I did it. I went through with the therapy session on Thursday. Reckon it’s past time to update you. But you should know, going in, this is going to be a bitch of a post. Avoid it if you need to.
Have some Portishead for your listening pleasure. This is what I’m listening to while I force myself to get this out.
~
Pre-Game Panic Attack
The appointment was for 1:00 PM on Thursday, so I was at work all morning leading up to it. You’d think that would be a nice distraction, but it wasn’t. Queen Bitch has impeccable timing and went on her worst rampage yet this past week. (I’ll save work for a separate post to try to keep this semi-coherent.) So I don’t know how much of my pre-appointment nausea and vomiting was from therapy anticipation and fear and how much of it was the extreme stress Queen Bitch had me under.
By the time I got myself to the counseling center, I was a bundle of nerves. I smiled at the receptionist and filled out my paperwork. Thankfully, I was alone in the waiting room. I had so much pent up anxiety, I felt I could literally bounce off of the walls…and not in a fun way. Imagine severe chest pain, heart racing, rapid breathing, roiling stomach, my leg bouncing up and down ninety to nothin’, mouth chewing on a hoodie cord, eyes scanning the room for every minute detail, hands twisting and squeezing each other. That was me, pre-therapy Thursday. It took everything I had to stop myself from bolting.
Off to an Anticlimactic Start
The counselor finally fetched me from the waiting room at around 1:05. (Yeah. That pissed me off.) Let’s call her Diane. Tall, blonde, forty-something Diane. At least she’s older than me, I thought. They nearly placed me with someone who graduated this past May. I cringed. Maybe it seems superficial, but it’s far less about age and more about experience.
Anyway. Friendly enough, on the surface. She smiled and shook my hand, led me to her office. While the waiting room makes the building look new(ish), Diane’s office was poorly appointed. Seriously, her chairs and couch had tears in the upholstery. I kind of approved, because I don’t want to be therapized by someone with a mahogany desk and all leather furniture. She said I could sit anywhere – I just took the chair facing her desk. I asked permission to place my wallet and keys on her desk, then shoved my fists in my hoodie pockets and willed myself to not bounce my leg and look around the room like a crazy person.
I began relaxing a bit at this point, because Diane spent the first few minutes filling out paperwork. A differently formatted document with the exact same information I’d already filled out at reception. Full name? Address? Social Security Number? Bust size? (Kidding, she didn’t ask for my social.) (Got you again. Look, it’s a good sign that I’m at least trying to joke, right?) Then she went over their policies and her personal qualifications. Twenty years as a counselor with this same group. Good sign, right?
I’ve been doing this for a long time, okay? And I’ve worked with every age group, but I no longer work with children. I did for many years, but I had to give that up. I work with people like you now. And don’t worry. You’re perfectly normal. You’re definitely not crazy, right? You’re not crazy. You’re just sad. You’re here because you’re sad.
I hope it doesn’t offend you when I use words like “normal” and “crazy”…
And just like fucking that, she’d formed her opinion and diagnosis of me. I walk through the motherfucking door, am able to show up and shake her hand and be calm and civil. And I’m just sad. Nothing more, nothing less. So glad this process was so fucking easy.
Then she grabs her little legal pad and starts in with her own standard list of questions, the answers to which she notes on her pad:
Have you received counseling or psychiatric treatment before? No.
Do you work? Yes, full-time.
What do you do? I sit at a computer all day.
Oh, do you like it? Yes, it’s so much fun.
*chuckles* Relationship status? Well, it’s like this…
Children? No.
Parents? Married/divorced? Living? Location? Uhm. Uh. Well. Uhm. See. Well. *breathes* They divorced when I was little. They’re both still alive, last I heard. Uhm. Uhm. I think. Maybe. I think. Maybe. My mom is maybe in town again. My father lives in _____.
I see. And what sort of relationship do you have with them? I don’t. *fidgets*
Siblings? One brother and one sister.
…
…
Do you want me to give you more details? I’m not sure how detailed you want my responses.
She then went into this long spiel explaining the two different ways of approaching counseling: starting from the past and working forward or starting in the present and working backward. She said that people usually had a preference, but she doesn’t. She just looked at me, and I just looked back.
All this time, Diane has been looking down at her phone. Look at me, ask a question, look at phone, note my response on the pad, look at phone, look at me, ask a question, look at phone, note my response….forget what she asked me and ask me again. Yeah.
I finally broke the awkward pause with something like:
Well, I’m not in any danger. I mean, if you want me to start by talking about my childhood, I’ll do that. If you’d rather hear about what’s going on right now, I can do that, too. I don’t know what I need or what’s best, really.
On Unprofessionalism and Suicidal Ideation
It was at this point, this crossroads of sorts, where she finally asked me what had led me to be there that day. She had her checklist and wanted to go by rote, and I wanted to know what we were doing and why. So she asked me. What led you here?
I’ve been depressed for years. And while I managed it best I could for a long time, it’s spiraled out of control over the last couple of years. And now…and now…my thoughts have gotten so dark that they scare me.
“Tell me what you mean by ‘dark thoughts.'”
Suicide. I think about suicide every day. And. But. Well. You see, it’s not so much that I want to kill myself. It’s that I don’t wish to be alive anymore. I don’t want to feel this way, but I can’t seem to make it stop.
“I’d call that danger.”
I’m sorry?
“You just told me that you aren’t in any danger. And now you’re telling me you think about suicide every day. Ongoing suicidal ideation is serious danger. Do you really think about it every day? Do you have a plan?
Well, I mean I think stuff. Bad stuff. You know. But I don’t have a plan. Like a specific plan. You know, written down. I don’t have a plan. No. And I would never do it. I would never act on it.
“Then tell me what you think about. Specifically. Tell me exactly what goes through your mind in your so-called dark thoughts. What do your suicidal thoughts look like?”
Well. I mean. Okay. Okay. There’s a gun. In the closet. And. Well. I think about the gun. And I think about…you know… (I’m crying now, talking softly. twisting my hands so much they’re throbbing in pain.)…I think about how it would affect other people. And I don’t want to make it hard on someone who finds me and has to clean up after me. So….so I wouldn’t do it in the house. I’d go outside. To the backyard. And…and I’d do it there. So I wouldn’t make a mess of the house or damage it or make it hard to sell after I’m dead. You know? That’s not really a plan is it? I guess that’s a plan.
But I wouldn’t do it. I’d miss or something and end up disfigured and living in a convalescent home.
She wrote “gun” and “plan” and something else on her pad. “You have a gun in the house?”
Yes.
“What else do you think? Are there other ideas?”
Well. This one. This one’s really bad, and I don’t…I don’t think I should tell you. It’s horrible. (tears are streaming down my face) But. Well. I imagine. You know. I imagine getting in my car. Getting onto the interstate late at night. Driving dangerously fast. Turning my headlights off. Closing my eyes.
But I would never do it. I swear I would never do that, because it would hurt someone else. It just pops into my mind completely unbidden.
“What else? Is there more?”
My arthritis medicine. I get it in three-month quantities. I’ve thought about taking them. All of them. At once. But I know that’s useless. I would just end up with my stomach pumped.
“Stephanie, your name is Stephanie right? Those are plans. Specific plans. And you are in serious danger.”
Somewhere in the middle of all of that, she interrupted me. She had been looking at her cell phone off and on the whole time, and at some point – while having me detail my thoughts on suicide – she interrupted me. Told me to hang on, and then texted her son.
I told her again that these are things I think about, but I’m not choosing to think about it. And I fight so hard not to entertain those thoughts or allow them to linger. But they rise up, unbidden, and I can’t always will them into silence.
On Reasons to Live and Hospitalization
“Everyone has to have a reason to live,” Diane pronounces. “You’ve demonstrated you’re strong and have a will to live. You made the appointment. You drove yourself here today. You kept the appointment. All of this was done of your own free will. Tell me what you live for. Tell me the positive things that you cling to in order to keep going and keep those thoughts at bay.”
I looked at her, my cheeks tear-stained and my eyes clouded, and I said…
I got nothin’
I don’t have family. I don’t have friends. I hate my job. I don’t want to get out of bed in the mornings. I feel sad when I wake that I made it through another night. I got nothin, Diane.
Well. I recently started blogging. And the people I’ve met there, online, are amazing and have offered so much support.
And. And. (crying and practically whispering) I have this…this vague hope that just won’t die. This vague hope that maybe, just maybe there’s a brighter future for me. A happy ending.
She scribbles “internet” on her little Stephanie page and says, “I’m talking about real life here.”
Church? No.
Social club? Like a book club? No.
Bars? No.
Professional memberships? No.
Work friends? No.
Family contact or support? No.
Really? Nothing? Nothing.
She spent the rest of the time between trying to convince me to be hospitalized (she lacks the authority to have me admitted without my consent) and defining “thoughts,” “feelings” and “behaviors” to me. Like I’m a fucking child and don’t know the fucking difference.
Again she told me I’m only sad, and there’s nothing deeply wrong with me. “You’re not crazy; don’t worry.” I tried to tell her there’s a lot more to it. I told her that sometimes I have wild mood swings and get very hyperactive, sometimes happy hyperactive and sometimes angry hyperactive. She said, “Oh, everyone does that. You’re not one of the crazies or you wouldn’t be here today.”
She really wanted me to consent to hospitalization. She said she’d take me in her car, right then and there. She said that no matter how hard people fight their thoughts, that if they’re persistent and ongoing for as long as mine have been, eventually everyone follows through.
Thoughts. Feelings. Behavior. “It is unavoidable. Eventually those thoughts and feelings result in acting out in a behavior. You can’t escape it. It’s ingrained. It is inevitable.”
But I stood my ground. In order to keep her from calling a psychiatrist and having them admit me against my will, I had to agree to some things:
- Get rid of the gun. Or lock it up and give someone else the key.
- Email her Thursday night telling her I had done so.
- Show up for an appointment next Wednesday at noon.
- Get a notebook and log my feelings. Like a motherfucking four year old. I can tell her my feelings. I know my feelings. I know my thoughts. And I know my behaviors. Stupid fucking shit.
As yet, I haven’t done any of those things. Though I have made a note in my phone, which I open occasionally and add a time and feeling to.
On Medication
She also told me that medication is unnecessary. That too many people are medicated, and it usually gives you brain damage. “You don’t need medication, because you aren’t crazy. Crazy people have brain damage. That’s what it is! It’s brain damage! But you don’t need it, because you’re normal.”
But. “Seeing as you’re suicidal, medication may not be a bad idea to get your moods regulated. Then during talk therapy, I’ll teach you TFB through CBT and you’ll get right off that crazy person medicine.”
I told her I have an appointment with a psychiatrist on December 21. She was shocked, saying it takes months to get in with one. But my insurance company found one for me. Apparently she’s only going to diagnose and medicate, though. So I don’t know how I feel about it. I’ll at least keep the appointment, though.
Final Thoughts
Diane is crap. She laser focused on one thing and refused to hear anything else about me. And her plan is bullshit and so was her motherfucking brain diagram she scribbled to show me that I’m behaving like an animal on instinct rather than a rational human being. But I know I need help, and if being accountable to that nonsense-spewing unprofessional moron helps me even a small amount? Then it’s worth it. For now.
I just rambled a buncha shit, y’all, and probably forgot most of it. But I just couldn’t muster up the strength to write sooner. To those of you whom I’ve worried, please accept my sincerest apologies. I’ve had an absolute week from hell, and I’ve pretty much been in bed since I got off of work yesterday. I’ll do my best to catch up on emails and things soon. I miss reading y’all, too!
I’ll be back on the upswing soon, you’ll see. (I believe that. I have to.) Maybe a music party tomorrow or somethin’, hey?
Thank you all so much for your thoughtful messages and support. As always, you’re the bestest.
stephellaneous.wordpress.com 
My experience is that psychiatrists reach conclusions and categorize you in one mental compartment or another for pill therapy. Psychologists on the other hand help to get you to see yourself with all your particulars on a personal level and lead us to make better choices with more insightful personal understandings. In other words they offer therapy and psychiatrists offer pill therapy based on categories which are impersonal and generic for this or that indication. When I began my meds for bi polar, depression and anxiety I had one session with the shrink and regular ones with the therapist/psychologist. I asked how they work in concert to help me and she confided that they do not because professionally they hate each other and have contempt for each other’s approach.
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Carl, this is such thoughtful and helpful information. Thank you so much for sharing.
I was upset and displeased when I learned that the psychiatrist I have an appointment with next week is only planning to use some diagnostic forms and then medicate me…without really knowing my personal history at all. Just some basic categories and conclusions based on a rubric of sorts, as you said.
The counselor I saw the last two weeks was frankly pretty terrible. I’m hoping the psychiatrist can help point me in the right direction. I need a good psychologist.
To your point about the two not working in concert with each other – the counselor I saw is proof of that. She explicitly told me that “medication is for crazy people” and that it causes “brain damage” in already “brain damaged people…all you need is talk therapy.” She changed her tune only when I told her just how bad I get in my head.
Thank you, again, so much. That was really thoughtful of you and well-received. I appreciate you.
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I take Wellbutrin and Lamictol since 2006. Often it is not a matter of being crazy. Our brains can have chemical imbalances which alter our emotions and perceptions. We should know how that works. The meds stabilize those chemical and electrical processes. The drugs help me be more stable and relaxed especially during crisis and take the edge off “attacks” when they hit but I still have deep depths from time to time but they are less intense and less frequent. I once told my psychologist that I was feeling better and wanted to get off the meds and she laughed out loud saying “Carl, you dumb jerk. The reason you are feeling better is BECAUSE of the meds !” That was not said in ridicule and we both had a good laugh. We must realize that doses may be adjusted and new meds come out all the time but must also realize we will probably need them for the rest of our lives. After 35 years of “partying” I am clean and sober almost 14 years and that has been a real boon to improved mental health and outlook on life. Some days I must really push myself to even leave the house but understand this condition must not immobilize me for that truly is a path to decline.Some days I do allow myself a “stay in bed with a good book” day, however. I would also suggest support groups but know this or that group may not be right for us and move on to a different one. You may like a blog to which I subscribe, afriendtoyourself . Dr. SJQ, Phd, MD, she is wonderful. I must be available to take care of dad who is 92 and lives with me and for my children and grandchildren so having a sense of purpose helps too.
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Thank you so much for sharing your personal experiences with me. I agree that it’s not a matter of “being crazy.” I couldn’t believe she even used terms like that. I wasn’t offended – I can take a lot – but I know it wasn’t right of her to say something like that.
Ahhh, you certainly put a new perspective on things. I’ve been hoping that whatever I get prescribed can be temporary for me. But you may be right…if it makes me feel better, I may need it for life. I hope not, but I won’t turn down feeling better. I need to feel better. I actually want to feel better…and that’s an improvement, really.
Thank you so so much. (And yes, I do need a sense of purpose. I currently have exactly none. And I remind myself of that daily. I need to work harder on that.)
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I’m not as brave as you so I can’t admit to how much I share of your feelings written here, but I can definitely relate to some of them enough to feel empathy, sympathy and, in a way, relief. Relief that we aren’t alone in finding ourselves in some of the dark places our heads take us.
I’m a lot further down the ‘shrinkening’ road perhaps, I do know more about myself, I understand a lot more, but putting into practice all the sensible strategies I hear just seems so difficult. It takes time and application. I think I’m lacking the latter!
I’ve been on different meds and they all have their pros and cons. I suppose I see them as plaster casts or walking sticks for the brain, providing support and stability while relieving pressure so things can start to heal, with the aid of some physio/rehab (talking therapies etc.) when we’re more receptive, but that’s a somewhat simplistic analogy.
Sometimes though, we know we need help and we just have to take the best advice we can get and go with it until we’re a little stronger. Reading your later posts I think you’re further on in that process and I hope you find some practical help that makes things easier. It would seem that this was a start but maybe not the best one for you.
While trying not to seem patronising, you did seek help when you needed it and that’s a big step, it’s just finding what works best for you.
Whatever you do though, don’t give up on looking for a way to improve things.
There’s some much more informed opinions here that I’m sure will help figure out what is going to work.
Thanks for sharing so honestly, it really does help others you know.
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What wonderful things you’ve expressed and shared. First, let me allay your fears about seeming patronizing. You don’t. Not at all. I love the give and take of conversation, sometimes a push and pull, delving deeper into each other to find the little pearls. Congratulating and sharing and commiserating.
You sound pretty brave to me, if you’re further down the road to healing and worked through different meds to get yourself sorted. I like your analogy of the plaster casts or walking sticks. Sometimes our brains just need a little extra support. That does so much to ease the stigma of “mental health issues.”
I’m nowhere near where I need to be. I still feel the things I wrote in that post and the one prior to it where I wrote all the things I wished I could say in counseling. But I’m trying. I’m not giving up. I can’t. If I give up, there’s no point to anything. And I’m trying to finally believe that maybe I’m worth something better.
I’m no longer seeing Diane, but I’m actively trying to find another counselor. But it’s tough finding one that will take insurance AND see me outside normal business hours so it won’t interfere with work. I’m also seeing a psychiatrist now. I very much doubt her intentions, but right now she’s all I’ve got. So I’m trying to learn how to be more assertive with her and maybe guide her to where I want to be until I can find someone better suited to me.
Thank you, so very much, for your kindness..your insights..your encouragement. I know I say this a lot to people, so I hope it doesn’t take away from it – because I sincerely mean that it means so fucking much to me and touches me so deeply.
Thank you.
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Oh you are SO worth something better!! Just look at how well you communicate!
I’m not bi-polar (as far as I know!) so I can’t relate to that exactly, but when my train de-railed and I got to a point when I knew I needed help, I fought with well-intentioned friends about medication because there were times I’m sure it saved me. I knew I needed drastic help. As it happens finding understanding and exchanging views here also really helped. I had lots of ups and downs along the way with meds because I always wanted to be free of them eventually but that has its own challenges and conflicts. As you improve you begin to question whether it’s you or whether it’s the meds or the therapy, and then whether it’s withdrawal or whether that’s where you’d be without them, and then, how do they affect you adversely and is that holding back progress?…etc.etc., but when you’re really bad and you know it, the relief can be tangible and welcome. It’s such a divisive and controversial subject though and I’m absolutely no expert.
As for talking therapies, again it’s a very diverse subject but I believe essential to gain perspective on our thoughts and guide us on how to change patterns.
I had private health which helped get good advice, but then lost that when I lost my job (which set me back quite a lot) and am now having to go back to public health services and start over, which will be interesting to compare with your experience! They don’t play country music in waiting rooms over here though, thankfully!
Anyhow, progress for me is up and down but generally up, and that’s the way it has to be.
I’m currently med free for just a few weeks since the last lot didn’t seem to do much. I’m not convinced I’m ready, but I had to know. And progress is measured by comparison.
I guess the point of this is to express from experience that while drugs are not the only answer, that have their place, and while mental health stigma still does exist, it’s much more accepted as ‘normal’ for many people to experience issues at some point and therefore less stigmatic. And certainly with the way WP works it just connects you with people who are more likely to have an understanding of the topic you’re tagging.
My first meeting with my psychiatrist, receiving a diagnosis from someone who understood and made sense of stuff I’d always felt all my life but never had explained, that was a revelation. And therapists who let me know that I wasn’t alone, that loads of other people struggled like me for all manner of reasons, that in itself helped.
I truly think that you are on the right road. Those first steps can be the hardest especially as they’re usually when you are at the lowest and quite possibly terrified.
What impressed me so much is how much support you’ve found here through your honesty and sheer ability to communicate with humour and humility.
Keep going!
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You’re incredible! Look at all this – and you say you’re too afraid to write about your experiences. Pretty sure that’s exactly what you’re doing here. And I thank you for it.
You know, I’m not convinced I’m bipolar, either. I’m more inclined to think I suffer from Major Depression and PTSD. And when those symptoms are alleviated for a while, I think a semi-decent person emerges. One who just so happens to be spunky and playful. I think it’s unfair to call that something that needs to be medicated. The playfulness, I mean. And yes, GAD is part of it, too. But I think “mania” is often misdiagnosed. I’m allowed to have great days now and then without being called crazy. But I digress!
I’m sorry to hear that you lost your job and are having to resort to public health services. I’m not sure where you are, but I hope like hell it’s better than the U.S.’ public health services. It’s an absolute nightmare over here. Though, I confess the “treatment” I’ve received on insurance this last year has been appalling (mostly).
So happy to hear you’re making (generally) positive strides toward getting better. And I know what you mean. Though I’m in the beginning stages, part of the reason I put off treatment for so long is precisely because I think we’re all over-medicated as it is. I hoped I’d get better. But the scarier my depression became, the more my eyes were opened to the fact that if a pill could at least diminish the severity of my symptoms, then show me where to sign and I’ll swallow.
I love WP. I am well and truly astounded at the magnitude and genuineness of the support I’ve received here. I hope that you have found the same. If not, the people here are pretty epic (present company included).
Thank you, so much, for sharing your experiences and your kindness with me. 🙂
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I’m in the UK so it’s the good old NHS, bless them.
Like you I think diagnosis is so subjective and maybe a bit of a moving target, but knowing that you have recognisable symptoms that other people exhibit kind of helps. And helps explain stuff you’ve always known was there but never understood.
I’ve never opened up that much, that’s entirely down to your frankness. So thank you. And perhaps now that fear of losing my job through exposure has gone away now. 🙄
Knowing when we need help at least enables us to have help there if we are ready for it.
And yes, the encouragement and empathy from interacting with people here has been supportive and enlightening just when I needed it.
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To be fair, I’m only able to be so frank because I’ve maintained some semblance of anonymity. If this had my identity attached to it, well I’d have probably scrapped it after a post or two. I realize untoward people can figure me out should they wish. I’m just crossing my fingers that doesn’t happen. Because, as you say, it can be a career ruiner. And also, the things I’ve said about my family – despite having no contact or relationship with them, I still wouldn’t want to hurt them with my words. Even though some of them may deserve it. It’s not my purpose to punish them.
I’m glad you have good healthcare – that’s worth more than I can express. Though, something tells me you already know.
And yes, you’re right. I do exhibit pretty much all symptoms of the bipolar II diagnostics. It’s just that – as you say – it can be so subjective. And look, I don’t mind if that’s really the case. I’m not “label” resistant. I’m just uncertain about it all.
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Yep, I have exactly the same anonymity concerns. It’s more of a limiter than I’d hoped as it would be relatively easy to work it out with a bit of knowledge. Still, since I’m going to be more ‘authentic’ from here on in I guess I should start worrying less.
The benefits from sharing outweigh the risks mostly.
Really good to chat with you.
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Likewise, I’ve enjoyed it immensely. Thank you for improving the quality of my day.
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😁
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Here’s a little share that might keep you amused when you have some spare time:
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Wow, that is GORGEOUS!
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Well hopefully there’s a few more snippets of sunshine from my world on my IG feed to brighten the odd moment.
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Sunshine is always a welcome reprieve. 🙂
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And so short in supply around here for ages!
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