How I lost myself to acne medicine
While I knew that I got the brainbuzz from minocycline, I never put together that it had something to do with the blank canvas daydream of a life that I was living. I thought that was just life.
“Doesn’t bad skin make you more suicidal anyway?” My dermatologist asked me, “What’s worse?”
He was in his mid-60s and seemed like he had made a very comfortable life as a dermatologist. He had a Princeton degree and a relaxed air of confidence.
I was thirteen and had expressed my interest in Accutane, toted as the gold standard for acne treatments, known to make blemishes all but disappear for the majority of its users. It was also publicly linked to some serious side effects. The media brimmed with Accutane suicides.
The packaging included a warning for doctors, requiring a patient's written acknowledgement that they are aware of possible psychotic side effects, according to a 2002 New York Times article about Charles Bishop. He was fifteen, a student at a flight school in Florida when he flew one of his academy’s planes into the side of a building. Bishop had been on Accutane and left a frenzied note before taking his life, saying that he “supported the efforts of Al Qaeda…[and that] Osama bin Laden was planning other terrorist acts, including ''blowing up the Super Bowl with an antiquated nuclear bomb left over from the 1967 Israeli-Syrian war.” Bishop’s mother tried to sue Accutane and lost, but her lawyer explained how the drug changed her son, “When you look at the note he wrote just before [he committed suicide], it tells you of his psychotic thoughts and break from reality.”
Various pharmaceutical companies blamed the acne itself for the adverse reactions patients felt when on their pills. When questioned about their drug’s link to psychological disorders, Swiss pharmaceutical giant Roche, who make an alternative form of Accutane called Roaccutane, claimed no responsibility for the psychotic mental states of Roaccutane users, stating that, "Severe acne can cause some sufferers to become depressed and can also affect their mood and self-esteem.”
My dermatologist urged me to call him or talk to my parents if I felt any adverse effects, but his words rang in my ears, “What’s worse?”
Taking these pills at thirteen, my initial Accutane treatment worked wonders for my self-esteem. It was easy to ignore any slight side effects. However, I did notice a few things: I had become increasingly prone to angry bursts, and my dry skin would leave me looking red in the face at the slightest exertion of energy. But my zits were gone and my confidence was up.
While on Accutane, I was very squeamish from making my situation public knowledge. I began lying to friends, who would see me busting out a pill bottle after a meal. My go-to excuse became “blood pressure medicine.” And while having high blood pressure was nothing to take lightly and was pretty unusual for a healthy and physically active teenager, most people bought into it and some even expressed their sympathies. “It’s nothing,” I would go on to assure most of them, too embarrassed that I had been submitting myself to acne treatment to be completely honest with them. I underwent three separate treatments with Accutane yet the benefits of the drug became less and less palpable each subsequent treatment. Over time, my body built up an immunity to the pills.
By the time I graduated college, I was completely off of the pills, using a weird mixture of over the counter medicine to try to combat what was a still a chronic problem for me. But that first run on Accutane, when it worked so well, stood like a glowing beacon of hope in my life. If only I could get to that place again, if only there was another pill. As my old dermatologist would no longer prescribe me oral medicine after my three runs with Accutane, I sought to find a new dermatologist that would prescribe me some other kind of wonder pill.
I began seeing a dermatologist that operated out of a strip mall in Bridgewater, New Jersey who, to my delight, prescribed me minocycline. Minocycline was a Tetracycline, it had been listed as an “exacerbating factor of depersonalization disorder” in a 1997 study called “Feeling unreal: 30 cases of DSM-III-R depersonalization disorder,” yet was never linked to the disorder in the Physician’s Desk Reference. And while the drug never cured my condition, I became addicted to taking it, believing it offered some relief, some kind of hope.
I was living in Midwood, a neighborhood of Brooklyn between Prospect Park and Coney Island, subletting a room in a house that I rented from a group of Serbian water polo players studying at Brooklyn College. It was 2009, I was twenty-two, had just graduated NYU and didn’t have a job, and so this room was the only way I could afford to live in New York City that didn’t involve moving back in with my parents. I had met the water polo players through a friend who also rented a room in the house, I was on the second floor while he was in the attic, and he worked as a beach lifeguard throughout the days as I stood indoors, locked in my room trying to find work.
But nothing was happening.
In the mornings, I would come home and make a feast; coffee, eggs, and bacon, thinking that if I became caffeinated and nourished enough that there was no way I wouldn’t be able to knock out a batch of resumes. But then I would take minocycline and my brain would turn off.
I was told to take the minocycline after a meal as it would induce nausea on an empty stomach but I found it to induce nausea regardless. After taking the pill, my stomach would bloat out, I would feel drowsy and weak, and my brain would buzz. It was a warm buzz that I couldn’t describe as a headache, but I would feel completely out of it for hours, unable to communicate clearly and unable to motivate myself to do much of anything. Living in Midwood, I spent that summer locked in my room, with an open laptop screen on a small dresser as I looked at the floor, counting the tiny ants that made their way into the room. I didn’t feel like I was anywhere, I wasn’t happy or sad but felt completely disassociated, like I wasn’t living my own life, like I was living a dream where I wasn’t in control of my body, as if my mind had left and watched over me like a drugnumb version of It’s a Wonderful Life. Associate Clinical Professor in the Division of Dermatology at the University of California, Philip R. Cohen, MD, postulates that this depersonalization stems from “hypersensitivity of the serotonin system.” I would talk to myself in my room, going through plans trying to motivate myself to action but I mainly couldn’t think. After not leaving my house all day, I would walk the streets of Midwood late at night looking at the traffic as Ocean Parkway turned into the Belt wondering if I would be like this forever, wondering if I should just die.
The drug provoked a hallucinatory state where I couldn’t process my emotions and invented paranoia that people were coming for me; my friends were against me, my family was going to put me in a mental institution, my Serbian roommates were plotting against me, and the government was sure to follow. While I knew that I got the brainbuzz from minocycline, I never put together that it had something to do with the blank canvas daydream of a life that I was living. I thought that was just life.
In his 1996 book, On Killing: The Psychological Cost of Learning to Kill in War and Society, author Dave Grossman writes of how the military artificially creates depersonalization in soldiers stating, “Without the creation of abstract images of the enemy, and without the depersonalization of the enemy during training, battle would become impossible to sustain.”
Not only was my sense of self lost but my compassion for others was eroding, I started to act extremely out of character.
I began stealing for no reason; on one particular night I removed a child’s bicycle seat from his locked bike as he went into a bodega in the Lower East Side. I would follow people I saw on the street, believing they were leading me to some holy grail. My mind raced from thoughtless pleasure to thoughtless pleasure, and I loved inconsistently, hurting those who cared for me the most. I would ignore people who tried to help me out of my situation, believing my present condition to be an ever present symptom of my life that would best be dealt with on my own. I’d stay in my second floor room, with barely enough room for a mattress, talking to myself while I stood up all night, unable to think. I would wake in the middle of the day and just stare out the window as I lied in bed motionless. I would hear Drake’s “Best I Ever Had” & Kid Cudi’s “Day ‘N’ Nite” blasting from car stereos but I couldn’t bare to get up or open my eyes. I would ignore calls from my family, not wanting to face them, believing they would put me away.
I’d lay there on the mattress all day in the summer heat, not sleeping, as life pushed forward.
Towards the end of July, my brother decided to visit me in Midwood. I had been ignoring my family for months, my mother’s birthday was coming up and they wanted me to come home. Thinking that I was in a rough spot, he made it a point to come to Brooklyn first to check up on me.
We spent the day at Coney Island, with a spot on the beach reserved for us by my lifeguard roommate. We listened to Hot 97, went swimming, and took naps on the beach till the sun went down. That night, we talked over beers into the early hours of the morning. The conversation topics went from careers to relationships to our family; we hadn’t spent that much time together in recent years and we covered everything two brothers could possibly talk about. As I transitioned between a bemoaned rant about a lost love I couldn’t live without to blabbing about an older woman I wanted to sleep with my brother seemed startled.
“You’re not making any sense. How can you be so depressed about one thing, and then act like a completely different person about something else? What’s wrong with you?” He could see my obvious self-disappointment and adjusted his stance. “Listen, I’m not saying you are a bad guy, I think you just need to make up your mind. You seem like two different people.”
The morning after, I woke up to find him cleaning the living room, putting beer bottles in the trash, and folding the blankets I had left for him making a neat pile on the couch. As soon as he saw me coming down the staircase, he suggested we get on the road. I went to the bathroom, took a Minocycline with four big glasses of water, and met him by the car.
As we drove back to Jersey in silence, the minocycline began kicking in and I felt the usual sickness. I decided to fill the void with some honesty. I had nothing else to lose. “Whenever I take these pills, I feel bloated and get this warm brain buzz, and I can’t think.”
He seemed surprised but kept his eyes on the road ahead of us. He paused before offering, “Why don’t you stop taking them?” I lowered the car seat back and agreed, “I should.”
It was the first time I realized that.
That morning would be the last time I ever took minocycline. Going vegetarian has probably had more of a positive effect on my skin than the drugs ever did but there will never be an end for people wanting that easy way out, that panacea.
I still have a full bottle of 50mg minocycline pills in my childhood dresser in my parent’s home in New Jersey. It lays there next to old IDs and memorial cards and other things I don’t need but can’t quite throw away.
The bottle will always stand as a token from a summer I lost, of a mind that turned off as ants seeped through the cracks in the floorboard.