23 September 2016

Honesty Is the Best Policy

 I arrived at my psychiatrist’s appointment last Tuesday. I’d already ran through how this appointment was gonna play out in my head. Now, this is the psychiatrist I started seein’ after I went through a terrible, no good, prolonged depressive episode last April on accounta… well… on accounta that’s what happened. Everyone says this new psychiatrist is brilliant, a genius! When I say everybody, I mean, everydamnbody. My family doctor, every therapist I know, the girl at the check out, my neighbor… everybody thinks the new guy is the shiz. But he took no guff from me the last time I saw him and I already knew he wanted me to stop taking a medication I thought I couldn’t do without, so yeah, I was ready for him. This made up conversation in my head went something like this.
My Brilliant New Psychiatrist: I’m taking you off this medication you want to take, because I said so.
Me: But…
MBNP: No buts.
Me: But…
MBNP: I said no buts, Beth. You will do as I say or I will place you in a hospital. {screams to nurse} NEXT!
This is how the actual conversation went.
Me: I think I need to stay on this medication.
MBNP: Why is that?
Me: It’s the only thing that’s ever helped me control bingeing.
MBNP: Why are you giving this medication all the credit for your hard work?
Me: You can’t- wait, what?
   And so then, I opened my ears and let go of my plan to abandon this brilliant (everybody says so!) new doctor to seek this medication elsewhere. That’s what got me into this situation in the first place. Let me tell y’all what happened. And I’m owning up to this out here in public, ’cause it’s important for me and for you to know that people do this shit. I did it. Other folks do it. And here we go…
   Last year, when I graduated from therapy, I was still taking a plethora of medications to treat bipolar II (rapid cycling) and the laundry list of other disorders and mental maladies I have. At one point, I was on nine different medications. NINE. I told everyone I was going to switch over to this psychiatrist who visits Lil’ Nashvegas once a month on accounta that was more convenient for me than runnin’ 45 minutes over to the next town just to get my prescriptions from my perfectly capable psychiatrist. I wasn’t seeing my therapist, Bob Hoskins, anymore. He was in the same office as the perfectly capable psychiatrist who saw me through a handful of stays at Ye Olde Mental Hospital. But why bother runnin’ out to see him every three or four months, when I could just see this one chick who rolls right into Lil’ Nashvegas with her prescription pad in hand?
   Okay, that’s what I said. What really happened was…
   I wanted to take this medication to help me stop binge eating. My perfectly capable psychiatrist said no way, no how he would prescribe a stimulant to someone with my history of rapid cycling (that means someone with bipolar who experiences four or more episodes of mania and depression in one year). Introducing a stimulant could trigger a manic episode. Manic episodes sound like such a luxury to folks outside the bubble of mental illness. Some of y’all think of them as bursts of energy and we get things done and are super positive and sweetbabycheezeits, look at her go! No, sugar booger bear. I might be energetic and think I’m da bomb some of the time, but a manic episode is usually when I end up in the hospital. We’re talking insomnia, racing thoughts, anxiety, anger, impulsivity, and aggressiveness. This is all followed by a plunge into the deepest, darkest bottomless pit of depression in the history of bottomless pits. Shit hits the fan.
   So, I left my perfectly capable psychiatrist and went to this new lady who came to town once a month. You know what she did? She prescribed this stimulant! Woohoo! I got what I wanted! Now, I’m pretty sure she just didn’t want me to be fat, ’cause she was so on about my weight, but I just didn’t want to be a slave to this one thing, this bingeing. And I wanted that medication, damn it.
   Do you know what bingeing is, friends? Bingeing is eating a huge amount of food in a short period of time to the point of being sick and then, there is shame and guilt. No purge here. Total binge. When I say huge amounts of food, I mean, HUGE. Like enough to make your stomach explode which is what I feel like when I do it. I was convinced I had binge eating disorder. My old therapist suggested this as well. Only that medication I wanted, the one prescribed for binge eating, is a stimulant, so I was shit out of luck, right?
   I went and found this other psychiatrist and she gave it to me like it was Pez. I’m not sayin’ she’s a quack, but I feel like she didn’t give a shit one way or another. You can read all about that here if you want to catch up. I’m just comin’ clean about why I did what I did. I wanted that drug to help with the binge eating. And you know what? It did. Of course, it did. I didn’t have to take sedatives anymore. I’d just crash and go to sleep. I wasn’t bingeing. I was sleeping at night. I had energy. I started working on my book! This medicine was The Shit. I was willing to keep seeing this terrible psychiatrist to have access to that drug… until I wasn’t, until she did what she did and I couldn’t see her anymore. But what would I do without my wonder drug? I had three refills. Three months to figure that out.
   Meanwhile, I had the episode in April. I needed help. A friend who’s a therapist got me hooked up with my brilliant new psychiatrist. I thought he was an asshole on accounta he didn’t hold with any of my shenanigans when I saw him. And then, the asshole went and correctly diagnosed me. No, let that sink in. After being treated for bipolar II for twenty years,  Brilliant Dude said nope and gave me the correct diagnosis  It’s a pretty common occurrence for folks like me to be misdiagnosed, but that’s something for the book and not this blog. Just know, since last April, I’ve been doing a shit ton of homework about what ails me and it’s been the single most liberating experience in my life. To see myself on paper, in the description of this disorder, to know why, is a big help in managing my life.
   The new diagnosis he gave me? Binge eating is quite common. And you know what the prescription for it is? Therapy. No pills. No medication. Therapy. Well, damn it all to hell. I just graduated from therapy and now, I gotta do more? Thankfully, I had enough refills of this wonder drug to keep taking even though my brilliant new psychiatrist wanted me to stop taking it. Fuck that noise. I’m doin’ great with this medication, even though I’m doing all this work and learning that bingeing is one of the indicators of my new diagnosis, but again… this. is. a. wonder. drug!
   I knew the Brilliant Dude did NOT want me to take it, because I have bipolar tendencies. Ugh. Great. My plan was to go into his office on Tuesday, make my case for why I should keep takin’ it, have him tell me no without even listening because they never listen, right? They just look at me like a mental illness, not a person. He’d tell me no and I’d start shopping for a new doctor who would do what I wanted. I was sick and tired of psychiatrists telling me what I needed. I know I need this medication. And doctors have been fuckin’ around with the treatment of my mental health for twenty years. It was time for me to take matters into my own tentacles.
  On Tuesday, the Brilliant Dude greets me with a smile and a handshake and he makes no remarks about my physical appearance or assumptions about my choice not to engage in traditional therapy like he suggested. I tell him I’ve had depressive episodes, a few panic attacks, a few (and by few, I mean, several) suicidal thoughts since April, but I’m better. Yeah, I’m better. I tell him how managing this mental illness isn’t easier, but the knowing why sure helps with choosing what to do about it. He asks me what I’ve chosen to do. Curve ball. I thought he’d chastise me immediately for not seeing a professional like he told me to last April.
   And for the record, I did try therapy, but I didn’t gee haw with this chick. I had to ask her to buy the workbook for the type of therapy we were supposed to be doing instead of giving me in hospital worksheets for homework. Huge, huge trigger right there. IN HOSPITAL. Yeah, you don’t do that with me. And besides that, y’all, seein’ both a therapist and a crazy doctor AND paying for prescriptions (even though I was down to two at that point) was not an option for me. Ah, the “benefits” of the health insurance we can’t afford!
   I brace myself and tell him I purchased the workbook for this particular therapy myself. I’ve also purchased a book about the disorder. I’ve joined an online community, downloaded two apps on my phone, and am now following Kati Morton on YouTube. I’m still meditating daily. I make sure I decompress before bed. I am journaling any time I have extreme emotions. I am continuing my work on radical self acceptance. I have my crisis plans in place and I use them. As I said it all, I thought, he’s gonna think this is so lame and such an excuse, because I already had this conversation in my head. But you know what? He didn’t say that. The Brilliant Dude said, “I’m happy you’ve found something that is working for you.”
   Wait. What?
   That’s when we talked about medications for the treatment of depression. He asked me if I thought adding another would be helpful. He asked me. So not prepared for that. I said, well, if we introduce one now, what if we need one later if things get bad and I start down the spiral of more medications? He said he agreed. He didn’t want to put me back on a ton of medications. He told me last April, as he waved his hand over the pile of pill bottles on his desk, “No wonder you feel bipolar!” The Brilliant Dude only wants to use medication if it’s needed and, even then, he considers all the angles. We decided to wait and see. I would stay in contact with his office.
   Okay, so now, I have to ‘fess up to y’all about that medication I’m determined to get, the one the Brilliant Dude (everybody says so!) is gonna take away. Not only was I not bingeing, I wasn’t eating very much at all. I couldn’t even put food in my mouth. I’d eat one meal at the end of the day by the time the stimulant wore off. Now, this may sound like a good thing to some of y’all, but remember, I was only taking it so I wouldn’t have episodes of bingeing. This whole not eating very much wasn’t my intention. I wasn’t looking to lose weight. What I was loosing was clumps of my hair on accounta my body was crying out for nutrients, but I could not eat. I started taking multivitamins.
   I knew the medicine was addictive. I knew the dose would have to be bumped up and up, so it would continue to work until I reached the max dose and what then? And it was becoming less effective over the last three months. But still, no huge amounts of bingeing! I was willing to go with very little eating and you know… my hair… and my body… and the hypomania that would strike like a lightning bolt every now and again. I was willing to do that… until I was sitting in the Brilliant Dude’s office and listening to him as we discussed the social anxiety that still plagues me.
   That stimulant? That was impacting the anxiety. I just didn’t know. I didn’t tell him about how I didn’t want to eat most of the time. I did tell him I was worried about the addictive aspect of taking it. I told him I was scared to stop taking it. That’s when we had the exchange, when he asked me why I was giving this medication credit for my hard work. That’s when I realized he was right.
   Damn it.
   Now, I’m still scared. I’m weaning off of it this week. I’ve had really low energy levels, giving way to mild depression and extreme emotions. He said that would happen. But here’s the thing. This guy didn’t treat me like a mental illness. He listened to me when I said I was scared. He asked me questions about my life as a whole, not questions to pigeonhole me into a diagnosis and then, scribble down some new medications and send me off to my pharmacy. He didn’t look at my tattoos and my hair and my me-ness and bark orders or make assumptions. And because of that, I’m willing to try. I’m willing to own up to chasing a medication that was making my hair fall out, that was unhealthy for me, a medication that was making my anxiety worse.
   It feels good to be honest about it all. I’m not saying I totally trust the new guy with my mental health. I want to say that, but I can’t. Not yet. It’s been too many years of good and bad providers. I have no reason to doubt this doctor and his staff are capable and caring. I have baggage and a willingness to continue working with them. That’s the truth of where I am on my journey.
   I left there with the same two prescriptions I’ve been taking for over a year. Again, I do not have the stimulant. I left there with the same litany of strategies for learning how to manage the new diagnosis. I have an appointment to see the Brilliant Dude (everybody says so!) in four months.
   I can’t tell you I totally trust the new doctor with my treatment, but I do trust me. Managing my mental illness is my business. I could have went with my plan of chasin’ that medication, but I didn’t. I could have never told a soul about it, but I am. Having a doctor act as a professional mental health care provider, one who was willing to listen, is helpful to me in managing my mental illness. Being proactive is helpful as well. Especially when I’m sitting here calm and such. I know the dark side of what all I have, but I know I’m finding something that works for me. And I’m gonna try to keep being honest about it all. Peace, B.
  • Genny Nutt
    Genny Nutt

    After reading this and waiting to hear what kind of medicine it was, you left that part out. I still wanna know 🙂

  • Rebecca Kauffman
    Rebecca Kauffman

    Have trust that you know what you need. It is never easy, but then again, neither is this life that we live. Thank you for being open and honest with us. Sending you positive thoughts.

  • Alice

    Your blog is very encouraging to me. My middle daughter keeps looking for a solution. She is very stubborn, and always has been. I believe that is what will save her. Herself.
    I am so glad you have found this doctor. Take care.

  • Susan

    It’s scary to trust. Anyone. Just keep trying to do what’s best for you and listen to those you trust. Your family mostly.

  • Dawn Naomi Walker
    Dawn Naomi Walker

    I’m so proud of you and your accomplishments! You da bomb diggitty! I’m trying to find myself and am in need of a therapist (calling Monday) . Thanks Mama B

  • Tara

    You are one of the strongest people I know, you may have a low point but you will make it through it and come out even stronger. I will always be here to help pick you up along the way. I love you

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Copyright 2017 by Beth Hallman. All rights reserved.

Posted September 23, 2016 by Beth in category "Mental Health

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