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I saw the psychiatrist yesterday.  I think it went well.

He’s South African, which I did not expect.  His diplomas on the wall were from some university in Johannesburg, the name of which struck me as amusing at the time but I forget now.  He’s a big, black South African doctor with a moustache, and I like him.

And I told him everything.

Which was exhausting.

I told him how amazing I had felt on the clonazepam, but how it was losing effect as I was clearly building a tolerance to it, and that the last week had been hell.  I told him about how, during my bad panic attacks, I felt suicidal and inclined to self-harm, although I had never gone so far as to act on any of these thoughts, short of biting very hard on my hand.  During the entire appointment I was so nervous I couldn’t stop moving, restlessly shifting in my chair and wringing my hands and clenching my fists.  It felt like torture.  A few times, during lulls in the conversation, I looked out the window, couldn’t see much but the hospital and a parking lot, but it helped.

We ruled out diagnoses like bipolar disorder or schizophrenia or OCD.  Just… general anxiety, which surprises no one at this point.  I’m puzzled by the question, though, of if I’ve heard voices or experienced hallucinations.  I said no, but I said to my father last night, how would I know? What if I was unaware that they were hallucinations?  Dad thought that was pretty funny.

The doctor doesn’t like me being on clonazepam either, and since it’s unwise for me to go on a higher dose, and since the effectiveness of the Cipralax will be weeks away, he has given me something called co-quetiapine, or Seroquel.  It’s an anti-psychotic, which is weird to think of.  Also apparently if my parts of my life really are hallucinations, I’ll find out soon enough.  It definitely has a tranquillising effect, though.  Luckily I have a couple of days to get used to the loopiness before I go back to work.  Working on cutting down the clonazepam now, not that it’s doing me a lot of good right now anyway.

The Cipralax is probably a good fit for me, but he mentioned another drug we can try if it doesn’t help.  Again, it’s the sort of thing that takes weeks and weeks to work, so we should at least give the Cipralax a chance first.

Speaking of my father.  We got on the topic of self-medication last night, and he asked me why I thought I had never got into that alleyway.  I said I wasn’t sure, although perhaps if I was a chain-smoker I’d be more functional than I am.  With alcohol, the line between “buzzed enough to be unanxious and happy” (and I am the happiest drunk in the world, for good reason) and “uncomfortably intoxicated” is too fine to walk regularly, and I can’t drink every night, although there have certainly been periods of my life where I’ve had, say, a beer every night for a week or two.  And later in the evening, thinking more on it, it occurred to me that when I’m at the low point in this cycle that I’m beginning to recognise in myself, where I am anxious and depressed and more anxious and more depressed and doing everything in my power to force myself to go out to work and accomplish tasks, I do self-medicate that lack of energy.  The amount of coffee I’ve had in the last week is… astonishing.

And of course, caffeine makes anxiety worse.

How much simpler would my life have been if I’d started smoking in high school?

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