Off Their Meds 

Modern psychiatrists prescribe pills for hundreds of "biological" disorders. The radical mental health movement isn't so sure

In 1980, the year Ashley McNamara was born, the Freudian era of psychiatry officially ended with the third revision of the Diagnostic and Statistical Manual of Mental Disorders. With the dissemination of a new psychiatric bible, hundreds of supposedly biological psych disorders were given a name for the first time. Lost a parent and sad? Adjustment Disorder with Depressed Mood, 309.0. Occasionally melancholy about losing a loved one at an early age? Separation Anxiety Disorder, 309.21. Vacillating between moments of exhilarating joy and excruciating sadness, sometimes threatening your own life? Bipolar Disorder I, Most Recent Episode Mixed, Severe with Psychotic Features, 296.64. Once the ailments had names, Big Pharma was there to freely dispense the medicine.

The biomedical era first entered McNamara's life almost two decades later, when she was nineteen. Attending college in Rhode Island, she describes her behavior then as "intermittently brilliant and completely self-destructive, snorting coke off my roommate's bed table when she was away for the weekend and then blowing people's minds in graduate level seminars on postmodern theory." After a month of mania, she crashed into two months of completely incapacitating despair. When her then-girlfriend couldn't take care of her anymore, she checked McNamara into a hospital. Later that month, she was hospitalized for a second time, and after a night spent cutting her arms and swinging from the curtain rods of the psych ward, she was diagnosed as bipolar. She was prescribed a number of psychopharmacological medications, including lithium, a powerful drug given to manic-depressives to stabilize their moods.

As these drugs helped McNamara regain her ability to read and think, she learned more about her diagnosis. Paradoxically, she became convinced it was bunk. As she later wrote in an essay called "Anatomy of Flight," "doctors were trained to dissect people's lives into terms, classes, rules, cases, neurotransmitters, algorithms, atypical antipsychotics, treatment-resistance, noncompliance ... which seemed like a ridiculous approach to understanding a human being."

Not just dissatisfied with the ramifications of her psychiatric diagnosis, she also was feeling a bit numb. So after a year of working with horses and living in a one-room cottage in rural New Jersey, she fled her quiet life, taking off for Greece. From there, she eventually moved to the Bay Area, where she tried to deal on her own with "the fragile fire in her brain" by no longer taking the little pink pills. She went cold turkey.

In September of 2002, McNamara happened across a copy of the San Francisco Bay Guardian that contained a personal account of manic depression by Sascha Altman DuBrul. Up to that point, she had never encountered anyone whose condition resembled her own. "I read his article, and resonated with it so much that I ended up sending him my entire life story," she recalls. The pair corresponded for seven weeks, and when they finally met, the chemistry was enough to change both their lives.

"We ended up talking till four in the morning," she says, "and we woke up the next day and started the Icarus Project."

Named for the mythological figure who flew too close to the sun on wings of wax, the Icarus Project grew out of the dramatic response to DuBrul's chronicle of dizzying heights and shattering lows. He'd gotten letters from many kindred spirits besides McNamara -- enough that he and she decided that what the bipolar community really needed was to actually be a community, one that cares for itself.

McNamara was the perfect partner for DuBrul in this endeavor. Not only was she bipolar, but she was off her meds. Had she been medicated, she says, "It would not have seemed reasonable to me to jump into creating a project with a complete stranger, who I met through the newspaper, and devote my entire life to it for a month straight. Or even doable. It's a lot easier to do things like teach yourself HTML sixteen hours a day if you aren't really sleeping."

For almost three years since then, the project's Web site has grown beyond its initial community of young liberals to provide a meeting place, information station, and writing and arts forum for all sorts of people with bipolar disorder. Last spring, the project put out a book, Navigating the Space Between Brilliance and Madness: A Reader and Roadmap of Bipolar Worlds, which is now in its fourth printing. Its sales, coupled with grants and donations, allow McNamara to work full-time at the Icarus Project.

But one of the most moving pieces on the site isn't included in the book -- it's another essay by McNamara detailing her experience quitting medications with the help of strict diet regulation, meditation, and other forms of purposeful self-care. It's a tremendously powerful manifesto, a testament to the idea of using everyday means to beat the demons that had been beating her for so long. It includes the following passage:

"This is not a quick fix and it requires more investment than popping pills. But I don't rely on the Man. I don't have to worry that if I lose my health insurance, I'll lose my medicine and go nuts. I can have babies and not worry that they'll have crooked spines. And I am honestly healthier, more consistently happy, and creating more beautiful art and pieces of writing than I ever could before."

But the essay also included a postscript. Shortly after writing it, McNamara went back on her meds.



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