No Use for a Title (Education)

The examination room was filled for its size. Four different kinds of doctors and a nutritionist all crammed into a room not really designed to fit all of them and myself. Luckily I was sitting on the stock, uncomfortable hospital bed in the centre of the room; pantless and feeling the wax paper that had been placed over the fake leather sticking to the back of my slightly sweaty legs. If I had known I was going to have to be naked except for my boxers for another examination today, I would have worn a pair that weren’t as tight as I had on.

A few official diagnoses were handed down to me after much debate amongst the doctors: Bipolar II Disorder (the less serious form, the kind free of psychotic delusions and visions) with severe Post Traumatic Stress Disorder that is so bad it could very well render me as being legally handicapped, but more on that in a moment.

I was naked mostly because I was going to have to get a shot in the ass, but the medical doctor in the room who was administering it, the same one who examined me previously, wanted to make sure all my vitals were somewhat normal when I got it. None of the doctors wanted to put me on lithium. Given my record for consistency and lack of funds I will be given a shot every two weeks (which I will from now on refer to as pantless Thursdays) of Depakote. Once the doctors have been assured that I can keep up with this, and once my blood pressure has dropped from its dangerously unhealthy levels, I will be placed on a morning, noon, and night regiment of medication, most of which has nothing to do with my bipolar disorder. All the psych doctors and therapists are in agreement that my bipolar is most likely hereditary, explaining quite a bit, but my PTSD is where the real problem lies. I can admit that I am bipolar, and therefore are well equipped to fight it. What I don’t do is acknowledge that I have been through so much bad shit in my life that it has stunted my growth as a person.

On top of all that, not only will the Depakote probably cause my thyroid to become hypoactive, but it is more than likely already fucked to begin with. I am going to have blood work done next week to check on this, as it seems like a problem that has gone undetected for quite a long time and is more likely than not connected to the annoying throat clearing tic that I have insisted to doctors has been a problem for years. Astoundingly, and in the only bit of good news to be found from the appointment other than the relief of finally getting treatment, it appears as if my ulcer is actually healing slightly thanks in part to a (mostly) healthier diet.

My blood pressure is a major concern to the medical staff. If I am going to be prescribed other drugs to stave off depression, the effects of bipolar, the effects of other medications, help my thyroid, and help me sleep, I need to de-stress and fast. I was told that if I wasn’t in good health I could have very well had a heart attack. Even though it means I will become a pretty mean person from the withdrawal, I have to cut back drastically on my caffeine intake. One cup of coffee or one can of soda a day. That is all. I can exercise, but I can’t over do it. Rest was recommended and given the fact that I am not exactly living the high life right now, that shouldn’t be a problem. Can’t drink beer or hard liquor, but wine is apparently good for me. Since I abhor wine, it simply means I am just not going to drink. This is going to have to extend longer than my pre-medication period. That is more or less permanent.

After my shot and the other doctors had left, I got dressed and headed upstairs to my therapist’s office for an unscheduled session. She told me the more that she looked into my case history she was far more concerned with my PTSD than my bipolar disorder. She gave me a test of 20 yes, no, or maybe questions and out of that 18.5 of them showed that I had such severe PTSD that it was essentially crippling. I only lost out on the other one and a half points because it is very weird that any kind of media can trigger my anxiety and because I have never in my life had paranormal visions. She said that while some of the symptoms could be compounded my bipolar disorder, most of them were probably actually making the bipolar itself worse than it really should be. She went over the symptoms with me in great detail as I took notes so not to forget any of it. I like to have something I can refer to that can keep me grounded.

-I am constantly suspicious of the motives of everyone around me. I am always thinking about what people are talking about me when I am not around. It shouldn’t affect me, but it is sometimes consumes me. When people have secret conversations in my presence, I get pissed off and angry; constantly thinking that everyone is talking about me behind my back.

-I am easily startled, and this is one that has been getting worse. Sometimes the slightest unexpected noise can trigger me, be it a door closing or even the creak of my mattress springs.

-I have irregular sleeping patterns that seem to fly in the face of attempts to rectify them. This will most likely be the last thing to get better after treatment, and no experts can really explain why. It also, might never get better, and it might be the one thing in the long run that I will just have to find a way to deal with in my own way. Sleeping pills can only do so much and the kinds I would need to be effective are more than likely habit forming.

-I have frequent and merciless replays of traumatic events either while awake or asleep. In the interest of full disclosure, I am actually having one right now as I am writing this. They are a lot more frequent than I would ever care to let on.

-I have an irrational fear of abandonment by loved ones. I hate to be alone. Hearing that one put a lump and my throat and tears in my eyes; my heart sank to its lowest point for many, many reasons.

-I am unable to and sometimes avoid properly conveying traumatic events to others. Despite all the things I have written about in my past, most works that go unfinished do so mostly because I am a perfectionist (almost to a fault) about what I write and I often feel like I am not doing justice to the material. There are, however, memories from my childhood so dark that until I can properly reconcile them that I will never speak of them to another human being. To put into context how bad they are, I can talk about watching my mother getting raped and beaten and I can do it openly. Things that... I need to omit the rest. All I will say is that it involves me being very young and a man whose face my brain won’t allow me to remember.

-I feel a full spectrum of emotions throughout a given day sometimes up to and including persistent suicidal thoughts. Persistent here should be read as weekly.

-I often feel in a state of shock and alienated from the world around me. Sometimes it feels like I am watching the world through a thick glass window. I am there, but if I screamed no one would ever be able to hear it. I put up a wall around me, but it is completely transparent.

-This next whole group is all lumped together and is the part that is made worse by my bipolar disorder more than the other symptoms: daydreaming, lying, impulsive and often ridiculous behaviour, loss of attention span, loss of confidence, feeling stupid, and constantly being distracted.

-I often feel completely misunderstood. I understand that sympathy is fleeting by nature but I also know that understanding shouldn’t be. While others might feel like I am “milking it,” I’m really not. I just haven’t been able to heal properly for a very long time; especially given the amount of stress I have gone through in the past eight years.

-Even though this ties into the previous one and the first one on this list, I constantly live in fear of the rejection of others.

-I am constantly frustrated and impatient with the healing time frame. Such healing only can only be assisted and can’t be rushed. I often stumble over this one because I always find myself surround by people who think I need a swift kick in the ass and that I need to get over what is bothering me as fast as possible. This includes friends, lovers, co-workers, bosses, and even past hospital staff and doctors. With PTSD there is no room for impatience, so from here on out if you tell me I need to get over something you will be greeted either with a stink-eye, a slap, or a “fuck you.”

-External and internal stressors have left absolutely no room for me to grieve or healthily reflect on everything that I have loved and lost in my life.

-Even writing this, I fear not only my own feelings, but the thoughts of everyone around me regarding treatment. I look at the stigma of treatment sometimes like I feel I have lost my mind completely. I also fear that instead of understanding and support, this will be greeted by people trying to stay as far away from me as possible out of the fear that they might inadvertently make things worse or say something that will offend or trigger me.

My therapist told me that part of the reason she put me on a writing schedule was not only because it will teach me consistency, but because it is imperative that anyone with bipolar disorder and PTSD educates how they feel to the people around them. Understanding and education are keys to the healing process, and in a way everything I have written over the past few months has lead to this entry.

She then said something to me that despite my dark and depressing thoughts, gave me some hope: “Anyone unwilling to understand you either because they don’t want to or because they think you are full of crap is a bigger jerk than you could ever hope to be.”

That one statement alleviated a lot in the paranoia department, but sadly not in the flashback department.

A treatment plan was finalized. On the days I came in for my shot, I would also have a therapy session for two hours at first then lessening the more I opened up in therapy. Group therapy could be helpful in the long run for my bipolar disorder, but not until I can resolve the serious PTSD issues. It was also suggested since my bipolar also exhibits some of the characteristics of Seasonal Affective Disorder that I consider phototherapy in the fall and winter.

She asked me to bring what I had been writing on, mostly just to make sure I had been doing what she asked of me. I showed her everything that I had written since the start of therapy. It nearly filled two notebooks, one journal, and a lot of loose-leaf paper. I also showed her the websites, and she asked if I had read anything from the reading list she gave me. I told her I had and wondered if she didn’t have anything better to recommend by Virginia Woolf. She laughed and said she honestly hadn’t read anything else by her.

I left the office with a better understanding and aching joints. The aching was a side effect of the Depakote and was probably going to last a few days. The crying on the way home, however, was not. I was still far too emotional and I really didn’t want to leave the office. I was terrified about how everyone would react to this. I calmed down after centering myself and realizing it needed to be done.