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.