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Tuesday, September 06, 2005

Depression vs paranoia

I really appreciate your input, you two. Your comments mean more to me than you might think.

But I still don't think you 100% understand.

If I had written the post that I did, but instead of saying that I was paranoid, thinking everyone was talking about me, and I had instead written that I was depressed and couldn't get out of bed, would you have told me to buck up and things'll get better, sunshine and roses and all that?

I went to the second opinion doctor today. And then a few hours later saw my own doctor. It's a bit of a long story, the brunt of which says that I am NOT changing doctors and that was no one's intention, just wanted to have a second opinion on my MEDICATION apparently. You might say that I've had a stressful and emotional day, full of anger, anticipation, huge let down and, once I got into my own doctor's office, some venting.

We actually talked about the one thing that's been hanging over our relationship since day one when he had me committed two years ago: the fact that he took 36 hours to see me in a 72 hour forced incarceration and the fact that he made me stay an extra week "voluntarily" because if I didn't "volunteer" to stay he was going to put in my chart that I had discharged myself AMA (against medical advice) and that that fact would mean that no psychiatrist in this city of nearly 700,000 people would ever see me.

We cleared the air on that and a couple of other things. And because of that I actually began to hear a couple of things he was telling me.

And I tried to explain it to Rob later on. When I used the term "part of the disease" (a term the doctor used) Rob made a face. When I asked why, he said he's never heard it called a disease before. I don't believe that, but hey, what can I say. So I calmly said, if I was hearing the television and was positive it was sending me secret messages, and I was schizophrenic, would you agree that that was a disease. "I guess so", he said. And if I was diabetic and my pancreas wasn't functioning properly, wouldn't you say that was a disease? "Yes," he said. "well, bipolar disorder is being proven as an organic brain disorder, one that is capable of deterioration through lack of treatment, just as diabetes would. It is an organic physical disease of the brain".

So then I said I need you to understand that when I'm paranoid, telling me not to worry about it is asking me to do something that my brain just does on autopilot. Can I learn not to? Yes, I'm sure I can, once I've got the symptoms under control. And what I've been trying to explain is that I don't think these particular symptoms have been under control. My mind has been a scary place lately.

My paranoia:

It's no different than someone's bout of depression. It is not rational and within my control. I can't just necessarily reason it away.

Apparently I have a version of bipolar that has a good dose of psychotic symptoms. I guess it's the trade off for not really ever getting that depressed. Instead, I have almost constant paranoia, have the occasional auditory hallucination, have delusions of persecution occasionally and have regular bouts of thought insertion. You know, when thoughts just descend from the clouds and find rest in your brain, thoughts on a clear sunny day where you feel great and then out of the blue something comes in and says gee, I wonder how bad it would hurt if I just jumped off that bridge. All psychotic symptoms. And since they've been happening more and more lately...

he's adjusting my medicine.


He is not adjusting it to what the second opinion suggested.

He is upping my antipsychotic (the Seroquel), titrating in two week increments over a month up another 200 mg to 600. We've also made a possible connection to increasing stress at work and the recurrence of these symptoms. I go back in a month to discuss both the changes in the medications (how they did or did not work) and any symptom recurrence.

He said something about upping the other if the moods showed more fluctuation, but that the Seroquel is being studied as a monotherapy for bipolar, so that the Seroquel adjustment alone might also help smooth the changes in mood (heading towards mania as I was for the past few weeks).

Anyway - it's well past 10 and I'm back at work tomorrow. Time for bed.

Anonymous Anonymous said...
I feel that we are living parallel lives in different time zones. Each and every one of your posts could have been written by me if I were that eloquent.  

Blogger synergy said...
I'm curious as to what caused your change in attitude towards your orignal p-doc. You've spent months being furious with him and suddenly there's an about-face. Was p-doc #2 that bad or did you begin to communicate better with #1?

I'm sorry to hear about the paranoia as part of your bipolar, but it's good that you've identified it and it can now be treated.

You also sound calmer in this post than you have in your recent ones.

Good luck!


Blogger sansanity said...
you are right sweetie, i dont get it 100% and i'm sorry if something i said seemed dismissive.

nah... if you had said you were depressed i would not have said "buck it up" because i hate when people say that to me.

i think i just wanted you to add something to your auto-pilot. i know that sometimes i can not control the racing thoughts (many of which have a paranoid, people are talking about me flavor) so rather than control them i try to add my own twist.

i get so caught up in the mental process of demeaning the mean people that i am able to survive the paranoia (i used to get myself so worked up i would physically get sick) (my latest coping method is dedicated to you as i imagine those i think are talking about me as hapless little ice skaters while i mow them down in full hockey gear and crush them against the glass or use my stick to send them flying like a puck into the net on their arses or if i imagine them in the process of talking about me, a well aimed puck ends up in their mouths!)

for me it is the equivalent of just interrupting the conversation that the paranoia is trying to have with me. i can't out run the demons, and i can't hide from them. but i can dance a crazier dance and wear them out and just outlast them!

DAMN i am proud of you for talking to your dr. about that whole incident. that took GUTS! i never seem to be able to question my psych dr's directly.

ok i have babbled on enough.  

Blogger blondzila said...
manica - I've read your posts, especially the recent letter to your husband. Eloquence is the eye in the beholder.

synergy - there's been no about face. Perhaps I didn't make myself clear (again) - I am not CHOOSING to stay with doc #1. I wasn't given a choice: doc #2 whom I thought would be my new doctor is not. He simply was there to listen and then send recommendations for med changes to my current doctor. We (current doc and I) did clear the air on some issues yesterday and that might be what you sense: I understand him a little better and I KNOW he gets me better.

sansanity: I know you didn't mean any harm my siamese sister. If I try and fight in my mind and say things back and fight off the things that I believe people are saying, I end up feeding the paranoid monster more, rather than calming it down. It's like I would expect those I'm paranoid about to recognize, in my attempts to be mean to them, further evidence of how fucked up I really am.

I do appreciate the comments, all. It means a lot.  

Blogger Shannin said...
Haven't been here in a while. You know, in the twelve years since my diagnosis, I have been asked a million times if I have psychotic features...I have always said "no". But, maybe I didn't fully understand what all the features are. I constantly get those "thoughts from the clouds" a hundred times a day....I didn't even think of them as an issue that could be fixed. Thanks for the insight!
Take care!  

Blogger moodymicello said...
heyyy,friend, I shoulda noticed the parahoia starting with your attitude toward your pdoc and your not wanting to be honest. Tjat comes from fear. You are just so strong in most of your writing that I MISSED IT. Mea culpa for the keep your head up's. I thinkk you did greatt in your approach to the pdoc today though.Maybe that will help rid some of the fear. Sorry where I was thoughtless. m  

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