Today I am having an existential crisis. I’m on a pain pill again, so it’s a soft, floating, Snuggle-Fabric-Softener-Bear kind of existential crisis. But deep, out of my very depths.

The first thing that strikes me is how much pills define who I am. I take pills for acid and sometimes for pain and most often for keeping my brain from killing me, for stopping compulsive hand-scratching and OCD touch reactivity, for calming me so that I don’t hit or scratch myself and so I can sleep.

Accidentally going cold-turkey off the lithium a few weeks ago was a black-pit nightmare. The suicidal thoughts returned as though fresh from a long vacation and ready to do their job. Then I took a lithium capsule and they left again. Right now, I’m reducing my dose back to 300 mg, and vague echoes of the thoughts called out yesterday, along with titanic irritability. Today, both are gone.

Whatever the pills leave open for definition, hormones fill in. There are days in my cycle marked for heightened bristling, expected intolerance of myself and others, weeping, malaise, even a runny nose. All due to chemicals whooshing around in my bloodstream.

The crisis is, when I take all of that and look at it, I come away asking, Who am I? Not my name and Social Security number, not my lineage, but my self.

My self. If I can be tossed about so easily by chemical forces, internal and external, what is left?

I used to have basic pieces of self-definition. P.J. and my therapist and most others I encounter believe in a person’s essence, faith in a self that underlies all of these influences. I am not so sure of that. I do not have faith.

I am kind, but now I do not know if I am kind without a pill, because sometimes if I do not take a pill, I am not kind.

I have an amazing memory, but I do not always have an amazing memory because a pill can mask it. Years of Lamictal have left gaping holes in my memory. “Hey, do you remember that time when … ?” No. No, I do not. I don’t even vaguely remember that that thing might have happened. There isn’t a hole where it used to be. There is no, “Oh my god, I totally forgot about that!” It’s just missing. Erased. My memory, not amazing. My memory, Swiss cheese.

I am funny, but there are nights P.J. tells a joke and I look at her and have to ask, “Was that funny?” because I really cannot tell. If the pills are not working, other chemicals in my brain take away my sense of humor, even my ability to perceive humor. I blink, and try to understand it intellectually instead. Do the pills give me a sense of humor, then? I am not always funny.

I am a writer, but sometimes I cannot put words together. Sometimes I have no voice. I am not always a writer.

I am honest, but when I became bi-polar post-surgery, and before I was diagnosed, I lied. I lied a lot, about something very big, and I hurt my loved ones unbearably deeply. I scream inside when I think about this. I am honest when my chemicals let me be. I am not always honest.

Sometimes, I lose empathy. Sometimes, I do not put others before myself. I have been called brave. Sometimes, I hide in the dark bathroom and wrap my arms around my knees and rock back and forth.

I am non-violent. Sometimes I beat my face to bruises and it feels good and I relish it. Sometimes I claw my left arm to bloody shreds with my fingernails. Sometimes I am a sick, bullying motherfucker who enjoys violently beating a weakling.

What is left? What is intrinsic, what is not malleable and ephemeral? Is there a core to Amy? I am not spiritual and I do not believe in souls or energy channels or anything supernatural. I am just a brain and a bloodstream. I am pills and some chemicals and a disease that have a name and a Social Security number.

I am sore afraid, afraid that there is no Me.