my first lithium journey
sometime in the middle of class I decided that I needed to stop by the Health Center on the way home. I wanted something to help me get on a regular sleep schedule, and to help with the very uncomfortable anxiety that made depression feel even worse. I also wanted to ask for referrals to community therapists and psychiatrists in order to get a second opinion about my diagnosis, and to get some help dealing with the diagnosis itself.
after class I took a nap for a little less than an hour. It was a deep intense sleep, and I’m pretty confident that for the first 30 minutes after I “woke up” I was still in stage 1 sleep. quite a bizarre feeling, almost psychedelic in nature. I was so engaged in trying to figure out this strange sensation when I walked by the Health Center, forgetting my original intentions. But, there’s nothing like a strong visual cue like a gigantic brick building to remind you to stop in.
I immediately saw the woman who provides referrals. There aren’t many people available in my area, to my surprise, neither clinical therapist nor psychiatrist. Of course, this has something to do with the fact that I asked specifically for a female PhD. Female, because I have trust issues with everyone but especially with males and I feel like females are more empathic, safer, and understanding. PhD because I’m asking for a second clinical diagnosis and even though the PhD doesn’t necessarily promise anything, I have some reasonable knowledge about the type and length of training they’ve had. Besides, I always grill them at the first meeting to make sure they meet my standards so I can be sure I could even form the ever-important “therapeutic alliance”. No Freudians or psychodynamic therapy for me, mm-mm.
while the referral lady had me in her office, the guy at the front desk came in to let me know that my psychiatrist just had an opening about an hour later. I had thought she wasn’t available afternoons so I wouldn’t see her until after my class is over in the beginning of June. My symptoms and quality of life have been beyond unbearable lately so I jumped at the chance. I thought I might end up with some anti-anxiety meds and some sleeping pills, although hopefully not Ambien because that just made me feel crazy.
to my surprise, I walked out of the psychiatrist appointment 45 minutes after it started with a stack of papers to look over and a prescription for lithium. she finally convinced me. i didn’t think it would happen, but it did. I’ve got book recommendations, prescription information, mood questionnaires for daily assessments, all kinds of goodies. see, at first, I didn’t trust her diagnosis at all. I felt like she had her mind made up already and that I wasn’t given a “fair chance”. I also wanted to see more explicit elimination of alternative diagnoses, so I would understand how the symptoms I experienced are specific to bipolar 2 as opposed to something else. she would appease me if I asked but sometimes I got the sense that she was a little impatient with my resistance, leading me to further doubt her.
not so today. it started off a little like usual, where I didn’t really feel like she remembered me from the time before and I had to re-explain things. as time went on I think she remembered more and more and was able to refer back to our past meetings, so that made me feel more comfortable. I described that my current existence is EXTREMELY unpleasant because I can’t figure out if I’m depressed or hypomanic or what. whatever it is, I’m unbelievably uncomfortable and can’t function.
we went through a mood questionnaire and she told me it looks like I’m having a mixed episode. Mixed episodes are VERY UNPLEASANT I might add. Too depressed to function but so agitated I want to peel my skin off. moreover, I’m experiencing Dysphoric Hypomania, which was described as: “Mind is racing but motivation and focus are poor. Can’t sit still but mood is depressed. Body is restless but energy is poor. Sleeping @ 4-6 hrs/night. Irritable, impatient, and anxious. ‘Not right’ Characteristic of Bipolar Type II disorder.
so I’m hypomanic but without all the neat stuff associated with it. Instead, I feel debilitated by the inability to move and supremely pissed off. like I can’t get comfortable. since I had been suspecting this was the case, and because the psychiatrist’s elaboration of this type of experience really resonated with me, she suddenly had my full attention.
she brought up lithium again. she again explained how lithium dosing depends on where along the spectrum I am, and described what type of experience I should expect after stabilizing on lithium. to be honest, what she is describing sounds completely foreign to me. kind of like I might be like one of those…”normal” people, but somehow still retaining the benefits of bipolar, such as creativity, passion, and energy. she kept describing what people with bipolar 2 often feel about others, and who they tend to associate with and I felt like she was peering into my past. feeling most people or “boring” or don’t know “how to live”. analogies like that that just brought tears to my eyes because of their truth in relation to my life experience. as she went on and described how a mood stabilizer would also help us isolate problems other than bipolar disorder, such as PTSD, I became more and more open to the idea.
at the same time, I have no idea what to expect. she describes “separating me from the bipolar disorder”. What does that mean??? If I’ve had bipolar disorder this entire time, what’s really me anyway? Have I ever really known?
Will I even recognize myself??