Power & Consent in Mental Health

This is a post about mental illness and medication. When I was sick, really sick, my consent kind of fell away. I did as I was told because I knew it was the only way out and back to freedom.

Sometimes, it’s the doctors job to tell you really bad news, like, if you want ADHD treatment it’s going to have to be supplemented by an antipsychotic or mood stabalizer. If you choose medication, it’s all or nothing, because you have bipolar and we can’t ignore that while medicating you.

The stuff that got me in this position, the combination of factors which pushed me over the edge, set off my epigenetics to say “bipolar 1” (if only it was bipolar 2, that would so much less intimidating of a label to claim) made me angry (it was unjust). Frustrated and angry and not myself, I stopped seeing my doctor. I needed… something, to understand this, I wasn’t going to just accept blanket medication for the rest of my life. This is my right to refuse treatment. This is my right to learn and know myself.

I do not regret this choice. “Stay on medication or else” was the looming threat of the situation, and I abhor making choices based on fear. I didn’t want to fear my mind, I wanted to understand it. So I backed down, stopped seeing my doctor, weened myself off the medication that would be more risky on its own first (stimulant) and then weened myself off the other (mood stabalizer). My mom was so scared and hyper vigilant about my wellbeing that I lied to her, only told her after 3 months that I had stopped the meds as I managed it and at that point could illustrate without fear that I was managing, functional and not going to fall immeditately back in mania. I maintained my position in life from prior to manic-psychotic episode (I would come to realzie that this was a ceiling, of which I could not pass without help). Then some shit went down and I lost so much, my position, my status, my wellbeing, but that wasn’t bipolar, that was my assault, my gender, my coming out, my social transition. When experience is complex and nuianced, I needed to focus in on self knowledge and understanding.

Eventually I met a friend who shared with me his tips to managing schizophrenia, he used teas and spirituality and only one very mild meditication to hold it all together. From his guidance I created my own forumla of mood stabilizing teas and this worked, and it was romantic, all natural self culmated medication and treatment is (romanticized). I also romanced the idea of boosting T naturally; my mental illness and my gender deeply intertwined, I can not cure one without working on the other (alas, neither is curable, it is a forever self improvement project). With these remedies I went back and forth, for a period of time used pine seed oil to affirm my masculinity and then used teas to stabalize my moods (could not go more than 3 days without Valiren root). At the same time, I was seeking treatment for my chronic pain related to the assault and so included skullcap and other relaxing melodies to soothe me. It’s a lot to take on, and a lot to cure “naturally” by myself.

Over the course of a year or so I rebuilt my capacity, career and self-confidence until I hit that same ceiling. I realized that with my psychosis 4 years ago I had reached as far as I could go without help to manage these issues, that the issues I face are self-managable as long as the demands of life do not pass a particular threashold. It is also funny, that is seeking treatment for gender affirmation, treating mental illness is a part of the process; so in order to get testosterone and potentionally surgery I have to address my mental illness. My doctor explained to me, even as it seems to be unrelated, my entire wellbeing is intertwined, and that by treating bipolar we are getting that out of the way so it does not become a barrier to me accessing gender affirming treatment now and in the future.

I suspect that I am going to look back on these 3 years without medication (as I may be on medication for the rest of my life) as invaluable. In this time I understood the nuisances of myself and also faced some of my greatest challenges. I discovered the depths and specifics of my limitations and exactly what I would want medication to do for me, so in the future I will be able to recgonize if it is or is not working. Perhaps if my condition was worse or more severe I may not have been able to go on this exploration (it was met with great criticism and concern from authoritative figures).

However, as a part of my journey I needed this period of time to understand myself and to come to terms with what my mental illness is, the specifics of what disables me and what I need to thrive and grow, not just hit a ceiling in my functioning; to accept the possiblity of my growth beyond what my limits would be without help; to enable myself to live in a self augmented reality. This knowledge grants me power and control over everything that will move me forward in life; it enables to understand and thus consent to treatment.


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