Exposition

Upon reflection, I feel it necessary to explain something to my readers. Whether they are family, friends, or strangers on the internet who have a way of becoming family and friends, you should know that I am generally a sad person.

I always have been; if you have known me for long, you know this about me.

I had a brief stint of not being a sad person–more of a cynical person–while taking twenty milligrams of Celexa a day for seven years.

Due to insurance reasons, I ran out.

This was last October, after my top surgery. United Healthcare booted me off their "community" plan after the COVID-19 protections for people on Medicaid lapsed.

They call it "unwinding." It started in April 2023, and over twenty million Americans have been disenrolled from Medicaid since then. The process is nearly over, and about a quarter of adults remain uninsured after being dropped.

Now, I have a tight and generous community. It is an actual one, not an empty word that carries and signifies nothing except to executives who want to seem like "good" people offering a fair deal.

My neighbors or people who have been my neighbors, close friends both near and far, former classmates turned close friends, friends of friends, and some family are my people. When I put out the call for help, it was received. An abundance of my mood stabilizer, Abilify, and some Celexa showed up at my front door. Everything from hand delivery to USPS was used to ensure I had medication while I navigated this insurance "snafu."

That's the sort of thing to help a sad and cynical person become a little less sad and a little more hopeful.

I ran out of Celexa again several months ago (about five). I have insurance now, so I can start using it in January. However, I'm not sure I'll refill my antidepressant even when I can.

When I started my medications over seven years ago, I was attempting to get a handle on some rapid cycling between mania and depression. I had experienced suicidality daily for most of my life but felt too depressed to do much about it. The new dynamic of manic episodes was creating a greater risk to my life.

I was becoming increasingly unpredictable and unhinged. More reckless and selfish. More harmful to myself and others.

Since being off my Celexa these past few months, I have not felt a single tinge of despair so deep that I turned to ideation as an answer.

You know what I have felt? Joy and excitement.

And sadness.

And grief.

And orgasms.

Deeper empathy.

And tears against my cheek.

Things I had not felt in years while taking that SSRI slowly came back to me. The sensations of my body and the beautiful relationship between it and my mind became clarified.

I remain on my mood stabilizer, likely for life, because... Safety. For myself, of course, but mostly others. I drive horrifically when I'm manic. Impatient and often cruel, I struggle to maintain meaningful relationships. I lie, I steal, I cheat. I'm unreliable.

It's psychosis in many ways, and I don't ever want to return to that space.

But my sadness has always been connected to reality, to the material conditions of myself and the world around me. That is something I don't care to lose.

I don't know if the mainstream and memeified discussion around medicalized social problems is nuanced enough to capture the morass that the issue is.

Yes, anti-depressants do make it easier to stomach living in a world that is untenable for most people to exist within.

No, we shouldn't have to continue living in this world, ignoring its problems and acting as if nothing is wrong.

I've seen some memes go so far as to claim the cure for people's depression is community. "Join a club or a sport. Get out and get to know some people in your neighborhood."

Sure. I don't hate that idea. But when the reality of a person's life is that they want to kill themself every day, sometimes joining a club isn't going to cut it fast enough.

Most people know that when it comes to taking pharmaceuticals to treat mental health, it is more complicated than that.

A niche field in the philosophical community is philosophical counseling. The university I attended had one of the few programs in the country.

There are two main branches: those who don't recommend using pharmaceuticals while seeking philosophical counseling and those who do. Everything else is about approaching mental health through a philosophical lens and understanding that much of our fear, anxiety, anger, etc., is existential. Although I did not pursue a specialization in philosophical counseling, I've also come to understand it as political.

Back to the material conditions of our world impacting one's feelings and emotional state.

It seems pretty basic when you put it like that, yet here we are, throwing anti-depressants at everyone who "can't cope" instead of changing the material conditions of our world.

These days, I work to do both.

As a result, I'm less sad, more hopeful, and still stable. I'm active and vibrant and feel like a voice in a greater communal effort for that change.

I experience feelings a bit more fully.

And I'm very thankful for that.

Author's Note: I'm attempting to find my subject for a cultural critique essay I've been invited to write for a new literary magazine. Consider this brainstorming.