I'm Not Angry - But
Sometimes I Forget That: Memoirs of Deborah Max
Most days I don’t
feel like a mental patient. In itself that might not seem like an odd
statement, but when you examine my history or simply the fact that it’s
my predisposition to insanity that pays my bills, you might expect that
I’d wear crazy year round.
From the time I was thirteen through the remainder of my teenage years,
I literally grew up in the inpatient mental health system. And now I earn
my living as the deputy director of an agency funded to help people who
also are labeled with psychiatric diagnoses. Additionally, I give trainings
for mental health workers to help them learn how to make treatment more
therapeutic and less traumatic for those under their care. Just as a model
relies on her beauty for her bread and butter, my recovery—the maintenance
of my mental health—is my earning chip. It’s funny, in all
the years I have done this work I am asked less often than you would think
about my health. More often inquiries are related to my illness. What
was it like being inpatient for six years? Was I really in restraints
for months at a time? Well, it sucked, and yes. What people are really
asking for is the gore, the blood and guts of mental illness.
I don’t mind these inquiries; I welcome them. I often joke that
my audiences are free to use me: “I’m a whore for the cause,”
I say. If my story and the atrocities I endured can prevent future violations,
then I am willing to relive my past. But when I’m speaking I don’t
think I recognize this past is mine.I often distance myself. It is a different
Deborah I am describing, from a long time ago and a galaxy far, far away.
And my audience seems to view me as a different person too. Maybe they
disbelieve my story. Or maybe they just see me as a medical anomaly, an
exception to the course mental illness typically runs. How else could
it be? Is recovery possible? I must be different. That is how they must
comfort themselves. Because I share tables with them, I am a colleague,
a peer. How can I have the same characteristics as those they treat, medicate
And yet, I was just like those whom some providers have written off as
incurable. I was noncompliant, self-destructive and disruptive. For years
I didn’t respond to medication, although I consumed it in massive
quantities and all forms—liquid, pill and, of course, intramuscular
injection. I frequented the quiet room on a regular basis and was often
forcibly put into restraints. And yet, like those of you reading this,
I am now a functional member of society. Normal as much as normal
can be defined. I have a job, pay my bills and live my life. I am no longer
a danger to myself or others.
How did this happen? What got me better? I have worked in the recovery
business for over a decade, and now when faced with these questions I
don’t have an easy answer. In contrast, I can say without blinking
what has been hard and what I hate. I hate my medications.
A colleague of mine once debated with me for hours over the benefits of
my medications. He felt I didn’t attribute enough of my recovery
to them. Well damn them, and damn him! I hate them. I hate them with every
essence of my being. They slow me down; they dull my senses; they have
made me fat, incontinent and lethargic. And yet I take them.
I have every reason in the world to be noncompliant with my medications,
for all the reasons I mentioned and more. But the fact remains I need
them, or something like them. While medication helps me maintain my status
among the sane, it is also one of the last things remaining that makes
me a mental patient. I am reminded of my condition every evening when
I pour my meds, breaking out tomorrow’s doses into my discreet little
gold pill box.
I get my meds at what my boss calls the ghetto pharmcy. I’ve
been getting my meds there for years now. And now that a new 24-hour CVS
with a drive-through pharmacy has opened up right by my house, it seems
increasingly impractical. My boss doesn’t understand why I continue
to go out of my way, why I need to compartmentalize my existence, but
my pharmacy knows me and reminds me of who I was and who I am.
I get my makeup and my cigarettes at the new CVS. The pictures I take
of myself and my boyfriend are developed in its one-hour photo lab. I
don’t want the neighborhood CVS workers to confuse me with someone
on psych meds. It’s bad enough I am treated differently at my lil’
ghetto pharmacy. Prescriptions for antipsychotic meds tend to have an
intimidating effect on pharmacists. At CVS, my predisposition to mania
is a secret. The staff know only that I have a good-looking boyfriend
and that I smoke Kools, hardpack.
In the mid-1990s I went through the rite of passage for bipolars. I made
the unilateral decision that I no longer needed medication. It was a funny
thing, really, the way it snuck up upon me. I can’t really speak
for others who too have played doctor, but for me it started benignly
I was facing a stressful life —my life, the life for which I was
taking these heavy-duty meds in the first place. And I simply could not
fit my meds into my schedule. I missed a dose here and a dose there. In
my defense, I had every intention of catching up. I promised myself I
would go back to my regular dose on the weekend. I had to wait because
I needed to have the extra time the weekend afforded me to sleep the day
away as my body re-adjusted. But the weekends would come and go. I was
busy; there were too many demands on my time. And so it went.
I slowly came off the medication completely. The longer I went without
it, the better I felt, at least for a while. And then I spiraled. I became
increasingly enraged, hateful of myself, hateful of my life. One night,
after placing a panicked call to my therapist, I was taken away by the
New Rochelle Police and brought to a local hospital ER.
I refused to be admitted, dodging the inquiries of the frustrated attending
psychiatrist regarding any plans I had to harm myself by saying I didn’t
want to answer her questions “out of fear that I might incriminate
myself.” I was released early that morning, and I signed myself
into the unit run by my psychiatrist that afternoon. I was manic. I signed
in and was asking for help, but in contrast with my other admissions,
this time I was an adult and a voluntary patient. This time help would
be granted on my terms. I filled out my health care proxy forms (binding
agreements where voluntary patients are allowed to place limits on the
care they receive) immediately upon admission. I assigned my employer
at the time, who was an attorney, as my proxy (spokesperson/alternative
decision-maker). My detailed plan delineated a course of treatment of
my own personal design. Taking the old drugs was not an option. The plan
prohibited my doctor from prescribing me the wonder drug to which everyone
but me attributed my previous health. His hands tied, my doctor prescribed
me a newly approved medication that I had researched and requested. I
was released within a month.
I felt ownership of my recovery. I had successfully outwitted the psychiatric
profession; I reigned supreme. Energy I hadn’t had in years returned.
I was losing weight. I felt good. I minimized the fact that I was awake
the first 48 hours after my release. I attributed this to post-discharge
excitement. But the insomnia continued. My energy levels continued to
rise. Soon this energy turned into something ugly. I became rageful again
and full of hate. And within two weeks I called my doctor, tail between
my legs, asking for help. “I’ll go back on the old medication,”
I told him. “Whatever you say, I’ll do it.”
That day goes down as a sad day in the annals of Deborah. I admitted defeat.
I caved to my dependency on this intolerable drug, a drug that forces
me into the mental-patient role every two weeks as I sit in my phlebotomist’s
chair while blood is drained from my bruised right arm. My doctor could
have been smug; instead, he felt for my defeat. On some level, though
it ran counter to all his research and faith in the drug he’d picked
for me, I think he wanted me to win my little battle. He may never openly
admit it, but I think he was cheering silently from the sidelines.
I will probably have to be on medication the rest of my life. I do realize
the important role that my meds have played in my recovery. But the value
of my flirtation with noncompliance is under-recognized and largely misunderstood.
Noncompliance was an affirmation of me. Mental patients do not have much
to barter with. We are stripped of our rights. We often don’t have
much in the realm of material possessions. For many of us, cigarettes
and coffee are the crux of existence.
When people have so little power, med refusal can be healthy because it
is a way of asserting oneself. Saying “no” feels good. “Ha,
ha! I’m going to do what I want!” Asserting and reclaiming
power is vital. True learning involves making independent decisions and
evaluating the consequences. Unfortunately, in the mental health system
asserting yourself is dangerous. It can be retaliated upon with force
and restraint. But for me, a vital part of my recovery was this noncompliance.
Not acting out as I had in the past, but having the opportunity to be
an informed consumer. The chance to make a choice regarding my meds was
the first time I had occasion to make an uncoerced decision to seek and
And now I choose to be on this God-awful, debilitating drug that I loathe
with every bit of hatred I can muster. Is it the drug that is making me
healthy? In part, yes. But a greater part of my health I attribute to
the fact that I choose to take the medication, and that I made this decision,
however mournful it may be, on my terms.
For the record, this drug hasn’t transformed my life into sunshine
and happy days. Some days I find I have little patience for anyone or
anything. I could pathologize this, I’m sure, as I’m certain
some who are reading this are doing. Once on a particularly crappy day
I found myself bitching about work while waiting in an incredibly slow-moving
line at the supermarket. I was exhausted and in a foul mood. “I
hate stupidity,” I muttered. “I hate stupid people.”
And then I uttered the coup de grace, "I just hate people PERIOD!"
The kindly customer behind me in line asked me what I did for a living.
“Oh,” I said, smilingly sheepishly, “I’m in human
I’m generally not an angry person, nor do I think I’m a mean
person. I’m compassionate, though I know I’m no Mother Theresa,
not by a long shot. But I’ve grown to recognize the value of anger
and to nurture and respect it, because my anger has saved my life.
Anger is a terrific motivator. Granted, it was my self-hatred and irrepressible
rage that landed me in the loony bin and locked me away in restraints
of all shapes and sizes and quiet rooms in two states, but it was my righteous
anger that freed me. Intractable folk like me are the oil to the water
of the mental health practitioners. Though it’s not said outright
anywhere in any social work program or any credentialed psychology program,
most mental health practitioners are conditioned to pacify patients. Mental
hospital walls are painted in shades of blue to calm and soothe. Compliance
is rewarded with privileges and the squeaky wheel’s complaints are
pathologized and punished. My anger caused me to rise above the supremacy
of the institutions and the system.
Prior to entering the inpatient system I had a lot to be angry about.
My father was dead. I was poor. I wasn’t very pretty; to say I was
homely was being generous. My mother seemed to resent me and showed me
nothing more than disdain on good days. I didn’t have any friends.
I realize this laundry list of ills may sound like things that should
have contributed to a paralyzing depression, things to make me sad. And
I guess they could have. I’d be lying if I said they didn’t.
But had I allowed the sadness to envelope me and take hold, then I would
still be a drooling mess, sedated in my own urine in the corner of some
back ward somewhere. Of that I am certain. I was locked up for the first
time shortly after my 13th birthday. The 4-year inpatient stint that followed
gave me tons to be angry about. Though my mother visited me on a fairly
regular basis during my first hospitalization, the visits decreased over
time. This was due in part to distance, part to the restrictions of the
facility and my therapeutic needs, and part, I’m sure, to her sheer
lack of interest. In her defense, my mother faced a difficult situation.
She was a single mother of two, trying to maintain a middle-class existence
in our orthodox Jewish world in Kew Gardens Hills. Her self-injurious,
crazy daughter certainly didn’t help her acclimation into this world.
I always felt sub-standard in regard to my mother’s perception of
me. In my young adult life, my mother continued to see me as I had been
as an adolescent rather than as the person I had become. My recovery was
invisible; Mom was stuck on crazy. My tireless efforts, the struggles
with the meds and all the problems they bring in their wake seemed inconsequential.
I’d be dishonest to say this didn’t hurt. But all that hurt
ever produced for me was armfuls of scars. I became successful in my own
right and showed her. I met and exceeded all expectations she had for
me. Her approval was an unattainable brass ring. My mother still sees
me as sick, and I have to accept that her view has less to do with me
than it should.
I am not really angry at my mother anymore. My anger at my mother generated
the energy I needed for a decade of work, with energy to spare. I was
forced to fend for myself from a very young age, without fiscal or emotional
support from anyone. With that, my focus was on the most basic thing:
survival. And that drive for survival helped me to face the atrocities
of the system. Had I familial support, would I be successful? Who would
I have become had I not had to fight for all I now have?
I set out to describe the elements to which I attribute my recovery, but
I’m afraid I have left more questions than answers. If my story
is any guide, should we abandon those we love, let them play doctor arbitrarily
and subject them to abusive treatment? I’m not saying there is one
standard route to recovery. Nor am I saying that my way is the right way.
I wish I didn’t have to be angry to survive. I wish I could have
been motivated by peace and love and all that good stuff. But my reality
was not one of love and kindness. It is changing, though, and on most
days I’m happy. Just remind me of that.
by Deborah Max
Deborah Max is the Deputy Director of CHOICE of New Rochelle Inc., a peer-run
case management and advocacy agency in New York. She has presented at
conferences for the New York Association of Psychiatric Rehabilitation
Services and the International Association of Psychosocial Rehabilitation
Services and she has provided technical assistance about benefits and
entitlements to mental health recipients and providers across New York.
Max offers consultations around the country on trauma and harm reduction.
continued in ABILITY Magazine subscribe
Other articles in the Christopher Meloni issue include Letter From
The Editor, Gillian Friedman, MD; Humor: My Year; Headlines: Project Hope,
Blind Justice & Down Syndrome; Senator Grassley: The American Dream
for All; USA Freedom Corps: Director Desiree Sayle; Employment: Latinos
with Disabilities; Book Section: Too Late to Die Young; Multiple Sclerosis:
New Development; Geoffrey Erb: SUV’s Director of Photography; Comedian
Spotlight: Tanyalee Davis; World Ability Federation; Events and Conferences...