Return of the Psychiatrist

Starting off this week with a bang! I got a call from the east coast this morning (apparently I’ve finally bugged the company I was previously employed at into submission) telling me my final paycheck is in the mail. I am so ready to have some closure with that situation, I never want to have to think of all of their ridiculous crap ever again. I also got a chance to wear one of my favorite dresses to work yesterday, which wouldn’t be a big deal if I had been able to fit into the darn thing over the last 6 months! To top it off, I woke this morning to clear blue skies and sunshine, which is very unusual for Seattle this time of year. To me, morning sun is synonymous with optimism, so any time I am lucky enough to get some it almost guarantees a great day!

Alright, alright, enough with the exclamation points.

In addition to those great things, I got a letter on Saturday from a local hospital/clinic that confirmed they are going to pay for my “medically necessary” doctor’s visits for the next 6 months.

Last year when I was really depressed I began seeing a psychiatrist for the first time in years. And I’m talking like seven years. 

I don’t think I gave him much of a chance. 

I was in depression mode, so it didn’t matter how clever or down to earth he might have been, I was extremely skeptical. On top of that, he had no basis for how I normally act or what a normal mood is for me, because by the time I met him I was so far gone there was very little of the usual me left.

I was desperate and in the depressed head-space (and had been for a while) so I had no clear memory of what “normal” was for me anymore, I couldn’t communicate what that was. When I’m that depressed, my thinking and feeling becomes so skewed that I have no frame of reference of what I’m talking about. I either can’t reflect on those “normal” periods because of where I’m trying to look at them from, or my interpretation is so muddled that I can’t discern which periods are which.

All I really remember from my visits is him saying (because he must have been repeating me), “Yes, I know you already said this episode should be over by now.” Apparently I was just a parrot exclaiming I should be coming out of the depression at any moment, because my episodes don’t normally last a year.

At the time, I was also completely oblivious to how complicated my case actually is, and it took numerous times of him actually telling me things were complicated before I began to listen and reflect on what he said.

Complicated? C’mon. But I admit I was overwhelmingly naive about my own situation. I don’t think it was until I’d tried the 15 different medications that didn’t work out that the weight of the word complicated really began to sink in.

Now that I have a better grasp on all of the elements and I’ve talked to numerous folks with bipolar disorder, I guess it is nothing less than truthful to say what I experience is complicated. Bipolar disorder is complicated even if it is your standard “right out of the book” case, but on top of that I have very rapid, sometimes hourly mood swings as well. Then sprinkle in the anxiety, PTSD, and OCD symptoms and it just becomes a big old stew pot of crazy.

When he began mentioning the possibility of ECT (electroconvulsive therapy), I scoffed & fled. Surely I wasn’t that far gone, right? Surely I didn’t require such extreme measures. And surely he must be even crazier than I am for bringing it up!

After my hospitalization we parted ways, I was put onto the Washington State disability program for healthcare and it didn’t cover seeing him. It was months before I found out they weren’t going to cover seeing any psychiatrist, even though I was admitted to the program for having severe depression. They definitely made me believe that wouldn’t be an issue, so I was more than a little frustrated when I was denied access to a prescribing doctor.

Now that the paperwork has gone through, I’ll be seeing the same doctor again. I couldn’t afford to go otherwise, and even just on the phone when I made the appointment (before my paperwork was finalized) I was told I needed to bring a $300 deposit to see the psychiatrist since I didn’t have insurance. Ahem. Yeah, right.

Since I’ve come out of the depression, I wasn’t initially planning to go this route, but after having a couple of those brief manic moments within the last month or so I’ve concluded it might not be a bad idea. Though infrequent, I really could do without those intense delusional moments, so I’d like to at least see what he has to say about things.

Honestly I am expecting to feel very embarrassed when I get in his office. I was pretty irrational the last time he saw me (in June), and I barged into his office on more than one occasion (not during my scheduled appointment time) hysterical and in tears. It is difficult to think about now that I’m in a completely different place, and I at least owe him an apology for the way I treated him.

Recently I’ve decided that I admire him for bringing up the possibility of ECT rather than despise him for it. He didn’t hesitate to lay out all the options, and I think that it is so important for doctors to introduce a patient to all the treatment options, not just a few. At the time it really scared the heck out of me, and in that depressed head-space I couldn’t seem to believe what he was telling me. I really do appreciate that he tried so hard to help me though, even if I couldn’t see it at the time, and that’s one of the reasons I’m going back to the same person.

So my first appointment is this week, and I’m working on revising my “symptom list” that I’ve been compiling over the last few weeks in potential preparation. The care I’ve been awarded by the hospital doesn’t remove the problem of ridiculously priced medications, but at this point I’m not sure what kind of route we’ll be taking with that anyway. The last round with this particular doctor, we pretty much explored every option possible, as far as medications were concerned. But, again, things are significantly different from the last time I was in his office, so I’ll be quite curious to see what happens.

Honestly, I’m just looking forward to having a conversation I can understand with him. If I can do that, the goal of the week will be met.

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8 responses to “Return of the Psychiatrist

  1. Good luck sarah. I don’t know where I would be without my psychiatrist. Not all of them are compassionate so I feel like you that I got 1 who is.

    • Thanks David! Yeah, he seems to be a good guy. The instant he told me he wanted me to avoid unnecessary weight gain was the moment I knew he had my best interest at heart.

  2. Good luck. It’s fortunate you’re seeing the same doctor, so that they can see the different you. It will give them more info about your condition. And I think most people’s reaction is “run for the hills” whenever ECT is brought up as a treatment consideration!

    • Thank you! And I’m definitely looking forward to getting to converse in a totally different head-space, I think he’ll be pretty shocked by the difference!

  3. I don’t think you have to feel embarrassed. I mean, he is a psychiatrist after all. I try to remind myself that the likes of me are the not the worst thing a psychiatrist has ever seen. In fact, it’s likely that this is relatively common in his practice. No one has an easy time going through the process. And I’m not sure if it ever really does end. So, just be you when you go in.

    But, I think being mindful of what you want, and what you feel might be best for you, is important. Giving all of the treatment options is great. But, don’t feel pressured into a particular one. Do what feels right.

    • Thanks Lulu,

      I definitely don’t have any issues when it comes to having an idea of what I want, treatment wise (and I often feel something akin to someone making demands in a ransom note when I get in the office).

      Really, *any* time I am rude to someone I feel embarrassed about 10 seconds later (unless I am somewhere on the manic side and it doesn’t even register), so it is one of those things that can’t be helped. After working in retail, I know what it is like to take the brunt of people’s rudeness -and that is a profession that receives very little credit for it. Credit or not, Doctor or Cashier, I try to treat people as well as I can!

      • I hear you there. I find it difficult to assert myself, even when my mind is considering it rude. Do others consider my emotions and circumstance when they are being rude to me? No. Do I even get a murmurred apology when someone huge bumps into me on the street, even though there is plenty of walking space surrounding me? No. Does someone apologize when they take up more than their fair seat on the bus? Actually, as no as that one can get. In fact, they assert their way onto my side so they are comfortable. And I’m crushed up against the window or falling into the aisle.

        I’ve been in retail, and I feel a tinge of guilt when I do it. But, I know that when I am rude, I am asserting myself. Someone forced my hand, and if I don’t do what I need to do to get what I need or get my point across, then no one will.

  4. Pingback: Return of the Psychiatrist, Part Deux « bi[polar] curious

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