Tag: Psychiatry

Mystery Potion

~ Lori Lynne ~ 1 Comment

I never, never want to change my psych meds. The overwhelming urge is to leave them alone, because I’ve found a regimen that has a minimum of side effects. Problem is…they’re not doing the job right now. I’ve had a consistent pattern of frequent hypomania for months, and the symptoms are starting to impact my life more. My rapid and disjointed speech is sometimes noticeable to others. Sleep is worse than my already-bad levels. I am hypercreative, but unable to settle to one project or get anything on paper. The urge to self-medicate with overeating is strong, and I’m not always able to resist it. So, it’s time for me to open my mind to a change. The last change I did was just a slight increase in the med I was already taking, but this one is adding something new.

Imagine you’ve been handed a magic potion in an opaque flask. You know you need to drink it, but you have no idea what it’s going to do to you…caught between the misery of the moment and your fear of the unknown, you raise it to your lips and swallow. And then you wait.

The next day, you feel sick. And the day after that. Or you’re semiconscious, or your mouth is so dry you can barely speak, or you can’t have sex anymore, or you’re heart-poundingly anxious, or you have sudden self-destructive thoughts, or you’re dizzy…but you continue to drink the potion, because you’ve been told all this is normal and will pass soon. But when will I feel better? you plead with the wizard. In six to eight weeks we’ll see, is the common reply.

Yes, though there are a few “big guns” of psych meds that have immediate effect, such as tranquilizers and antipsychotics, most others manifest side effects long before any therapeutic effect is felt. Which is why the popular misconception of popping an antidepressant to lift one’s mood is a pile of crap.

After an eternal couple of months, it’s time to assess whether the new med seems to be helping–and if not, it’s time to start over again with the next candidate, beginning the cycle of side effects all over again. Anyone who thinks psych meds are a crutch used by people who want to avoid the pain of life is invited to ride this merry-go-round a few times, until they understand it’s not the easy way out. It sucks, and we wouldn’t do it if we weren’t convinced it was our best bet for being more present and useful to the world and the people we love.

My Halloween Costume is a Human

~ Lori Lynne ~ Leave a comment

How many times have I sat in a group of people and wondered how long it would be before it became clear that I didn’t belong there? Whether someone would call me out at group level, or take me aside politely and say, “No offense, but this space is for humans only?”

I saw my psychiatrist on Friday, and as often happens, the process of digging into my symptoms makes me more aware of them. I get used to the way things are for me, but when I’m sitting with the psychiatrist, when he nods sagely at a description and suggests increasing or adding a med, well…I get reminded how far from normal-normal my normal is.

I know normality isn’t a real thing, nor should it be a goal. But when I feel so far from it that I see myself as an alien cosplaying as a human, that’s a problem. It’s a problem when the sounds around me fade out and an invisible spotlight appears above my head, marking me as the intruder.

As a result of Friday’s meeting, I am facing another meds change. This means, at a minimum, days of disorientation. Other side effects could happen, maybe for weeks. Historically, I tend to have a pattern of “it gets worse before it gets better.” So…I might be feeling even more like the alien in the human suit soon.

Trick or treat.

La La La La I’m Not Listening…

~ Lori Lynne ~ 1 Comment

“Don’t believe everything you think,” goes the saying. There’s a constant negative monologue in my head, competing with and trying to drown out anything positive I generate, and when I’m in a depressive dip it gets fucking LOUD. I want to stick my fingers in my ears and hope it gets tired and shuts up. But that doesn’t work. Trying to artificially pump up positive thoughts doesn’t work either. Trying to debate or fight the dark feelings just fuels them because now they’re getting more attention. I have to coexist with the voices, not fight them, not try too hard to distract myself from them…but, somehow, not believe them.

When I was studying counseling, one of my favorite professors told a story about a schizophrenic client who believed he lived on the moon. The professor, then a young therapist, tried the techniques he had been taught to challenge and question the client’s delusion. But all this did was reinforce the client’s resistance. One day, tired and discouraged, the therapist went a different direction. He decided, just for the day, that he would not try to convince the client of anything. Instead, he asked, “What’s it like to live on the moon?”

And for many sessions to come, he listened to the client’s stories about living on the moon. As the client came to trust him more, the therapist was able to tie some of the stories to what was happening in the real world and engage on that level some of the time. But he had let go of the idea that it was his job to convince the man to give up his reality for a more approved one.

I have to be like that therapist. I have to sit in a room with the dark version of reality my mind generates and allow it to be itself…but maintain a certain detachment from it. It isn’t me. There’s an entire universe outside of that metaphorical room, full of light and dark, too complex for words.

Diagnose Me

~ Lori Lynne ~ 2 Comments

There’s someone in my life who is starting to dig deeper into their neurodivergence. Whatever diagnosis might fit–adult ADHD, bipolar II, something else–they want it. They want it so they can try associated treatments that haven’t been available to them before. They want new items to add to the list of things that might help them, a list that is all they have to cling to on some hard days. They want to get at what might be standing in the way of doing what they need to do to improve their other conditions.

When I was taking psychopharmacology in grad school, many of my fellow students had a lot of negative feelings about diagnosis in mental health. They didn’t like the idea of putting people into boxes. They felt certain diagnoses were given too freely and caused more harm than good. And both of these things are valid concerns.

But here’s my own experience–the right diagnosis was life-changing for me. Until I was diagnosed with bipolar II, I spent more than a decade being treated with medicines that were ineffective at best and dangerous at worst (for example, many antidepressants have unfortunate effects on a bipolar person). After being diagnosed, I started to be treated with medicines that, while they didn’t fix everything, were far more on target. Having the diagnosis also gave me a language for the things I had been experiencing and made them a little less scary. It validated what I’d been going through and gave more opportunities to seek new methods of treatment. It empowered me.

I hope this new seeker finds a way to get the screenings and evaluation they need (no easy task, these days, if you aren’t rich). I celebrate the insight they’ve reached about themselves and their desire to address it. And I pray that diagnosis will be a useful tool for them; one that opens doors.

Why Am I Surprised?

~ Lori Lynne ~ Leave a comment

I know how this works. I’m hypomanic for a while. I get all sorts of great ideas for projects. I even work on some of them. My mind whirls with possibilities…then comes the crash.

Then come the nights of less and less sleep as the exciting part of hypomania turns into a complete inability to focus on one thought for amy length of time. Then the disorientation. Then the onset of a depressive phase.

I know how this works. So why is a tiny part of me still taken aback when it happens? Why am I surprised that now my mind is sluggish, or that I react to questions with a “deer in headlights” expression? Why am I surprised that the happy projects of a few days ago seem as far away as the moon and just as unattainable?

Why can’t I accept that I, in effect, have lost a good part of my intelligence for a few days? That I’m going to be physically clumsy and have to take care not to fall and hurt myself?

No matter how much acceptance I achieve, there’s a part of me that fights. I don’t want to be like this. I don’t want to slog through the days ahead and wait for the spark to return. I don’t want to be spending way too long writing this post because of the constant typos my fumbling fingers are making.

I don’t want it, but that’s the way it is.

Who Counsels the Counselors?

~ Lori Lynne ~ Leave a comment

I’m not working in the counseling field right now. I may never be able to work in it again; I don’t know. But my experience from both sides of the relationship makes me acutely aware of both sides of the mental health crisis which is a secondary effect of the pandemic.

In the last six months, the therapist my health plan allows me to see (a sad once a month) has been replaced three times. There are no longer any therapists there qualified to run certain groups, the only type of help available more often. Counselors all over are quitting many jobs like rats leaving a ship because their client overload and working conditions become too much to handle.

The people who need ongoing therapy for their conditions need it more than ever. People who didn’t need help before now need some. And it’s getting worse as those who marshaled all their strength and white-knuckled it through the last six months feel their grip begin to slip.

Counselors have always faced a high risk of burnout. They must fight to protect their psyche against “vicarious trauma” that builds up when engaging with a client’s trauma. Well, I’ve heard it said that we are all experiencing low-level trauma right now. That means that the stress on the counselors now is not just a matter of time and energy. It’s a matter of extra injury to their minds and souls.

You Don’t Say?

~ Lori Lynne ~ Leave a comment

So, my psychiatrist thinks I am depressed.

More than usual, I mean; my general diagnosis includes a type of depression. But just because I told him about how often I’ve been thinking about death lately, and how much I’ve been struggling with food and other self-destructive behavior, and how much time I spend in circles that talk a great deal about the dark aspects of all our futures on this planet…he thinks I need more help with depression.

So out he comes with this particular health care organization’s chart of meds and starts suggesting things to add to my regimen.

Poor man. He means well. But either he hasn’t been taking notes at our previous sessions, or he hasn’t been looking at them.

The names of the meds are listed in little boxes by group, and as he proposes things I have to keep shooting him down.

No, we can’t add anything from this box. I’ve tried many of them, and they increase anxiety to a dangerous level. No, I don’t care if this one is new, I’ve seen the chemical formula. They moved a hydrogen atom so they could get a new patent, that’s all.

No, we can’t add anything from this box. They’re all addictive. I know my addiction history is in my chart. I made a point of putting it there.

Dear God, no, we can’t add anything from this box. Two of them almost killed me when I tried them; I’ve told you that before. You cannot give me any of these unless I’m an inpatient under close supervision so I don’t walk into traffic.

We could try a slight increase in this one med I’m already taking, or we could try one from this tiny box here…or maybe we could get me a therapist I could see more than once every six weeks.

Ha, ha, just kidding, I know that’s not going to happen.

Through the Cracks

~ Lori Lynne ~ Leave a comment

I just found out I am one subject of criminal irresponsibility on the part of my particular health care system.

After some of the struggles of this spring and summer, I decided it was time to make a couple of appointments with my mental health team. When I went onto the website, the name of the psychologist I see was gone. I inquired with the department and discovered she doesn’t work there any more.

I assumed I would be scheduled with a replacement, but was told that it would take some time. Basically, I am going to be treated like a new patient again.

It took nine months to get in to see someone when I was new.

So, first, putting me back in the new patient group isn’t right. Second, even if they had to, someone could be letting patients know their care provider is gone and put them in the queue for upcoming openings, instead of only starting the process when the patient (who, hello, has a mental illness that affects their functioning) manages to reach out.

I’m upset on my own behalf, but I think I’m more upset about people who are doing worse than me right now. Being cut off like this may tip them from barely coping to needing hospitalization.

Not to mention the stress of losing what may have been an emotional support without warning, or a chance to say goodbye, or a single sign that anyone associated with their treatment gives the slightest fuck about them.

Discomfort Zone

~ Lori Lynne ~ Leave a comment

When I grow, it’s because I did things beyond my comfort zone. Granted, there are times my comfort zone is smaller than my own skull, but whatever it was at the time, I made conscious efforts to leave it. In everyday living, in social interaction, and especially in writing, I try to push the edges and perhaps push them a little further next time. And, naturally, I dance with the questions of whether it’s wise to push a certain edge at a certain time.

It isn’t productive for me to push in ways that will render me nonfunctional for days. It’s productive for me to push just enough for discomfort, just enough to require some courage. Enough to have consequences in my thoughts and emotions for days or weeks, but have them be consequences that I can manage without being propelled into a serious dip that will make me useless.

I’ve been sharing poetry with others for two years now, and I recently began to share prose for the first time. My essays on my blogs, theoretically, have been shared for years, but never critiqued by other writers or otherwise given feedback. That’s the new thing I did this week, and it was a very different experience from sharing poetry.

One piece of feedback I got is that people wanted more personal detail in some of the pieces. They encouraged me to depart a bit from the conversational style of these essays and branch out into a more personal viewpoint. So this week, I’m writing a piece that focuses more on describing an experience and isn’t about outreach per se.

It’s hard. It brings back the memory in a more visceral way, without the intellectual and the clinical to soften the edges. Even without that discomfort, it’s just different. For the millionth time, I’m the new kid at school.

Just Sick Enough

~ Lori Lynne ~ 2 Comments

When you have a psychiatric diagnosis, there are times when it’s obvious you need help. Other times, it might not be as obvious.

I had to jump through some hoops recently to get seen by a psychiatrist with my new insurance. Among these hoops were multiple rounds of the same questions about the nature and severity of my symptoms.  As I tried to answer as patiently and honestly as possible, I was aware of feeling anxiety about whether I would be deemed “sick enough” to be worthy of care.

You see, although I have been under some form of care for many years, it’s been seven years since the last time I was in a hospital outpatient program and nine years since the last time I was hospitalized outright. I’m only on one relatively benign mood stabilizer.

In recent years, I have been aware of how lucky I am to be where I am. I work hard not to throw this good luck away by falling back into addiction or other self-destructive behavior. But should “doing well” mean I don’t need help any more? Especially with bipolar, where patients are quite likely to float out the door while in a happy place, stop their meds, and wind up in the ER?

So it’s a dance. Be sure to appear “sick enough” to be taken seriously, without appearing so ill that you get a level of intervention you don’t need or want. Be eloquent enough about what goes on in your head to make sure someone knows you aren’t “fixed.”

Why? Why not just have enjoy having fewer appointments and one less thing on your current record? My reason is simple: my condition means that matter how well I am doing, it is possible for me to have a serious episode and need more help. Having a psychiatrist of record means having someone to call for an urgent meds adjustment. In the event of dire need, it means I have a name to give the ER staff.

It’s regrettable that people like me must defend our need to be responsible and prepared for trouble.