My doctors have suggested that I go on medication. This suggestion was made previously but I refused. At the time, I was experiencing a strong impulse to self-destruction. I did not truly trust myself, or my ability to make decisions, and was concerned that any medication might further impair, or cloud, my mind. These events took place in the late spring of 2013.

In the spring of 2014, the situation is different. I still encounter mood swings. I still find myself entering depressive episodes. I still find myself wanting to retreat from the world. I still have thoughts of self destruction. I still ponder the question: is the new me the way I want to live out my life? According to actuarial tables, I have fourteen years worth of sunrises and sunsets ahead of me. Does my present quality of life make those days welcome?

In trying to answer this question, I have come to the following conclusions. These are not hard and fast, objective outcomes.  They are not final decisions. They are essays, attempts to gather my thoughts, to think things through on paper, and to see what is arrived at.

Medication – Change in Thought Style

I am not sure one can alter their thought style in the same way one alters one’s clothing fashions. I may be remiss in attempting to introduce a form of medical haute couture. But my sense is that my present day thought style is different from that of a year ago.

I am not sure what words to employ to characterize this difference. First, the difference is experiential in nature. It is my “sense of difference” rather than an objective measure. If one has experienced love then one understands immediately the failure of language to fully capture, or convey, the experience. I face a similar problem.

In 2013, I felt more overwhelmed by my thoughts, More driven by them. Perhaps more reckless and out of control. There was no fear but there was a sense of being out of touch, uncertain, confused. There was considerable experience of mistrust – mistrust of my own experience, mistrust of my perceptions, mistrust of my ability to engage in the common casual ordering of body and mind in the effortless way the uninjured so easily take for granted.

In 2014, I am less overwhelmed. There are still strong patterns of thoughts but I appear better able to surf these thought waves, to ride through the turbulence, to keep my head above water. There is less sense of being submerged, out of touch, the grasping for reality that was present in 2013.

I have more confidence in my ability to think things through. If it were possible to reduce everything in my life to a set of logical syllogisms then I would be able to operate quite happily, an imitation of Lieutenant Commander Data from Star Trek (I may mean Spock. I have no idea. I have enough trouble keeping track of my own life to worry about confusion between these characters).

Much of this confidence stems from the blog. I use the blog as external memory, as a form of “thought processor.” It forces me into an attempt to commit my thoughts, to fix them to the page, to make them discursive. I believe I am more successful in this than I was earlier and that the blog has been of significant benefit.

Medication – Self Destruction

In 2013 I experienced a strong wish to go to sleep and never wake up. This impulse was expressed in other forms. I feared medication would alter me in unknown ways, might leave me less able to avoid a destructive impulse. The medication itself might provide a means to the end.

Today, I continue to have down periods. I am not sure if these are less, or more, powerful than previously. There is a sense that these questions, questions Camus described as being central to the human experience, are by now routine, like a pair of worn shoes, well accustomed to the shape of my feet. There appears to be a quality of greater objectivity, more distance, less immediacy, less impulse. I seem better able to accommodate my deficits despite the fact that recognition of them remains a strong trigger for depressive episodes.

Medication – Self Perception

I remain concerned that through the use of mediation I might become less, rather than more, self-perceptive. I believe my ability to exercise logic, to analyze, and to write about my experience, has significant therapeutic value. Would medication impair these capacities?

If they were to be impaired, would I retain the capacity to notice?

This last item calls up memories of a stage in my accident recovery prior to the commencement of blogging. I would find myself sitting motionless, staring out into space, devoid of all thoughts and motivation. Acknowledging this vacant state as unhealthy was a key motive driving me to accept the difficulty of blogging. I am concerned medication may place me back in the twilight zone.