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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?

Climbing the mountain

I was feeling frustrated and annoyed and anxious yesterday, going to a counselling appointment I had to wait a full month and a half to get.  Jesus, I had to wait two weeks for the intake appointment for where they worked out where the hell they were going to put me and what sort of program they were going to funnel me into.  Having been going to this temporary, casual sort of counselling, the sort  of counselling which has been pretty typical in my experience, I was wondering what the hell the point of going to this guy too was going to be.

It turned out to have been worth the wait.

I suspected, based on some admittedly paranoid dissection of the questions they asked me during my intake, that they were sending me to someone versed in anxiety issues.  This turns out to have been true.

But this was not like any counselling appointment I have had before.

I was very anxious going in.  New counsellors make me anxious.  When I climbed the stairs and looked down the hallway towards reception, I realised abruptly that I had been in this building before, years before, when my mother had wrangled things to get me on Plan G.  Plan G is a provincial drug plan providing psychiatric drugs to patients who need them and cannot afford them.  At the time, it was for some antidepressants that were having a debateable amount of effect, possibly not much.  But this?  This was where we’d got the forms.  I hadn’t had any clear memory of what the building had been but this had been it.

I suffered a sharp spike of anxiety and loitered for a moment at the top of the stairs, aware that I could see other people in the waiting room, and that made it worse, but I took a deep breath and soldiered on, feeling progressively worse.

I was a bit early, and the recptionist was still on lunch.  Again, anxiety.  What was I supposed to do?  I picked up a magazine on anxiety and depression, and managed to read part of an interesting article on medication before the receptionist returned.  She gave me a form to fill out.  Again, another spike of anxiety.  I recognised it right off as what it was, actually.  It was the Beck Depression Inventory on one side and the Beck Anxiety Inventory on the other.  I have filled out many of these lately, many in my life, this is nothing new although having to do the anxiety test is a particularly new shade of thing.

But I hate these tests.  I am conscious constantly of self-editing and trying to see if I’m answering “right.”  Obviously there’s no right answer, but I worry constantly about my ability to judge this accurately, and my sense of what the various gradings on the scale mean, and it’s always in the back of my mind that if I do it wrong, they’ll send me away as not really needing help.  On the other hand, if I err on the other side, what will it mean if they think my situation is far more severe than it is?  And how severe am I?  I can’t judge myself against other people, I can’t say how much of the mess in my head is “normal” and how much is not.

And then I had to wait again, and the magazine I had been reading had vanished (and I didn’t see anyone else in the waiting room with it, either, so I couldn’t even blame anyone) so I fidgeted until my counsellor showed up, by which point I was in a state of high anxiety and building towards a panic attack, and had to be walked around the building until I calmed down.

And this was, as I said, not like any counselling appointment I’ve had.

He is versed in anxiety problems.  In fact, he suffers from them himself.

He says he doesn’t believe in “fixing” people.

He says he doesn’t approach this as “dealing with anxiety” or “coping with anxiety” but instead as “accepting anxiety.”  His view is that anxiety, or depression, or anger, or other sources of “negative energy” come from the emotional mind, and that the rational, thinking mind is trying to fix them.  And of course, they cannot be fixed, they cannot be suppressed, they cannot be ignored or diverted without suffering backlash and problems and generally just making things worse, which is something I am becoming aware of.

His process, he says, is to allow the rational mind and the emotional mind learn to work together, to accept what the emotional mind is doing, to allow oneself to experience anxiety or depression or anger without it taking over and without trying to “fix” it, and to then be able to tap into the wise mind.

This is a different approach than I’m used to, and the idea that by learning not to fight myself — because fight myself I certainly am doing — I can be better… well, it’s very appealing.  What counselling I’ve done in the past has been, when it touched on anxiety at all, was focused on learning to calm oneself down, which is impossible to do in a crisis, and does not prevent the anxiety from being an issue in the first place.  This is new.  This sounds promising.  Possibly I’m grasping at things, but it sound promising.

As he puts it, I’m scaling a mountain, and he’s climbing the same one, and he can offer me advice on which tool to use or which handhold to take, but he’s there with me when he knows  how difficult it is.

Of course, it takes time.  At any rate, I’ve come away with a Plan G form, so that I can afford the Cipralex in the meantime.  Assuming it helps.  I hope it does.

Sliding backwards

I feel like the clonazepam is losing effect.

I was doing so well, I felt competent and capable, and I thought, “maybe this is what it’s like for normal people” but I can feel myself sliding backwards.  No more skipping doses, maybe, it might be a short-term acting drug but let’s stay safe.  Let’s hope for the cipralex to start working, and soon, but antidepressants take weeks.  Doctor’s appointment on Friday to review the drugs I’ve been taken, we can see what she says.

Oh.  Oh my god.  I cannot.  I am fighting this, I am trying to be calm, but this terrifies me, to feel myself slipping back into the anxiety.  Yes, this is the way I’ve felt nearly constantly for years, but I’ve had a taste of something else and I don’t want to give it up.

I’ve always had good days and bad days, as far as this goes.  Possibly this is just a bad day, and it if weren’t for the clonazepam, I’d be doing a hell of a lot worse.

I have an appointment today.  I need to leave to catch the bus in about twenty minutes.  I should eat, can’t face food, am rocking in my chair.  This is that stupid counselling appointment that I initially tried to make in mid-December, had to wait two weeks for an intake, and had to wait another month for an actual appointment.  What sort of bullshit is this, that it takes this long to get help?  Thank god for my temporary counsellor, is all I can say.

Speaking of which, the temporary counsellor asked me to make a list of everything that makes me anxious.  Everything.  I’m adding things as they occur to me.  It’s becoming… a daunting list.

It comes.

I have a psychiatrist appointment on Feburary 4th.

One way or the other, I’ll be looking at an official diagnosis.

Either way, that’s something that carries a lot of weight.

I muse upon a beginning.

I am beginning to hate the term “mental illness.”

It’s a very broad term.  It carries a lot of stigma.  And I hate the fact that I am beginning to think of it as applying to myself, without really knowing what it is that I’m defining, either.

There is a little bottle of pills.  It is sitting on my desk as I type, in its place next to the monitor.  The bottle is blue and white, the pills inside are also white.  I take one once a day.  I don’t know if they do anything.  Some days I think they help, and some days I think they don’t, and some days I think they actually might be making things worse, but I take the little pill every day, because my doctor tells me to, and I will take them and tell her what happens until she tells me not to.  That is a lot of trust there.

It is also, frankly, insane to be blindly taking pills that alter your brain chemistry because someone else tells you to when they can neither predict how it will affect you personally nor entirely grasp what is going on your head because you have no way of describing it.

I tried recently to describe a panic attack to a friend of mine, and found I couldn’t.  I can describe the physical aspects of it, sure.  I can describe my inability to breathe, the pound of my heart, the shaking, the tunnel vision, the anxiety, the fear that I am losing my mind, but there are no words in the English language to properly express the oppressive and all-encompassing despair, the misery that is so strong that it is very nearly a physical symptom, despite all logic, like a million tiny hands are pressing outwards from your skull and that your head might very well explode.  I cannot explain the thought process that leads me to seriously consider banging my head on the wall or inflicting some other injury upon myself in the hopes it might stop that feeling — I haven’t done this, but I think about it.  When I’m having a panic attack I know that’s what’s happening, but that doesn’t mean I can make it stop.

And what brought this panic attack on?

Nothing.  Merely the come-down from an exhausting and inexplicable rush of energy and good mood and productiveness.  I have felt like shit since.

I’ve been diagnosed repeatedly over the last decade as severely depressive.  They give me antidepressants, but they don’t seem to change anything, and in the last three cases have been worse than not taking anything.   I have a counsellor, albeit a temporary one, who is finally listening when I talk about the crippling level of anxiety I am experiencing, that I drive myself to work through somehow in an exhausting and self-defeating fit of stubborness which leaves me depressed and limp and crying, and that in turn serves to only make the anxiety worse.  It’s a terrible vicious cycle, and I can’t explain it, and I can’t break it, and it all builds until I break down.  I lash out, because when I am screaming and irrationally angry, then at least I can’t feel anything else, at least I don’t hurt anymore.

“Depression” is a weighty enough label to live under, but at this point… I’m wondering if all of this is leading up to a diagnosis of something more, because it’s a little more complicated that that.  I don’t know how I feel about that.  I’m waiting on an appointment at the health unit.  I have been waiting over a month and have weeks to go.  Sometimes I feel like I won’t make it.

I feel crazy, and possibly I am. I feel broken and I feel a failure on some intrinsic level that I can’t deal with my own brain without help.  There are good days, and there are bad days where everything is a struggle, everything from deciding what I will have for breakfast to using the newly-introduced style of bus pass to grocery shopping to making it to work, it’s all so insanely difficult to accomplish.

My brain is my own worst enemy.  I’m trying to commit that to paper.

But this is a beginning.  It will get better — I have to believe that, because the alternative is to go on like this indefinitely, and that’s an unbearable thought.