Hi Doctor, it’s (BipolarLawyerCook). Wanted to follow up with you about last week’s toxicity episode and the step back to a lower dose of lithium. I am feeling much physically better now– the headaches are essentially gone, as is the sensation of a waterlogged, heavy head. I am less dizzy, less sleepy, and less nauseous. That permanent lump in my throat is almost gone now.

But I’m really bummed out, because while we were waiting for my blood work to come back, my mood snapped into place, like a dislocated joint, or like that pop that your back makes when the massage therapist finally gets that one knot out. It’s since dislocated again, and I’m back to feeling a little too close to the surface. Before I slipped out of place again, the husband and I had a fabulous night, and he said “you haven’t laughed like that in a long time.” No, I haven’t.

I say “close to the surface” not in the sense of boiling over in irritation, of exploding with rage, of imploding at any minute into a sucking vortex of need. More like seeping through whatever dry, calm, surface I am trying to maintain. Cute puppies, a touching email from a friend, a favorite hymn? Teary-eyed. A sarcastic remark from the husband, a thoughtless interruption from some in-law? The eyes well, the hands and voice shake in anger and hurt. A question in an interview about some unresolved stuff from my last job? My face flushes, my voice and hands shake, I have to apologize for my “clearly still feeling angry.”

It never lasts too long, and I am learning to just be quiet through it, but I’m feeling I still need a tune-up, a popping back into place. Certainly, I could live close to the surface like this– because it’s still not the prickly cranky ouchy huffy angry enraged hurt self-conscious depressed worthless I don’t want to wake up, I’ve been holding this bottle of pills in my hand for too long spectrum. I could live like this– perhaps the inability to maintain a poker face is better for me, given my not-so-successful history of repressing my feelings. But I am getting tired of constantly blotting my now-slightly damp to outright-soggy surface– I really don’t own that many towels.

So, once we get me back down to my non-toxic dose, get my new level, and confirm the passage of the poison, I hope we can talk about some fine-tuning. I don’t know– half doses? Mega doses of B vitamins or Omega 3s? A gym membership? I feel the need to tinker, to tune, so I feel truly fine.

(Only slightly more detailed than the voice mail I left my poor psychiatrist.)