Because it really is personal…

Sunday, I drove to Alabama, to spend some time with my parents, and to see The Good Dr. H. Monday morning. He’s in Montgomery.

“Rootie!” you query, “Why do you drive 5 hours to see The Good Dr. H. when there’s a whole page full of psychiatrists right here in Statesboro and many more just 45 minutes off in Savannah? Why, Rootie, Why do you contribute to Global Warming with such self indulgent behavior?”

Well, it’s fairly simple. If you’ve ever had a psychiatrist you ‘clicked’ with, you’d know why. The Dr-patient relationship with a psychiatrist is a loaded one. I mean, you can go to a surgeon who’s an arrogant asshole, and that’s ok, because he’s probably arrogant because he’s really good at what he does, and you can live with that. A surgeon doesn’t have to have an opinion about your spiritual life, or understand the dynamic between you and your spouse, or even particularly respect your ability to comprehend the medical situation you find yourself wallowing in.

A psychiatrist, in order to be effective (and understand there is a big difference between a psychiatrist and a psychologist. Some folk get the 2 confused but it’s like the difference between a doctor and nurse, kinda) has to factor in your whole life, everything that goes on in it, as well as whatever medical issues you may have, as well as your personality and how you handle whatever he throws at you. The Good Dr. H. has done all these things for me over the past 14 years, and I simply don’t have the desire to start that sort of relationship all over again.

Not only that, there are NO psychiatrists in the area, save 1, who take our insurance, and I’ll treat myself with nettle tea and weekly floggings before I go back to her.

So anyway, I saw him Monday morning. I informed him I was having occasional hypomania (twice since January *wheeee* hypomania’s fun!) and (what I call) Crunchy Depression- 2 episodes lasting 3 weeks each since January. Crunchy depression is an active form, characterized by intense anxiety and hyperactivity, paranoia. Soft depression is the dark and moody kind where you lay on the couch and don’t feel like taking a bath. The crunchy kind is exhausting because you’re on High Alert looking for something aweful to happen because you can feel it coming.

So he asked me, “Any suicidal thoughts or ideation?”

me: “Well, you know I would never act on them because I know what’s going on but that really doesn’t make it any easier because the thoughts are still there but I wouldn’t want to hurt my family so I wouldn’t act on them…You know.”

him: “Well, thank you for trying to preserve my feelings by NOT ANSWERING THE QUESTION!”

So he tells me the lithium is starting lose it’s efficacy a bit, but he isn’t ready to take me off of it because the alternative- Depakote- he doesn’t think it would be a good fit for me. So, instead he decides to add another layer to the cocktail. This time it’s Lamictal- an anticonvulsant- because the nature of my depression suggests perhaps I’m having seizure-like activity in the emotional seat of my brain. Lamictal has very few side effects, it won’t make me sleepy or fat, the only risk (very rare, he sez, like 1 out of 3500, and he’s never actually seen it himself) is a repugnant flesh eating rash down the midline of your face. It starts at the top of your nose and crawls right down around your mouth to eventually reach your belly button but by then you’ll have completely isolated yourself from all human contact. So, if I break out in a rash, even if I just rolled in poison ivy the day before, I have to quit taking it and call him. I can do that. I don’t think I have the prettiest face on the planet, but I don’t want to make people run screaming in the other direciton, either.

So. We’ll see. I am fixing to go look up Lamictal on the interwebs. I am hoping it will work. Every time I go through a crunchy depression (the soft kind I can handle. It’s what Jane Austen and the Bronte sisters are for) I feel like a little bit has been chipped off my soul. Enough of that and there won’t be any left. It’s exhausting, both physically and spiritually, and it is very, very hard on my family.

Right now, tho, I feel great. Something is being done for these mood swings, and just knowing that gives me hope and optimism.

Now I’m off to investigate this rash issue.