Across and Inside my Universe

Overheard Psychotherapy - Intensely Complex & Painful Fallout

Well. If one is going to overhear a loved one's psychotherapy session, wouldn't it stand to reason that various random elements in the universe might align to coincidentally allow the overhearing of probably the worst possible session for that person to have overheard?

Just kinda figures, doesn't it . . . .

Imagine, if you will, that events have happened in the previous week that have brought out a surprising (to you) amount of anger, with all sorts of angry thoughts peppered with demeaning and insulting things about a loved one. I am not proud that, in anger, I have thought some really terrible things. I am far from proud, in fact, as you'll see.

SO, in an effort to expunge this intense but over-reactive anger from me, in an effort to see things in a less blown out of proportion way, in an effort to gain a healther perspective, in an effort to process the anger and come to a realization of how I ACTUALLY feel, rather than the extremes to which my mind sometimes goes when angry . . . in all these efforts for good and positive things, and more besides, I opened up in therapy in a way that is often hard to do; I let it all out, the anger, the things I thought in the extremes of my anger, every negative, unpleasant, unkind and even cruel thing that went through my head. Some of these things are things that I know are sensitive areas for this loved one; this makes everything about this situation WORSE. Except for the fact that I recognized I didn't want to hold on to these extreme angry thoughts and feelings; I wanted to see, think, and feel a more healthier, reasonable view.

Well, imagine my shock when, a while after I'm home from therapy, I find out that this loved one overheard all but the first 10-12 minutes of my session! Imagine the feelings of, "But therapy is supposed to be PRIVATE!" Imagine the feelings of being betrayed by the loved one, by the therapeutic environment which was not sufficient to keep what was said in the office, confidential, the feelings of horror when I started to run through my mind the things I had said, and, as if in a disembodied third-person overhead cutaway view, I could "see" the office and the environs outside it, with no roof, and see everyone involved in this situation. Imagine the intense pain I began to feel as I thought of how this person might or could be feeling upon hearing the vile, angry things I was spitting out in therapy . . . . the pain that pierced my heart like a knife, realizing that, though it shouldn't have happened, it shouldn't have become public, it HAD been, and that I had deeply hurt this loved one, whether it "should" have happened or not.

I had all sorts of complex feelings, like, "But I didn't do anything WRONG; I was only trying to do the best by both this person and myself, because I had intentions to in the near future discuss the feelings of anger that had come up about them, but I first wanted to air them in therapy and gain a more healthy view as I would NEVER in a MILLION years have dreamed of ever telling this loved one the things I had thought and felt that I spilled out in therapy . . .

Mostly, though, after the first two hours of shock and a myriad of all sorts of feelings, I mostly felt PAIN. A deep and abiding pain that I had caused such (what I felt to be) DEEP pain to my loved one. As the evening wore on, this pain consumed me more and more until I quickly became incapable of functioning very well at all; in fact, I could not sleep at all that night, and at 8:30am the next morning, I asked for an urgent appointment that day with my psychologist, if he could fit me in.

He did, indeed, fit me in; and later reassured me when I enquired (inquired?) that this was an appropriate request for me to have made, given the situation and my level of distress (well, not in so many words but that's basically what he meant).

After the appointment, having gained a bit of perspective, and a little bit of distance from my pain, I was able to function a bit again, but I was still filled with pain.

I still am, close to a week later, although the feelings, especially those of an anxious nature, were mitigated and reduced by the miraculous to me fact of his eventual forgiveness of me, last week.

I am doing my best to process this and move past it, but it still has a bigger hold than I'd like. I also realize that some time may be part of the necessary healing element, here. Writing will be helpful as well.

Also helpful was the fact that my psychologist was unhappily surprised by the fact that people could hear some or all of sessions (I speak louder than many in day to day life; on the overheard session in question, I had so much to say I was unaware that I was speaking even louder than normal, but apparently not loud enough to elicit any cautions from my therapist . . . . ). See, I have heard bits & pieces of others' sessions since he moved to the bigger office down the hall a few years ago; my loved one has had the same experience of my sessions, hearing bits and pieces.

My therapist is going to put some kind of noise generator, a white noise, ambient noise thing, in the waiting area, after consulting and getting agreement from the lawyers who share that waiting area with him. This made me feel safer, although I won't feel entirely safe again there until it's done, and even then, the fear I feel inside, because I REALLY opened up COMPLETELY and showed the UGLINESS inside that I've always feared would lead to really bad things if people saw it or heard it, well, I don't know when I'll get over that fear, which is obviously fodder for therapy.

Anyway. Just because this person forgave me, doesn't mean they aren't still hurting, but it does mean they've gotten to a better place with it than I have. For my part, I forgave them for not moving to a further location when they realized they were overhearing my private session. Still, I have a whole host of other issues to deal with, and the biggest one may be how to forgive myself. That's something I'm not very good it. Yep, more fodder for therapy.

Double-Booked Psychotherapy Appointments: When It Happens To You

You feel unpleasantly surprised, when you arrive and see the waiting area (in my therapist's case, there's only seating for two) occupied, with a mother and teen son.

You feel brought up short, yanked backwards, because in the car on the way to your appointment, you've been shuffling through a whole host of important things currently going on with you, trying to prioritize, trying to decide what to talk about, and then BAM, the rug is yanked from under you.

Before the therapist's door opens to see the situation (he's running a few minutes late with his 4pm appointment, it's now after five) you start discussing the situation out loud with your husband, knowing the other patients will hear you. You say things like, "I could have sworn he said we were switching to Mondays," and other things that indicate you have a right to be there, too, as you feel as if you have to justify yourself (which you don't, at least not to the other patients, but my anxieties tend to run amok . . . .)

When his door does open, he greets the other patients and then steps out far enough where he can finally see you, and a look of being unpleasantly surprised crosses his face. There's no getting around it, seeing your psychotherapist seem to feel unpleasantly surprised by YOUR presence, by YOU, is slightly jarring to the therapeutic relationship; pushing forward through THAT awkward feeling, you realize that of course this is awkward for anyone (although throughout it all, the other patient(s) never said a word and acted as though the appointment was theirs all along).

So, you step forward to greet your therapist as he gets over his initial surprise quite quickly, flashing through some confusion as he queries you about what you are doing there . . . and you realize inside, feel, that "Oh no, I am really stupid; what and how did I get this wrong?" On the other hand, you DID bring your spouse up to his floor with you, which you usually don't do; this was done in case I remembered our schedule change incorrectly, although I had been pretty sure I'd remembered it right. I pretty much always bring my spouse up when there's been a schedule change, because of anxieties about getting it wrong.

So I explained what I was doing there, and what I thought he'd said during our discussion in December about how our schedule was going to change, and he told me, "Yes, but," and told me some other things he thought he had added that I didn't remember. Quite quickly he started apologizing since there'd obviously been a misunderstanding (it felt, to me, at the time, right there, that perhaps he was apologizing just to speed things up to get to the other people, and not because he actually thought he might have messed up), and I started apologizing as well; things before he went on vacation at the end of December WERE kind of hectic and who knows, maybe I remembered it wrong.

So, after that wrapped up, about 90 seconds total, I and my spouse left, and I said that I felt like an idiot.

Still, I got over it. One does, you know. Everyone makes mistakes, and misunderstandings happen. Whether it was his mistake or my mistake isn't very important to me, anymore, I realized after I got home. I had more time to think on it and really felt more badly for the awkwardness the situation had caused him, than for my being put out at all by it.

Still, it was VERY nice of him to call me a bit after his 5pm appointment was over; he apologized in a way that felt more thoughtful, less rushed to me, but then he'd had some time to think about it since it had happened. He said that he did feel that he'd contributed to the misunderstanding, and he was sorry that he'd had a part in creating such an awkward situation (well this isn't exactly how he put it but it's what I can remember of what it seemed he was trying to get across). I accepted his apology and gave my own; after some time at home (it took an hour lol) some of the things he'd said that he'd thought he added started to sound a little vaguely familiar. So I did indeed feel like I'd either not heard him due to distraction at our last appointment, or that I'd remembered what he said wrong; for his part, based on our conversation before his 5pm appointment started, it seemed like he had remembered our discussion a little incorrectly as well.

Regardless of who remembered and forgot what, the fact that he called me really made me feel better about the slight unpleasant feeling I'd had when he was looking at ME as though I were the cause of something unpleasant; it was really nice of him to call, and I think especially nice, as a professional courtesy, to do it.

Another stigmatizing board game

DeathMatch Asylum

Description of the game:

You’re a patient in a mental hospital. You awaken one morning to discover that all of the doctors and nurses are missing! This means that A) your control mechanisms are missing, and B) you’re low on medication. You do the obvious thing of course, you grab the nearest high-powered weapon and lay into your fellow inmates with a passion!

DeathMatch Asylum(tm) is a miniatures game / board game that simulates the multi-player first person shooter computer games. Play is fast-paced and humorous, and it’s a snap to learn!

I know this appeals to a juvenile male mentality, and setting seems to matter little to that demographic quite often, but this is really quite awful. This is a GAME?

Of course, I'm sure there's been bloody video games set in sanitariums and the like, but I don't think that makes it socially acceptable. The stigma associated with mental illness, especially with anything perceived to be related to "insanity", including hallucinations, etc., seems to make this seem even like a FUN setting for such a game, to some people.

If mental illness were truly seen as equal to other illnesses, well, then we'd either have people setting first person shooter games in cancer wards, or they'd set nothing violent against or by the patients there in either case.

The fact that people would be horrified if they made a game like the above, if it'd be set in a cancer ward, but not for a "mental" ward, well, it shows that we've got a long way to go in reducing and eliminating stigma for mental illnesses.

I could go on and on but here is a Geeklist on Board Game Geek.com of "insane" games; ie, they involve mental illness in some way. Some are rather offensive. Others seem to be "mad" because they are based on Mad Magazine. I haven't checked any out, just scrolled through and saw some horribly offensive ones.

http://boardgamegeek.com/geeklist/1230/item/19573#item19573

 

 

Pummeled by Wind

Well, I was going to blog about what last thursday's wind storm, clocked at 102+ right at the worst of it where we were (and that was the worst of it anywhere) was like, but I feel weary because the winds are coming again. They just started, and will supposedly last for about 13 hours.

Sleep? What's that!

Last Thursday's winds started at 2 am and tapered off around noon; they were equivalent to category 2 hurricane-force winds. Apparently they were NOT canyon winds like was thought for the first half of the storm; I forget the technical term for it, but when the winds come at JUST the right angle, instead of pouring down the canyons they'll just ride up the slope on the other side of the mountains and waterfall crash down on top of us right from the peaks. It certainly felt like something massively violent was crashing down upon us.

The worst of it psychologically was hearing the destruction going on around us; tearing metal, siding peeling away from our building like a banana peel, strip by strip, with extra worry every time one came off, hoping it didn't hit the windows. Hearing a bunch of metal clattering and clanging as things over in the store parking lot to the west of us were torn up, from small things like shopping cart returns (boy those metal poles make a racket when they're flying through the air!), pieces of signage, and other things, added to the discord and sense of destruction.

The tendency to anthropomorphize the wind into some sort of ferocious beast, lashing at us sometimes with whip-like cracks of wind on the windows, or voracious-sounding swirls that seemed hungry for targets, or the sense of being under Thor's Hammer, well these things weren't that helpful to dwell on, although hard not to think about as the violence around us went on. Sleep was out the window; thank goodness nothing broke the windows because also, anytime any debris slapped up against one, there was worry.

But, we surived, power out and all, the place cooling uncomfortably, with us nestled in wool socks and beneath blankets. Storm over, we eventually pulled up roots and stayed elsewhere for the night, leaving faucets dripping to avoid frozen pipes.

The damage and debris afterwards around town were quite startling. Heck, 1000 trees on golf courses alone were down. The ones down in neighborhoods were much more jarring. A 20-30 foot tree limb with branches crashed down yards from our back window. It's still there.

One of the eerie things was how swept beyond clean the front lawns were; I eventually nailed down the "unreal" feeling as the fact that it looked like the artificial lawns/environment in the Truman Show movie. Most of the debris here got swept into our lower stairwells.

Anyway, here's hoping the power doesn't go out tonight cause it's a cold one. I also hope the stupid school district makes better decisions, faster, than last Thursday. I had to decide myself she wasn't going in then 96mph winds about half an hour before school closures were announced. The school was closed Friday as well, so I'm worried they'll push for staying open even if it's dangerous tomorrow morning . . . my daughter walks to school, and I haven't been able to wrangle a ride for her yet if school is open in the morning.

Anyway, we're in for a loud and unnerving night, but the winds should be supposedly only gusting up to 60-65 (last time they said 70 or so, so I'm taking this prediction with a grain of salt.)

Thankful for brick construction despite the peel-off siding (well, in hurricane winds it's peel-off siding lol.) Thankful for our safety, and power, and warmth.

Special Needs Child & Starting Junior High

OY.

It's been two weeks, and I've got a headache just thinking about it.

Every time I think, "Oh, I've just emailed back and forth with x period's teacher and gotten on top of something, " something else will smack me in the face a minute later, like missing work in Computer class because it wouldn't print and she didn't know to ask for help like other kids might.

Or tonight, after sending an email to all her teachers to introduce some of the issues (self and time management and organization of both, being the biggest ones). I had been encouraged by the responses from two teachers I had individually emailed the week before, so I thought I'd better email them all, even though I hope they've all read her IEP as it demands certain accommodations that every class had better make.

I get done doing this, and then my husband flips over a recently-graded Enlish assignment and on the back, written twice, harshly, is, "I HATE ENGLISH CLASS".

My heart is breaking and I feel like how can I expect her to stay on top of so many things when I'm having trouble staying on top of trying to keep her organized and on track with everything?

How can I expect her to be up on all this when new things and all sorts of changes are difficult for an autistic child to handle, when she's likely overwhelmed by all these new things that I feel like a "Bad Mommy tm" for doing what I need to do to help her, but feel like I'm just piling on her more?

And yet I feel like a "Bad Mommy tm" for the days when I've not reminded her about EVERYTHING, when I've not gone through her accordian organizer and her planner to check if she's written down homework and tests, and then see if she's brought the homework home . . ..

Can I pull my hair out yet? Please?!! Somebody say Junior High and a special needs child will get easier, at some point, pretttyyyy pleassseeee!!

"Take the Money and Run"

This newish TV show is interesting . . . I'm finding tonight's episode much more interesting than that parts of the premier episode, but maybe it's because the two gay mens' reactions to lockup (cement block walls, no windows etc.) is so different. I'm not enjoying watching distress, but they DId know what they were signing up for. What I find interesting is what's going on with them, psychologically.

During the first hour they had to hide the briefcase full of $100k, the stuff they did to decoy the cops' later investigations, some of it was quite clever, one thing I thought, oh there's no way that's going to fool the cops, but it is! And stuff.

The one gay partner thought his partner, the opera singer, wouldn't handle lockup very well, being claustrophobic and all. Part of me wonders if they put that on their application for the show, to make him seem more vulnerable to the cops . . . because this opera singer guy is making ME think sometimes that he's not doing so good, and then later, when he reveals to the camera for the show that won't get shown to the cops, that he's playing them, well, he's an awfully good actor! Then again, opera singers act . . . have the cops forgotten this? One is on to him a little the other isn't, but during one bold-faced lie to the male interrogator the cop responds with, "That's the most honest answer I've heard in 20 hours! If it's a lie, it's a damn good one!"

That's the first point I thought, either the cop is an idiot, the guy is a superb actor, OR the cop thinks it's a lie but doesn't want the "perp" to know he knows it . . . Plus, nothing like a little flattery to make the guy think he's getting away with it, hoping he'll get overconfident. . .

I still have the last 5-10 mins of the show to go, so I don't know who's going to win the $100k, cops or the gay couple, but I suspect it's the latter. Just not enough time for the cops to suss out what happened, with the dodges and decoys the two men put in place.

The show also has the men describe what's going on with them psychologically/emotionally as it shows them pacing their cells, and it's very interesting. I imagine for some people, there comes a point where they want out so bad they give up the money's location in order to get out a day or half a day sooner.

I don't know if it's psychologically such a good idea to put yourself through the traumatizing experience of arrest, detention, interrogation, but then they don't have to sign up for the show, either. And of course, it's not an arrest that will be on your record because it's not a real arrest. It just feels all TOO real once they're in there, though, much more so than they could have imagined.

It's also interesting to see the psychological/manipulation techniques the cops use as they interrogate the "perps". The female interrogator actually got to feeling really guilty after her first interview with the opera singer.

Things I Never Want to See (or Step On) Again After Cleaning Daughter's Room

PERLER beads!! Ouch

Easter Grass. Not a pain to step on, but when you are sorting out umpteen billion tiny things, and have to pull strands of Easter grass out from around them and among them, you curse your autistic daughter's love for stringy things . . . (not out loud, just in my head!)

Tiny Polly Pocket accessories; especially footwear, that you practically need a magnifying glass to see.

Orphan puzzle pieces, that seem to have been breeding in the heaped piles of stuff (yes, it's been awhile since we overhauled her room.)

Lego, of course. Some of the pieces rival Polly Pocket stuff for microscopic-ness, although these hurt much more to step on.

All the torn off, torn apart, dissassembled pieces of toys that my daughter's urge to deconstruct has left in her wake.

Things like screws, washers, twist-tie wiry things or similar from packaged toys, miscellaneous wire, and even a "be careful where you dig this flag marks an underground gas pipe" flag on rusty wire from the local gas utility (sternly scolded for that one, with lots of internal frustration because her desire for metal objects, and especially wiry ones because that intersects with her desire for long, thing, stringy objects, makes it likely that something she shouldn't be bringing home will definitely be coming home with her in the future).

Some of my clear, vinyl cling stamps or silicone clear stamps, ruined. I think the texture and feel of them appeal to her sensory cravings, like the metal and stringy things.

Umpteen-billion rocks, some smooth, some with sharper edges (at least as felt when stepped on. If given a choice, I believe she prefers smooth rocks but she'll take any rock that catches her fancy. Lots of tactility here (and muffled or not-so-muffled curses when stepped upon).

15 shirts of varying sizes from the 4 years previous, almost always gifts (at least when we buy we have some idea of her preferences as well as she has alot more input on her wardrobe now), and 85% long sleeve. A few even still have the original sales tags on. It's money wasted, but grandparents and others that want to buy her clothes for her birthday and Christmas (she has a cool-weather birthday) would get offended if they didn't get to pick out clothes for her, or if we asked them not to. They enjoy that aspect of grandparent hood; the problem is, if they don't get worn, it's money down the drain until she grows out of it and we give it to a cousin or something. The long-sleeve issue is partly because of the water on the elbow that she gets, in both elbows now this last year, which we are having her tested on Thursday for rheumatoid arthritis . . .

The same frustration with little to no times worn, for dresses. If it's a dress that's not red, or pink to a lesser degree, then there's onlyu a 10% chance she'll wear it, and only if she likes it.

Erases popped out of the end of pencils, and the little metal piece that divides it from the pencil is also off, and chewed to almost unrecognizability. She has sensory issues here, too.

A host of other things but these things I could really do without. Because of her cravings for certain sensations, feels of objects, etc., some of these problems aren't going away any time soon.

"You Are Not a Resident of Utah"

That's news to me!

I knew I was expecting some forms in the mail from Medicaid or Department of Workforce Services, since my husband starts work at the end of the month and I needed them to send an employment information form to report the new job information to them.

As well I needed to know what they needed to get my daughter on my Medicaid.

So today I get a thick envelope, with a letter and form for the employment situation, and a letter saying what they need to consider my daughter.

But smack on top of the pile, is a NOTICE OF DECISION. Regarding me, and it says action taken is CLOSURE (of Medicaid benefits). Reason given? "You are not a Utah resident."

WTH? I've been living in Utah since the late 80's, people! I figured, after a few heart-palpitating moments, that since I had them amend my address last week (they'd been forgetting the apartment number so sometimes I wouldn't get my Medicaid cards), that the system now thinks the Apt. number is on the line of the address that city and state used to be on, so it thought that I'd left Utah since Utah wasn't on that address line any longer.

I called the guy I talked to last week (thanking goodness that I'd gotten his direct number, because he was layers and layers and layers in to the various recorded menus in that phone system) and he said that the computer shows that this notice was sent, but there's no reason for it. He said sometimes it messes up. He says my benefits are open, and not going to close, although they ARE waiting for the new employment information. But the benefits aren't going to close at the end of the month, and I asked him if I needed to appeal like the notice said and he said no.

I really, really hope he's right, because if I miss my time period for appealing something that needs it I'll be really angry and upset. Still, I can see that this could be a stupid computer error based on what I said above . . . . but WHAT an error!

Government can be so stupid sometimes. At least it was "efficient" in sending me all of these papers in one envelope.

Don't Sweat the Small Stuff

After 40 minutes of walking around Wal-Mart, with half or more of that time spent looking at things in aisles without walking much, this is how I looked as soon as I came home.

Sweat was raining off of me if I tilted forward a little. But only my head and neck were sweating.

 

This has been the case ever since I started Effexor some years ago, and it hasn't stopped though the Effexor was halted in February of '09. Recently I read that excessive sweating can be a symptom of serotonin syndrome, but there's other symptoms as well; I don't think I have that because of one symptom. I did take Cymbalta throughout much of the rest of '09; then, in '10, I was tried on a few different antidepressants but none after the summer.

This symptom or whatever it is, is extremely embarrassing to me, and highly inconvenient; it's already hard enough for me to go to the store and walk around, with my knees/legs hurting, and often a limp, so my motivation to go out is already low, but this sweating causes me to not want to go out anywhere if much walking is needed.

I suppose I could wear one of those around the neck fans, into the store; we've got one, although it eats batteries . . . but I'm afraid people will think I'm wierd, especially if I do it in the winter. My therapist says, "Nobody's looking at you, they're not thinking about you." I think he may be right, partially, but the fan makes a noticeable though not loud noise, enough to catch someone's attention, so . . . and even with the fan, I sweat too much, but it helps slow the rain a little.

For years, I've thought of this as a small, permanent side effect of that medication. Now, I'm thinking maybe it's not so small, since it's interfering with my life. Granted, part of what's interfering with my life is my anxiety about this side effect . . .

I remember way back when, mentioning this side effect to my first psychiatrist; the thing is, this may have been while he was temporarily suspended, and so the substitute heard it. He may have gone over her notes before seeing me again but maybe it didn't jump out, if she wrote it down. I might have brought it up with him later but I really can't remember. Nothing much was made of it if I did, and I wish, if I did bring it up with him, that he had asked me more about it.

Maybe I feel that if he had he could have done something to make it go away, but if it's permanent now then maybe it was permanent as soon as the side effect first showed up . . . but that doesn't mean the psychiatrist shouldn't care about it, right? I'm just feeling really let down by those who one trusts to take the best medical care of them . . . it's just that this is a pretty big thing, for someone who tends to have hermit tendencies, this kind of clinches it . . . and that fills me with sorrow, though I don't know why.

So, for a long time, I didn't "sweat" what I thought was a small thing. Now, I no longer think it's a small thing. Maybe I'd be better off if I didn't care, because that would be one less thing to be depressed about; ie, being depressed about something you can't change probably isn't the best thing in the world.

About My Psychiatrist/Patient Relationship

My last appointment was almost two weeks ago, with the psychiatrist.

She's decided to keep me on 150mg Lamictal, though I told her I wasn't sure how effective it was. She said I need to modify my behavior, implying that I'm expecting the medication to take care of the problem.

You know, I can understand that and that's fine, I work hard on modifying my behavior anyway even if it often seems to be futile and frustrating.

The thing is, when I came back to her last November after not seeing her since July, and told her about my mania and the most troubling behavioral symptoms of it, she was all, "OH! We need to get you on some medication right away so you don't ruin your life!"

So, I feel like she's being a bit of a hypocrite; actually, what she's telling me now with, "Oh, modify your behavior," it seems the exact opposite of what she told me last November!!!

Now, regardless of whether a behavior is influenced by or triggered by my mania, I believe a person should work as hard as they can to modify/change that behavior. BUT . . . when the mania is pushing you, urging you, sometimes overwhelming you . . . . that makes it so difficult it feels impossible at times to just manage it yourself.

Another thing: If I only engage in the behavior when I'm manic, whilst other times I have enough self-control to keep from engaging in the behavior, as well as at these other non-manic times I don't have any desire or wish to engage in the behavior, well that to me says there's a biological factor influenceing and/or triggering the behavior. Meaning in order for me to deal with this, medication would be more than helpful.

I am frustrated though that so many medications have not worked out for me, but I can remember how moderately well the Risperdal worked, as opposed to how moderately poorly the Lamictal is working at 150mg. When I was on 200mg Lamictal, it felt like it was closer to the effectiveness of the Risperdal, but I can't go that high on Lamictal. We had actually been shooting for 300mg even.

I'd say the Lamictal is taking about 24% to 30% off the edge of my mania, while the Risperdal was more like roughly 55% or so. This is academic however since I can't go back on Risperdal.

I am also rather afraid of Lithium, given its high side effect profile (not sure if I'm phrasing that right.)

I think besides Lithium and Zyprexa, the only other medication might be Seroquel, which we tried last year for depression and it didn't work well for that; I wonder how it would do for the mania, though. We stopped the Seroquel (it was 300-400mg, I forget) about two months before the mania hit big-time. I will NOT take Zyprexa, after the Depakote caused me to gain weight; I can't deal with the diabetes risk. I've heard that PCOS (polycystic ovarian syndrome) is a pre-diabetic condition anyway, but I have no idea.

As far as I know, we've run through almost all of the bipolar medication options. Then again, I don't know much lol.

I'm frustrated with my psychiatrist for acting like a hypocrite though. I do realize that 25% to 30% off my mania is better than nothing. I did not put it in terms of a percentage to her, however, I just came up with that as I was writing this post.

Another frustration is that I'd heard Lamictal and birth control pills can affect each other; I've heard that either one makes the other less effective, or that both make each other less effective.

So I asked her, and she said that, if anything, the Lamictal makes the birth control less effective (I had mostly heard it was the other way around.) So I had my husband ask the pharmacist when he went to pick up my pills, and he confirmed what my psychiatrist said.

This angers me, because neither the pharmacist nor the psychiatrist told me of this side effect with potentially huge consequences. Granted, I wasn't on the birth control pills when I started the Lamictal, but when I did start the birth control pills, I emailed the psychiatrist, as well as discussed them and the reasons for them as opposed to the permanent solution to birth control I am working on getting comfortable with. So during this whole discussion about my fertility and deciding to end it, and why I'm taking birth control pills instead of doing something else right now, she never mentioned this important side effect. And neither did the pharmacist, though I thought drug interactions were part of their main concern.

I know no one is perfect, though. It just could have huge consequences . . . . this is the first time I feel my psychiatrist has not been on the ball, really sharp mentally, extremely knowledgeable, about medications and the issues related to them. So she can't remember everything, all the time, I'm telling myself, trying to not expect perfectiong. Still, of all the side effects to forget, this one is a doozy.

I REALLY don't want to do something permanent to my body, ie, the uterine ablation or whatever it's called when they freeze the lining in there, until I'm comfortable with it, until I've come to terms with how I feel about ending my fertility (what little there might be with PCOS).

I'm also frustrated with my psychiatrist for not wanting to deal with my depression; we haven't tried anything for it since the Seroquel last year. Perhaps she wanted to get the mania under control, first, but it seems she's decided it's as under control as it's going to be . . . so why not address the depression?

I think there may be a couple of reasons for that. One, anti-depressants can set off mania, and we don't want to make that worse. Two, her practice has been getting busier and busier; it was six weeks between the last two appointments, and now it's two months until the next one. While I'm kinda happy not to see her as soon, on the other hand I wonder if she's getting too busy. Although it could be that since she feels I'm as good as I can be on the Lamictal, she wants it to float that way for awhile, and see in two months how I am . . .

I keep reading back and seeing I say, I think she may have these reasons, or she may feel this way, etc., and I wince, because shouldn't she and I be DISCUSSING these things? Then again I AM afraid of her, and we've discussed what I've thought of to discuss in recent appointments; it's been less of her forced "Let's talk about whatever comes out of your mouth first" contrived technique.

Do I think my fear of her may be part of the reason I "forget" important stuff to talk about? Perhaps. I'm certainly not gonna be near as critical of her in appointment as I am on this blog. There's a difference between being critical and asking genuine questions that may sound as if I'm questioning her reasons for what she's prescribing and why; I can see why I might be afraid to ask her such questions, but in a good doctor/patient relationship the doctor should feel or act threatened by a patient wondering about these things. Our relationship is not a good one, however, and after typing this post which is helping me think through these issues, I wonder how harmful to my health IS this doctor/patient relationship becoming, if I can't ask her the questions I feel are necessary for the best care . . . .