In advance of International Self Care Day on July 24, I’d like to share my own self care routine, which you can modify to your own needs, according to your free time etc etc. Check with your doctor before starting any new exercise!

I get out of bed after a few hours of nightmares, tossing and turning, and general sweaty discomfort. I stumble to the kitchen to turn on the coffee, and take a cup to the couch, where my phone is. I take my Adderall.

I turn on MSNBC for the liberal-leaning news, and settle in for the next 4 or five hours. At some point, I remember to take my Cymbalta and Welbutrin. While I hear about the latest deranged shenanigans of the Republican party, alarming Covid statistics, geopolitical conflicts and climate catastrophes, I scroll through my Instagram feed, clicking Like and typing “beautiful!” or clapping hand emojis.

In between liking and clapping, I check my email, deleting billions of shopping site updates and pleas from Eric Holder and Kamala Harris. I dutifully look at the 450 new items at Net-a-Porter, careful not to miss a single offering.

Periodically, I get up to pee and inspect my hair situation. Is it nice and smooth or a frizzy rat’s nest? I squirt saline in my nose in a doomed attempt to clear my sinuses and breathe.

In the afternoon, I get dressed and wander around the house, wondering what to do and why I’m even alive. I might go grocery shopping or to the mall, where the endorphins of commerce lift my spirits enough for me to charge something at Nordstrom that I will return in the next few days.

Back home, I continue with the news and scroll Instagram some more. I consult the mirror a few more times to evaluate my hair and wonder if there’s a way to get a neck-lift without getting a neck lift.

I walk the dog for 20 minutes or just let my husband do it.

After dark, I smoke some weed and wait for him to make dinner. My husband, not the dog. We watch TV while we eat, starting with our favorite shows and ending with some poorly written and laughably performed garbage about missing girls and homophobic Spaniards.

Finally, I shuffle off to bed, take a teeny bit of Ativan, and read a novel, preferably something dark and devastating, until my eyes start to close.

There you have it. It’s challenging, sure, but you can do it. I forgot to note all the cups of coffee, the scrupulous avoidance of water, and the chips and salsa. They are actually essential to my wellness program.

What are you doing for self care?? I really want to know, but I will deduct points for the words yoga mat.

I went to London with the expectation of enjoying the usual pleasures of travel, only to find that the horror follows me wherever I go.

After a few days of feeling like I was coming down with a cold, I was unable to get out of bed. I coughed all night and day, watched BBC TV, and finally hurt my back in a stupid move to hide from the room service guy when my sister opened the door without warning me.

Crippled, feverish, coughing my head off, I was determined to catch my flight home, where I was diagnosed with pneumonia.

I’m not saying it was all bad. Not at all. It was amazing to be back in London, where I lived as a teenager with no parents to curb my waywardness. What a time! Hashish and Mandrax all night, reading all day, I formed my adult sensibility there with the help of some arty college students who took me in.

It was amazing, but so different from the London of 1969. It is ridiculously crowded, and people don’t mind smashing into you if you don’t walk fast enough. The streets are full of beautiful immigrants and native Londoners who give you conflicting directions when you ask which way to Spidalfields Market.

I managed to go to the National Gallery, the British Museum, Harrods, Camden Passage, and to meet a couple of dear blogging friends who I’ve loved from afar since forever. I flirted with a hot street performer who passed under a flaming limbo stick. I ate a bunch of scones and learned to effect an all-new, obnoxious English accent.

But what I’ll remember most is the horror of being sick, in agony, worried about bursting my eardrums on the flight home and counting each hour while mentally repeating, I can’t go on, I’ll go on.

I came back on October 8th and I’m still pretty screwed up. Now that I’m almost done with coughing, I can really appreciate the pain in my back whenever I move or don’t move.

What about you guys? Anything?

My meds don’t work anymore but I’m afraid to get off them. Effexor is notorious for terrible withdrawal symptoms like dizziness, nausea, migraines, nightmares, brain zaps, insomnia and more. Drug companies prefer the word “discontinuation” to “withdrawal.” They warn you to seek your doctor’s help if you want to stop taking your meds; they know you will be fucked, no matter how slowly you titrate down.

My prescribing doctor insists that I should try adding Abilify. Call me crazy but I don’t want to add drowsiness, weight gain, blurred vision, drooling, restlessness and possible tardive dyskinesia to my current panoply of “challenges.” He has written prescriptions several times, saying, “What’s the worst that can happen?”

The original literature on Ability says:

[it] can be effective in treating the acute manic episodes of bipolar disorder in adults, adolescents and children. However, its effect is only useful for the manic phases with little or no effect on the depressive phases.

Abilify is an expensive drug and so naturally the strategy is, Just use it for other shit as an add-on! If I wanted some more debilitating side effects, I could just stuff my face and bang my head with a frying pan every day.

If you’re taking antidepressants, you probably had a compelling reason to start. But no one ever says, “Hey, you’re functioning pretty good now, let’s get you off these meds!” And no one knows the long term consequences for your poor brain.

Once in a while, I forget to take my Effexor. I can always tell the next morning, because one day without them triggers epic nightmares of blood pouring from the ceiling or worse.

I’m never going to be “happy” in the usual sense. I would settle for miserable. Meanwhile, my brain is stuck in exhausting circular rumination and an urge to be unconscious. I keep wondering about the purpose of life. Not just mine, but mine most acutely.

Do normal people wonder about this? I just don’t know. What are they thinking about instead?

Does anyone have any advice that isn’t a personal horror story? Or if you must, I’ll listen to your horror story. “What’s the worst that can happen?”

*

My memory of hearing the Velvet Underground for the first time is indelible in every detail. I had just moved to London and I was sixteen and up for anything. I was smoking hash with some guys I’d just met, sitting around stoned in their dark attic flat, when someone put on “Sister Ray.” I was transported to another dimension,  thrilling and unspeakably depraved.

I loved the Velvet Underground. By the time Max was in high school, he loved them too.

But in the last 15 years, I have come to hate Lou Reed, so his death left me cold. Big deal, is my feeling; he wasted a liver that should have gone to someone younger. Expressing my antipathy to Lou Reed on Facebook brought me new enemies and inflamed old ones. I guess that’s what Facebook is all about.

The problem, for me, is that Lou Reed was a willing and eager role model for young musicians who admired his stance as a flagrant dope-loving junkie, whose love-songs to dope make Keith Richard look like a Catholic schoolgirl. For those drawn to the dark side, Lou was a formidable siren. He made heroin synonymous with coolness.

I know you can’t blame artists for the actions of their followers. Marilyn Manson was rightly annoyed when people blamed him for the Columbine shootings. Gangsta rap might offend you, but it doesn’t turn law-abiding kids into gangsters.

Still, young people are vulnerable. They are searching for an ‘identity’ as they struggle to break away from their parents’ dominion. And a rock star who glamorizes intravenous drug use is a real problem. The worst thing Madonna’s fans could do was to go around looking like a slut. And they did. But fucking Lou Reed has lured kids into hospitals, Hep C and early graves.

I wish he had wised up early and had cautioned people not to romanticize heroin. Even William Burroughs described addiction as a gruesome nightmare of endless need and decaying flesh. But not Lou. For the last ten years at least, Lou Reed has appeared all over the place, blathering drunkenly about how important he is, or how important his friends are. Just a few months ago, I heard him blabbing about his friends Marina Abramovich, Yoko, Anthony Hegarty (who he kept calling ‘Ant’) and on and on. He was an asshole.

Max didn’t live long enough to see what an asshole Lou Reed was. He learned that heroin was a rocky path without glamour or romance, but then it was too late.

Lou Reed didn’t persuade me to use a needle, but maybe if I’d been a boy with a guitar things would have been different. If I was god, I’d go back and erase Lou Reed. I would also make sure that people knew about depression in children, so it couldn’t go on unchecked. I would trade the entire musical output of Lou Reed for the two kids I met in rehab who died from an overdose.

Fuck you Lou, and the horse you rode in on.

Intermezzo was a movie starring Ingrid Bergman, and of course it’s a musical term. Now it’s also a drug for people who wake up in the middle of the night. I’ve seen ads for Intermezzo at least ten times tonight while watching TV. In the last week, I must have seen the ad 100 times. I almost know the side effects by heart. (In depressed patients, there is a risk of suicide. Not suicidal ideation, but suicide.)

You might also drive, eat or engage in “other activities” while not fully awake, without remembering the event the next day. Other abnormal behaviors include aggression, confusion, hallucinations and agitation. Common side effects are headaches, nausea and fatigue.

Is it worth all this shit for a few hours of drugged sleep? It is right to market Intermezzo as a brand new drug when it’s just Ambien at a lower dose?  Why this deluge of  TV commercials? I can answer the last question:

“Facing lower-than-expected demand for sleep drug Intermezzo, Purdue Pharma and Transcept Pharmaceuticals are broadening the commercial strategy to include DTC and a larger selling force.

Intermezzo is a sublingual version of Sanofi’s blockbuster insomnia pill Ambien (zolpidem). But the new formulation, approved in November 2011 and introduced earlier this year, has had a lethargic launch. Hence, the firms are rolling out a $29-million DTC ad campaign and, for the first time, tapping into Purdue’s analgesics sales force of 525 reps to call on PCPs and retail pharmacies. Another 90 contract reps will detail specialists.

“There are a few ads for Lunesta out there, but the market has been fairly quiet,” said Transcept president/CEO Glenn Oclassen on a conference call this morning. “So we get to take fullest possible advantage of that and believe this level of expenditure will be sufficient to get the impact being sought.” (more here)

Oh no, the ad is playing again RIGHT NOW! Unbelievable.  I won’t be happy about this until the lawsuits start rolling in.

All my life I have thought of myself as an Irritable Organism, like an amoeba under a microscope, being poked. Now, finally, there’s a treatment for this!   Read the product description:

“This profoundly calming perfume has a fresh, soothing fragrance with powerful undertones. It lessens irritability and helps you become centered, easy going and relaxed. Smelling of apples, bitter herbs and fresh grass, Roman Chamomile is soothing and comforting, calming, balancing and deeply relaxing, with a gentle, restorative effect which banishes irritability. The sunny Bergamot smells fresh with floral, lemon notes. It is reviving, soothing and balancing, cheering and heart warming and gently relieves irritation and anger. Rose is passionate and deeply rose fragranced, it banishes the blues and warms the heart. Patchouli is soothing, helping stabilize the mind; it has an earthy sensual nature that grounds those who get lost in too many circular thoughts, and gently helps irritation float away.”    (my italics)

OH MY GOD! At $65, can I afford not to get it? I feel soothed just thinking about it, but also kind of anxious. What if it’s sold out?   Do I need expedited delivery? Will I go crazy before I can get my hands on it?

I’m going to order it. I’ll keep you posted. You’ll probably know if it works or not. In fact, if it works, you won’t be hearing from me. Once I feel stable and centered, I won’t need to write.

I like the sound of this product much better than Doxepin, the drug my GP suggested when she noticed my war-torn legs. Doxepin is an old fashioned tricyclic antidepressant with the usual array of side effects.   I’m reluctant to take more meds, but I was intrigued by the following revelation:

“[Doxepin] is particularly useful in treating depression symptoms, which include anxiety, tension, trouble sleeping, guilt, fear, and lack of energy.”

That’s right, you saw it with your own eyes. Guilt and   fear. Imagine a life free of guilt and fear. Pretty fucking tempting, right? All they need to work on now is  loneliness, apathy, bitterness, greed and insecurity.

Still under the influence of bad hair, I was informed by KOS of an online fashion mag whose editor is 15 years old. Sure enough, it’s all about high-priced ‘avant garde’ designers and models whose hands are THIS CLOSE to touching their faces, with text like “combining armorial pieces with organic materials…”   Wait a minute, do they really mean armorial, which means “pertaining to heraldry” or do they mean “armor-like?”

Take a look at the young Sister Wolf, a poor little hippie girl at age 14. Check the velvet thriftshop dress, the crown of daisies, the elegant cigarette.

Do I know what I’m talking about, people?!

All you horrible teenage fashion girls, listen up. Stop blabbing about Rodarte and Rad Hourani and your fucking shoes and your mom’s shoes, go out and smell the roses! Put them in your hair and buy a pack of fucking cigarettes! Find a new way to be pretentious, for the love of god!   I hate all of you!   This is why it’s so hard to get a babysitter!

These girls are too busy talking about “leggy cashmere playsuits” and not spending enough time experimenting with drugs. Better to be sexting with their BF’s than squandering their precious youth on being epic in their fierce wedges and expounding on the timelessness of the Birkin bag.

Two words for you girls:   Shut Up. (I was going to say “Try Anal,” but then I thought better of it.)

I’ve been wondering where the Republicans have been hiding poor Bristol, and now I know. They’re hiding her on buses and planes, along with her sister, the very hot and soon to be impregnated WIllow Palin.

Wasn’t Bristol supposed to be finishing high school? Oh well, who needs schoolin’.

Why isn’t Bristol allowed to appear with Mrs. P? I just read that Mrs. P brought little Piper onto the Hockey rink where they were booed, in the hopes that no one would boo at a little girl! Mrs. P admitted this, so I guess she still doesn’t think it’s wrong to exploit her children.

Bristol, when your mom turns her back, run like the wind! Actually, make sure you get Trig first, so he can grow up with his real mom.   Don’t bother with that dummy Levi. Let your mom have him, he might come in handy later.

Here’s another nice picture from the McCain Palin tour, with Grandpa enjoying a midget as Cindy looks on, praying for a chance to take some Oxycontin.

A federal appeals court in San Francisco ruled Friday that a parolee cannot be obliged to attend an AA or AA-affiliated program as a condition of staying out of prison. For those who believe that 12 step programs are indeed religious in nature, and that “the God of my understanding” refers to the Christian one, this decision may come as welcome vindication.

But what else is an addict to do?

I have attended 12 step meetings in support of a loved one. The god issue was always a huge sticking point. Seasoned 12 steppers always dismiss that sort of attitude as a form of resistance to The Program. For me, it is a resistance to pretending I believe in a higher power. I know and accept that I personally am not the creator of the universe; but I don’t believe in a higher power in the sense that I can’t surrender my will to “It” if it doesn’t exist.

I’ve read about one person who decided that the law of thermodynamics would be his higher power. I’m happy if it saved him from the tragedy of addiction, but I can’t think of anything similar for my own purpose.

So, if not a 12 step program, how can an addict break free of substance abuse? A book called Romancing Opiates convinced me that addicts (in particular, opiate addicts) are addicts by choice. Not victims, not slaves, but people who lack the moral fortitude to step out of the cycle they’re caught up in. Statistics based on American Vietnam veterans suggest that the majority who returned to the US as drug addicts were able to stop using without seeking outside help.

Those statistics are refuted by everyone who uses the addiction-as-disease model. They insist that the vets who got clean did so because they weren’t as badly addicted as the group that continued to use.

“The Heroin Diaries,” a book by Nikki Sixx of Motley Crue, was reviewed here by a writer whose main complaint about it was that Mr. Sixx was really only a coke-head and therefore not worthy of the respect due a real junkie (ie a real Suffering Artist.) It struck me as irresponsible as well as stupid to perpetuate the myth of the noble junkie. I even wrote to the reviewer in the hope of having a dialogue with him. He didn’t write back.

More recently, I read a piece in the New York Times magazine by longtime Times reporter David Carr, who has written an account of his addiction called “Night of the Gun.” His writing blew me away. His brutally honest depiction of his bad behavior is difficult to take, but it is certainly bracing and honorable. For some reason, though, the comments his excerpt provoked are mostly angry and bitter. I still can’t understand why, unless it’s the fact that he doesn’t beg for the reader’s forgiveness.

If you love an addict, or have an interest in addiction, I can’t recommend both David Carr’s book and “Romancing Opiates” highly enough.

If you are an addict, you are breaking more hearts that you can possibly imagine. Choose life, damn you!

If you are neither of the above, thank the god of your understanding for missing this particular bullet.