This was in June.
Since I'm going to be seeing her again this next week, I'd better update the blog with this exceptionally positive step forward in our relationship. Not perfect, but positive between her and I, to this degree, was unexpected.
I even brought up being afraid of her, and the last time I did THAT, she yelled at me. Things went much better, this time.
She was running late, this appointment. It was late in the day, and my appointment was for 5:20. When she came out of her previous appointment (I assumed) right then, I prepared myself to get up and go in. Instead, on her way back to the office, she called to a different patient, and as she passed me she apologized for being behind. I indicated I understood and that it wasn't a problem, which she seemed to appreciate.
I could see that the next people to arrive, were startled/surprised to see that someone else (me) was called in, at the appointment time they thought was theirs. I believe she apologized to them as well.
I like that she's conscientious of her patients like that. It gave me the beginnings of a feeling inside that maybe today might be less confrontational in the past. Just an inkling, really.
I forget what I first mentioned, which is a shame because she usually starts our discussion with something springing from that. Ah, I remember, she commented on my positive demeanor as I settled myself on the soft green couch. This startled me; she was the second person in three days to use those words to describe me.
She asked about it, and I said maybe it was from having dealt with formal church discipline and now it wasn't hanging over my head, I could move forward? I'm not sure why I said that; it still hurts deeply, but with a bit of time I've come to see that actually it is better, now, moving forward with that behind me.
She went on with the discussion for a bit but her curiousity had been peaked and she had to return to the church discipline thing, ask about it, what it was, how it worked (briefly, very), why/what for, and such. I had thought what for would be obvious, but I briefly, in about 40 seconds or so, described the situation, including that they were disciplining me for doing something for which my mania was a contributing factor.
She got indignant on my behalf, saying things like, "Mania is part of your illness; you enter an altered state of mind!" She went into this for a minute or two, aghast that they would penalize me as harshly as they did, for something she feels was . . . well, that I wasn't in my right mind for, wasn't acting completely from who I'd choose to be were it not for the mania.
For myself, I've always taken responsibility for myself and my actions as soon as I return to a state of mind where I can do so; however, I didn't frame it that way for my clergy, lest they think I was trying to not be responsible. I was being responsible, but . . . I framed it as, the mania was a contributing factor.
She went on to tell me that I should educate my Bishop and congregation about my illness and the way it works. No one actually has ever outright said to me before that you go into an altered state of mind. It would be nice if sometime someone would actually tell me more about it; yeah I can read on the internet, but I need a doctor to tell ME.
My first shrink to my face thought I was borderline, not bipolar, and when I said that to my psychologist he pointed out that, well, he prescribed a mood stabilizer, and that'd be unethical if you're not bipolar . . . I never thought about it til now, that after that I just went into symptoms etc. with each new psychiatrist, and never asked for any education; no one had ever explained anything to me. I got more explanation from the government-contracted shrink who evaluated me for disability than I did from anyone else, ever.
So, her advocating for me, showing that she cared that people had/were judging me for things that at the very least were influenced by mania, and that she was indignant that they wouldn't know or consider my illness to be much of a contributing/mitigating factor at all, well, this made me feel good, and more importantly, made me feel more connected to her as my doctor. This strengthened a . . .turbulent therapeutic relationship.
As she made some notes and asked something to further our discussion on other stuff, I worked in my issues with her (some of them), such as that I was intimidated by her, scared of her, and that when she threw out advice to me as to stuff she thought I should be doing, stuff that I felt didn't fit my belief system (like the previous appointment's ridiculousness where she told me working on my marriage and family was selfish, I should look to serving others instead, I took this as her karmic point of view), that I felt like they were harsh, rigid orders and that she didn't understand or accept that I needed to take what I could from her advice, sort through it, despite any difficult feelings about her manner of presentation, and keep what worked for me and set aside what didn't.
She heard me out, and seemed a bit astonished that I didn't know that she wasn't ordering me at all; that she said what she did, and that it was my life and my decisions about what to follow and what not to. That of course we're from different backgrounds, and that it's my life, I"m the one living it and not she, so who better than I to sift through what she advises and make my choices.
I was kind of stunned; I thought that if only we could have had this conersation 18 months ago! I was so bouyed by her remarks I added some other things to the discussion of our relationship.
As far as meds, at our first appointment this year I had just gotten to 150,g Lamictal, with a mild non-sunburny rash. In a different place than the last two times (and according to my hairdresser, there's an allergic-looking rash on my scalp, too). I said the Lamictal was doing ok, though I needed more time to be sure. I actually mentioned adding Seroquel; we'd tried it two years ago for depression, which it did not work for. I didn't have any noticeable side effects except for being sleepy alot.
She said, "I thought we stopped that because of your PCOS?" I was confused; what does Seroquel have to do with that, does it make it worse? I ignored asking that and said, "No, we stopped it because it wasn't working for the depression; however, isn't it supposed to be a mood stabilizer, work on mania? It didn't cause me side effects other than tiredness, so what do you think of trying it again?"
I went on to mention, a bit embarrassedly that I'd seen on someone else's blog that they were on these two meds. Of course there's no guarantee they'd work well in combo for me. Still, she seemed to want to know all of why I was asking, and so I told her.
She was very open to it and, in fact, had prescribed the Seroquel at our first 2012 appointment in May. At the June appointment, she asked if the meds were smoothing me out, making me serene. They were definitely helping, and I told her, but I wasn't what I'd call serene. In fact, I wondered if we needed to raise the Seroquel? She held it at 150mg for now, and after some key things during our appointment had made her actively diagnose me w/ADD herself, instead of relying on other shrinks' diagnosis, we discussed Vyvanse.
I'll be trying it at what is it, 30-40mg? Since the 70 I'd been on was seeming to be too much. I'm just in a mess of getting the new dose approved by Medicaid, and dealing with her incompetent secretarial substitutes as her main secretary has been on two one-week vacations in 4 weeks. UGH. I may not have the prescription by this appointment!
Oh, one other BIG thing, is I will be going to a monthly group she holds there, for ADD adults. No fee, at 7pm. My appointment is at 6 or 6:30. I'm nervous about this, but somewhat less so after clearing the air in our relationship.
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