We Do Not Choose
Mental Illness and
We Do Not Choose Addiction

Sara Berelsman

Copyright 2014 by  Sara Berelsman         


Image of a red button with HELP on it.

We do not choose mental illness and we do not choose addiction.

If you think otherwise, then get on your knees right now and thank God, because you have never experienced the true horror that is addiction. You have never suffered through mental illness. You are one of those people who happened to be born with a “normal” brain. Many times I’ve been jealous of you, but I’m not anymore. These are the cards I was dealt. I often think that God just took the stack of cards and flicked them out onto the population, and is then sitting back, watching crazy situation after crazy situation unfold. God has one hell of a sense of humor.

I quit drinking two and a half years ago. I didn’t choose to become an alcoholic. An addict is born an addict. We are born with a genetic predisposition, something in our brains that doesn’t signify when enough is enough. It’s never enough. Never. It took for me to become a completely different person, and one that I didn’t like at all anymore, for me to realize I had to quit drinking. Something else happened; this power came over me, and helped me make the decision. God was part of the decision.

I’ve never been someone of blind faith. I’m always questioning the existence of God. The intellectual part of me overpowers the intuitive part of me, and because I don’t have concrete proof of God, I don’t believe. At least, that’s how it’s been up until this point. What happened to me this week changed all that.

When I quit drinking, I felt as if God for the first time in my life was really present. I felt it. This decision to quit was bigger than I was. It was fate, combined with my decision to quit. That’s something else I’ve always had a hard time with. Is it fate or is it free will? Well, my therapist thinks it’s both. Now I believe that, too. It is incredibly hard for me to not think in black and white terms. It’s all or nothing. Go big or go home. My brain is wired differently than a “normal” person’s. I am bipolar. I am an addict. This is where much of the population seems to step in and voice their opinions about addiction being a choice. About anxiety being for “wussies,” as one of my Facebook friends stated quite confidently this week. Man up, wussy.

Screw that.

Anxiety is real. It is very real. It is biological, not a choice. I know this with every fiber of my being. Depression is real. So horribly, horrifically, terribly real. I can’t tell you how many times I’ve wanted to die. And I’m an intelligent person with a lot going for me – everything going for me. Please tell me why I’d choose to feel suicidal. The answer is, I don’t. And for people to minimize depression, to scoff at it, to trivialize the very real thoughts I’ve had about wanting to kill myself because nothing is good – I don’t care how everything appears to people on the outside – depression is biological. I love my children more than anything. I love Andy. I love my parents. Yet, when I’m depressed, that doesn’t matter. All that matters is the here and now, and it is horrible. There is no future in depression. The only thing I can ask you to do is to take my word for it. Trust me, Philip Seymour Hoffman did not choose to die. He did not choose his mental state. He did not choose to be an addict. I am no different than he is. Addicts crave a high. Once the high is achieved, the brain is automatically chasing the next level of high. It’s like an elevator that’s rising to the top, but stops on every floor. And suddenly is going by itself; no one is pushing the buttons. One beer used to get me tipsy. That wasn’t enough anymore. I needed that next level of high. Two beers was a little better, but nothing like the euphoria of three beers. Of four. Of five. It’s never enough. Never.

I found God again this week. I was telling my therapist yesterday, that all this time, the past few months, I’ve been wondering, where the hell is God? The answer is, God’s always been here. It’s, where the hell was I? I know this because I felt God’s arm around me this week in a way that I’ve never experienced. True, I had a life-changing experience when I quit drinking. I found God. As my therapist said, though, as human beings we grow, and then we regress. It’s normal. We take a few steps forward, then take a few steps back. It’s life. Well, I had regressed and didn’t seem to be going forward again. I was frustrated and lost. I lost God. In the back of my mind, I knew this. It just took a dramatic experience for it to really sink in for me.

While I gave up alcohol, I still smoked, and I took Ativan for anxiety. It calmed my nerves. It was something I could still do to achieve pleasure. Except I discovered the electronic cigarette. You see, in the past when I thought I was addicted to smoking, I was wrong. I really didn’t smoke much at all. With this new invention, however, I could do it anywhere. All day.

My electronic cigarette had become a permanent fixture. I had a routine. Wake up, reach for the electronic cigarette. Drink coffee and vape on the e cig. Write an article and vape on the e cig. Drive somewhere and vape on the e cig. In the beginning, I was going through maybe a cartridge a day. That turned into two. Which turned into two packs. Then, this week, I blew through the equivalent of a few cartons of cigarettes. I don’t know about regular cigarettes, but my e cigs contain 16 mg of nicotine. And I never understand nicotine withdrawal until this week. Because I’d never really been addicted to it until now.

I’ve been in a cloud the past several months. I was feeling better mentally, so I stopped taking my mood stabilizers. This happens often with bipolar people. Even thinking about it now sounds stupid, but when you’re high, you don’t remember what it’s like to be low. When you’re low, you think you’ll never be happy again. Take my word for it. So since I was feeling better (and I’ve done this numerous times), I thought I didn’t need that medication anymore. The thing is, I was feeling better because I was taking the pills. In order to continue to feel good, I had to keep taking my medication. When you’re manic, that makes no sense. At all. You often feel great, so you think you’re fine. You’re not.

I noticed my highs and lows were cycling much more rapidly than they usually did. It didn’t occur to me that the absence of a mood stabilizer was responsible for this. After all, I was fine. I went off the meds because I was fine. Sometimes, it takes getting down to the lowest low to think otherwise.

I’d been in a fog. No inspiration to write. Nothing. I thought maybe by ingesting as much caffeine and nicotine as possible, I’d push myself into a nice manic mood and feel inspired to write. I did become manic, but it was not a good manic. Think of the best you’ve ever felt. Multiply it by one hundred. That’s mania. Except lately, my mania wasn’t euphoric this time. It was agitation and restlessness. Extreme uncomfortability. Thoughts darting in and out of my light at lightning speed, and nothing I could do to turn them off or shut them out. Picture how in movies or TV shows when they speed the cameras up so fast that you see traffic moving at lightning fast speed, flashes of colors and lights. That’s a manic brain. Burning, burning, burning, and nothing can stop it.

My therapist said it was a perfect storm for me to have the major panic attack I ended up having Thursday morning. I slept Monday night. I did not sleep Tuesday night. Or Wednesday night. I’d been awake for days. I’d also unknowingly been sucking down nicotine around the clock. I say unknowingly because it really was. It was like breathing at that point. I didn’t even notice it. I was constantly switching from whichever cig I was vaping on to the one that was charging, because I was using it to the point that it needed charged every few minutes. I was manically sucking on this thing. With every breath I took. For about two days straight. I had also been taking Ativan every day, three a day. But then three didn’t cut it. I was up to five a day. (Most people are prescribed one a day.)

Ativan is classified as a benzodiazepine. Benzos are extremely addictive, incredibly hard to come off of, and easy to build up a tolerance for, which is what I’d done. In the back of my mind, I’ve known since I quit drinking that I probably shouldn’t take them. But what did I have left? I needed something to take the edge off. But my addictive brain could no longer be satiated with the edge being taken off. I needed more and more and more pills to achieve the desired effect. Well, I ran out. Before my prescription could be refilled. This happened right around the same time I took my final puff of the electronic cigarette. I was out of cartridges. I wanted more. I didn’t have any more. It was the middle of the night, and I’d been awake for days. This was when I started having withdrawal symptoms. Symptoms that are the scariest thing I’ve ever experienced. Symptoms that scared the living shit out of me. I was shaking all over. I couldn’t stop. No part of my body was still. And it couldn’t stay still. I couldn’t lie down. I’d lie down and my legs thrashed around involuntarily. My arms were flailing. I paced around the house. And paced. And paced. And paced.

Then, the really scary shit started happening. My lips were making the puckering motion made when inhaling the cigarette – involuntarily. They would pucker up, the twitch back to normal. Pucker, retract. Pucker, retract. Pucker retract. I was scared as hell. I woke up Andy, having involuntary muscle spasms, telling him I didn’t feel right. I couldn’t stop.

This went on for hours.

Andy told me to try lying down. This was the pattern for the next 24 hours – lie down, get up, lie down, get up, lie down, get up. Right away. When I was walking, I felt uncomfortable. When I was lying down, I felt uncomfortable. I was horrifically, painfully uncomfortable for hours. My heart was beating out of my chest. My skin was crawling so badly. I wanted to jump out of my skin. I couldn’t breathe. I just started breathing like you do when you’re in labor, and with every passing millisecond, I had to tell myself that I would live through this – through this pain that was worse than childbirth – worse than anything I’ve experienced in my life.

That’s when I felt God’s arm around me. I could just feel it. I told myself that I could live through this, I would live through this, I had to.

My jaw and neck were still involuntarily tensing up, my mouth was still moving on its own. Still, I tried to breathe and tell myself that with each passing second, it would get better. I would live through this. See, the thing is, during the past few months, I haven’t cared if I lived. I wasn’t really doing anything to attempt to actively kill myself, but I also wasn’t doing anything to help myself. If I died, I died.

It was in the midst of this withdrawal Hell that I decided I want to live.

And I don’t mean just live; I want to take an active role in my well-being. I’d been stuck at this plateau for so long. As my therapist said yesterday, It is only through pain that we grow. No one grows when they’re comfortable. It is only through pain that we grow. He said he knows that without a doubt in his mind. I believe him.

While I was experiencing these symptoms, I wished more than anything that it could just be over. I’d have given anything. Now, though, I see that it was essential. I’d been passively sitting here, letting whatever be, be, when deep down I’ve known something is missing. I’ve known I had more potential than what I was showing, but I was too scared to let go.

Thursday morning came, and there was a two-hour delay at school. At this point, I had been awake since Tuesday morning, and things were really starting to accelerate. I felt like I was going to die. I was sure of it. There was nothing I could do; I couldn’t fall asleep, my body was still involuntarily twitching. Yet if I went through this much longer, I would die. I couldn’t drive Adele to school. I couldn’t function.

I called the doctor’s office, thinking at the time that my Ativan was due to get refilled that day. I asked the nurse about it on the phone, who said, “That’s not supposed to be refilled until the 15th.” I told her I’d thought it was the 13th, and she told me again it wasn’t until the 15th, because it was a 28-day prescription, not 30, as I’d thought. “You’re not supposed to get it refilled until the 15th,” is all she kept saying. Then, “Have you been taking more than you’re supposed to?” I told her, “Sometimes…to help me sleep.” Then she told me she knew the doctor wouldn’t refill it until the 15th, and I wanted to scream at her, “Do you know what I’m going through, you stupid bitch?! I need something!” And I thought I did – I thought, if I just take a few Ativan, it’ll take the edge off; maybe I’ll feel better. Instead, “I asked, “Well, is there anything I could have for anxiety? I was having trouble with my speech, along with all the other withdrawal symptoms. I was kind of slurring, and sentences were longer and more drawn out than normal. She just said no, and I felt like some sort of drug seeker, of a junkie begging for a fix.

Suddenly I was up outside of my body looking down at myself. I was having a panic attack. I called Andy, saying, “I feel like I’m going to die,” and I started crying, saying I’d called the doctor, that I desperately needed something, and the nurse made me feel like a criminal. “I can’t do this,” is all I kept saying.

At the same time, I had to somehow find the strength to get my kids through the day. I love my kids more than life itself, but this made me appreciate them even more. I heard Adele whisper to Eleanor, “Something’s wrong. Mommy’s upset.” Eleanor came over to me as I was crying and asked, “’Cause you lost your job?” For the first time in days, I started laughing. The girl’s obviously noticed a pattern with my inability to keep a job and my ability to cry about it. I was still on the phone with Andy, and he told me, “See? Just do stuff like that. Sit with Eleanor and laugh.” I called about ten people before someone answered. It was Lisa, Eleanor’s preschool teacher. I told her, “Ummm…I wondered if there’s any way you could drive Adele to school? I’m having a panic attack and I can’t function,” as my voice cracked and I started sobbing again. “I’m gonna start crying,” I told her, and she said it’s okay, that she would be here to pick up Adele.

When she got here, I told her not to look at my house, which was in complete disarray. I was wearing my stained bathrobe, crying, still enduring waves of impending death. She came in the house and the sun was shining directly on her through the kitchen window. She was an angel, here to save me.

Not long after she left, I called the woman who helps with my support group, who also used to be a psychiatric nurse, and told her all my symptoms. She calmly helped me understand that I wouldn’t die, that I could get through this. I called my therapist, who told me to take a walk outside, to do whatever I could to expend energy so I’d finally crash. My feet were raw at this point from pacing around the hardwood floors and walking up and down the stairs of our house, nonstop, for days. My whole body ached as if I just ran a marathon – my joints were swollen, everything throbbed. Still, I was willing to do whatever these people suggested to feel better.

My mom came over and confiscated my electronic cigarette, which I gladly handed over. We had some good times. I remember looking at it in the middle of the night, thinking it was the devil. And it is. For me it is.

I was starting to get better. While my mouth was no longer involuntarily puckering, it was still involuntarily tightening up. Part of me wanted to lie down now but I was still anxious. I threw snow boots on over my sweatpants, threw a coat on, and took a walk.

As I walked down the street, suddenly everything seemed perfectly peaceful. I was still in pain. But I all of a sudden knew that it would all be okay. I was feeling so much better than I’d felt hours ago. I could do this. I heard the birds in the trees, which for the first time in months sounded beautiful. Lately the sound had agitated me and only made me want to shoot them.

The snow was pristine and sparkling. I could see my breath, so I knew I was alive. I walked to the IGA and bought lots of candy. My oral fixation was out of control. It’s exactly like newborn babies, when they crave the nipple. It’s painful. It’s uncomfortable. You need it. I understand. I understand why they scream their freaking heads off. I needed something in my mouth. As I walked home, I sucked on one of the Dum-Dums I’d bought, and it was the best thing I’ve tasted in my life.

I came home and ran water to take a bath, something else I was told to do to try and relax and come down from this panic attack. I poured some lavender bath fizz in the tub and played some Kings of Convenience, music I listen to when I want to zone out. My head-to-toe aching body felt so good getting into that water. It was like experiencing a hot bath for the very first time. It was indescribably amazing.

I’ve always hated my body. My looks in general. I compare myself to supermodels and live in a constant state of negativity. When I got out of that bathtub, though, and looked in the mirror, for the first time maybe ever, I thought, you know what? My body is just fine. In fact, it’s pretty darn spectacular.

It was like my entire outlook on life changed from going through this experience. On Friday I went to the psychiatrist and explained everything, and I’m back on mood stabilizers. I will stay on them this time. I went to my therapist after that, and covered pretty much every issue going through my head. He asked me how I’ll make sure I’ll keep taking them this time. I will never forget the pain I was in, and I never want to go through that again. I wouldn’t wish it on my worst enemy. I will re-read this if I ever think I should go off my meds again.

All of my cognitive distortions were making sense now. I could change my thinking, my therapist said. I’ve never believed I could change my thinking. I now believe it’s possible. I now see myself as a creation of God, and who am I to criticize one of God’s creations? I need to try to be the best version of myself and stop comparing myself to everyone. I need to focus on what’s good about me. And there’s a lot. I feel like a bad mom a lot. I don’t want my kids to see me this way. I want to shelter them from this. I feel guilty for possibly passing my DNA on to them. I don’t want them to be like me. “But what about the good things you’ve possibly passed on to them?” my therapist asked. “What are some good things about you?” I never think of it like that. As for sheltering them from this, this is life. They will learn that there are bad days. And when they’re old enough to understand, I will sit them down and explain Mommy’s disease.

I will never forget how horrible I felt during this withdrawal. I’ve never in my life felt more like I wanted out. I wanted to not feel this pain anymore. But I made it through. I know for sure now I can’t handle nicotine. I can’t handle Ativan. I can’t do moderation. I am an addict. I was born this way.

The misconception so many people have is that it’s the choice to do drugs. The genetic predisposition is there. Lots of people try cigarettes and stop. An addict can’t. Our brains are wired differently. Cancer patients get nothing but sympathy. The mentally ill are still largely seen as weak, and addicts are seen as people who choose to screw up their lives. Why would someone with the talent and luxuries of Philip Seymour Hoffman choose to screw up everything he had? Choose to leave his children?

When I was living through the darkest, scariest part of this ordeal, I knew I was no different than Philip Seymour Hoffman. Addicts are addicts. Withdrawal symptoms are painful, no matter the drug. I don’t know why people don’t believe us when we say we do not choose to be mentally ill, we do not choose to become addicted to anything. It was hurtful to read the comments I read on Facebook following Hoffman’s death. Following Whitney Houston’s death. Following Amy Winehouse’s death. Hurtful because I get it. I completely get it, and telling me that the completely horrible feeling of not wanting to feel at all anymore is something I choose to feel, couldn’t be further from the truth. I would have traded places with any one of you during that time. Believe me. We do not choose this.

Why would any talented celebrities want to throw away their lives? They have it all. Addiction is an equal opportunity disease. It doesn’t care how much money you have, how well you can sing, how many Oscars you’ve won. We do not choose this.

I’ve gained empathy from this experience. I’ve been kind of questioning lately whether I should be going back to school at all; what if I’m not meant to be a chemical dependency counselor? I have a renewed sense of wanting to help people. I want people to understand that having a mental illness is no different than having cancer. To state otherwise slices through me like a knife, hurts me at the core of my being. If only you could experience this. Then you’d get it. You’d understand, and you’d realize how ignorant and hurtful you’ve been to those of us who suffer with abnormal brains. Trust me.

We do not choose mental illness and we do not choose addiction.

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