments and by email -- are quite the unexpected and lovely support group! All is well except for this one very weird phenomenon. I keep getting this sensation that's like...it's like if you were about to be transported off the Enterprise, right? And the gizmo had just started to disassemble your molecules and then jammed and you snapped back into focus. It's like I go blurry then snap back. Blurrrr...snapback. Like 20 times an hour. Very peculiar, this samsaric projection, no?

Dara -- Thanks for the heads up. I better write something witty and normal or I'll scare everyone away! Got some funny Mooj pix today. Maybe that'll do it.

[Christian]

"It's like I go blurry then snap back. Blurrrr...snapback."

That could be the fruit of the Castaneda Tantra: do you reassemble your perceptions in this world? Do you become a cat?:-)

We usually ignore what it the part of ourselves which is organic. We know where is our body, sure, we identify with it, but until a certain point: we miss that a part of our mental processes, our mood etc., a part greater than we would like to acknowledge, is the result of pure organic activity. Sometimes this biological determinism can be oriented towards healthy states that point towards the non-organic, sometimes we need material help, medications. My experience tells me that, when in trouble, the remembrance of that knowledge (not to identify with the perceptions, basically) helps to reduce the tension, which is something, despite not being enough. Take good care of yourself.

And, anyway, there is this huge no-man's-land between the neuron and our true nature, that murmurs when we don't listen and that is completely silent otherwise, which makes us a bit paranoid or depressed.

Until.

[Sophie]

Aaaaauw. Here a pride amongst the pridest... Reading you I am struck with similarities in the depressive condition. Because I still go to work, it's too easy to hide to myself the fact that despite all the struggling, my life is a complete misery. Why the heck is it so difficult to get on meds????

Thank you for that honest, helpful post. Take good care and don't forget to show us when you'll put those toe-socks yourself ;-)

[Vedran]

You know Konchog it's great when you occaisonally put in some Star Trek reference! It remindes me being hardcore fan back in the school. Late night episodes of Voyager and Enterprise were really something rare to look forwared too on tv.
I never understand diference betveen psychologist and psychiatrist until standard recruitment process for military service. Guys who got suspicious results from written test got to chat with psychgologist. Those were many! During conversation most of us just smooth things over and were declared eligiable, myself included. However guys who could'nt get things strait with nice lady psychologist got sent upstairs for chat with actual psychiatrist. And those were mostly exempt from military service! Lucky bastards...
My point is mental doctors- yes if you want them or need them to help you. But if goverment needs them to screen your mind for it's own purposes then they'r nothing but tools in the hands of devil...
Stay sane Konchog!

[Lee Ann]

Here's hoping your molecules realign properly, every time. A big hug to you, Konchog.

[Marianne]

I am working on my gratitudes daily, trying to move gracefully through midlife. Sometimes they unfold so deeply. Little do these men know how grateful I am to them for allowing me the opportunity to knit with great purpose. Thank you for all you do in our world family. Marianne

[Norma]

Cuzzin Tom, a big hug to you. I find that is one of the aspects I love most about my job, too -- the "If you think you've got it bad" aspect. Every day I'm reminded of what I've got to be thankful for.

[Sarah]

Dude,

I nearly plotzed, as you would say, when I read about your sis asking "What'd you do that for?" That's EXACTLY what Alan says when I run out of my stash. Every. Single. Time. And I ususally suggest ever so gently that the time to have a deep, introspective chat about why I'm a such a moron and so incabale of getting my shit together should be when I'm NOT in a trembling, sweating, eyeball-gouging withdrawl- induced rage. Geez.

[Marianne]

Me again. One more thing I'd like to share with you. I tried to go off my depression meds this summer and even though it was very subtle outwardly, those who know me and love me most noticed that I had lost my zest. My affect became flat at best. Yes, I'm back on them and your post has given me the strength to know that this is right for me, even though I would prefer to be drug free my entire life. But I'm wondering about the side effects of Prozac. The TRUE side effects, not those posted by the drug company. Any idea? Thanks agin for being who you are and so very honest...Marianne

[marylee]

I don't know quite what to say, so I suppose I'd just better go knit. The more I learn about you.......

[Carol]

Thanks for the topic, I think it's one we can't talk about enough. I went through a similar soul search, only for me it was about whether to treat my son. He was sliding into depression and paranoia, but it wasn't until he hid behind me one day because 'the people in the car driving by were watching him' that I smelled the coffee and figured out that his need for meds was more important than my need to feel like a 'good parent'. As if somehow treating my child's problem was akin to admitting that I had failed. When you look at the work in SPECT brain scanning, and see how people's brains look, on and off meds, you can see how some people really need them the way diabetics need insulin.
Tell Mooj to keep an eye on you while you wait for your pills. Maybe some catnip tea would tide you over!

[Aarlene]

If it's not 'hug a monk' day it ought to be. Here you are having a bit of a crisis, helping those in other circumstances and still able to bring the funny and a ST reference or two. Go Monkman!

[Franklin]

I'm just catching up on the fun things in life, like reading your blog, and the first thing I find is this entry.

I'm a Guy on Meds, too: Lexapro and Wellbutrin. They go together like peanut butter and jelly.

It's not an easy thing to write about and I'm impressed with how clearly you describe the experience - including being asked why you don't just stop taking them and cheer up.

And you know I look up to you - so finding out we have this in common is a shot in the arm for me when I really need it.

Between that, and seeing Dulaan Action Shots, you made my damn day.

[Konchog]

Sarita -- I should clarify that my sister didn't ask me why I'd allowed my stash to lapse; the question was rhetorical. She simply responded with the love she always shows by zipping to the PO and sending the goods (I'm lucky, she's a doc). And, my darling, I'm afraid I feel a bit sympathetic with Alan for his POV, if not his timing. I'm copping to doing this once; sounds like you're saying you do it *on a regular basis*. This is tough on those who love you.

Marianne -- I don't know anything about Prozac. But I do know that everyone's different, of course, and won't fit neatly into a Pharma co.'s model.

I would say, in general, that the only good reason to "get off meds" is if the side effects are worse than the disorder. And even then, I'd first try to either adjust a dosage or switch to another, always under the care and observation of a professional.

[Sherab Lhamo]

Very wonderful story!
Your Budhicitta mind is the best doctor that heals you. I also look up to do...

Best wishes ~Sherab

[Janet]

Sheet. Ah, the countless times I stood in line on a weekend, waitin' for the ole' overdue refill... one time the one-time-too-many came and the pharmacist's disapproving sighs merited a "hey, dude, didn't they teach you in Pharmacy school that depression makes you, well, forget sheet?" Then again, maybe that was the sudden rage talking... depression is SUCH a beast - best book I ever read on it was a graphic novel (comic book) written by a teenager - she calls it the wolf and talks about the stuff that makes the wolf stronger and the stuff that makes the wolf smaller, and it was a wonderful thing, to see depression as a non-integral part of me - you know, the whole dang thoughts arising, thoughts subsiding business? I think those B-boys came up with that, didn't they? (Conquering the Beast Within by Cait Irwin)
Wishing your postal goodness a speedy delivery!

[Nathania]

Your response to Marianne brings up an interesting point: for those who suffer, don't despair if the first drug you try isn't the right one. It's a fine balancing act of chemistry to get the right solution.

There is a strong lineage of depression and even full blown mental illness in my father's family and I suffered bravely for years before I finally sought treatment. Depression looks different on different people. Mine is very internal. My outward appearance of energy and togetherness is fine, but details of my life start slipping and tasks go unfinished. I lose contact with the joy of living and become internally disengaged from everything and everyone around me. The mental lethargy builds up until suddenly an explosion of pent up emotion knocks me on my ass and I realize that I've been depressed for weeks.

Thank you for sharing your story. May life treat you gently until your dear sis' package arrives. Peace and blessings to you...

[Kristen]

Oh man do I know about the first part of today's entry! When I was overseas last year I was without my happy pills (which I also resisted taking for years) for about a month. It was NOT pretty. Hang in there, help is on its way. (I also use the insulin argument with friends in need now.) Thanks for the pics of the prisoners.

[Zendette]

Konchog, I agree that it was very brave of you to write this post. Maybe you can find a local dr. that can help you find the AD you need locally so even if you happen to run out again in the future, you won't need to wait for an express delivery.

About 10 years ago I was put on an MAOI, nasty stuff. The side effects were worse than the original symptoms. I didn't realize going cold turkey was dangerous and ended up spending almost a week hospitalized. Not trying to scare anyone, but just a word of warning to anyone on any sort of meds, especially when you travel, make sure you have a backup plan and always talk to your doc if you plan to go off them.

[Canadian eh?]

I have seen a photo of His Holiness sporting a sun visor. Somehow, I think he would approve of the cheerful socks for prisoners.

[Konchog]

Zendette -- You bring up something I forgot to mention. At a dinner I went to last year, I met a Mongolian psychologist. She said that even the oldest, most common psych meds were completely absent in Mongolia. But, I do have SOS insurance, and like a dummy haven't checked with their clinic...live and learn.

[Angela]

Thanks for some many things Cuzzin Tom.

I'm going to knit some hats in my friend Erin's memory for F.I.R.E.

Depression played its part in both our lives.

[Bolor]

Yeah, generally speaking, mental health issues do not receive much attention in Mongolia. There are institutions for the mentally handicapped (schizophrenia, etc), however the less serious varieties such as depression, OCD, ADHD, bipolar disorders, etc simply do not exist for all practical purposes. No diagnosis, no treatment.

I see two main reasons for that:

a) backwardness, both in terms of public awareness and access to treatment (there are pros and cons to this point: cons - people suffer, often needlessly, pros - no dependence YET on cash-hungry, unsrupulous pharma co's keen to come up with more and more new "conditions" that get stigmatized and require VERY long-term "treatments" of course, as opposed to cures...

b) Mongol culture + environment, which might be less conducive to developing such problems. Due to harsh conditions + overall vulnerability, dependence on one another is recognized and emphasized, as opposed to the ideal of total self-sufficiency pursued in the West. When I went to US as a teenager, at first I simply couldn't understand why and how my roommate was depressed (and what for). Such a thing simply didn't exist where I came from.

Not to say that mental health is not an issue - alcoholism, domestic violence, crime, etc are widespread and require attention.

[Vicki Yehling]

Thanks for sharing about your meds, Konchog. Didn't know you were on them. For someone who takes them four times a day, a handful at a time, I am eternally grateful for Jetsunma's instruction to do so. I can sort of live a life now. But thank you for having the courage to come out and admit it. Hard for a Buddhist monk to do so.

[Rabbitch]

The guy with the daisy and the big grin ... shows that there's some folks you can't keep down no matter how hard their circumstances are. And I'm glad of it. This post brought me joy, thank you.

[jennifer]

You're an inspiration. Thanks for sharing. I won't go so far as to say that I will ask my doc for meds, or get into therapy. But I will think about it.

[Daniel Haszard]

90,000 pharma reps in the usa,you can't watch the evening news without being bombarded.

What irks me is that the Eli Lilly company's blockbuster Zyprexa has been implicated in causing TEN times greater risk of developing type 2 diabetes.
They then turn around and sell other blockbuster drugs to treat the same diabetes.
--
Daniel Haszard www.zyprexa-victims.com