RealMental

Big Daddy Tazz, a comedian from Saskatchewan (Canada), does a set on mental illness and his bipolar disorder. (You can read his back story here.)

Since I couldn’t figure out how to embed the video, you can watch it here.

Enjoy!

My post about my first appointment with my (psycho) psychiatrist made a couple of waves in the mental health blogging world. Phil from Furious Seasons did a huge post on it, and told me it was one of the “worst stories I’ve ever heard,” which, coming from a dude who blogs exclusively on mental health injustices, is pretty bad. Liz Spikol from The Trouble with Spikol also picked it up, with the title, “This is why people don’t trust doctors,” calling the experience “bizarre” and stating, “I have heard of similar experiences, but only with cults.”

It was nice to have others recognize how horrible this situation was. Unfortunately, it didn’t really change my situation.

After that first appointment, I vowed I would never go back to psycho psychiatrist again. I went to my family doctor and told her what happened, (she was horrified and said, “Maybe she was hypomanic that day!”) and she agreed to refer me to another psychiatrist.

The problem is this is a small city with a limited number of psychiatrists, and the majority of them work in the same clinic downtown. I made sure that she referred me to a psychiatrist who had a private clinic so there wouldn’t be any problems.

A few weeks later, I got a call back from my doctor’s office saying that the psychiatrist’s office had rejected my referral, stating that it’s his policy not to accept any patients who have already been seen by another psychiatrist in the city.

My doctor tried to refer me to another psychiatrist, again in a private clinic, and his office also rejected my referral, based on a “conflict of interest” because I had already seen another psychiatrist.

[And may I also mention that before I even went to psycho psychiatrist, I tried to get in with my mom’s psychiatrist, and he also refused to see me because he felt it was a “conflict of interest” to see two members of the same family.]

So, not only is it really difficult to get in with a psychiatrist in the first place, once you get in, you’re stuck with her no matter what, because everyone else will refuse to see you because they don’t want to get involved in any drama that may be going on between other psychiatrists and their patients.

Aaaaaaaaaaghhhh!

I didn’t feel like I had much of a choice, because I strongly felt I needed a psychiatrist to monitor me because of my family history. Unless I wanted to try and get referred to a psychiatrist in one of the neighbouring cities, wait another six months to get in with him/her and then take time off work to drive a few hours to my appointments, I was stuck.

So, I did what any semi-sane person would do: I went back.

But I went back armed with six months of mood charts, a list of supplements and drugs I’m taking and a very guarded attitude.

It was six months after the first appointment. And the weirdest thing happened.

She was nice.

She smiled, she laughed, she was friendly and helpful.

It was like she had switched personalities since the last time I saw her. This was the woman my doctor had described when she first referred me to a psychiatrist. This is the woman I wish I had had during my first psych appointment when I was scared and vulnerable.

Maybe she has some kind of personality disorder?

I think I’ve also learned how to deal with her. One of the first things I did was hand her a piece of paper with all my supplements and drugs listed, along with the doses. She exclaimed, “Oh, I wish all my patients did this. This is so helpful!”

I then said things like, “I took your advice and started taking fish oil supplements, and I noticed a real difference.”

“I took your advice and went off the Wellbutrin, and I’m really glad I did because I don’t think it was a good drug for me. I feel much better now just on the Celexa, as you suggested.”

“I took your advice and kept a daily mood log, and I’ve brought a graph of all my moods for the past six months here with me for you to look at.”

She was really pleased. “You’re doing everything right! You’re doing so well!”

Of course I was: I had followed all her advice and made sure she knew it.

We looked at my mood graph together and she agreed that there was no hypomania there. I reminded her that the only time in my life that I’ve ever felt hypomanic was when the Effexor made me wonky and again with a high dose of Wellbutrin.

She hasn’t deviated from the initial diagnosis as far as I can tell, but she was much better to deal with this time, and didn’t push any additional drugs on me. She just said we’d monitor it and only respond if something changes. She didn’t try to get me to go off the Celexa either.

So, while the situation isn’t ideal, I think I can work with this woman, particularly if I only have to see her once every six months.

I don’t think I can ever fully trust her, though, because I will never forget the things she said/did during the first appointment and the horrible way she made me feel.

The main problem with this psychiatrist, as far as I can tell, is that she needs to be the authority figure. She doesn’t know what to do with an educated, intelligent women who has done her research and who knows her mind/body/mood well.

During my first appointment, my psychiatrist was very defensive and aggressive, and it seemed as though she was threatened by me asserting myself and not agreeing with everything she said. If I had to guess, it was that dynamic that led to the weird behaviour/accusations on her part.

I was able to diffuse that dynamic by appeasing her in the second appointment, but I did notice that anytime I spoke too much, inserted my opinion, or let my guard down and tried to crack a joke, she would cut me off and dismiss me.

So, it’s all about walking that fine line with her. Acting the part of the patient and choosing my battles in order to get the care that I need in the very weird system we’ve got going on here.

My next appointment is in December. Hopefully, I’ll get her nice personality again. Wish me luck.

Liz Spikol posted a very awesome video about depression advice over at her blog yesterday. It makes light of that oh-too-familiar advice that we get from well-meaning people who have no clue what it’s like to be depressed.

If only laughter really were the best medicine. For now, I’m sticking with my Celexa.

I’ve been told to “snap out of it”, to turn up some music and dance around my living room, and to quit taking things so seriously by people who couldn’t understand why I was debilitatingly depressed or anxious.

They meant well, but they had no idea what they were dealing with because they have never experienced it. Their advice only served to make me feel like more of a failure because I was unable to control something they thought was so easy to solve. It made the gulf between me and what was “normal” even wider.

What’s the worst, most ignorant, or most insulting advice you’ve ever gotten from someone in regards to your mental illness?

At the end of September, when the antidepressant I was on made me go wonky, I asked my doctor to refer me to a psychiatrist.

 And then I waited.

 And waited.

 And waited some more.

 Because, while I usually have nothing but praises to sing about the Canadian health care system, when it comes to mental health care, if you don’t have a knife to your throat, you’re shit out of luck. If you want to get in with a psychiatrist for the first time, you have to wait three to six months, no matter how bad you are doing. As long as you’re not actively suicidal or homicidal, you wait.

 I waited five months. By the time my appointment came up, I was feeling fine. My drugs were working and I wondered if I even needed a psychiatrist after all. But, given my family history, I decided to go anyway. It couldn’t hurt, right?

 Wrong. Oh, so very wrong.

 The psychiatrist, whom I shall call Dr. R, came very highly recommended from my family doctor. I had told her, “I want someone who will allow me to be an active participant in my own care, who will listen to me.” She said this woman is fantastic and very compassionate. I adore my family doctor and we get along quite well, so I trusted her opinion.

 My appointment was three weeks after I had major jaw surgery, and only one week after I had my jaw unwired, so I was still on some painkillers and having problems getting enough calories into my body. That didn’t really help my emotional state going into the appointment.

 However, I was determined to have a positive attitude and to be open-minded. Sitting in that waiting room, I tried not to be nervous and instead psyched myself up (hah), telling myself: this is something I’m doing to make my life better and ensure I am going to be healthy long into the future.

 I quickly figured out that this appointment wasn’t what I was hoping it would be, no matter how much positive energy I tried to throw at it. The moment I told Dr. R my family history and the adverse reactions I had to the Effexor and Wellbutrin, she decided I was Bipolar II and tried to fit everything I said into that diagnosis.

 I’m not disputing the diagnosis itself; it’s a fair hypothesis, and one that I have considered myself. However, I have a huge problem with a doctor diagnosing a patient within five minutes and then “accusing” her of all kinds of behaviour that doesn’t exist.

As the “interview” (or interrogation, as it became) went on, the two of us got more and more frustrated, and the conversation grew heated. She was frustrated because I refused to just accept what she was telling me about myself, and I was frustrated because she wasn’t listening to me or considering my explanations for my decisions or behaviours.

 And then it just got plain weird.

 Dr. R: Do you ever spend large amounts of money?

Savia: Sure. I have a house. I’m doing home renovations right now.

Dr. R: How are you paying for that?

Savia: A line of credit.

Dr. R: That’s hypomanic, irresponsible financial behaviour.

Savia: But I’m making an investment in my home, and my house value has quadrupled in the past seven years.

Dr. R: Going into debt for any reason is hypomanic.

Savia: What? But it’s not just any debt. It’s good debt.

Dr. R: There is no such thing as good debt.

Savia: But… [about to explain how her sewer blew up and also how the energy efficient renovations were eligible for a $3,000 government grant, which would pretty much pay for them, not to mention the savings on the monthly energy bills.]

Dr. R: [Cuts me off] The only way it would be acceptable for you to go into debt for home renovations is if you were selling your house and would get the money back right away.

Savia: [looks at her like she’s on smack] I guess we’ll have to agree to disagree on that one.

 Note how she didn’t even ask how much money I make or how much the home renovations cost or any other details that would have explained why I was going into debt for this project? It was all about absolutes. And let me just say, if going into debt for any reason makes a person bipolar, I guess the majority of North Americans have this disorder. Maybe that’s why it’s so hard to get in with a psychiatrist?

 After that, it quickly went downhill. She snapped her questions at me and cut off my answers. Any time I tried to explain or elaborate on one of my answers, she said, “You’re rationalizing your behaviour.”

Um…no…I’m just trying to give context – the grey answer to a question that she tried to make black and white. Because life isn’t like that – it’s all about the shades of grey.

 At the beginning of the appointment, I was quite succinct in my answers. But then, she would jump in and fire several more at me, obviously looking for more context. So, I started giving more thorough answers. She never smiled and she cut me off a lot, which made me really nervous and uncomfortable. I started talking faster and being less concise. At one point, she stopped, tilted her head, smirked at me and said:

 Dr. R: You’re talking fast and circumventing the question. That’s hypomanic.

Savia: I’m nervous!

Dr. R: [cutting me off] There you go, rationalizing your behaviour again.

 I’ve lost count of how many arguments we got into in that hour and a half. Our personalities clearly do not mesh, and I could tell that she didn’t appreciate me challenging some of the things she was saying or asking questions to help me understand where she was coming from. We both ended the session thoroughly pissed off.

I was so angry and upset, not about the diagnosis (though that did scare me quite a bit, because I don’t want to have this disorder and I don’t want to have to take mood stabilizers, ever), but about the way she treated me. Her cruelty to someone so vulnerable cut very deep.

 I didn’t sleep at all that night, and then I cried for two days straight and fell into a depression. What if she was right, and all of these things that I consider as part of my personality are just a disease? I thought I knew myself really well, but if this is the case, who the hell am I, then?

 I talked to a few friends who’ve known me through all of the ups and downs, and they said the same thing, “You’re always Savia. No matter if you’re depressed or anxious, there’s still something about you that’s always there and doesn’t change.”

 And they were right. I tried to put Dr. R’s harsh words behind me and take the good out of the appointment. A few things that she said did ring true.

 For instance, when I told her that I don’t have hypomanic or manic episodes, she said that for me, hypomania may manifest itself as anxiety. I found that interesting, and it would fit with what’s been happening to me. She also gave me the signs of hypomania and told me to keep a mood chart for the next three months so I would have a record of my patterns.

 Dr. R said that the current drug mix I was on (Celexa and Wellbutrin together, in low doses) could put me at a higher risk for hypomania and that it would be better for me to be on just one of those drugs, or off them entirely and on a mood stabilizer, my reaction to which would serve as a diagnostic tool.

 She also told me to take Omega 3 fatty acids, which she said is the one thing that has been clinically proven to help with depression and mood disorders.

 So, I did take the good advice she had and used it to my advantage. I went off the Wellbutrin at the end of April and found that just being on the Celexa was much better for me. I started taking Omega 3s, along with a daily arsenal of B complex and Vitamin C, and am amazed at what a difference that makes in stabilizing my mood.

And last, but certainly not least, I am keeping a daily mood blog where I quickly jot my mood, appetite, sleep, spending, menstrual cycle, drugs and sexual interest levels. It takes me two minutes a day, but it has made me aware of some of the factors that affect my mood, which gives me the opportunity to deal with things before they get out of hand.

 And the best thing about the mood chart is that the next time I go to a psychiatrist (in six months, if I can get in with someone else, that is), I will have that record to show him/her. And, hopefully, I can avoid any further nastiness.

Because going to the psychiatrist is stressful enough without having to prepare yourself for a knock-down, drag-out fight with the person who is supposed to be helping you.

In December, the lovely Diva wrote me a guest post that snagged a mention on Five Star Friday and also caused some controversy with some of the Internets because of its sexual nature. The controversy was focused on the issue of whether my blog is pornographic or merely risqué.

I found this question intriguing, because over the past year, sex has started seeping into my writing, and yes, at times, it is a bit risqué. However, you may be interested to know that in the early days of my blog, sex was never mentioned. (You can check the archives if you want, but consider yourself warned: nothing racy going on there.)

The reason it wasn’t mentioned is I felt uncomfortable typing anything remotely suggestive on the screen. I’ve always been a very sexual person, but for many years, I struggled with how to express that side of myself. I felt trapped in the middle of the virgin/whore dichotomy, full of ambivalence about my sexuality. I flipped between wanting to be seen as “the good girl” and acting like “the naughty girl.” Somehow, I wanted them both. But how do you walk that line?

My relationship with my sexuality is made even more complicated by the fact that I was sexually abused at a very young age. Sexual abuse changes who you are. It changes the way you experience your body in every possible way: the way you see yourself in the mirror, the way you feel inside your skin, the way you relate to other people, personally and sexually.

And if that weren’t enough, I was also raised by an overprotective religious fundamentalist mother. We never spoke about sex in our home. When my brother and I asked where babies came from, we were given a long talk about the female menstrual cycle and how the sperm and egg came together to make a baby. If we asked how the sperm and egg got together, the lecture was repeated once more with no further details.

To make things even more uncomfortable and unhelpful, from the time I was 10 years old on, every time I left the house, my mother called out, “Keep yourself pure.”

Because that shit is not going to fuck you up. At all.

Yeah. Good times.

The message I got from my mother, literally on a daily basis, was sexuality is evil, unless you’re married. So, until then, it might as well not exist, unless you want to burn in hell for eternity. Combine that with a lack of sexual education, and you end up with a very confused and anxiety-ridden adolescent gal.

I remember the first time I masturbated. It was completely unintentional, since I had no idea what masturbation was or how my body worked. I was 12 years old and I was having problems falling asleep one night, so I just started touching myself out of boredom. Hmmm…haven’t really touched that before. Next thing I knew, there was this explosion of light and my body was convulsing, out of control. I was terrified. Something was horribly wrong with me. Why was my body doing this?

But it felt kinda cool, so I did it again, and again, and again. At 12, I became a compulsive masturbator, taking extra time in the bathroom, sneaking off to my room to “read”, and making sure that there was always a blanket on top of me when I was watching TV with my family. (Oh, yeah, I totally did it with other people in the room. That’s how hooked I was. They had no clue.)

Sounds like typical pre-teen sexual behaviour, yes? Well, the difference is each time I did it, I felt immense guilt and was convinced that God hated me and I was going straight to hell. Afterward, I would bargain with God, beg forgiveness and promise I would never, ever do it again. Until the next time I felt powerless to resist the urges. Whenever anything bad happened, I was sure God was punishing me for my horrible, horrible sin. This continued throughout my teens.

Some women who were sexually abused and/or raised by religious fundamentalists turn into real rebels. Others withdraw and comply with their parents’ religious beliefs. I fell somewhere in the middle. Part of me was afraid – in fact, I went through a phase (years, really) where I saw penises as weapons – and part of me was very sexual and just wanted to cut loose and be free.

I have always felt pulled between those two extremes – fighting against the repression of my childhood and struggling with others’ perceptions and judgements when I express myself.

A few years ago, I found this quote in a Katherine Mansfield story that has become a sort of mantra for me: “Why be given a body if you have to keep it shut up in a case like a rare, rare fiddle?”

Now that I’m in my 30s, now that I’ve found an amazing man that I trust and love, it feels like it’s time to open the case and play that fiddle. I don’t want to be ashamed anymore. I don’t want to be afraid anymore. I just want to be.

And while some people may not be comfortable with it, this is who I am. This is how I write on my blog. I am neither a virgin nor a whore.

I’m just Savia.

Originally posted as a guest post on I Am the Diva on May 30, 2008.

Sometimes, I think our partners have the patience of saints. Is it just me, or do we Real Mental types tend to find the most supportive, understanding, kind partners, ever? From what I’ve read on others’ blogs, it’s not just me. Our mates, they are pretty awesome. I’m so very happy I finally found someone who understands me and accepts me for who I am.

Here’s an example:

If you’ve been following my blog, you know that my jaw is currently wired shut because of a recent jaw surgery. Because of this, I’ve had to find alternate ways of taking my meds. The Celexa can be crushed and sucked back with some juice, but the Wellbutrin is a slow-release tablet and can’t be crushed. It has to be swallowed whole, which is a bit of a problem when your jaw is wired shut.

While I was in the hospital following the surgery, I devised a clever way to take my pill. I pushed it along my top gums until it reached the very back of my mouth, and then I finessed it into the small crack behind my back molars. I poked and prodded and sucked at it until it popped through the other side. To help it along, I also doused the thing in juice from a syringe.

I was pretty proud of myself, and my surgeon was most impressed. I just knew that I had to find a way to take it, because there was no way in hell I was missing a single pill. It had taken me so long to get to a place where my meds were in the proper balance and I felt like a human being again. I couldn’t take the chance of jeopardizing that.

Late last week, I noticed that my mouth tasted funny. Bitter like crushed pills. All day. I couldn’t figure out what it was. Maybe one of the fragments of Celexa had caught in my wires and left a lingering taste? I put it out of my head. Then, on Saturday, Superstar and I were out and I noticed something caught behind one of my back molars. I coaxed it with my tongue until it came free and lolled it around my mouth, trying to figure out what it was.

It dawned on me that it was the casing for one of the Wellbutrin tablets. Instead of slow-releasing in my stomach, it had done so in my mouth. I wasn’t sure how long it had been there. I didn’t think much of it and swallowed the casing.

On Sunday, we went out to the movie Juno. At the end, I cried my head off. Not just cried. Bawled. Lost it. I mean, I controlled myself in the movie theatre pretty well, but if there had been no one else around, I would have had a big sob fest for a few hours, at least. It was a good movie, and every woman I know has cried at the end, but my reaction surprised me. I passed it off as mid-30s ticking biological clock hormones, and Superstar and I went for coffee.

For some reason, I decided this was a good time to talk about the future of our relationship (since minutes after seeing the movie, I decided I wanted to pop out babies, and soon – huh?) and we end up getting into this big, emotional discussion where I sobbed my head off almost the entire time and said ridiculous things like “I don’t respect you.” Yes, it was over a specific issue that is a bone of contention for us, but I have no idea why I said that. I certainly didn’t mean it. I will never be able to erase the memory of the hurt look on his face after I said those words. It aches just to think about it.

We got through the discussion and I managed to convince him that I had said the wrong words and he misunderstood me. We made peace and left the coffee shop. As we were walking out, I became aware of all the people around us and wondered if I had made a spectacle. Then, we went home and lay in bed while I cried for a few more hours about nothing in particular, and he stroked my back and tried to make me feel better.

The thing is, I’m usually not a drama queen. I certainly don’t cry in public, and Superstar and I rarely argue or have upsetting discussions. But this day, he got a big dose of The Crazy. And then some.

It wasn’t until a few days later that I realized the emotional rollercoaster was a result of the wonky dosage of Wellbutrin from the stuck pill. It was then that I resolved never to go off my meds. I don’t want to know what it feels like to be that out of control and out of touch again.

And as for Superstar, I thank my lucky stars that I found him. I’m not sure I could be so patient if the tables were turned.

They’re working. My drugs are working. After months, MONTHS, of going through hell, I feel…almost normal. Whatever the hell normal is, that is.

I saw my doctor two weeks ago and told her what happened with the high dose of Wellbutrin. I had already knocked myself down to the half dose, expecting that she’d take me off it altogether, but that’s not what she did. Instead, she kept me on the low dose and added a low dose of Celexa to the mix. She said that because I did not react well to any one drug thus far, mixing two different classes of drugs was the next course of action.

I was skeptical. If one drug could screw me up, what on earth were two going to do?

Starting on the Celexa was not fun. Nausea, migraines, diarrhea, exhaustion. Hours would go by without me noticing. It felt as though the world was spinning so fast and I was moving in slow motion. It was almost impossible to get even the simplest tasks done. By the end of the second week on the half-dose, the symptoms were beginning to abate and I was starting to feel as though the depression was lifting a little bit. Then, I started taking the regular dosage and the side-effects dealt me another blow to the head and gut. Physically, I felt like hell. But emotionally…I was happy.

Happy.

I had forgotten what it was like to feel happy: to laugh, to smile, to make an effort to go out, see my friends and have fun.

Fun.

I was finally having fun. After being miserable and zoned out of life for so long.

What amazes me about this disease is how easy it is to forget what it feels like to feel good. When you have a bad day or week or month, you feel as though this is what life is going to be like from now on. On the flip side, when you start feeling better, it’s hard not to think, “Hooray! I’m cured! I’m never going to be depressed again!!”

Right now, I’m trying to find the balance between those two extremes. Things are looking up, but part of me wonders, “How long until the other shoe drops?”