Psych Lingo

Well, a month has passed since my last med check where I was ambushed by a filler doctor.  He had me taken aback with his recommendations for heavier medications, such as “real mood stabilizers” and replacing all my benzos with antipsychotics.  Apparently, in his professional opinion, my bipolar disorder was not well managed.

I’ll be honest with you.  Not only did his recommendations scare the bejesus out of me, they insulted me.  Typically, I would really refrain from faulting myself from being a particularly proud person.  With all of the knocks I’ve taken in my life, I can ill afford pride and arrogance.  But, in a way, it felt like he dismissed a year’s worth of legitimate complaints with the flick of a wrist.  It was almost as if he were nullifying all of the effort I’ve put into managing my mental health.

His suggestion?  A condescending tutorial on how to use Google to research my disorder and make informed medication decisions.

Ugh.  *Eye Roll*

That didn’t stop me from obsessively combing the internet, haunting message boards, putting messages in a bottle, and taking a battery of online assessments.  My assessment?  Don’t self-diagnose from the internet.

Ironically, there I was on Friday morning watching Silver Linings Playbook.  It was neither the first nor the tenth showing of that movie on that screen.  I had always admired the screen portrayal of Pat, and felt that it did justice to the disorder.  There was always something that I identified with, but not entirely.

I hopped in the shower, almost hysterical.  Before I’m about to meet with someone, I usually have a script ready in my head.  It’s just a set of questions I’ve already prepped myself to answer and topics that are safe and well researched.  This is especially the case when I’m preparing to meet a professional.  It’s easier than getting bullied into treatments that I’m not entirely familiar with.  At least I have some ammo when I go in.

But, I had no answers this time.  I’ve been to enough med checks in my life to know what to say and what not to say.  It’s a matter of knowing what’s going to get me in hot water and take me down a road I’m not willing to go.  Call that non-compliant, but let’s be real.  How many people are completely 100% treatment compliant?

I was ready to lay all of my cards down on the table.  Xan cautioned, “Don’t go in there guns ablazing.”  Again, eye roll.  I was panicked to the point of wanting to cancel.  It wouldn’t be the first time I’ve done that with a doctor.  But, Dr. K has this soft cleverness about him.  He’s far more observant than any other psychiatrist I’ve ever had.  And at the same time, he’s far less talkative, so he’s entirely less likely to show his hand.  Most doctors will give a tell as to their personal opinion, rather than a professional opinion if I engage them in a little extra conversation.  Dr. K just doesn’t bite.

Which brings me to what happened.

He was running almost an hour behind, which rankled me far more than I care to admit.  It’s amazing how cozy folks in a psychiatrists office can get when they’ve been in close quarters for more than a few minutes.  It was actually the first time anyone had the guts to politely ask why I was seeing Dr. K.  I always thought that there was some kind of unspoken code that it was almost forbidden to “fraternize” with one another.  I assured her the question was fine, and that I had been seeing him for bipolar disorder.  “Two,” I added, seeing a mildly startled look on her face, “Kind of the ‘lesser of’.  ‘Diet’ bipolar.”

An imaginary tumbleweed blew through the office accompanied by the soundtrack of a multitude of crickets.  A man’s voice sounded a boisterous, “BOO!”

Boo yourself!

I quickly and gently asked about her condition.  If I was taking home anything that day, it was the knowledge that folks in a psychiatrists office are a lot more eager to talk about their own conditions than I imagined.

Dr. K called me in, and I wished her well.

I guess all of the psych talk in the waiting room primed me.  I sat down in one of his plain black leather armchairs that did the rest of his ornate office no justice.  Naturally, he asked me how I was.  I admitted that I was well enough.  Then, somehow, I trickled into it.  I told him that I’m able to manage.  But the “insanity of it all” was just overwhelming.  The burning need to perform certain tasks in a particular way was killing me and causing conflict in my family.

He asked me to elaborate.  And did I!  I told him about the cumbersome nature of housework.  I like everyone to be out of the house, because I can do it the way I need to, without any interference.  And Xan, he tries to help when I’m getting more and more stressed and less and less gets done.

I told him about an incident where Xan did the dishes.  I don’t like when people do my dishes.  They can’t work within my system.  It’s infuriating, because the system is so easy, but I don’t expect anyone to know how, because it’s my system.  They have to be done in a certain order so they can be stacked in a certain order.  If they’re not, then something is going to break.  I described the awful Jenga game and how all of my favorite glasses and mugs have been broken by such carelessness.

Then, they have to be air dried to avoid any contamination.  The last thing I want is to accidentally give my family and friend food poisoning because I was being careless.  If there are multiple loads, then it slows the entire thing down.  But, then they have to be put away in a particular way, because that’s how they fit in the cupboards.  I try not to swear and complain when I go into the cupboards for something later, but it’s hard.  If they aren’t put away correctly, then they don’t fit, then things get lost, and then that delays all other kitchen activity.

I told him that I felt like I knew that the level of obsession with such detail was unhealthy, but there wasn’t any way to fix that.  I’ve always been like that.  He asked if there was anything else like that, and I exclaimed excitedly, “Oh the closet!”  And I went on to talk about how the closet is arranged and how the clothes have to be folded exactly so they fit in the drawers without incident.  And again, I went into how I know it could be done differently, but it’s not right and it doesn’t work.  I’ve spent years developing these systems.  It is supposed to make everything easier, but it actually kind of makes everything more difficult when I don’t have the time or energy to devote to it.

I actually went into more length than I wanted to there.  But, I felt like I had to illustrate the entire madness.  To leave anything out wouldn’t do it justice.  I expressed to him that I didn’t understand why I had to do this.  But, in truth, the act of organizing and sorting usually gives me some peace.  Well, when everything goes as it should.

Apparently, I used the right key words.  He answered my questions about the “level of obsessiveness” with a sentence that contained the keyword: compulsions.

Note:  I usually refrain from using psych lingo or any clinical terminology.  Most doctors aren’t very receptive.

Dr. K explained something that I never really got until then.  Anxiety manifests itself in many different ways, sometimes all at the same time.  And there are many different coping mechanisms that a person develops over a lifetime.  Anxiety can manifest in obsessions, which often lead to compulsions to alleviate that stress.  His response was to treat it with Prozac.  I’m pretty hopeful.

He added that it’s characteristic of obsessive compulsive disorder.  In all of my education and research, I am still a little unclear on it.  This is going to be a new journey for me.

In a way, I feel a little vindicated.  I was right to trust my gut sense that bipolar disorder wasn’t the entire picture.  And I was right in believing that there was more to it, as if we fixed something, but uncovered something else.

Most of all, I’m glad it’s all resolved, and I’m on an appropriate treatment for it.

So I guess all it takes is a little bit of clinical reference to speak the language of a Pdoc.  I’ll keep that in mind in the future.

10 thoughts on “Psych Lingo

  1. The reply thread wouldn’t let me ask you how that meeting with the employment board people went… I hope you survived with your soul intact, if not your dignity 😉 If you think about it – to get a job on that particular jury you’d have to be a major toe-the-line-group-think-right-vs-wrong person… not to stereotype here or anything lol. The whole situation pretty much sets you up for agonies – but such is the system we live in. And I suppose we’ve got to take its perks with its ignorances, when compared to any sort of feudal every-man-for-himself historical paradigm. Ah well.

    As someone who used to end up weeping on the kitchen floor curled into the fetal position when faced with an overwhelming pile of dishes… here’s the thing…. your brain is giving you the cruel unwanted permission to live in a more dangerous, unmanageable world than the people around you. No amount of medication can compare with the cognitive freedom of accepting this concept as FACT. To know, in the face of madness, while your body is twisting reality to match some inside unspoken urgency… that you still have choice… that you can create new permissions… that if the very survival of the people you love depends on air drying… then ask yourself…

    Who are you really trying to protect? And from what?

    • The job stuff, ha ha. We drove fifteen miles up the river and past the county line. I sat through some incredibly lame orientation with about 30 other people about their “re-employment program” in a sauna of a room. When the presentation was done, they called us individually to meet with a counselor. When I sat down and explained my circumstances to the woman, she was pretty much stuck. That county couldn’t provide me with any of the wonderful services they boasted because I am not a resident.

      So, I got a referral to speak with Allegheny County’s program. And do you know what the guy had to say to me? “I don’t know what you’re asking of me.” In so many words, he couldn’t help me and had no desire to even try.

      The good news is that I was offered the opportunity to apply for a spot in an 8 week course for free CNA training. The bad news is that I might be considered ineligible. The program is for 18-29 year olds, which I currently am. But, by the time the interviews are all finished and the candidates are drawn, I’ll be within a month of my 30th birthday. So, I don’t know if I’ll “age-out” before I even have an opportunity. I basically have to wait and see.

      As far as I’m concerned, I fulfilled my obligation to that program. I attended, they couldn’t help me, and now we’re all done with that. It’s not like I love unemployment or anything, but for now, I’m comfortable with it. It’s far better for my mental health than jumping from job to job to job.

      Anxiety – that’s a horse of an entirely different color. Bipolar disorder is something that manifested in my teens, and I’ve been managing it since. Of course, within the last five years with treatment and everything, it’s been far more successful.

      I actually wrote an article that I’m about to post about how this is probably more a part of my being than the mood swings. I kept telling my doctor over and over, “I’ve always been this way” when it comes to the anxiety that often threatens to cripple me. I just didn’t realize that it was, hell for lack of a better term, “a disorder”.

      It’s one of those things that I can pinpoint so early in my life, and I’ve just been living as if it’s been this inevitable part of me. I knew that there would be moments where I would take a blow and end up trembling on the floor. I’ve lost many jobs over poor attendance, because I couldn’t. I mean, I just couldn’t. There were times my mom just let me stay home from school, all because I had succumbed to this wild hysteria.

      At least now I understand why my mind throws walls up and blocks over certain things. I have an entire childhood locked up in there, like I suffered from some kind of trauma. I know I didn’t, or someone would have eluded to it. I feel like my entire childhood was one big traumatic experience.

      For a long time, it was just everything before about 11 or 12. Now, I’m starting to lose things from my teens too. I’m talking important things that have nothing to do with any kind of traumatic anything. There is an entire chorus trip that I’m missing. I have the pictures to prove I was there. My parents were even on that trip. Old friends remark about it and other ones when we are catching up. But, I have nothing. I just have to go from the pictures, and force a laugh about events I don’t remember.

      It’s odd.

      Thanks for checking in! I appreciate it! I know I’ve already written at length, but I have to cut it short. I have to go get my son off the bus. Then, I have to bust my hump around here because I spent the day sleeping instead of cleaning. Gotta love that.

      • For a sensitive brain, the natural arc of childhood is wildly traumatic without having to add in any extra chaos or violence to the mix. You are fabulously brave for bringing another new life into the world and guiding it along its own roller-coaster. Wheeeeeeeeee!!

        Take care of yourself Lulu, and don’t let ’em docs twist your perception of self too far from where you need to be to know yourself as the hero of your story!

        Oooo roller-coasters and heroes? Must have Disneyland on the brain lol. Guess it really is a Friday after all 😉

  2. I really hate it when filler doctors decide to complete change things and re-do our meds. Don’t they realise that all they are is a fill in? Earlier this year I have a filler doctor tell me that I had a brain tumour. Without MRI or CT scan too. I spent the next four months (waiting to see a specialist) struggling to come to terms that I was going to die. I also spent too much money on hats. You see, I was also convinced that before I died I was going to lose my hair. As it turned out I wasn’t going to die and his was a complete overreaction on something he really knew nothing about.

    Moral of the story… never listen to a word filler doctors say and don’t buy hats on the internet. They sure as anything might look good but now I have a pile of hats that don’t suit me. 🙂

    • I’m pretty glad I didn’t listen to the filler doctor, and stuck to my guns. Thankfully, he didn’t seem to have the authority to change my meds. He just wrote me a script for more of the same and sent me on my way. My regular doctor had no interest in putting me on heavy duty meds. But, he did finally make the connection between the anxiety I had been trying to describe for almost a year now and obsessive compulsive disorder. I’m on Prozac instead of Wellbutrin now, and so far, so good. It actually seems to have the added bonus of curbing my appetite!

      What you experienced is just awful, and I’m so sorry you had to go through that. That’s ridiculous, and why would that doctor even tell you something like that?! I probably would have hunted him down and demanded those four months back, plus reimbursement for all of those hats!

      At least you have a bunch of nice hats, anyway. Lol. And my head is way too oddly shaped to consider hat shopping on the Internet.

  3. This is a well written post…and informative…and funny…and full of the
    frustration with which I am so familiar. Thank you. 🙂

    • Thank you for reading! I appreciate the feedback. I wish I could write funnier posts, actually. I think this is one of the more frank things I’ve put out in awhile. And it means a lot that people have responded so much to it.

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