Borderlines?

The followup was this: I was there again, and he admitted that’s what he thought of me. In some ways, he was really immature about it. For example: instead of just telling me when asked  what I thought he thinks, he threw it back at me, “What do you think I think?” and I said borderline, and he assented. But then after that he kept trying to argue, “You said it, not me.” And refused to tell me why because “it would be harmful to me” and he knows best and all that.

I can’t really have therapy from someone who takes a patronizing attitude to me, who isn’t honest, and fully admits it. I think this is a fair enough request. I told him also that I hope never to be that kind of doctor where I know better than other people what is better for them and stuff.

It really stings right now, but I think in the long term I will be better off. I went to him because he sort of gave me hope that I could stop wrecking my writing career. I didn’t want personality analysis. But he isn’t willing to do any kind of therapy that treats a simple problem.

I guessed that if it made me feel really sad (though, to be fair, I was before I went in there too) to be treated like that, there is some truth to it. And that I hope he realizes that he did harm to a patient, and maybe thinks twice next time - which I guess is kind of manipulative and borderliny too.

Jake pointed out to me that from the moment he says that, it CAUSES the borderline type behavior. I learned an important lesson from that. The moment he said it, I lost all control of my anger. But that doesn’t, in and of itself, make me borderline. I learned about how expectations as a doctor actually end up dragging people into roles. I now wonder, some of the patients who have been angry with me, who I assumed had their own issues - maybe I somehow expected them to be angry and caused it? I learned from this, and that isn’t all bad.

And I hope I never ever start seeing people as “borderlines.”  I’ll have a shitload more money. Back to my old technique of buying myself something equal in value to the cost of a session when I feel horrible.

I just need to get back to my life. No more introspection and thinking about myself. It’s funny, since I decided to quit, I immediately went back to enjoying aviation magazines, my partner, and even being a doctor. This is why I hate psychotherapy - it makes you focus on yourself, when what really makes people better is to enjoy and find interest in the world around them: the people, the beauty, even the tragedy. And just ignore the crazy feelings until your life is full of other things.

Of course, being obsessive, as I also am, I went and immediately sat down to read everything ever written, ever, about borderline personality, from the newest “part of the bipolar spectrum” research to the ancient “caused by the fetal conflict between the nurturing womb which later becomes the rejecting womb” psychoanalytic shit.

After about an hour, I had calmed down a lot. It became immediately clear that I’m not. I don’t have the sine qua non features. The impulsivity and mood swings, sure. But identity problems? Nope. I know who I am, and I haven’t changed, well, ever. I don’t have stormy relationships, and I don’t have the panic at abandonment. I don’t split or have any of those other defenses. I don’t have a problem with ambiguity. Even during my rage at the shrink, I didn’t think I hate him. And before that, I definitely didn’t idolize him either.

And most of all, in my gut, I didn’t feel it any more than you feel a vague sense of relatedness when you read about any personality disorder.

When I first was brave enough to read about cyclothymia, light bipolar, it was like getting kicked in the stomach. Repeatedly. The immediate recognition that there had been no mistake, that this was my life in clinical terms. It still can do that to me. Borderline - I read for two hours with interest, then with relief. Three days into the reading, I got bored.

The other thing that pisses me off is the way the term is tossed around to generally mean a young woman who is angry, who turns on a therapist, or both. I mean, I realized that if I were a patient of mine, and had to hand myself off to another doc, and give a one-sentence description, I’d probably use that word. A glimpse into the medical subculture.

So - I am both relieved, and frustrated. Return to the shrink, realizing that he is using shorthand when saying that? I wish I were religious, or lived in a different century, where psychiatry wasn’t the only game in town…

On further reflection and the rest of the story

Today in the light of day, I still had the kick in the nuts feeling about it. But I made an appointment to go back…and just chill out. And explain why I feel so fucking betrayed. I did realize that part of it is just like what my father used to do to me. He would, for example, be fine one minute and then you trust him and open up, but then what you say comes around to bite you in the ass, which is probably why I am so fucking closed off to begin with.

Example: one time, right in junior year or so when people start getting college catalogs I ordered a bunch from all kinds of good art schools. So I sat with my father (sorry, hard to call him Dad or something, as I always call him by his rather distinctive first name) looking at them, one time, when he was nice and not crazy. A nice father-daughter moment.

Then, two nights later, he was beating the shit out of me because I had considered going to art school and not medical school. If that cannot make you crazy, then what can?

In short, it felt like the shrink did the exact same thing. I was honest, and it landed me a manic-depression diagnosis. More honesty - borderline.

After he said that, there was just no way I could even focus on anything else. I went home feeling horrible (managed to score 30 valium off him at least because he felt guilty).

But then I thought - say I quit therapy. What would happen? I’d have a lot more money, and stop thinking about how miserable and fucked up I am all the time. And guess what? That felt damn good. I told myself that that was it. I went to look at some travel magazines for the first time since I started going to the shrink. I looked at some aviation catalogs (another hobby).  And then my partner came home, and I had a nice evening where we enjoyed each other’s company, also for the first time since I’ve been to the shrink because I stopped thinking about how many bad things there are in our relationship. I had a good day at work even. Enjoyed just being with colleagues, patients. In short, I went back to feeling and functioning the way I did before therapy and the med horror.

So once again, why the fuck am I going to therapy? It is without doubt making me worse. First the manic depression thing, then this all.

I just don’t really believe in therapy. He once again wrangled me into going by sort of suggesting he could get me to stop sabotaging my writing career. Well, nothing like that came out of anything. He made the manic depression diagnosis which caused me an unending amount of grief to try to come to terms with…and now throws another, worse one at me, just as I get my feet back on the ground.

The thing is, personally, when not in shrink mode, I like the guy, so when he says, “You need therapy,” I really believe him. Even though the last time, four years ago, it was the exact same thing. And last time I absolutely promised, swore to myself not to fall for “therapy” again.

And it isn’t even the borderline thing. I am not stupid, I’m sure I have some borderline tendencies, maybe even a lot, and probably with how I’ve been medicated lately, you could make a good case for schizoid as well. The thing that bothers me is that, if he decided/knew I wasn’t manic depressive, and that the thought that I was was causing me great grief, why not, oh, say something about it? It’s the dishonesty that bothers me more than anything.

Another reason I have trouble opening up to him is that, god help me, I feel sorry for the guy, and it’s hard to throw my shit on him. He’s one of those depressive types too…and not always, but a lot of the time, he’s barely going through the motions. He has that stench of the misery of someone who went into a psychoanalytic institute and actually took all that shit seriously. I get the feeling that I want to just stop everything and say, “Oh honey, tell me what’s wrong.” Which is not surprising, given my job / personality / overdeveloped sense of empathy. But I can’t tell him that because he’d just blame transference or projection or some other bullshit. So I’ve been closing myself off to pretty much any of his wavelengths, otherwise I wouldn’t be able to dump all my shit on him.  And that can’t be a good relationship for a therapist.

And for my usual dose of irony: I went into his office totally suicidal that day, miserable, restless, thinking there is NO WAY I could come out feeling worse…

The whole reason I bothered to write this here is that, though this blog isn’t widely read, sometimes I write something and then get emails from a lot of people who, say, are diagnosed borderline who want to comment. Once, I wrote something about shrink troubles, and surprisingly, I got a deluge of emails from psychiatrists, telling me to speak up. So I’m putting this out there, asking for advice. Worth trying to salvage something here, or not? Should I say that his burnout has made me hold back, or is that just going to kick me in the ass? Anyone? Comments or email - either would be appreciated. I go back Thursday, but can move that if I’m still undecided. I wasn’t going to go back at all yesterday, now, not sure. Thought there might be something worth saving or at least trying to close out politely.

Psychiatry claims another victim

…or Dona Juana falls for it again.

I have been having a really horrible week. So horrible, in fact, that almost every night on call I get to a point where it is difficult to avoid thinking about suicide seriously…climbing up to the top of a tall building and jumping. I have been inconsolable. I haven’t really been able to talk about this to anyone. Just…all I can think of is the relief I could have from being me.

I wonder what happened to the version of me that was okay. But I know. Therapy happened.

Now, today I had to see the shrink again. I mentioned that I hadn’t been feeling well, that it had been difficult for me lately. I did not go into detail about the chronic suicidal thoughts and so on. Figured it would come up if it would. I went into the appointment knowing that I am in desperate need of some kind of relief, comfort - maybe a med change, definitely a little support…and also knowing well that I wouldn’t find it there.

Finally, I just asked rather simply, “What the hell is wrong with me? That I have everything and can’t just live.” I also may have mentioned how it seemed like being in therapy - again, his idea, not mine - seemed to just be making things worse. That instead of living my good moments and enjoying them, I was stuck on monitoring my feelings all the time, noticing pathology everywhere.

His answer to what was wrong with me: “I don’t think anymore that you have bipolar. It’s a personality disorder.”

This came out of nowhere, though I guess deep down I knew somewhere not to trust him. This is after letting me spend over a year mourning the fact that I had been diagnosed with bipolar disorder, taking that to heart, coming to see myself as broken and learning to live with that. All, of course, on the basis of his diagnosis.

I didn’t think it would be possible to go into that appointment and come out feeling even worse than I already did. But he did.

I just feel sick and betrayed. Someone who encouraged me to trust and trust - despite my better instincts - encouraged me to do talk therapy, despite the fact that it only caused me harm in the past, was so dishonest with me, never would have even told me unless I pushed for an answer, and even then couldn’t be honest enough to name the name.

The most horrible part: his solution was to increase the frequency of therapy.

No, wait, that’s not the most horrible part. The most horrible part is that I was reasonably happy with my life until I went back to him in late winter. Now, thanks to all this therapy, I’m back on the same med cocktail I was to start with after losing months of my life to the misery of many unsuccessful med changes, and am an absolute fucking mess.

So when they ask how therapy is harmful, here is my story. I feel okay, and that gets me a bipolar diagnosis. I spend a long time in mourning, trying to come to terms with that. It hurt. Then the so-called helper decided it wasn’t even a right diagnosis and actually did not even intend to tell me that.

I am out several thousand dollars, at least six months of needless suffering, and once again, cheated by psychiatry.

This wouldn’t be so bad if I hadn’t been through the same thing four years ago, promised myself to never, ever go back to therapy, for these exact reasons, and then walking into it again. Six more months of wasted time, wasted money (money is a big worry for me), and most of all, personal hurt and dashed hopes. I can certify that I came out of therapy worse than I went in.

For a while, when I quit last time, part of what I promised myself was that if I felt the urge again to go back to any kind of therapy, to immediately go out and spend the cost of a session on something that would give me pleasure. It made me feel infinitely better than therapy ever did.

So now, after another painful and expensive lesson, I am back to where I was four years ago, with additional hurt, in a fairly severe crisis with nowhere to turn, and with no med doc to fix this shit. And a new, deep wound to add to it all.

I probably should go out right now and buy myself something nice with the value of a session. But I’m too fucking tired, too fucking full of wishing for death, for relief. Of course, now I can’t even kill myself, because that would just be some crazy borderline manipulation.

God, I promised myself then never to do this to myself again. Back then, I said to myself, this is it. No more therapy. No more money and time and hope in a dead-end. No more subjecting myself to the judgment of some of the most fucked-up people on the planet. No more looking for relief, for humanity, for help, where there is none to be found. I swore to myself deeply then to never go back.

I guess with time, the reasons I was so adamant got blurry. I managed to forget. Managed to buy into all that crap about how people in that profession really care, are committed to service. Are sensitive. Are empathetic. May even care about patients.

So now, I am out a drug provider. And I am, if anything, worse off than I was this morning with no hope in sight.

I’ll probably call Jake. Just to get reassurance that I’m not personality disordered, a touch of real life, real people. The things that psychiatrists shy away from more than anything.

Thanks for listening, whoever is out there. And if you learn one thing from me, it’s this: don’t go to a fucking shrink. And if you do, never trust one.

Article Link

Take a look here:

http://www.medscape.com/viewprogram/14636_pnt

I wasn’t expecting anything new in this article that came in my email updates, but it was worth reading because it made me laugh out loud. About halfway through, he describes the life of someone as full of “intermittent and recurrent chaos.”

Holy fucking hell. That is just hilarious. And I guess maybe if that had been a criterion, I could have been diagnosed a lot sooner.

It’s all coming back to me now

It is so strange how you can be okay for a while, enjoy life, live normally, and then, just when you breathe, overnight it all comes back. You’re crazy again, hurt again, suicidal again.

I must admit, even though I went back to an old, previously successful drug routine, I haven’t really stabilized out. How do I know this? Because when I am really stable, I don’t think about my mood every day, every hour, every minute. When I fully recover from a mood episode, I am horrified at myself, the monster that took over my body for a while. I think back to my meticulous suicide plans and all of the details and it is as frightening to me as if I had planned a murder. And how I acted. The shame, so much shame. Worse than being drunk in front of everyone, but similar in tone.

I didn’t get that far this time. I still don’t feel the horror. I still don’t really want my life back.

I am doing well at my new job. I am one-upping people with much more clinical experience than I have, in fields that are their specialties, not mine. I have made obscure diagnoses before anyone else raised the possibility, and been right on things when every expert thinks I’m wrong. I am again the shiningflamingscorching star I was apparently meant to be. It all comes so naturally. Other people are knocking themselves out to do half as well as I do.

And the big secret: I don’t really want it. That’s how the universe gets you.

It is strange and ironic and sad that in the cutthroat arena so many people would kill to do what I do, for the sprezzatura with which I do it, to be me. And all of this, all of it, all that I can do and all that I did do and all that I do means nothing to me.

I am not yet 30 years old. I am relatively at the start of my career, one that apparently, despite anything I do, has the auspices of being a brilliant career.

And yet, last night, awake and pacing and storming at 4 AM, hating everyone and everything and impatient and restless and full of animal fury, I couldn’t help thinking that it isn’t good for someone to be like me. I mean, it’s good for the world and the patients and the hospital and whatever. But for the person, to do it all and see it all so young, to be unstoppable, without struggle, to be where nothing impresses me at all, to have everything so easy and nothing to look forward to or work toward…to be empty and bored already. I would trade it all for a little happiness. Not big happiness, just the ordinary happiness that ordinary people have. Picnics without rain. Seeing kids playing and not seeing the years of tragedy that await them.

A few rough days and nights, a heat wave, exhaustion, the mood swings again, and I am back to wishing I weren’t alive. Moreover, I’m so restless and so very fucking angry that I can’t help thinking about jumping off buildings, a giant fuck you to the universe, for giving me everything except the ability to live with it. And for some quiet. To know that I will never, ever, have to do anything I don’t want to do again.

When every moment of every hour of every day consists of something you don’t want to do, and everything you see in the possible next ten years is more of the same, the relief inherent in this idea is considerable.

I lost my temper today. The reason was, at least on the surface, justifiable.
More work for me due to someone else’s doing less work. Unfortunately, I ended up taking it out on the messenger. And having to do more work for all these women who are pregnant and men whose wives are pregnant. I am considering starting to tell everyone that I am pregnant. It seems to be an all-purpose, unquestionable excuse for anything. But I’d never really be pregnant because I couldn’t possibly bring a child into the world.

People always ask me why, seem to think this is strange. Don’t they see? I don’t even want to be alive. It’s sort of like when people admire me. (No, I don’t think they like me much, but a lot of them in medicine admire me.) I mean, they see some stuff and think they’d like to be like me. No one ever seems to notice that I don’t even want to be like me.

This is self-indulgent and rambling, which I guess is fair enough, considering it’s the internet. Time for a fucking med change, methinks.

But before I get myself drugged into mediocrity, one question: why the fuck can’t I just get a little euphoric mania for once?

Psychiatrist woes revisited

As I said, I’ve been trying to get along at least superficially with this shrink, because I don’t think he’s stupid, which is a lot to start with. Trying to trust his judgment, though I do love the comment someone left on here about med adjustment having the feel of an eighth grade science fair.

This last appointment kind of upset me, because I think it is reflecting that underneath the quiet demeanor and all the right attitude, there’s a lot I really don’t like. I am not totally sure if my problem is with him specifically or psychology as a discipline.

The issue, or at least the one that really is eating at me, is this: I mentioned some work I have been doing in a free clinic. I mentioned and talked about a patient I really liked there recently, how she has been on my mind - in a good way, a caring way - that I hope she’s doing well. I’m glad I have met her, that my life crossed with hers even minimally, even though I may or may not see her ever again. I found her admirable, living in a difficult circumstance and remaining optimistic and not bitter. This was one of the nice points of my work recently. I’m pretty sure I told this warmly, though also mentioned my embarrassment because as doctors we are not supposed to “like” patients, but rather be cold machines who treat everyone exactly the same, based on algorithms and protocols. I mentioned something about how if I weren’t doing work in that kind of a clinic, I’d never cross paths with someone like her, so even when it sort of sucks to be at a place like that, the rewards can be wonderful and unexpected.

His comment, almost reflexively, was something like, “Of course you’d like her, there at a clinic like that and not one of your patients at the hospital. She needs you; they don’t. Just like you.”

Something about that bothered me. I don’t think that it’s even the question of whether it’s true or not - there probably is some truth to the fact that I’m a caretaker type, and even that I use taking care of others as a reason to keep myself relatively stable. I can accept that.

But there’s something basically ugly in his statement, in the worldview implicit in it. And that’s where I always get back to hating psychology/psychiatry: the idea that anything, any human behavior, no matter how noble, beautiful, intense, or intricate, is always based on pathology. Why view things like that? Does it matter if Dostoevsky wrote The Idiot about his own epilepsy and misery? If Rigoberta Menchu was dealing with childhood trauma and a sense of powerlessness?

I have plenty of horrific qualities - a massive ego, a sense of entitlement and narcissism, impatience - so why take one of my few sincerely redeeming ones - that I have a tender spot for people in hard situations - and pathologize it, make it ugly? It isn’t hurting me, and it isn’t hurting anyone else, might even be helping someone…so what is the point?

What, to someone with an extremely psychoanalytic bent, would constitute a good reason for becoming a doctor? For adopting a child? For writing a novel? There is no acceptable answer, and that’s why I always end up quitting therapy. I just realize, again and again and again, that there are no answers to be had there. The unexamined life may not be worth living; but sometimes the overly examined life needs to stop being scrutinized and start being lived. One could potentially stay on the couch forever. A lot of psychotherapists seem to think that that is a good idea.

And in that bizarre, quasi-religious system, somehow the patient is always to blame. You aren’t allowed to disagree without that being pathological. Say I bring that that conversation bothered me. That I think that that comment shows more about his worldview than anything about me.

Naturally, that’s only because I am denying, reaction forming, resisting.

Sounds as rational as any random religious belief one could choose. I could throw myself into any fundamentalism with as much success. Maybe more, because a lot of fundamentalists in other fields are happy. I don’t believe in belief systems. I believe in science, and rationality, and also hope and tenderheartedness and beauty.

So then I wonder. I know most psychiatrists hate their jobs in the end, they burn out, realize they went into it for the wrong reasons, often go into it because they are melancholy at their core. But I don’t think I want to be talking about anything too personal with someone who sees the world as differently from me as this. Psychiatry is a nihilistic discipline at its core, believing in little of anything other than pathology. That’s why I always tell myself not to waste my time in going back. And somehow, whoever I go to for drugs always manages to sell me the whole package.

I guess that despite my wretched suicidal depressions, my lack of faith in much of anything, my unrelenting intensity and horror at the world, somewhere, deep down, I am something of an optimist. I do think that someday, if we work hard enough, things might not get exactly better, but they can get less bad. I believe in the power of small deeds, kindness, contact with others. Moments of something like grace down here in the mud, moments when despite it all, we look up and see the sky.

Should I mention this? Just quit, find someone else for meds? Because now I doubt I can quit therapy without his ego getting all blown into things and him pretty much firing me.

And why do I end up going back, despite my better judgment and reminders and promises to myself to quit wasting my time, to stop looking for answers from a religion that offers none?

I guess I need therapy to answer that question. (Note the sarcasm.)

Sorry I haven’t posted

I’ve been working hard - extremely hard - at my new job. The mood has sort of evened out as I’m back on the old good med routine. The shrink seems much less diabolical when I am well medicated, though seems to think that I should try another experiment with changing meds soon, which, after seeing the results of the last six months, makes me doubt his perspicacity a wee bit.

Since I haven’t been writing much, try this great blog that I found today. A good starting post is here. An MD with BP, and he just transferred from emergency med to psych and he told his bosses. And he takes reboxetine, so I’m hoping to get the dirt on what that’s like, as it is next on the ever-growing list of drugs the shrink thinks would be good for me that I refuse to take.

Scared, but back

I am slowly turning human again. A human that has to live in the dark, yes, but human nonetheless. But I don’t feel well. And I start a new job this week, and my first night is a 30 hour shift.

I really wish I had tried to delay starting by another month. But no one forced me to, and I’ll always punish myself if I can, so I said I’d start. Never mind that I am worn down. My mood now is nearing normal. Does the fact that I just went through four months of hell make a difference? It is hard to say. On a practical level, there are many things I neglected during that time that all need attention. This makes me busier. And lying in bed for weeks on end does not do much for one’s physical shape. But I suppose I am back to something resembling health.

My question is something like this: after a severe mood episode, is one expected to be back to normal once the mood is more or less stabilized? The symptoms are gone now - so one should go back to full function, right? And the drugs will only work better as time goes on, since I’ve been taking them for less than two weeks - things should only improve as they kick in. I should be fully functional right now.

But I feel like I am standing on terribly shaky legs. I am not sure if my strength is there underneath or not. Though all my symptoms are mostly gone and nothing is wrong with me now, the proximity of the episode, the loss of control, the fear and the pain, the horror of how hard and fast I could fall, did fall, seem to be near. My usually unstoppable confidence, boldness, fearlessness are not back yet. I still feel like the real me is lost.

I wish one of the doctors involved had stepped in and told me, recommended strongly, that I take more time. But, of course, I in my stubbornness, my denial of this illness, my refusal to allow it space in my life, made it almost impossible for anyone to say such a thing, even for my own good. But I wish that one of them had been big enough to brave my rage, to trample the independence they give me out of the deference for my profession. I probably would have been angry. Definitely would have. I might not have listened. Probably wouldn’t have.

But I might have. Then I could have taken the break gracefully, blaming them for making me take something that I myself am unable to admit that I need. Sometimes people do need to be saved from themselves.

Who knows? Maybe moving on as quickly as possible, acting like nothing happened, is better. Sometimes I think back and count up the months and the years that this has sucked from my life, and it horrifies me. Depending on how I count, often, the years taken away are more than the years I have had. Maybe that alone is a good enough reason to run back into a full schedule as soon as I can.

*********

What do you think? What do you do? When the episode lifts, do you rush to embrace your life again, or do you enter timidly? The episode seems to have vanished, and the wake left behind is invisible, internal, so much so that only you know it is there. Is it enough to rock you?

Mixed states?

I can’t sit still and can’t find anything to do, having finished a million projects today and now I am filled with an insatiable appetite for anything physical. Sex, food, violence, motion. I forgot how strange a trip it is from starting medication to the phase where you are balanced again. Crossing all sorts of strange valleys, strange depressions and strange manias. The med has done enough to drag me out of depression but not enough to make anything feel right.

This leaves me pacing like a wild animal. All instinct, no intellect. Normally, in this state of activation, I’d write, but my cognition is still too slow to do anything like that successfully, my mind is still depressed. So instead, I pace, clench and unclench muscles, feel cagey like an animal. Eat apples again and again - something about their crunch is satisfying, raw, the just-right substrate for my fangs. I feel like prowling the streets, looking for sex or a fight. I feel like growling and hissing.

And, unpleasant as it is, at least when it is unsatisfied, I am not altogether sure I want this feeling to end. It feels like me at the core, stripped away to my most raw, untrapped by drugs, society, identity. While there is no place for this person now in my life, my location, I wouldn’t want her to disappear forever. I just wish I knew what to do with her, what she needed, what she is trying to say.

Onion link fun

Just a quick update, I probably won’t post in the next couple of days. I’m back on the old med, sunburn be damned, and hope to feel something closer to back to life soon.

This is more or less the situation: http://www.theonion.com/content/news/area_man_makes_it_through_day

And then…things you don’t want to hear your doctor say

come morning, my bedmate started yelling, “Your eyes! Your eyes! What the fuck happened to your eyes? You look like a fucking alien!”

So I wait until it’s a decent hour, then call the shrink. “Whaaaaat?” he says. “Really? I’m going to have to go Google that and get back to you.”

Mydriasis, or my pupils got stuck open all the way. Yep. Google Effexor. It’s there.

Adverse Effects: Effexor

Yesterday mid-day I took the first dose of 75 mg extended release Effexor. Since then I can’t sleep, am shaking with my teeth chattering, want to throw up, and have bad akisthisia (when you can’t keep still) and racing thoughts. My eyes hurt inside and are fuzzy. Every muscle in my body is screaming. I ran around all night and am exhausted, yet can’t stop. I need to work at a million things this week, which is terrifying in this state.

I am terrified to take the next dose. Does this get better? Is this normal for starting, or an unusually bad reaction? I think back in the early days of Prozac, I had the same kind of nausea at first. But nothing like the rest of it. And I understand that to get the norepinephrine effect that is the whole point of me taking it, I need to take a much, much larger dose.

Anyone? I am afraid to keep taking it, afraid to stop, and afraid of later trying to get off. It is still too early to call the doc. Who has been there?

My Dealer and I

A nice surprise. No lamotrigine, no carbemazepine, actually he came up with the idea of trying Effexor alone. I was sort of surprised, as it was his first suggestion and I was okay with it. So I’ve already taken the first pill. It has made me feel a little spacey and pukey, but that’s alright. Hopefully, it will be the solution, and will work fast enough to get me functional by the time I need.

And I’m off to the races trying to get everything done that I need to this week. I got a call from my third job that they need me to come do something. This job isn’t worth the hassle, not enough money to be worth my time anymore. But I always feel so fucking guilty and obligated. When that phone call came in, I almost lost it, almost broke down crying right then and there. One more thing that is going to take a half day or whole day that I have to run and do. I am so, so achingly tired.

I have a new med that doesn’t make me panic at the thought of swallowing it, though I do suspect it will kill my emotions and sex drive. Probably my writing as well. But for now, I can live with any of that, just as long as it gets rid of this horrible insomnia, and inability to sit still. Later, I can worry about being me, having a life that is worth something.

I still came out of there feeling pretty bad. I was late because there was a huge traffic mess on the way, and the thing is, I really am at the end of what I can take here, but I think nobody ever really notices that. “You’re still working, right?” they ask. “Then it can’t be that bad.” I guess maybe they are right. Maybe I really am ok. But I always get the sneaking suspicion that I might be that one kind of person who looks fine and does everything perfectly and then one day jumps off a bridge and everyone says, “What the hell? She just was at work like usual. Nothing seemed wrong.”

Do you have to be unwashed and uncombed to be depressed? I certainly have had those days, but the idea of being homeless because of not paying bills is a huge motivator. I just can’t see how that will help me. I certainly haven’t been working well, not a valuable employee or anything, but I’m not one of those people with a family to fall back on, someone who will help me out of trouble, so I keep showing up.

Anyway, I am exhausted, to put it mildly, and my reserves are winding down. Despite the med solution, this meeting was terribly…well, whatever the opposite of comforting is. Intrusive without really being helpful, misunderstood (again, we both are working in a language that is not our native one, where nuance is often lost), and dismissed. Accused of being too judgmental, the real ache apparently invisible. Exhaustion and more exhaustion. I guess that’s sort of a good description of my life.

Executive Decision

That’s it. Everyone has a breaking point, and six months of non-function, of, let’s face it, non-stop insanity, is mine.

This med has been enough to get me out of the wicked depression and into a horrible agitation. It is once again 5 AM, I have been awake for hours, unable to shut the fuck up in my head, angry, suicidal, cruel, and terrified. I have one week left to pull together all the shit I haven’t been able to deal with before starting this new job, and I can barely move.

Tomorrow, I am supposed to meet with the shrink about whatever the hell med disaster is next. But I know the options, and unless something comes to the table that I wasn’t expecting, I am making the executive decision to go back on the old med, and apologize formally to the universe for ever thinking burnt skin was bad enough to justify complaining. I know I have said that I sometimes hate Super Sara, but right now, I need her.

I wrote a long time ago about rage dreams. Last night offered me a new twist - I had the typical dream, but whereas in every previous dream, I flew into the same rage and woke up shortly after, this time, I had the same rage, but the dream kept going. Because of the rage, I was considered out of control, and dragged off to a mental hospital.

Thank the shrink for that dream. I guess I’m still furious about that. But I know that finding another doctor isn’t the answer, not really. All the king’s horses and all the king’s men don’t have any magic drug to offer me. And since I still cannot speak the words “manic depression” or “bipolar,” going to another shrink would probably just delay the diagnosis again. There’s no way I would go to another doctor and honestly tell them that. Not after all that this diagnosis has brought me. The best I can do is listen to this guy’s take on the meds, take the opinion for whatever it’s worth, and try not to put my fist through a window while I’m there.

The worst thing about being crazy is that you lose the right to your emotions. Anger, sadness, existential angst, even happiness - it’s all a disease. You are a child, irrational and unreasonable, and anyone is allowed to pass judgment on you, to dismiss you. None of your good qualities, achievements, or contributions count for anything nearly equal to your crazy. Nothing you could ever do could ever possibly compensate for that.

And the fact that this will hover over me every day, over everything I do and everything I touch, for ever and ever, until the day I die and probably beyond, into whatever pathetic posterity I may merit, makes a more than adequate case for suicide, does it not?

The follow-up

Just warning, this is going to be a boring post, but I’ve had a few emails asking for the end of the story, so here is at least the next bit.

I finished the big deal project Monday, and agreed to hit the shrink again today, this morning, before work. I decided that now was as good a time as any to start being honest. So I was. Said how the fuck much it upset me to get treated like an out of control child last time, that I found it incredibly insulting coming from someone who knows me well enough to know that I never fuck up anything (at least not anything professional), ever, no matter how bad I feel.

He actually didn’t apologize or backpedal, instead tried to argue that it really looked to him like I was “not in control of my actions, out of control,” manic, whatever. Maybe, maybe not, but I always pull my shit together. I should get a little bit of props for that.

Then I went on to lay out what I laid out here. That I secretly think he’s a little bourgeois, which makes it hard to talk to him sometimes. So he tried to prove his street cred by saying he was in Berkeley in the sixties (again, we are not anywhere near North America, so this is a more significant claim than it might sound), which would have worked better if I were poorer at math and couldn’t figure out that he must have been about 10, therefore he wasn’t exactly there burning bras or whatever.  Then he tried to blame me for painting people in black and white, which I don’t think is fair (I think any doc in a field like mine knows enough about people to know that there are complicated sides to everyone and I honestly don’t think anyone who really knows me would ever say that about me), but he had to strike back somehow, so I guess that was reasonable enough.

I tried to explain that I just don’t have much to judge on. I have to judge on gut feelings and whatever leaks through in conversation. And gut feelings don’t come from nowhere - at least, that’s what shrinks believe. I gave several specific examples of things that had made me think that way, though.

And I asked for clarification on why he said I should be a writer (trying to smooth things over by using this as an example of when he surprised me in a good way, because at the time I really did expect him to tell me to just go be a boring doctor and shut up), and he said it wasn’t ever because he doubted my ability as a doctor. So that was the party answer; whether true or not, I don’t know.

The last topic that came up, again, was the mood stabilizer one, i.e. I need one. But I can’t think of a single one I’m willing to take.

For some reason, when I came out of there, I felt horrible. I went to one job, did it but only a little, then came home. Now I need to leave to the next one. For whatever reason, honesty hurts. All I could think about was shooting myself in the head all day.

Since I tagged this, I guess I owe a Shrink’s Line of the Day. It’s not that funny, but I guess there’s some truth to it.

Shrink: You by force or by talent or by charm always run everything, take charge of everyone. And finally, you hit the psychiatrist that won’t let you be the mother. That’s gotta sting.

I’ve gotta go to work. Maybe I’ll follow up later. But probably won’t have time.

The only good thing that happened to me today: my Stargazer Hair Dye came from London. Electric Blue and Fuschia. I can’t wait.