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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