15-Minute Session
"And I'm wondering if you maybe already knew that I could get addicted to the medicine? But you thought the pros outweighed the cons somehow?"
I'm planning what I'm going to say at my appointment with my psychiatrist tomorrow. When I'm talking to my psychiatrists and I'm not in a debilitated mood, I find myself trying to impress them, with my normalcy or agreeableness. I want them to believe I'm trustworthy, that I can be counted on to show up and cooperate, so I am worth the effort of last-minute calls and messages between sessions. I'm going to keep my tone tentative, maybe throw in an eyebrow furrow at most.
I looked up the latest medicine my psychiatrist prescribed, and I read about its potential for dependency. I’ve been taking this medicine off and on for two months. I know that I am supposed to discuss these shortcomings with my doctor, and I am supposed to do my own research. I don't have a good excuse for not following through. The promise of relief crowded out any concerns in my mind.
I don't wear a mouth guard at night as my dentist instructed; my teeth might be grinding each other into powder. I get strangely long nosebleeds every few months, sometimes more frequently, and I haven't talked to my PCP about them.
I don't feel like I have much bandwidth to be appropriately inquisitive about my health. Barely staying on top of my psychiatric appointments and psychotropic medication refills takes all my capability. Everybody keeps asking if I want to synchronize my prescriptions, I keep saying yes, my prescriptions get all mixed up, I keep decoupling the prescriptions. Then I forget and agree to synchronize them again.
I take three medications, a total of six pills, every night. One big yellow, one small yellow, three white with a line down the middle, one plain white.
"And I get that, I do,” I’ll continue. “I know there are risks of being severely depressed, too."
I've lost count of the medications I have tried. Probably at least eight. The best combination, which doctors believe I have found and therefore generally don't mess with, has coincided with a long stable period. I'm skeptical that this medication combination I'm on is truly golden, or if we're all calling it the panacea, when the real driver behind my stability was probably my old psychiatrist.
I didn't always used to feel confident taking medication. I remember attending a support group in college, crying when, although my doctor had informed me I would be on medication for the rest of my life, this group leader told me he had "more hope than that." My fate, taking medication, being the hopeless one.
This person disappeared from leading the group, for the rest of the sessions. I worried that I'd gotten him into trouble, for giving me what he thought was a positive message. In a way, wasn't his belief the most generous judgment on my life, that I could someday get back to what he considered normal and happy?
"Maybe next time you could let me know, though? If I might get addicted to something? Like ask me what I think about that?"
I once was told by a psychiatrist that my case was too severe, after multiple hospitalizations in a year, and she refused to see me anymore. It seems like psychiatrists can say almost anything they want.
I will be asked whether this psychiatrist provided a referral, before she rejected me from treatment. I am certain she did. But for whatever reason, my latest breakdown of volition or bureaucratic fallout, I didn't end up with a regular psychiatrist again until I was assigned a new doctor following another hospital stay. This was my old psychiatrist.
I've gotten used to not expecting much from my psychiatrists. The exception being my old psychiatrist, who once sent me a list of summaries and links of her own research, materials on how to talk about having depression to your child. I’d mentioned in a session that I was worried about these eventual conversations with my now-toddler.
I'm not sure what my new psychiatrist will say. I'll smile and wait.
PS: She said, "I don't prescribe any addictive medicines. You can read a lot of stuff online, but this medicine is perfectly safe."
Photo: Cosmin Deaconu