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.

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Meds update. I’ve been on remeron for 5 weeks now. I see a big difference. I am able to do work again. The crying spells have lifted almost completely. I still have what I call “blue funks” (my own combination of anger/irritability/sadness) but not as frequently. I still have general anxiety daily so I’m continuing on with the clonazepam on a low dose. The addition of remeron was making me quite sleepy with the prozac and clonazepam, so the psychiatrist lowered the prozac dose by 20 mgs. Since the prozac has a long half-life in your system I’m only starting to see a difference now in regards to sleeping, after a week. I’m taking fewer naps and I’m getting a full 8 hours of solid sleep each night. Granted I have bizarre dreams, but it’s a side-effect that is not a deal breaker. Oh,  and I’ve put on 10 lbs. I’m trying to exercise more to combat the weight gain that remeron can (and has) caused. Also because exercise is “good” for me. Blah.

But what I really want to write about is that my therapy with M has ended. I’m pretty upset about it. Two weeks ago he told me that he had done all he could for me, that we have used all the resources available to us and that it was up to me to do the work, outside of sessions. It really came out of left field for me. Of course I didn’t expect therapy to go on forever, but I don’t think I am ready to leave the proverbial nest quite yet, either. I feel like there’s a ways for me to go yet, in terms of learning to cope with daily situations, work on my thesis, and especially in terms of my personal relationships. He thinks he’s done all he can.

I’m not sure I buy it. Maybe it’s because I don’t want the sessions to end, because I’m losing my support system. He wants me to lean on friends. I told him I didn’t have any local friends that I felt I could share my deepest feelings with, and he told me it was time to reach out, make new friends, outside of my partner and sister. I have no idea how to do that.

Maybe it’s my ego talking, but part of me wonders if he felt anything for me, beyond being just another client. Could that have been why? Or maybe he terminated sessions with me because he saw that I was starting to care too much for him. Not romantically, but as a friend, instead of a therapist. And therapists frown on that sort of thing. Maybe that’s why I feel like I was dumped.

He knows I’m upset and not ready to let go.  We talked about it for the entire session today, our last session. After our time was up, he shook my hand. He refused a hug.  It’s over.

And I’m more than a little sad and confused. He was my shoulder, and now I don’t have one anymore.

 

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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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Back to dr for psych recommendation

I went back to my family doctor because she received the recommendations from the psychiatrist consult I had. Neither of us were satisfied with his evaluation of me,  or his proposed method of treatment. We are going to get a second opinion from a different psychiatrist.  I don’t know if I presented really well that day,  or he didn’t deem me that serious, or he just couldn’t see the seriousness of my depression (I was much more anxious that day). Probably it was a combination of the three.  Either way,  I knew when I left the office that day that I was unhappy with the appointment. I am really glad that my family dr got the same feeling from his letter.

So,  I am to continue on the prozac and clonazepam, and stop the wellbutrin in two weeks. By then I’ll have the appointment set up with the new psych. My dr thinks the psych will take me off the wellbutrin and substitute it with something else. Sigh.  It’s so frustrating. I can feel that the depression is lifting but the anxiety is still high. I just want to get better,  and I’m sick of this waiting game/runaround.

Had some tears of frustration today but have been overall not too bad the past few days.