The psychiatrist, round 2

Today was the big day, put off a week due to a ridiculous conference at work. I got in this morning to him, and it was the usual ambivalence.

He doesn’t know what the problem is, thinks it’s some kind of depression, not a side effect. But whether this “depression” (I’m not totally convinced) is from the lithium or not, he doesn’t know. He gave me the option of upping the dose – the levels were low-therapeutic – and seeing if the antidepressant effect will kick in, or switching, which I wanted to do, but he recommended the raising the dose. So tomorrow I have to check levels, and then take more.

But I’m going back a week from today, and if this isn’t better I’ll switch. Of course, that’s another three weeks lost. I am starting to panic about all the shit I have to do. I also know that raising the dose will take forever to kick in and I just don’t have that kind of time now.

I’m not sure it’s the right decision to stay on. I think it might be if I had more time to up the dose and get it working, but, again, I don’t. But he thinks it is the right thing to do, and I think he’s competent more or less (as much as anyone in that field is), and at least is respectful and willing to work with me. He pointed out what I already found out for myself, latest studies show that lithium alone is the way to go, that there’s not much point in adding an antidepressant, though not too long ago, they used to do that.

I also told him about that conversation I had with the psych med pharmacist, how he didn’t have any more information about the tricyclic than I did. He asked who it was, and I told him, and also added that he was a major asshole per my conversation with him (which he was, holy hell, I don’t know if I recounted that whole thing here, the gist of which was he couldn’t believe that I could be what I am and have manic depression), and he said, “Oh yeah, he is a real asshole.” So at least we agree when we sit in judgment on others, which I am taking as a good sign for the therapeutic relationship.

Oh, and because he’s a psychiatrist and doesn’t understand shit, there was one lab value that was a teeny bit high – totally insignificant, but he doesn’t know how to deal, so I gotta do MORE lab work, in addition to the levels tomorrow, which is inconvenient.

In other words, trying to end positively, thank you tons and tons and tons to the people who leave comments, emails, everything. It is deeply appreciated, and thinking that my story might help someone else, well, it doesn’t make it all worth it, but it does soften the blows.

And, if you are looking for some fun, the best mental hospitalization story ever is at this great blog.

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