Death Grip

by Matt Samet

  “Okay, Matt,” he said. “But we need to find a way to keep you safe.”

  “I know, man. I know…” And we did.

  Andrew and I reached a compromise: I would call my father, and my family and I would sort out the situation. I shut the car door. This day, at least, there would be no more hospitals, no more psychiatrists. Back in Carbondale, Andrew dropped me off at home and then called other friends to come over for lunch so we could debrief. Four of us sat at the table eating bread and slurping yam soup while I assured them I would not harm myself again.

  “Well, you’re a pretty clever guy, Matt,” one friend, Jeff, said. “I’d hate for us to leave here and then you go and try something like this again.”

  “I won’t, Jeff,” I said. “I promise.” I could see in his half smile that he didn’t quite believe me. I explained the situation as best I could, emphasizing that I could not return to the doctors. I laid out the specifics to strengthen my case. Barely anyone around me knew what was going on. It was too complex, too convoluted, to be elevator chat, so I mostly kept mum about my situation; besides, I needed time more than I needed friends’ well-meaning platitudes in order to heal.

  I’d taken my final dose of nortriptyline only a week earlier, a twenty-five-milligram capsule washed down after dinner. Psychiatrists at Johns Hopkins had prescribed the pill to treat major depression, though it had served mainly to mask anxiety caused by the cessation of benzos nine months earlier. That last nortriptyline brought to a close a checkered fourteen-year history with crazy pills: Had I been lucid enough to do the math, I would have realized I’d been on thirteen psychiatric medicines in as many months. Now I’d entered a rawer, more fragile epoch, the underlying benzo withdrawal kicked into hyperdrive by this final chemical insult. The worst, ongoing benzo symptom had been hyperventilation, which left me wheezing, irritable, and in physical distress. The overabundance of CO2 set my muscles on fire, and only increased the constant, black, gut-piercing terror. I couldn’t walk up hills, and could spit out only three or four words at a time, punctuated by flurries of weird, shallow, triplicate yawns that worsened as my nortriptyline dose declined. I slept with my mouth duct-taped shut and nostrils opened with breathing strips to promote diaphragmatic breathing, in the hopes that my body might find equilibrium. It didn’t, and would not for some time. I was not safe out in the world, but neither did I have real refuge—especially not in my bedroom, alone with my ex-junkie’s guilt and self-hatred. I needed time, distraction, and somewhere to lie low, but it wasn’t happening. No one would let me. I’d tried to tell a few friends, family, and coworkers of my plight even as some urged me to “get help,” “go back on the meds,” and exploit my “support network.” But the support network—of therapists, doctors, and hospitals—had, through chemical paternalism, helped orchestrate this undoing. In fact, the only people who’d verified the reality of my experience were people who’d been through it themselves, ex-patients and survivors of benzodiazepines. It hadn’t been the doctors. It was as if I had vertigo after an hour strapped to a merry-go-round, but everyone I lurched toward for help asked, “How can you have vertigo? I don’t see any merry-go-round.”

  There is no merry-go-round.

  Imagine that you have been poisoned for years but have eventually come to realize the mechanism. And you know that, given time and a safe harbor, your system will normalize. But no one believes you because the poison is medically legitimized. In fact, the withdrawal symptoms themselves mimic the very conditions—anxiety, depression—for which the medicines were originally prescribed. They mimic conditions you’ve tussled with your whole life, only amplified so profoundly—a banshee howl piped through a bullhorn—that you can no longer function. Which is sure proof that you mustn’t stop your medicines, because your original condition is worse than ever. In fact, you may need new pills, and at ever higher doses.

  It is a tough cycle to break.

  Mind you, I don’t have these fits anymore. Writing this seven-plus years later, it would not occur to me to behave this way. I go about my days assuming sanity, climbing again, taking long walks with Clyde and my wife, Kristin, and our little boy, Ivan. Working, writing, being a husband and father. The madness is as remote, as hypothetical, as the ice rings of Pluto. And it’s all because I stopped listening to the doctors and started listening to myself.

  I kicked myself in the ass and changed the basic message. I changed it from, “You, Mr. Samet, have a lifelong anxiety disorder that must always be treated,” and, “We need to approach this benzo withdrawal from a place of strength, with other medicines on board” and, “It’s very dangerous to stop your antidepressants. What if you become suicidal?” and, “Meds give you choices,” to, “You are a whole, functional human being and not just the sum of your symptoms and diagnostic labels.” I changed it to: “You do not need these meds.” I changed it to: “The choice to live chemical free is a good and a necessary one.” Choices: It’s all about making choices. The five times I’ve been hospitalized—four of those for what I now realize was benzo withdrawal—the psychiatric establishment always offered more “choices.” This blue-green pill or this white one, this pink pill or this yellow one. This useless support group or that one. This endless, navel-gazing talk therapy or that one. Their choices have given me rashes, headaches, dry mouth, a deadened libido, dampened creativity, palpitations, head rushes, electrical zaps to the brain, slurred speech, glassy eyes, sleepless nights, rage … “Choices.” Without such choices, I might have healed years ago.

  Writing this, seven years after “the incident,” with a drug-free mind and hard-earned lucidity, I will say that the “choice” to trash my car and slash my wrists beneath a beloved cliff, in front of a beloved friend, is not one I will make again. I won’t take another med; I’d rather swing from a noose. Try me: I will end it before I let the brain-vultures spiral in again. I will endure every thunderous brainstorm and the filmiest wisp of depressive fog, knowing that this is my lot and that here, in darkness, rests my core, authentic self. I will sit with depression when it comes and listen, to decipher its barbed and cryptic teachings.

  Now, listen: I’m not some rabid coyote ululating from the badlands. I’m just a guy. I have a graduate degree, grew up on middle-class streets, held jobs, paid taxes, flew in airplanes, went grocery shopping, slept with women, brushed my teeth, tied my shoelaces. And whether you admit it or not, you do know someone like me. A friend, perhaps, who has trouble sleeping and ended up on three different pills that came to worsen her insomnia. Aunt Betty who lost her husband to cancer and was given “a little something” for her grief, and soon that something snowballed into a polydrug cocktail and she can no longer leave the house, her face a jelly of twitches and tics. Your nephew, an overly plump “bipolar” five-year-old taking an antipsychotic drug to control “irritable outbursts” and to temper the side effects of the ADHD drug he’s been on since age three. Grandpa Tom benzo-anesthetized at the nursing home so he’ll be less belligerent, less prone to sclerotic frissons, though now he can only count stucco dots on the wall, his mien gray-washed and slack. A co-worker who ghosts white during meetings and escapes for a high-potency benzo, only to return composed; but now, five years in and three milligrams deep, she has a constant tremor and must carry a pill vial from which she never separates.

  Do these characters sound familiar? Are you one? Do you believe that these people have been given “choices”?

  Surely the cure outstrips the disease.

  Welcome to the Psychiatric Death Machine—hospitals, doctors, the FDA, and their bedfellow Big Pharma—which has created an ever-expanding universe of dependency-fostering, side-effects–laden pills and profitable “mental illnesses.” If we are to take certain facts at face value, there has been an explosion in mental illness in America in the past quarter century, an epidemic requiring aggressive pharmaceutical intervention. More than 1.5 million Americans are on disability due to anxiety, depression, or bipolar illness,5 a 2.5-fold increase betwee
n 1987 and 2007.6 Six million adults are now considered bipolar,7 with a forty-fold increase in the diagnosis of children and adolescents with bipolar disorder between 1995 and 2003.8 Between 1996 and 2005, the number of Americans taking an antidepressant more than doubled, from 13 million to 27 million (10 percent of us over the age of six are now on antidepressants),9 with global sales of antidepressants equaling $19 billion a year.10 A 2006 estimate cited a whopping 8.6 million Americans who take sleep medication.11 The atypical antipsychotics Zyprexa, Seroquel, and Risperdal have surpassed cholesterol drugs to become America’s top-selling class of pharmaceuticals.12 And benzodiazepine sales are on the rise, climbing from 69 million prescriptions in 2002 to 83 million in 2007.13 In total, one in every eight Americans is regularly popping psychotropic pills, with total sales of these drugs in the tens of billions: $40-plus billion in 2008 alone.14 If you look at it one way, we’ve all gotten crazier, driven mad by the exigencies of modern life. But if you look at it another, it’s that the psychiatry has swollen like a bloodsucking tick, infiltrating the darkest corners of the human soul with empty promises and dangerous nostrums that are only making us sicker.

  In my experience, it’s the latter.

  You see, I’m whispering from outside the concertina wire, but soon it will be a scream. I crab-crawled through the spools one moonless night while the guards dipped their heads for a smoke, one of the few to slip away. I drew on my strength as a climber—my firsthand experiences with fear and mortal peril—to do so. From what I see peering back, too many prisoners yet languish. We should free them. We should bring them back into the world, back into the daylight. We should show them that this insanity need not continue.

  CHAPTER 2

  Before we go too far, I need to point out the difference between fear and anxiety, because this book deals with both and because they’re not quite the same. Fear is our gut, animal reaction to a perilous situation—it’s a physical response. Anxiety, meanwhile, is psychological: It’s nameless dread, a mentally concocted fear state. The psychologist Paul Foxman’s treatise on anxiety, Dancing with Fear, better explains the distinction: “Fear is the instinctive reaction to danger. Anxiety is a learned, irrational reaction to fear—a fear of fear.”1 If a mugger holds a gun to your face and demands your wallet, that’s fear; if you wake up in a cold sweat for the month afterward, flashing back to the robbery and feeling helpless, your hands shaking and your heart slamming, that’s anxiety. Anxiety can wear many guises, both physical and mental. My 2,600-page Webster’s Third New International Dictionary defines anxiety as “a state of being anxious or of experiencing a strong or dominating blend of uncertainty, agitation or dread, and brooding fear about some contingency.”2 Part two of the definition gets at the physical manifestations: “an abnormal and overwhelming sense of apprehension or fear often marked by such physical symptoms as tension, tremor, sweating, palpitation, and increased pulse rate.”3

  Climbing exposes you to both fear and anxiety, often in spades. This much I learned early on. When I was sixteen, my father and I and his college roommate, Bob, who introduced me to climbing, along with Bob’s girlfriend, Marion, climbed the enormous glaciated volcano Mount Rainier, at 14,410 feet Washington State’s highest point. The mountain is a singular heap, a mammoth castle of ice visible for hundreds of miles, floating in the sky like a hallucination. An ascent via the standard Disappointment Cleaver route is a two-stage affair: Stage one takes you up broad, gentle, nontechnical snowfields to a stone shelter at Camp Muir, at 10,000 feet. Climbers bivouac here, cook dinner, rehydrate, and prepare for stage two, which involves roped travel on crevassed glaciers, steep fields of frozen snow, and scrambling across loose, black volcanic crags. You leave Muir in the wee hours when the mountain is quietest, before sunrise. As the sun heats the slopes, Rainier comes to life, shedding its skin through rock and ice avalanches. You want to tag the summit and return to Muir before the peak heat of midday. Falling seracs—huge, semidetached blocks of glacial ice—and stones have killed dozens.

  Our party of four left Muir at midnight, crossing the Cowlitz Glacier on a well-worn trough in the snow, the headlamps of dozens of guided climbers in pack trains bobbing behind us like fireflies. We soon neared the end of a rising traverse to a col called Cathedral Gap, Bob and Marion on a rope team ahead, my father and me behind. As our friends stepped from the snow onto a protected scree field, my dad and I heard a calamitous clattering: stones peeling off a giant cliff called the Beehive that loomed overhead. They seemed to hurtle unseen from the stars, bright in the night sky above.

  “Run, run, run, run, RUN!” Bob yelled.

  Our headlamp beams playing wildly across the ice, crampons biting—nitch, nitch, nitch, nitch—in the snow, my father and I sprinted through the dark, making it to the col just in time. When we recrossed this stretch on the descent, we saw dark rocks as big as televisions scattered in the snow, the kind that can cut you in half. Fear had been our motivator that night; fear had kicked us into overdrive, keeping us alive. Yet until we returned safely to Camp Muir from Rainier’s upper flanks, I’d also felt anxiety, a buzzing, all-consuming meta-awareness of our frailty on a mountain as massive and indifferent as Rainier, a knot in my gut over the possibility of more rockfall, an idea I could not, no matter how hard I tried, dismiss. Anxiety—the fear that another boulder will hurtle through the darkness.

  * * *

  My first tangible memory of anxiety comes a couple of months after my parents’ divorce—the night in February 1982 that my mother went missing. They had had a good marriage, at least while it lasted, with much in common. My parents are both bright, rational, science-minded people. My father skipped ninth grade, going straight from elementary school to the boarding school Christchurch School for Boys and then on to Choate Rosemary Hall—and thence to Harvard. And my mother graduated in the top 5 percent of her class at the University of Rochester School of Nursing, winning its Dorothea Lynde Dix Prize for outstanding performance in psychiatric nursing. Both worked in health care, my mother as a pediatric nurse practitioner, my father in clinical medicine (pulmonology) and as an epidemiologist. (Today my father is still an epidemiologist, specializing in public-health issues including smoking and air quality, while my mother pet-sits and raises honeybees.) And both had grown up in quiet East Coast settings, my father in Newport News, Virginia, my mother in Chevy Chase, Maryland, and northwest Washington, D.C. I was born in Panama, in the Canal Zone, where my father served as an army physician during the Vietnam War draft, working as an anesthesiologist at Gorgas Hospital in the army’s Canal Zone company. After his discharge, we’d moved to Albuquerque, stayed two years, moved to Boston for three years so my father could complete a fellowship in clinical epidemiology, and returned to Albuquerque when I was six. I would live there until I was nineteen. It’s a tough, eclectic city that shaped me in a tough, eclectic way. I was always a smart kid, or at least bullheaded about getting the highest grades: In elementary and middle school, I always had the highest marks. When you’re the child of university people—and an only child, moreover—academic excellence is a given. It all starts at home: Instead of the Atari 2600 that all the other kids owned, I had a Mattel Intellivision with its more cerebral titles. Instead of a Lite-Brite, I had a Speak & Spell. Instead of cable TV, we had literature. Instead of seeing The Bad News Bears at the mall, we’d see a Woody Allen revival at the art-house theater. Everything, even play, had to have a purpose. It was simply understood that one lived this way.

  Another thing about my parents is that both are exercise fanatics. Even today, when they visit Boulder, each parent pair stays either at a hotel with an Olympic-sized pool or near the rec center, so they can swim laps each morning. Weekends in Albuquerque would find us running around a grassy triangle called Altura Park or on the two-mile loop around the University of New Mexico golf course. Or at the pool. Or in the backyard, lobbing the birdie across a badminton net. Or playing tetherball on a maypole cemented into the grass. Or on our half basketball cour
t, playing one-on-one or horse. (At only five foot six, my dad is a crypto-missile of a basketball player: the Jewish Spud Webb.) In winter we’d head to the gentle east side of the Sandias—the 10,500-foot mountain range framing Albuquerque to the east—or the nearby volcanic swell of the Jemez Mountains and cross-country ski through silent stands of Ponderosa. We loved to hike, and it was in the Sandias that I’d crane up at the range’s stark pink Precambrian cliffs and spires as we switchbacked along the La Luz Trail, wondering what it might be like to climb them. I had a child’s curiosity about the vertical world, dating back to an incident at the Grand Canyon at age four.

  My parents and I had stopped there on a driving tour of the Southwest. Standing by a guardrail, I’d taken one bite of a Red Delicious apple then flung it capriciously into the abyss. Off to the side, two climbers were rappelling off the guardrail, and I asked my parents if I could ask them to retrieve the apple, or if I could go down there with them. The men looked like superheroes, wearing sit harnesses, red helmets, and bedecked with glinting metal carabiners, their stubbled jaws beaded with sweat.