RealMental

See Why I Saw My First Psychiatrist, Part One and Why I Saw My First Psychiatrist, Part Two and Why I Saw My First Psychiatrist, Part Three for the full story.

And so, I found myself at twenty years old in a small office with Dr. Ragu, the psychiatrist to whom my medical doctor had referred me. I had no belief whatsoever that he would be able to help me, but nothing else had saved me from my hallucinations, paranoia, anxiety, and depression – not alcohol, not marijuana, not LSD, not food – and I was finally willing to pursue the officially accepted avenue afforded to those who do not know where else to turn. He handed me a styrofoam cup filled with water.

Why are you here? he asked.

I have to be. I’m depressed, paranoid, I said.

You don’t have to be. You wanted to come. Why are you here?

I’ve been depressed my whole life, but I can’t deal with it anymore. My voice sounded unconvincing and hollow, but that may have been the cheap office walls.

Is there more than just the depression? he asked.

Yes, but I don’t want to talk about it, I said. I had never spoken openly about it before, and I was not sure that I wanted to start now. I felt like an idiot sitting across from him in that chair. I suddenly did not know why I was there.

But that’s what you’re here for, isn’t it? The sooner you open up the better.

I guess, I said to my knees, which I noticed my thumbs were massaging compulsively.

Well? Why are you paranoid?

I decided to give in and tell him about the hallucinations. I needed to come clean, and his lilting East Indian accent was comforting.

I hallucinate. The words blew in tumbled breath past my lips.

Dr. Ragu’s eyes lit up as though this were an exciting turn of events, and I could not help but smile at him. His face made the idea of hallucinating seem like fun. It wasn’t, but I liked his enthusiasm. I told him about the six-inch aphids I saw crawling through his spider plants, the snow that fell softly most days despite the fact that it was July, and the bodies in vehicles at night. I still did not believe that psychiatry held any promise for me, but I liked letting my stories out into the air.

For the first time, I was not hidden and locked in a struggle to maintain a veneer of normalcy.

(This is also posted at Schmutzie’s Milkmoney Or Not, Here I Come)

I am so frustrated and exhausted, I have no idea where to even begin. Remember how I was waiting for the Wellbutrin to kick in? Well, it didn’t. Or rather, it did, with disastrous results.

After two months of being on it and noticing no change in the near-crippling depression I was experiencing, my doctor decided to increase the dose. I didn’t notice the change at first, but looking back, I can see that shortly after the increase, I became more and more anxious. I started isolating myself from my friends, believing that they didn’t want to be around me and that some of them were actively turning people against me. I stopped picking up the phone, going out, writing emails. I felt utterly alone and scared.

And then, the panic attacks started. I thought I had experienced these before, but I’ve never felt anything this extreme. Racing thoughts, a barrage of negativity, shaking hands, heart pounding out of my chest, difficulty breathing, inability to sleep, and the intense fear that I was going to lose control and do something I didn’t want to do.

Once they started, almost anything triggered the anxiety. I went to work last week and had to go home after a few hours because everything set me off. A simple assignment, a notice of a meeting taking place in a few weeks, even getting a new email filled me with panic. I was paralyzed by fear, unable to work or even be in that place.

It’s now a week later and I still can’t shake that feeling.

I can’t get into my doctor until Tuesday, but I know she’ll take me off the Wellbutrin, so I’ve stepped myself down to the regular dose. Since I did that, the attacks have stopped and the anxiety has abated (though I’m sure taking work out of the equation also helped), but the depression is back. I’m not sure what she will put me on next, but I’m beginning to dread it, because as we have seen, my track record with negative drug reactions is less than stellar.

I feel like we’re playing chemistry set with my brain, but I don’t know what else to do because I can’t get an appointment with a psychiatrist for three to six months. So, we put on our white frocks and pull out the test tubes and see what happens when we mix up the next batch of chemicals.

Cross your fingers for me.

We have a stressful situation coming up, and I worry. I’m already seeing signs that I recognize…they could go away as quickly as they came, or they could get worse. I won’t know until it happens. I am on eggshells, unable to figure out the “right” thing to do or say, just trying not to crack the surface I tread. I don’t know how to respond to thought processes that are, to me, foreign. Nothing terrible is happening, indeed, nothing bad is even happening. But I have that ache all over my insides, like the ache you get in your eyes when you’re straining to see in total darkness, the tightwire tension of trying to be perfectly still and silent so that you can hear what might–or might not–be coming up behind you.

You’re welcome.  And, I’m sorry.  But I think I’m doing just that.

After a visit to the psychiatrist in which I described my symptoms (regular physical symptoms of  panic/anxiety with no underlying emotional connection or distress) and he responded by refilling my Xanax prescription, and dismissed the idea of checking my hormone levels, I went back to the OB/GYN/Reproductive Endocrinologist who performed my hysterectomy last year.  I described the same symptoms to him, and he nodded throughout, and said that, while he wasn’t prepared to say that I do not need psychiatric care, all of my symptoms fit the profile of someone suffering surgical menopause without enough estrogen replacement.  And my bloodwork confirmed that my estrogen level was low-ish, so we increased the dosage of my estrogen patch.

Ten days later, I feel on my way to being a new woman.  It is supposed to take three weeks for the effects of the dosage increase to be fully realized, but already, the 5 hours a day I was spending in a cold sweat, feeling panicky and unable to leave the house is down to a matter of minutes.   And what is bugging me right now is the idea that I have, perhaps, had hormone-imbalance problems for most of my adult life, and no one to recognize them as such, and treat them accordingly.

Knowing that many mental illnesses are triggered and/or exacerbated by hormonal events such as puberty, childbirth, and menopause, why is this not factored into diagnoses more often?   It’s not just women–men are affected as well.  My own husband seems to have experienced the first symptoms of bipolar disorder just after hitting puberty.  But with women, I have the feeling that it just gets…overlooked more often.  I mean, the very word “hysterectomy” pretty much indicates the medical community’s attitude toward things female, doesn’t it?  That woman is unbalanced, moody, highly emotional, downright erratic…hysterical.  By removing her reproductive organs, the part of her that’s female, we can make her sane.  Whatever.  I’m not crafting a very good explanation of what I’m getting at here, but I think you understand.   Hello, AMA?  It’s almost 2008.  Can we have a NEW WORD to replace “hysterectomy,” please?  Ugh.  And by going on a rant about this, HEY, I’ve just proven them right, haven’t I?

At least they can’t say I’m “PMSing” any more.

How about the rest of you, ladies?  What is your experience with the relationship between hormonal fluctuations and your mental/emotional state, particularly as regards diagnosed, medicated mental illness?  Are hormone levels checked regularly as part of your treatment regimen?  Is your “femaleness” even considered…or worse, is your mental state “written off,” even in part, due to gender and the perceived instability/emotional weakness of women?

Do you ever get the feeling that a doctor is listening to your symptoms, and wondering if it’s just “that time of the month?”

Right now it’s crunchy/scrapey noises. I hear it when my coffee mug touches my sweater or when my fork runs along the plate. I hear it in my ears even after the actual noise stops. Like cotton getting pressed together or really dry snow under boots. Or chewing lettuce leaves. Just typing about it makes me cringe.

I’m also super sensitive to smells. Sometimes they make me cry with….frustration? Irritability past the point of knowing what to do about it? Super-sadness? Not sure. But all this makes me feel weird.

Well it’s Tuesday morning and I’m supposed to post here but I don’t much feel like it.  Been up all night and I want to sleep but if I go now, getting up in two hours will be hell.

I called the therapist back.  She answered her own phone and I told her right off that I wasn’t sure if our health insurance would cover her.  “Oh!” she exclaimed, “You’re completely covered by the government!”

“Well then,” I replied, “I need fixing.”

We scheduled the appointment for the 23rd.

I have no clue where to begin with this.  So I go in there, full guns of verbal diarrhea and let ’em fire?

Right now I can’t think that far ahead.  Everything is coming at me again as far as life goes, so I am busy dealing with the brushfires of kids, home and work, like everyone else.  There’s not much room for thinking, which really?  Is probably good.

Thank you to everyone that encouraged me to call her back.  I think I’m glad I did.  She sounds nice and comes highly recommended, so we shall see.

In food news, which I know I need to talk about here, I’ve been sort of okay.  The husband, when he is home, notices the not eating sometimes so he makes extra effort to make things I will eat, like fish, salad and cut up fruit.  Part of me wonders if I do this to see if he will notice.  I think there’s a few layers that need to be peeled back there so I can see clearly regarding this.   Especially since I do avoid food even more so when he isn’t around, like I’m testing myself too, seeing how long I can go, which is like 14 hours now.   See?  Even here it’s a sick pride, quickly followed by a shadow of shame.  I know it’s wrong, and I feel stupid for doing it, but at the same time I’m all like 14 hours!  That’s such an accomplishment!  And then right back to shame.

I am really a huge mess of a person, and when I have all these overwhelming, noisy thoughts swirling in my head like leaves in the park, I just want to run like hell.  But where the hell would I go?

I have been meaning to write about what these last two weeks have been like for me since I upped my dosage of Celexa from 20 mg to 30 mg, but when I sit down to explain everything, all I can come up with is a hodgepodge of emotive descriptors, such as anxious and defeated and scared.

I want to have more to say than feeling words. I want to be able to tell you what I have done, realizations I have come to, behaviours I am hoping to change, but I have got bupkis. This is not at all surprising, really, because I am still making it through that first month after a dosage change, but don’t we always want to have more to show for all our hard times than orange stains on our fingers from cheez puffs and a dwindling supply of facial tissues? I know I do.

Yesterday, I was setting out cartons of asian takeout and chopsticks and whatnot for the Palinode and me, and you would have thought that I was waiting for someone to beat me by the way I was behaving. My anxiety was so high that I was fumbling with everything, and each time I dropped or bumped something, I would jump or squeak or issue an apology. I ended up reaching such a fever pitch that the Palinode took to patting my arm and saying You’re doing really well, really good, don’t worry, you’re doing fine.

Who needs this kind of support to get through setting out utensils and takeout? Apparently, I do, and it is frustrating. I always have high hopes when I change dosages or medications, so when the road to wellness is bumpy, I take that as a personal failure. I become certain that I am weak, that I am less intelligent than I thought I was, that I am inherently unlovable, that this is all there will ever be for me. I know this line of thinking is not entirely realistic, but even so, these ideas take me by the nose.

If this scenario works out the way I hope, this is just the storm before the calm. My body has to take its (sweet) time to adjust to its new chemical configuration; I have to adjust to not being the kind of anxious depressive I was when my experience of the medication (hopefully) evens out. Transitions are rarely easy, even when they do not involve psychological illnesses, so I just have to keep in mind that I am in transition and try to stay patient.

Is there a drug for patience?

(also posted on Schmutzie’s Milkmoney Or Not, Here I Come)