I did not see this coming

The latest in my escapades – no essays or deep thoughts or medical stuff here, just my personal update.

The anxious racing episode, naturally, crashed into a depression that hit hard and fast. Or maybe not so fast, but I didn’t feel it until it was out of control.

I think I am more and more becoming a burden. I haven’t had many normal conversations with any of my friends lately, it all revolves around my condition. I feel like a burden, and though they’d never say it, we are all doctors in training and under so much pressure that we are very limited in how much we can give to each other. It’s sad, but it is how things are. I also just sort of want everyone to go away and leave me alone, so they won’t see all this, and I can return to my life after I’m better without having done too much damage.

It is very hard for me to accept help, and I just want my partner and everyone else, well, I want them to help me and care for me, but I don’t want them to see me like this.

Since the depression got worse and worse, I went to my GP, who is very sympathetic to these kinds of problems, having had a son commit suicide, so he treats people with mental illness like people, not diseases. Actually, I didn’t want to go, but the psychiatrist wouldn’t treat me further unless I did because he wanted to be sure I wasn’t physically ill. I had attributed a lot of the physical symptoms to medication side effects and the depression effects.

I went to the GP and told him to just sign off, send some basic blood tests etc, and to give the shrink a green light to continue treating me. I told him I was not alright, but I couldn’t tell him about the suicidal thoughts. He knows about the depression, not sure how much about the whole bipolar story. He said I looked bad, and asked if I had ever been this bad before – I had, twice.

He started to do a brief physical exam, like, put a stethoscope on me while I was just sitting in the chair, but once he heard my heart, he told me to get up on the table, and did a full exam. He started yelling at me (well, not “yelling at me” but he got surprised and upset) that I was in horrible physical condition – apparently malnourished and dehydrated almost to the point of shock – racing pulse, minimal blood pressure, gray, the whole textbook version.

I had been feeling dizzy and horrible, but thought it was some central effect of some drug so I didn’t really pay attention. I was surprised because I’d been working as usual. I knew I hadn’t been eating because the depression sort of took away my appetite and one of the medications or another was making me either unable to eat or throw up often. But I didn’t think it was so much. I had been trying to eat a lot of calories in whatever I did eat – adding butter and honey and always juice with lots of sugar. It’s my “depression diet” because I know that sometimes I lose a lot of weight fast when I get like this, so I try to pack as many calories as possible into what I do eat. I guess I didn’t start early enough this time.

He called the psychiatrist from the office right then and there. This felt really bad, like I was this wayward child who needed to be taken care of – all of the sudden I was the ward of these two doctors, playing ping-pong about what to “do with me.” I only heard the GP’s side of the conversation, but he said at the end, “Look, I really think we’re getting to the limits of what can be treated outpatient.” No idea if he was referring to mental or physical state.

He sort of vaguely asked me about suicide, asked if I could or would talk to the psychiatrist about that. I said, “Probably not.” But it got the idea in my mind that maybe I should say something.

I walked out of his office and I remember sitting down at a bus stop just to rest and catch my breath for a few minutes before going to the car. It was freezing. But I was so tired, two hours passed while I sat there, watching people and buses come and go, waiting for the energy to get up and leave.

I did the blood test and the H. pylori test, and then went to meet a close friend (also a doctor), and told him how scary facing hospitalization was (for either the medical or mental stuff, I wasn’t even sure which anymore). He told me, “You look terrible. I’m a friend, not your doctor, so I’m not going to tell you what to do, but maybe you should go to the fucking hospital.”

The next day, I went to the shrink and confessed the suicide stuff, even though it was hard. It seemed like the responsible thing to do. I think I was actually looking a little less depressed by then because going to his office makes me so nervous that it gives me a little energy. He basically didn’t react. Nothing. I asked what to do. Nothing. I felt ridiculous, like some drama queen. He didn’t ask any of the suicide questions that even I know to ask (Do you have a method? Plans? What do you think will happen if you do? What stops you?).

Finally I asked, “Do you think this is some sort of manipulative thing, just to get attention, or something?”

His answer was, “It would only be manipulative if you were doing it consciously.” (I guess that qualifies as a Shrink’s Line of the Day.)

Then he said he wanted to give me Zyprexa “as it recently got approval as a mood stabilizer.” He sounded like a fucking Lilly commercial. I absolutely refused. Then he got angry at me. “You just can’t work with you! You say you want help, but then you refuse the help anyone offers!”

I asked him if he would take a pill of that. He said that that wasn’t a fair question. I said I ask myself that every time I prescribe something for someone (true). At the same time, he told me to stop the antidepressant that he started a week ago – just as I had started to get over the nausea from it, way before anyone has any idea as to if it will work or not.

As usual, I left there feeling worse than when I went in. Maybe he was right, who knows? Maybe not reacting will discourage me from threatening suicide again. He’s a nice guy. He did call today to suggest maybe somehow finding some derm specialist who can solve the side effect problem of the old drug (or possibly that was the subtext for calling to make sure that he didn’t kill me after all), that he had searched around the area and there was some guy a few towns away who specializes in drug reactions in the skin.

I said I was sorry for being such a horrible patient.

The next morning I went back to the GP for the test results and because he had said he wanted to see me again the next day. To make sure I was still alive, I guess. I told him what happened. I asked him if he thought I was being unreasonable to refuse the Zyprexa. He did the screening for psychosis (of which I have never had any symptoms). Then he said that Zyprexa seemed a little excessive (“an atomic bomb drug”), but that he didn’t know why a psychiatrist would suggest that or what psychiatrists consider.

You see so many psych patients who come in with lists of maybe 5 or 7 psych meds, from all different categories, and they look horrible, like zombies, and you have to think that whatever their illness, it can’t be as bad as that, and that there is no rhyme or reason to treatment, they just keep throwing more drugs at them, one on top of the other. That poor girl I wrote about was on something like two antidepressants, and old and a new antipsychotic, a benzo, valproate, and a sleep aid. No wonder she could hardly speak.

I felt like I was slowly turning into that. I was on a lot of peripheral shit at the time. The psychiatrists, including mine, mean well, but it’s such a strange field, no one knows anything, and they just keep throwing more and more drugs on people until they are just shells. I feel bad, so he gives me a med, and I still feel bad, so he gives me another – it’s all well-intentioned, trying to relieve my misery. But I got the feeling that that was what was happening to me – I was being made sicker.

So a few days before, I had also stopped taking all kinds of benzos and sedatives and phenergan and shit that the shrink had put me on, and only left the antidepressants, so I think I had a little more affect when I walked in to the GP, looked a little better, even if I didn’t feel better. I wasn’t like the walking dead.

The clinic was very busy so I didn’t want to take up a lot of his time. But it took me a minute or two while I asked him to wait so I could get up the courage to tell him that I had been checking my life insurances, making sure everything was in order. I didn’t tell him the rest. But he took me seriously, told me to go home, go to sleep, and come back in the morning again.

I was supposed to go with my partner to his parents’ for a few days, but when he got home from work it was late, and I had showered for hours and gotten minimally dressed to leave. But I was so weak and lying in bed, thirsty, sort of hungry. I couldn’t move (as had happened most of the week, lying down with no willpower to physically move my muscles). I just couldn’t get up and pack a bag and get in the car. The wind was howling outside, and the bed was warm and soft, and I was so tired, and thought of the uncomfortable bed at his parents’, and their yapping dog and the noise there…when I finally felt sleepy and warm and safe at home. I just told him to leave me a glass of water and go without me.

The prospect of a silent weekend alone was so tempting. I slept. Woke at 3 AM again, but not as restless as usual. Just relaxed in bed and listened to the wind until I fell asleep again at dawn. I got up in the morning at 9. I wanted to go back to sleep, but I figured that since the GP had been so decent, the least I could do was show up. (Friday is a half day for him at that clinic.) So I went in there, and sat down to wait, and started to feel faint so I went and bought some juice. I didn’t want to pass out and make a scene, or worse, be sent to the emergency room of my own hospital.

I told him that I thought all the drugs had really knocked me down and out, taken away the last bit of energy I had to cope with anything, including the depression, that they were slowly working their way out of my system. I kept taking the antidepressants but stopped all the heavy shit. And suddenly I could move again.

He asked me about my plans for the weekend, and I told him honestly…that I just really wanted to be alone at home. He said I deserved some rest. I was glad he didn’t try to insist I be around someone, that my partner be home or that I go with him. I thanked him and apologized for making such a mess and scaring him, and he hugged me and told me to come back sometime next week.

Then I went across the street and bought a newspaper and some bread and light food and went home and, for once, instead of dropping it all on the floor to deal with later, put the things away. I took out the garbage and minimally cleaned the floor. I drank and ate a little bit, then went back to sleep until the afternoon. Then I moved to the sofa and watched bad 80s movies. The quiet day, no one at home but me, the big bed all to myself…the sleep, for God’s sake. It was all so sweet.

I hate to say I’m getting better because every time I say that something horrible happens, but I wish this quiet could never end. I am just going to try to enjoy the rest of the evening, watch bad sitcoms. Try to sleep off the rest of these drugs. Not to worry about all the things that got me to this point or when I will go down again. Not to fantasize about suicide. To eat long enough before taking the meds that I will gain some calories from it. To drink. To try to orally fix the electrolyte mess that came back in the bloodwork.

* * *

I’m not sure if I learned anything from all of this or what the point of writing it down was. No profound insights. I didn’t suddenly find purpose in life, and I don’t know how long I will remain ok. I have to go back to the race shortly and I am terrified and still exhausted. It’s not a big happy ending. I don’t “know that I have more of a safety net than I thought” or that “people really care about me” (they do, but I already knew that and it doesn’t really matter when I’m in that place). And it seems like I have made a real mess of my body that will need some straightening out. I guess that there are probably some readers who read for the personal stuff, the same kind of stories as they go through. So that is why I am trying to be honest here for you.

I may go back and remove or edit this. It feels very raw and exposed. But for now, this is my story.

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21 Comments

  1. I am so sorry that you are having such a difficult time at the moment, hope things get beter. Hannah X

  2. I am really pleased that you have a place – here – that you can express yourself.
    Does it matter you dont gain insight from from writing – I dont think so. Expressing yourself is in itself a good thing.
    And know there are some out there listening.
    And understanding on some levels.

    And I dont think you are attention seeking btw, by your sucide thoughts.

    Hang in there.
    xx,

  3. sara, i’m sorry things suck so badly right now. i hurt for how badly you are hurting. i wish there was something i could do.

    it sounds absurd and paternalistic, and I sincerely hope you will look past that part, as you know that i’m in more or less the same stage and place in life as you, but i am very, very proud of you for letting your shrink (of whom i am not a fan, for the record) and the GP know how bad (sort of) things had gotten.

    i know how hard (read: virtually impossible) it is to do that. i respect you greatly for doing it anyway.

    i hope the rest of the weekend is peaceful and calm, filled with bad tv/movies and light food that you can keep down a while. i hope remnants of that peace will cling to you through the start of the week to come.

    hang in there. you’re in my thoughts.

  4. Many good thoughts and much love coming your way from me! I do not know if they will do anything….but they are coming anyways!!! watch out!!!!….seriously they are like the smart bomb of the carebear world….(Lion heart aint got nothin on me)

  5. I think it is good that you are getting back to basics concerning your medications and only taking your anti depressives. It will give you a better idea of what is really going on with you and not have it all muddled up in the side effects of the other pills. Eating well and getting lots of rest and peace and quiet are definitely good remedies and you should try to stick to this regimen as long as you can. Maybe some sick leave is in order here. Try it if it is at all possible until you are recuperated somewhat. You need to take good care of yourself for a while and you are doing that now. Keep putting yourself first, there is nothing wrong with that. Take care, sweetheart.

  6. I’m sorry you are feeling badly, but I am sending positive thoughts your way. Staying in bed for a whole weekend sounds lovely to me, I hope it revived you and that you are feeling better soon.

  7. Sara,
    Thank you for sharing such a personal story with us. i am so sorry you feel so horrible but am really glad you have such a great Internest, sounds alot like mine. i wish you could have a psychiatrist like mine…(guess whose turn it was to cry at the shrink’s yesterday?…ack!). i hope your quiet weekend helped you feel better, it sounded like something you really needed. And i could just picture you listening to the wind howl….please take care of yourself, you are a precious person.
    Sending Love,
    tracy

  8. Hi Sara,
    I read this post this morning and have been trying to work out what to write in response. I wish I could do something to help. Your GP sounds lovely, and I’m glad you could be honest with him. I hope you’re taking care of yourself over the weekend and that you start to feel better soon x

  9. The last time I went into the hospital, I was yelled at for not eating enough, and the staff wasn’t happy unless I was stuffing my face every hour and drinking Gatorade. It’s easy when you’re ill to abuse your body because we’re so at war with ourselves all the time.

    I guess there’s not too much to say other than if I was in the ER, I’d want to be seen by you.

  10. Lots of people that are NOT bipolar, fail to take great care of themselves and get in sad shape. Some of them DOCTORS, some of them diabetic, some professors, ect.. Don’t feel so guilty about being bipolar IMO. You deserve a break;~))

  11. Sara, hang in there gorgeous, please? I love you, so does my dogie
    lots of hugs and kisses xxxxoooo
    Milo

  12. Mental illness is truly a cancer.

  13. Thanks for being so courageous and in sharing this. It can’;t be easy – and I’m sorry it;s been so horrible for you. I don’t know if anything I say or write here will be helpful, but I will think of you and hope that you will feel better soon.

  14. I know there are no words that can stand up to this ongoing experience, except to say that I understand, more than you know, and to be here to hold your hand in silence. Thank you for sharing this– sometimes it helps to see in someone else what I sometimes unexpectedly find in myself.

  15. Much love to you, lady. I hope this too shall pass. x

  16. HUGS.

    Sucks. SUCKITY SUCK SUCK. I have nothing more since I’m sinking myself lately. Winter. I hates it.

  17. Hey,
    Just wanted to check in and let you know you are in my thoughts. i hope you are feeling better and please know how much you are cherished.
    sending love,
    tracy

  18. I popped back here to say Hi; I am wondering how you are doing.

  19. Huuuuugs Sara. I love you so much beautiful. Please hang in there. I love you. Hugs from me and my dogie.
    Milo… xxxxxxxxxxxoooooooooooooooooooooooooo

  20. Sara,
    I have been thinking of you since you posted this. I am sorry to hear you are feeling so bad. It is so difficult to keep trying when nothing seems to work. If you received my e-mail you will know it has taken me forever to find a medication combo that helps me, but it has been worth it to keep trying because once you find something that helps your regular world will return in full force.
    hugs,
    …aqua

  21. Sara, please get well soon…
    i love you.
    Milo xxxxooooooooooo


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