Why Do I Require This Many Pills To Function?

 Tap tap tap, is this thing still on? I know it has been a minute, or, more accurately, 2,628,000 minutes since I visited this corner of the internet. Despite continuing to pay for this domain, for the last five years I have neglected my creative pursuits, save for a Medium article here or there. I have not yet succeeded in fully comprehending why. A COVID hangover, in part, and the physical, mental, and intergenerational turmoil it brought. A Trump hangover, too, after holding our collective breath watching the Biden administration soft land the economy only for Trump 2.0 to take a massive fascistic shit on it (and the shit is named Steven Miller). In order to take this journey into deeper self-knowledge I decided to examine my various psychotropic prescriptions in the hopes of revealing why it is I need to take a handful of pills every morning to keep myself from swan diving off the Broadway Junction platform at rush hour (reserving the right to include having to commute through Broadway Junction as a potential contributor to the mental chaos). Let us hop into my quaalude time machine and go back to where it all began: 2016.

Snapshot of a woman's life as told by dresser minutia

2016 - Present: Venlafaxine ER 150mg and 75mg 1x daily with food

In 2016, not long after Trump took office, I went through a breakup and was certain it was going to kill me. The immensity of my grief definitely reflected my feelings for the person, but in hindsight the relationship was not worth the months of turmoil I put myself through before getting on antidepressants. Within six weeks of starting the drug I was able to form coherent sentences again, and in the intervening 10 years my dose has gone up incrementally. Notably, it went up once again after the most recent Trump election. So, I suppose I can attribute this need to antidepressants to fascism and men. After feeling stable for a few years on this drug I asked my doctor if I could come off of it. He responded, "why?"

I still don't have a good answer for that, other than I feel a vague sense of discomfort at relying on a capsule of SNRI dust to remain regulated. 

2016 adjacent: Clonazepam .5 mg as needed

Also around the 2016 era of first darkeness I began having panic attacks with dissociative elements for reasons I could not articulate, so I was prescribed klonopinnies as needed. Due to a very present fear of addiction, I rarely take them. But those little fucks are useful when I feel the walls closing in around me. 

2021 - 2025 Adderall XR 20mg 1x daily with food, 5mg IR booster

In 2021 I received a diagnosis of ADHD. My doctor was hesitant to give me the test, at first, both because I am a high functioning professional and the wide adoption of TikTok led to a bevvy of internet "experts" self-diagnosing out of a used copy of the DSM-5 to excuse their shitty personalities. I will admit, the TikTokers were the ones who first raised the alarm for me. The information from real clinicians there proved enlightening, however. One thing that spoke to me in particular was a set of video interviews from the 90's with a 6 year old boy and and 6 year old girl, both with ADHD. While the boy presented with the typically discussed symptoms: restlessness, fidgeting, inability to stay on topic, the girl presented much differently. She was quiet, introspective. She said she never felt proud of her accomplishments in school, that she didn't think her high grades were anything to be proud of. She spoke of a self-hatred whenever she got someone wrong or faced rejection. She could not understand why other kids didn't like her. Basically describing my entire existence up until 10th grade (when I got boobs).  I realized that many of my weird "habits" like needing to busy my hands in order to listen to someone, picking at my fingernails, chewing on the inside of my mouth, inability to start or complete tasks, disorganization, and general lack of motivation were all part of what could be something other than, in my words, being a faking piece of shit. I was given the ADHD test and passed with flying colors. Finally, at age 36, I was diagnosed and prescribed Adderall to help manage the symptoms. It was life changing. For 36 years my head was a noisy place - fragments of songs playing on repeat, thoughts crossing and merging like little mental rivulets, to-do lists, remembering then forgetting appointments, self-admonishment, and ideas for things to write/create/produce etc. Adderall felt like closing all those doors and being in a quiet room where I could just THINK. The sounds were muffled, still there but not so loud that they demanded my attention. I felt a calm in my days, less anxiety and panic. And I got some of the best sleep of my life. In 2025 the dream ended with a national shortage of Adderall, and, unable to fill the prescription, had to raw dog life and withdrawals. The latter wasn't too terrible, because weed is legal in NYC. Life, as always, found a way. . . to remind me that I am unwell. 

November 2025 - November 2025: Ritalin 30mg 1x daily with food

After clawing my way through half of 2025 unmedicated for ADHD the wheels really started to come off. Any focus I was able to maintain was directed solely to my job. My house became a mess, I stopped cooking for myself at all (would occasionally cook for my husband), I forgot and missed appointments, I struggled to leave the house when I didn't have to, and could not keep a concise thought in my head long enough to execute on it. With no end of the shortage in sight, my Dr. switched me to Ritalin, in the hopes that this weaker-yet-available substitute would keep a lid on my worst symptoms. 

It did not. 

Rather, after seven days on the drug, I felt increasingly weirder. Energy without focus. Buzzy but without direction. This feeling built until it culminated in what I now know was a manic/depressive episode. On the most manic day I dressed up in an over the top outfit to stomp around Manhattan in as I attended a few (non-psychiatric) doctor appointments. Once concluded, feeling full of health and on top of the world, I strode into a designer store and charged nearly $2,000.00 USD (in this economy!) on a few pieces of flashy clothing that my usual, meeker self would never deign to wear outside. I am famously bad with money but never in my right mind would even make a purchase that large, let alone in the name of frivolity. The following day I woke up entrenched in a deep sadness, and spent an hour on the floor outside the bathroom sobbing, much to the bafflement of my husband. I could not figure out why I felt so awful after having ridden such a high the day before. I confessed to my husband what I'd spent, and we got into a vicious fight which I handled in perhaps the least mature way I ever handled any conflict with him. As I continued a descent into misery throughout the day, it occurred to me that I may be experiencing some kind of mental episode. I texted my psychiatrist AND my therapist (we text, NBD), and the following day had appointments with both. 

Serving cunt and hypomania

December 2025 - Present: Lamictal 25mg 1x daily with food

A psychiatric evaluation immediately following this episode suggested a diagnosis of bipolar 2, or bipolar light, as I prefer to call it. Despite having taken so many of them over the past decade, this was a difficult pill to swallow. Couldn't it have been a reaction to the ritalin (unlikely.)? Could it be just a weird one-off (probably not.)? Could I just hang out for a while and see if it happens again (at my own peril, yes.)? I reluctantly filled a script for Lamictal. For those of you who are not struggling with increasingly severe mental illness, Lamictal is an anti-convulsant medication that was found to also have mood-stabilizing properties. It contains a black box warning - the most serious warning the FDA issues for pharmaceuticals. When started at too high a dose, Lamictal can have serious side effects which produce, let me see here, eye ulcers, mouth lesions, a full body rash, and death?! And this is preferable to occasionally spending a few Gs on quasi-ugly fashion choices? 

The answer is yes, because, while I can probably find ways to make up for more than one shitshow shopping trip, the back end of a manic episode can be terrifying. Dissociative depressive episodes have, in my past, led to self-harm and thoughts of s*icide. Though this medication and its implications scare me, I take it every day. It seems to be working (despite Science having no idea why or even fully how it works). My mood is more stable, and, though I have had a subsequent manic/depressive episode, it was nowhere near as powerful as the previous. 

Why am I like this?

A question I ask myself when looking down at the pile of pills in my hand every morning. Why do I need all this to function every day? Should not my will to live continuously buoy me from hard times to good? These questions, as it turns out, are impossible to truly answer. Some of it (ADHD, OCD) is genetic. Having done therapy to help cope with my various diagnoses, I very plainly see the symptoms in both my parents who do not ascribe to the notion that such afflictions exist. Some of it (depression) is triggered by increased, prolonged stress. What do I even have to be stressed out about? Aside from deep familial strife, economic instability, climate catastrophe, post-pandemic existence, and a nationwide descent into fascism? Whether we perform normalcy or not, we are wired with a central nervous system that will override executive functions if it thinks you are not paying enough attention. When I moved to NYC 14 years ago, unmedicated and flailing, writing this blog helped me cope. Maybe now is a good time to try again. 

Take your pills, drink your water, and do something, anything each day that lets you feel good for a minute.