What if you can’t tell?

Had another psychiatrist appointment today.  This dr is keeping good tabs on me, which is a good thing, I guess.  I see him monthly.  I guess I didn’t expect to see him that frequently, seeing how overbooked and overworked our mental health system is.  But, hey, I’ll take it.

My anxiety is through the roof.  The house is up for sale but we haven’t had any offers.  The new house is built, and they are in the process of putting in the hardwood floors this week.  Every other day I have a meeting with my partner, the designer or contractor, or a house showing. I feel like I’m going insane.

But then there are times when I’m fine. I feel calm. I feel okay. I wouldn’t say that I’m super happy, but I’m definitely okay. Unfortunately, these days, the days when I am fine are infrequent.

So today, when my psychiatrist asked how I was doing, I didn’t know what to say. How do I sum up that I feel mostly okay depression-wise, but not so okay anxiety-wise, but oh, it’s not all the time, but most of the time?  Well, I think that is pretty much what I said.  But what really sucks about having depression/anxiety is that my concentration is shit and my comprehension is sluggish.  So, self-assessment is not exactly my forte.  I try to “check in” with myself, to compare myself to last month, or two months ago, but I find it incredibly difficult.  Am I better than I was last month? Worse?  I think I had a good bump up when the remeron was increased, but the dr decreased the prozac, which I think probably didn’t help the anxiety. So today he bumped the prozac back up. The medication balance is very tricky. And frustrating.

So what do you do, dear reader, if you can’t tell if you are better or worse? I am looking for insightful ways to figure out myself.  What works for you?

p.s. here’s a great blog post. I love her language.  Three Things You Need to Know about Mental Illness.

By the way, I have decided I am vanilla bean ice cream.

The hospital

I never spoke about the hospital I go to for my appointments with the psychiatrist. It is well known here as the “mental” hospital, and has even been colloquially termed “The Mental”. Of course it has all of the typical stigma attached to an institution associated with mental health.  I have told hardly anyone in my real life that I go there for appointments. I am afraid people will talk about me behind my back. Say “she must be bad if she has to go THERE.” So I absorb the fear and stigma and keep it to myself.

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There is something inherently creepy about a building that was erected in 1855. I can’t help but get the creeps. I was very nervous the first time I went there.

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Even though the grounds are actually quite pretty and it is next to a huge part of land in the city that was owned by the Bowrings and is now called Bowring Park. This is the entrance to the hospital.

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Getting back to the creepiness of the hospital, I was wandering around inside and found one of the staircases that had protective steel guards encasing the empty space between the stairs. My guess is that this prevents patients from jumping or hanging themselves.

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I may not be doing a good job here of decreasing the stigma. My doctor’s office is a very typical office, on the first floor. It looks like any regular hospital office inside.

But if you wander the North ward you may see a locked steel door like this.

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It is a bit unnerving. My mind races with media images that propagate the “escaped lunatic.” But fear is unwarranted most of the time. The only people who have ever spoken to me in the hospital are one guy who wanted to know if I had a smoke, and another who asked if I had spare change for a pepsi. Nothing scary. 

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There is a common area/field outside for sports, but I’ve never seen it being used. 😦 The intimidating fence and barred windows don’t help.

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I think some of the images I’ve presented of the hospital look intimidating, but it looks that way, in part, because of the age of the hospital. It is in serious need of a makeover.

What you don’t see is the faces of the people.  Friendly staff and other patients JUST LIKE ME. I wasn’t comfortable taking any pictures of people there. But, the people who work there really do seem nice, approachable, and non-judgmental. That’s really reassuring to see.

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I think stigma needs to be challenged about mental institutions. But I have no idea how to do it.  Certainly, the look of hospitals such as this one doesn’t help. But we have to get a dialogue going. We need more bequeathments and monetary donations to mental health and mental hospitals. We need to continue to give the very best care that we can to patients. An old hospital building is nice, as a historical artifact, but a new building would sure be nice.

Appointment with Psychiatrist and Santa

No, I’m not delusional or hallucinating. Santa really was there! A two foot tall standing ornament.  I guess a psychiatrist’s office that is too busy to de-Christmas (in June) is a good sign. Or,  as a friend said, it’s just a “really good conversation starter”!

The appointment went well.  Much better than the first psychiatrist I met. This guy actually asked me what my symptoms were, and focused on how I was feeling now, as opposed to my childhood. He asked relevant questions, and all in all,I left with a much better feeling than I had with the first one. It pays to listen to your gut, and get a second opinion if need be.

So, he agreed with me that the wellbutrin was too activating for me, and that it might have actually increased my agitation level. Apparently 20% of patients react poorly to the wellbutrin.  We are going to keep me on the prozac and clonazepam for now, and add mirtazapine. That might work. It will be more calming than the wellbutrin for sure. He wants me to come back in 3 wks, and he told me to be persistent with calling his secretary if I felt any really bad side effects like suicidal thoughts, and he would get me in.

I have hope. It’s been awhile since I’ve felt that, and it feels good. This dr said that it would be possible for me to finish my thesis, get out of the depressive/anxious state,  and actually concentrate. What a concept. I look forward to it.

I also got a diagnosis. Major Depressive Disorder with likely Generalised Anxiety Disorder as well. For some reason, a diagnosis helps. Just the label, I guess, makes it less of a mystery, less scary. He does not think I am Bipolar II; the sheer lack of any manic symptoms prevents that diagnosis. The agitation is likely due to the anxiety.

I apologize if I’m being repetitive, but I’m excited and hopeful. Tonight I start the remeron (mirtazapine) and maybe I will get some rest. Maybe this one will work.

Meanwhile, here’s Santa. Happy Christmas in June?

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