A Second Appointment

Last week I had an appointment with the psychiatrist. She is very nice, and seems to be up for at least a bit of discussion, rather than pronouncing a mood state and sending me away with a prescription.

This was the second time I’d seen her, but I barely remember the first. What I do remember is a few strange questions, or at least questions that seemed strange at the time: have you made any new friends? Why are you thinking about the nature of the universe and infinity? Have you been taking your medication?

The answer to the first was “yes of course, why wouldn’t I be?” I’d been meeting people at bus stops, in cafes, in the waiting room at the CMHT, and just talking to them. Why shouldn’t I? I didn’t understand why not. I never went beyond just talking, never a suggestion of a second meeting, but I still considered them friends. I think, and this might be largely guesswork, that most people were happy to chat. I remember a few slightly worried or bewildered faces, but I just couldn’t process what that meant, and I didn’t want to stop talking anyway. I must have said some strange things, but no one actually walked away from me. I think.

The psychiatrist asked me again this time. The answer was no, I hadn’t met anyone new to make friends with. I’d forgotten about her asking the question the first time around, and it really threw me. I’ve been feeling like I’ve actually been faking the whole bipolar thing somehow and that actually there’s nothing wrong, but the reminder of how I was feeling and behaving then was a little bit of a shock. It wasn’t how I’d remembered the episode, if that’s what it was, what little of it I do actually remember seems like it was me as I truly am. So no, no new friends, even if I am naturally an extrovert and a fairly gregarious person.

She asked me last time why I was thinking about maths, the nature of the universe and infinity. I won’t go into too much detail as it’s vaguely triggering for me, or at least upsetting to realise I can’t think about such things without losing quite a lot of my marbles. Suffice to say, it interests me to think about what might be and what could be. So that’s why I was thinking about it – it’s interesting. What I didn’t understand at the time was why this was even an issue. Why shouldn’t I think about interesting things? It’s not like I was psychotic and planning to save the world through creating clean, cheap energy like I have done before. I’m not sure if I made that clear. She seemed to think that thinking about maths, the universe and infinity was not normal. And it probably isn’t for some, but if I actually don’t have bipolar, then maybe it’s fine to think about. Maybe it’s normal for me, the real me. I’m all in a mess about this and I can’t quite work out how I feel about it all. I’m probably wildly contradicting myself. That’s really all there is to it. I thought it was interesting, and I wanted to understand things like modular forms.

This time she asked me if I was still thinking about these things, of course. It hadn’t even occurred to me to think about them. Now I know I can’t, not without going down that path again, and I’m not sure I’d even understand it if I did. But if nothing is wrong then I can think about them. I’m so conflicted. Again, last week at least, the answer was simple – no. I’m thinking about more practical things like getting a job, making blankets for my friend’s babies, and concentrating on cooking suitable meals with burning the house down. There’s no time for the universe.

I’m sure she asked several other questions both last time and this one. I remember something about too many projects, annoying people, and my ability to sit still. Last time she asked me to rate my mood on a scale of one to ten, five being normal. I said six, so I must’ve had some insight. She put me at an eight. I’m not sure what that means for a psychiatrist. I wasn’t sectionable anyway, by anyone’s standards. I think.

The big one. “Have you been taking your medication?” The answer both times was the same. Yes. I might have forgotten once or twice a week while my mood was high, but I remembered enough. I remember about the same amount now. My brain is foggy these days. She told me I had to take it “religiously”, and promptly increased my aripiprazole dose to 30mg. I remain slightly confused by this. If I was manic, then why not increase my mood stabiliser rather than my antipsychotic? Aripiprazole doesn’t exactly bring people down fast, so why not take that time to stabilise with lamotrigine rather than maxing out my aripiprazole dose? Perhaps she was hoping it’d bring me down faster. Perhaps i should have asked. I wasn’t happy about taking more meds, and I’m not quite sure why I agreed to it. That bit is lost to the sands of time. I’m told that if I can’t remember what happened, that should give me an indication of how high my mood was. I’m not so sure. She also increased my clonazepam dose from 0.5mg per day to 0.5 twice a day, plus 1-2mg at night depending on the amount of sleep I was having. I was barely sleeping at all then. The clonazepam did mask those feelings of clarity a bit. I felt very slow, and it was frustrating. I took out though, and again I don’t know why I agreed to any of it.

And now, of course, I am still taking the aripiprazole (I dropped the clonazepam about five weeks ago). It’s an issue. I don’t want to, I definitely don’t want to take it at the dose I am taking it. So why am I taking it? It’s a good question, if I don’t want to then why should I? There is no simple answer for this one. Mostly I don’t want to piss people off – if I don’t take it people will worry. “You will get ill if you don’t take it.” To paraphrase my husband, “don’t you want to get a job and have kids and a house?” I do want those things, but I’m not sure that the meds will help with that. If I don’t need them, then not taking them would still result in all those things. I’m working on it.

People keep presenting me with evidence of my having bipolar. I don’t remember it, my mood was clearly manic and scaring my friends and family, I was climbing trees and making friends with strangers, I wasn’t sleeping, I was barely eating and yet somehow still alive and running at three times the speed of everyone else.

I don’t know what to do with this information. It doesn’t tally with what I remember. I remember everyone else being very slow, for example. I’m questioning myself – is it everyone else that had a problem, or was it just me? Is it more likely that I was fast, or that every single other person was slow? I suspect this was the case, logically. But my experience is so firm in my mind. It was like there was a time dilation bubble going on. Very sci-fi. I don’t remember taking risks like climbing large trees or driving too fast and recklessly. I can only take other people’s word for it, and I don’t know how much their perceptions are skewed by the label. It’s possible I was just a bit hyper and everyone else panicked and read too much into it.

This is the crux of it. Was I really manic or was it just the perception by others? If the former then meds are necessary, and perhaps I can reduce them or come off them in time. If the latter, then the meds are not necessary and are only causing unnecessary side effects like this god awful tremor. I don’t know how to work out which way around it is without coming off the meds, and I can’t do that because people will be angry and scared and worried, and because I run the risk of being wrong, and I’m not perfectly healthy. I could end up back in hospital, I could end up dead. I could of course be fine. It’s a mess. This post is a mess. I’m stopping now.

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