Started my period yesterday and am expecting to feel a lot better because of it.

My periods stopped being 28 days apart 3 or 4 cycles ago. Lately they’ve been 3 weeks apart, 2 weeks apart, 25 days apart, and very heavy. I suspect this is perimenopause because of my age (44), and I wonder how long until I stop having periods all together, and what impact that will have on my health.

I remember Mom going through it. It’s still strange to me that she’s beyond menopause, now. Periods were something that tied us together for so long. Menopause was hard on my mother. Maybe it’s a hard time — the 40s and 50s — for most women. I’ve read that menopause is a lot like puberty and I can see how that is true. My body is changing (has been for a long time, really) in ways I never anticipated. Weight, fat distribution… nix that, actually. It’s more the permanency of the changes. I am moving beyond regeneration. It isn’t that my body is no longer at my command, it’s more that it doesn’t respond the way it used to. All that is old news and has been going on for 10 years, even though I didn’t understand it back then. I always think of my weight when I think about this but the thing that is happening is happening in all areas of my life, as strong and inevitable as water rushing around me and pushing me forward.

I think of the last school portrait I had made. I as 17, and pregnant (barely on both accounts) with short brown hair. I didn’t know I was pregnant, I don’t think. In my portrait my chin is stuck out to show my determination to do something important with my life. I was disdainful of platitudes and cliches and other people’s failings and mistakes. And yet now, after nearly thirty years more of living, I am beginning to see that I was mistaken. I thought that by doing things my own way I was following a short cut to some kind of promised land. But there are no short cuts and there is no promised land. There is just terrain — the same terrain we all pass through. There is just living. We’re all walking down the very same road and maybe success is nothing more than an imaginary scene we conjure up to keep us occupied. Maybe we’re all mere mortals pretending to be gods.

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I love my house. Love my husband, my marriage, my dogs and cats. I love my familiarity with this city, and the cache of living here. I love that we make enough money to get by. Love my parents and that my grandmother (whom I also love) is still alive at 90 years old. I love that I have long hair and that it is just as curly as it was when I was give years old.

I love that things are growing in our backyard and that the pool is clean, and I love the sound the water makes when the pool pump is turned on. We have blue dragon flies that flutter around at eye-level out here and I love their blue-ness and their extra-large, round, eyes.

The wonder of it all is that I could be so constantly surrounded by all that I love and yet be consumed, today, by the two things in my life I detest: my job, and my health. Consumed as in fixated, overwhelmed by anxiety, weak with worry and unhappiness.

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My grandmother, Neta, used to listen to me tell her about the latest catastrophe in my life, and then she would tap her temple with her index finger, shake her head, and say, “Think! Think! Think!”.

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Alternatively, she might say, “Stoooopid.” I loved the way she did that. Her minimal response was loud with the notion that the catastrophe had happened simply because I needed more practice thinking. Her “Stoooopid” was far from insulting; instead, it was an opportunity to laugh about the ridiculous mistakes we all sometimes make in life.

My husband listens to me tell him about the latest hard day that I’ve had, and then he simply says, “Uh huh.” And that’s about it. If he worries about me, he doesn’t say so. Last night, I told him I’ve been having some doubts about whether or not I have a mental illness. I told him I’ve been wondering about the power of suggestion, and he seemed to understand what I meant even though I didn’t go in to any detail. He smiled and said, “Uh huh.”

“You know, you have this unique ability to listen to me, no matter what, and never take a side, never give advice. I mean that in a good way.” I said.

“I pick sides,” he responded. “I pick your side.”

What strikes me about both Neta and David is their confidence in me. I can’t imagine either of them ever denying me the right to my own thoughts, my own ideas. Why, oh why, do I have so little confidence in myself?

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I am critically and curiously reevaluating the assumptions and facts I have at my disposal about me and mental illness. I’ve done this often, over the years, never willing to pick a specific side and stick with it. It’s all a gray area for me, the area these doubts occupy. Sometimes I lay them down for a very long time. Sometimes I pick them back up and examine them curiously, like a puzzle I keep coming back to.

• I doubt that I have a mental illness at all.
• I doubt that my behavior isn’t within my control.
• I doubt that my experiences are as extreme as I make them out to be.
• I doubt that the worst of my mental states did not occur because I was experimenting with alcohol and psycho-pharmacutical medications, and because I was dealing with the consequences of immature and self-indulgent decisions I knew better than to make when I made them.

Over the past several days, as I’ve read more and more posts on other blogs by authors who are struggling with psychosis and mania and truly crippling depression, I’ve begun to doubt my diagnosis. More than that, I’ve begun to doubt the way I cling to my diagnosis, and I’ve started wondering if I’m hiding behind it. How many times have I made the decision not to do something I need to do – from cleaning house, to getting my dental work done, to eating a half-way healthy diet, to exercising – and blamed it on being bipolar?

Am I taking pills instead of making good decisions?

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When I was 30 I started seeing a psychoanalyst. I don’t remember her name, which isn’t surprising, given the number of mental health professionals I saw in succeeding years. I’m talking about it here because it was the beginning of a long, horrible road.

I made the appointment because I was drowning in stress. The stress wasn’t surprising, since I was the sole technical support person for two busy Price Waterhouse partnerships, and was involved in a horridly obsessive romantic relationship, and my family was in the middle of a red-alert-crisis I didn’t care to become involved in. I didn’t know what a psychoanalyst was supposed to do to help me feel better, but I thought it was worth a shot.

The doctor was cold as ice. When we met, I asked her if she was married, had children, etc. — the normal chit-chatty “get to know you” type stuff, and she responded by telling me it was inappropriate to ask her that question. Everything about her was impressive, from her fancy leather couch to her wardrobe. If I was a bit nonplused by her demeanor I was also reassured that I had found an expert. I just wasn’t sure what she was an expert at.

Psychoanalysis was hard, though I don’t remember what we talked about. This was not the type of therapy sessions I had later, with other therapists. I believed in the process we were going through – weren’t people always seeing analysts on TV and in the movies? Wasn’t an analyst one of the hallmarks of a successful career woman? – but the truth was it wasn’t making me feel better or worse. It was just a weekly appointment with someone.

My brother had recently been diagnosed with bipolar disorder, and my parents were getting up to speed on what that meant. I refused to participate in the learning process because I was so angry with my brother, and that was disappointing to my family. I found the suggestion to be extremely insulting, at the time, and I refused to see a psychiatrist for an assessment. So it was somewhat surprising when I decided to see a psychiatrist for my own reasons.

I made an appointment with a shrink because psychoanalysis wasn’t making me feel better, and I thought an antidepressant would. After all, wasn’t an antidepressant one of the hallmarks of a successful career woman? My psychoanalyst was dubious about my decision to see a psychiatrist, possibly because I wasn’t depressed, and asked me to at least wait, and voiced her deep concern about taking an antidepressant, but I ignored her stern warnings. So I saw a young man, fresh out of medical school, and simply asked for an antidepressant. He put me on Paxil, and threw in a prescription for Klonopin as well. I didn’t get the Klonopin filled because I was leery of benzodiazepines.

The Paxil seemed to work well for a couple of weeks. I felt happy all the time; in fact, the energy expended by my stress before I took my first Paxil seemed to reroute to happiness. But then… the change. The insomnia. The first mixed episode. The nervous breakdown during a business trip. I didn’t understand what was wrong with me, and I wanted the reassurance of a diagnosis, so I saw my psychiatrist again and asked him what I had. Was it depression? Could I be bipolar? The psychiatrist looked through his notes the way a college student thumbs through a notebook during a pop-quiz, and came back with this: “Well, it says here you have an eating disorder.”

And I said, “What?” Because we’d never discussed my eating habits, and at 5’1″ and 115 pounds I certainly didn’t look like someone with an eating disorder. I was all about caesar salads and pasta and queso. He shrugged and told me a diagnosis really didn’t matter, and I let it go.

I started seeing a different therapist that summer. She didn’t think anything was wrong with me, and blamed a stressful family situation and less than stellar coping skills for my irritability. And then… on and off the Paxil. Take it until I couldn’t stand the insomnia any more than then simply quit taking it. Lay off the Paxil until I started sobbing uncontrollably every night and go back on the Paxil. Stop taking the Paxil because my therapist didn’t think I needed it. Lay off the Paxil until I got a wild hair and decided to start taking it again. Stop taking the Paxil because I didn’t want my boyfriend to think there was anything wrong with me. And on, and off, and on, and off.

I became suicidal the following fall. I couldn’t stop thinking about it. Or about my (temporarily ex) boyfriend. Or about any other number of things that were rushing through my head so quickly I couldn’t catch any one of them for any prolonged period of time. I told my therapist about it, and she was shocked and concerned and immediately called my psychiatrist. I saw my psychiatrist who seemed angry and had me go home and get my medication and come back to his office and give it all to him because, in his words, I obviously couldn’t be trusted with it. So, off the Paxil again.

And then the night I couldn’t stop sobbing. Fine one minute, the next sobbing so uncontrollably that I had to leave my cousin’s graduation ceremony where I unceremoniously plopped on the grass outside the auditorium and sobbed. My mother taking me back to my apartment, calling my psychiatrist, going to the pharmacy to pick up the long-unused Klonopin prescription, and the weird feeling after I took the Klonopin, the magical cessation of sobbing, the odd feeling of feeling nothing. My mother leaving angry because her son and her husband (another story) and her daughter were all in crisis and she was trapped, taking care of all of us at once.

And then my psychiatrist told me he had decided to leave the profession. And I told him I thought that was probably a very good idea.

And then the impulsivity. The deciding, one night around 8pm, that I would move to Denver the next day, and the stopping by the (no longer ex) boyfriends house to tell him it had been nice knowing him. The changing my mind the next morning and deciding to remodel my rented apartment, instead. The taking a contract position with IBM in Boulder, Colorado and my mother coming over the night before I was supposed to move because I hadn’t packed any of my belongings to take with me. The running away from Boulder and back to Austin after one day on the job, leaving behind a fully-furnished, $1200 a month apartment I had just rented. The writing hot checks all over Austin before borrowing $50 from an old friend and driving back to Denver, where I accepted a different job with a hefty signing bonus. The getting pregnant. The leaving the new job with no notice, one day, and packing everything up and putting it in storage in the space of 4 hours, and the running back to my parent’s house near Houston. The miscarriage. The pawning my TV for gas money to get to an interview. The commuting between Houston and Austin every day for a month while I saved the money to move back in to my own place. The psuedo-suicide-attempt. The two hospitalizations. The affair with my psychiatrist. The year of booze and Ambien. The shaving my head. The sudden switch to every psychopharmaceutical drug on the market. The temporary psychosis. The new psychiatrist telling me I couldn’t possibly be experiencing psychosis. And then, that he, too, had decided to leave the profession. The being evaluated at the Baylor Mood Disorder clinic and being told I was not bipolar. The finding a different a new psychiatrist and settling down in to Neurontin and Seroquel. The new doctor telling me I probably didn’t need to be on medication. My terrified refusal to stop taking it. The realizing the music I’d been hearing in the background all the time might not be real.

And then the road to today.

In thinking about the period in my life that I’ve just mentioned here I suspect it isn’t surprising to anybody that I am relatively distrustful of mental health professionals — or, at least, that I am aware that it’s important to pay attention when entrusting my mental health to one of them. It also isn’t surprising that I often feel guilty about being on medication at all.

And how, you may wonder, did I come to the conclusion that I am, indeed, bipolar? And old psychiatrist that I saw a few years ago. And a discussion I had with my current psychiatrist after I quit drinking, last year. The one where I told her I am certain I must be bipolar. There’s more to it than that, of course. As she said, the diagnosis isn’t as important as the symptoms. In my case, the symptoms are what we’re treating, and the symptoms sound very much like bipolar disorder. What has never been clear, in my case, is what my diagnosis might be if I were on no medications at all. After all, it’s been 12 years since I was completely drug free, and I wasn’t seeing anyone before that. 12 years of weight gain, high cholesterol, horrid mood swings, weird behavior (not that I wasn’t weird before).

Are the medications worth it? Am taking them to avoid dealing with psychological issues I’d rather not deal with? Much to think about.

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