What I Want To Say To My Psychiatrist But Am Scared To

Dr Psychiatrist:

 

I’ve been waiting an hour for a 7-minute appointment. 3 minutes to chat and 4 minutes for you to look at my chart and write my prescription. I comment that your office is too hot, and you squint at the thermostat and say something about how you’re waiting for the maintenance man. This is the first step in our prescription dance.

 

“How are you doing, Brandi?” He asks as he crosses his legs and slowly pulls at the seam of his dress pants. He removes a piece of lint that isn’t there.

 

This is what I say: “I’m ok.” 

 

This is what I want to say: I can’t make it through one day without crying hysterically and sometimes it looks like the ceiling is stretching like taffy. But I want you to be proud, so I lie. I want you to look at me with a smile that reaches your eyes like you did before I became a complicated patient. Are you still proud of how hard I work to stay stable? Were you proud because you had done a good job or because I had? Please don’t put me in the psyche ward again.

 

“How’s work?” He asks while distracted by an email that’s popped up on his computer.

 

This is what I say: “Um. It’s going ok.” 

 

This is what I want to say: I’m barely hanging on at work. When I get really overwhelmed, I have to close my office door and hide under my desk. I cover my ears and repeat to myself that I’m safe until I can breathe again. Sometimes I go home and just sit in my closet and cry. Luckily me and my husband own the business or else I would be fired.

 

“How’s your sleep?” He asks.

 

This is what I say: “It’s not great but I’ll be ok.”

 

This is what I want to say: Each night I struggle to sleep. I’ve tried to plan out the exact time to take my pills so I can fall asleep at 9pm, but not wake up at 3am. Still, I wake up at 12am, then 4am, and it takes me 30-60 minutes to fall back asleep. I get up and move to the couch so that I can listen to a show on YouTube about serial killers or plane crashes because that seems to lull me into sleep.

 

“How’s your weight?” He asks.

 

This is what I say: “I’ve lost some weight.”

 

What I want to say: I wear hoodies to these appointments to hide my bulges because you’ve hurt me in the past with comments about my weight. Of course, I need to lose weight, but first I need you to hear and validate how much I’m struggling. I know your job isn’t to validate, but do you know how much your patients want to hear it? Just a quick, ‘That sounds hard, but I can see you’re really trying.’ Because trust me when I say, most of us are trying our asses off.

 

“How are you doing overall?” He asks.

 

What I usually say: “It’s manageable.” Because this is what you want me to say. If I don’t say this, we have a conversation about how I feel my anxiety is unmanageable and you, in a dismissive and frustrated tone, say, “Brandi, you know there will always be symptoms and we’ve tried so many meds with you.”

 

But, after taking a deep breathe, this is what I said this last appointment: “So, here’s the thing. I’ve tried everything I can think of. Yoga, meditation, decreasing caffeine, eating healthier, more exercise and I can’t make these symptoms leave. I know you say that there will always be some symptoms and I try really hard but at some point, I just can’t do it on my own.”

 

I don’t think you mean to, but the frustration you have with my complicated case comes across as if I’m failing. As if I’m sitting at home trying to figure out ways to stop the pills from working and excited to try a new cocktail. A new colorful collection of pills that will give me a tremor and nausea but help enough to overlook the side effects. This new cocktail will work for a few months, if I’m lucky, and then we have to adjust them again. The truth is that I’m far more disappointed and frustrated than you are. I’m sure I’m not on your mind when you go home for dinner, but your disappointed voice swims through my head for weeks.

 

I know the older I get the harder it is to treat me. I don’t know how to fix this. Maybe we take a picture of my brain and see what lights up? Maybe I take one of those GeneSight tests to see what meds would probably work best? Maybe we try decreasing Seroquel, stopping Lamictal, or increasing Wellbutrin? What if I take my meds standing on my head at 4am in a clown costume? I’m willing to try anything at this point. Are you?  

 

From you’re complicated patient, 

Brandi

 

5 Hacks for Eating When Depressed or Anxious

You wake up feeling like you’re covered in cement and even breathing takes a lot of effort. After snoozing the alarm five times you get up in a fog. You swallow your meds medley, glare at your toothbrush, and go into the kitchen because you’re supposed to have something to eat but find it’s too overwhelming.

Or,

You wake up two hours early and start googling all the diseases you could have or all the ways the world is falling apart. There is no cement, but a boa constrictor is slithering into your bed and squeezing the air out of you. Your mouth is a desert, the drummer for Slayer is beating on your heart, and your clothes are soaked. You swallow your meds medley, glare at your toothbrush, and go into the kitchen because you’re supposed to have something to eat but you’re nauseous.

Eating can seem impossible when unwell and that sucks. It really, really sucks. You may be nauseous, overwhelmed by the choices, or too exhausted to pour cereal and milk into a bowl. (Let alone use a spoon!) I understand the struggle so deeply and I’m right there with you. You are definitely not alone in eating challenges.

So, here are some eating hacks I’ve learned to keep from perishing.

1)Small and simple. If I have to use a knife and fork to cut it or find a pot to cook it, it’s too complicated. I look at eating as an all-day snack. Anything I can get into my body with any sort of nutritional value is a win. If it means nuts and milk for breakfast, cheese for a morning snack, Boost for lunch, grapes for an afternoon snack, and chicken nuggets for dinner then I’ve been successful. If I try and get too complicated with what foods I think I should eat, then I just get overwhelmed and can’t eat anyway. Be gentle with yourself. It can be so overwhelming to prepare and eat food when all you want to do is crawl back into bed or throw up. Do what you can and then celebrate the hell out of it.

2)Protein. Protein. Protein. Now, I’m no nutritionist or dietician but protein seems important. When we have no energy, it can give us enough fuel to take a shower or brush our teeth. I tend to gag a lot when my anxiety is at an all-time high, so I find it hard to swallow whole foods. For this reason, liquid nutrients are my go-to and I always have Boost in my fridge. If you can get your hands on a protein shake or smoothie (preferably made by someone else) that’s great. Other foods with high protein that are easy to eat are cheese, yogurt, nuts, oats, milk, broccoli, tuna, beans, hemp seeds, sun-dried tomatoes, and pumpkin seeds.

3)Be prepared. Almost all my coping skills have some version of being prepared. It’s easier to come up with solutions when your brain isn’t fuzzy and tummy cranky. For me, it’s all about having food that’s easy to find, make, and eat. Microwave meals are a good example. They aren’t cordon bleu prepared BUT it’s better than stale crackers under the couch. You can also fill your freezer with leftovers, get pre-cut fruits and veggies, and stock up on protein bars, cereals, mixed nuts, crackers and cheese, yogurt, and have Domino’s on speed dial. It also helps me to have some favorite foods in the cupboard because I’m more willing to eat them. On really bad days if all I can eat is Cheetos and chocolate then that’s what I do. I show up the best I can every day and hope that’s enough.

4)Ask for help. I know this can be really hard, especially when we already feel ashamed because we’re unable to take care of ourselves. But, often loved ones want to help and don’t know how. They see how much we’re suffering and can’t hug or talk or love us out of it, so this gives them something concrete to do. It also creates a chance for reciprocal vulnerability. When we start to feel better and they need help, they may be more likely to come to us because they know we won’t judge them. As someone who sees the ceiling stretch like taffy and hangs in the psyche ward, there is no room for judgement on my part.

In the vein of asking for help, I asked my husband for some ideas for how loved one’s can help.

5)Guidance for loved one’s. He says aim for finger foods and smaller portions because lots of food on a plate can be overwhelming. Cook simple meals that are easy to digest and if they need someone to cut up their meat then do it with patience and compassion. Most important, don’t guilt or shame the person into eating. Be there to provide the food when needed but don’t be pushy about it.

Extreme Health Anxiety

1 Day

5am: I’m frantically googling the percentage of people diagnosed with lymphoma at stage 4, the life expectancy of lymphoma under 40, and rare side effects of chemotherapy.

1pm: I’m giving myself a Romberg Test I saw on You Tube to see if I have sensory ataxia.

7pm: I’m measuring my blood pressure in 8-minute intervals to see if I have orthostatic hypotension. I take it 5 minutes after laying down, 30 seconds after standing up, and 2 minutes after I sit. I lay, I sit, I stand, lay, sit, stand, lay, sit, stand. My left arm is covered in red scratches from scraping the machine cuff on and off.


7 Days

Monday: I’m bent over the toilet with my iPhone flashlight examining my poo to see if it’s black, pencil thin, smeared with blood, yellow, floating, fatty, or covered in mucus.

Tuesday: I’m taking many, many pictures of my poo. I do it with the lights on and off and then the flash on and off to get the most detailed pictures. I rush to the computer to compare it to the images of colon cancer found on medicinenet.com, webmd.com, and cancer.org.

Wednesday: I’m hiding in my closet and meticulously searching my breasts for lumps, swelling, thickening, dimpling, red nipples, nipple discharge, and pulling near the nipples.

Thursday: I’m taking pictures of my breasts from all angles and swiping back and forth between them to find the most detailed. I want to make sure I have the clearest one to compare to the breast cancer images found on healthline.com, mayoclinic.org, and cdc.gov.

Friday: In secret, I’m downloading a microscope app to examine my skin for moles that are asymmetrical, have irregular borders, are bleeding, waxy, scabbing, scaly, or red.

Saturday: I download an app that diagnoses moles, and it finds something suspicious. I anxiously wait until Monday to call my dermatologist in case I have squamous cell carcinoma, basil cell carcinoma, or melanoma.

Sunday: The day of rest.

12 Months

January: I’m waiting an hour in my doctor’s waiting room for him to fill out a requisition form for a complete blood count, basic metabolic panel, and lipid panel. He says, “40 is when things start to go wrong.”

February: I’m playing phone games for two hours as I wait in line to have a diagnostic mammogram and breast ultrasound. My doctor is concerned and says, “Your sister died young from breast cancer. We just need to be careful.”

March: I’m at my optometrist’s office for a full exam and she tells me to come back immediately if I start to see lots of floaters or flashing lights. “That means your retina is detaching,” she explains.

April: A month off from diagnostic tests.

May: I’m sitting frozen on an exam table in a blue gown, naked from the waist up. My doctor hands me an ultrasound requisition form because, although he can’t feel a lump, “It’s hard to feel breast cancer in young women. Always come in as soon as you think you feel something!”

June: I’m starving for 12 hours because my bowels have to be spotless for my flexible sigmoidoscopy. My internist has me in the fetal position, in agony, searching my rectum and lower colon for inflammation, ulcers, abnormal tissue, polyps, and cancer. My mom warns me, “Brandi, colon cancer runs in our family.”

July: I’m once again naked and freezing, waiting for the dermatologist to inspect my body for suspicious lesions because my mom said, “Me and all four of your siblings had skin cancer.”

August: My doctor is on holiday’s.

September: I’m pinched by an IV for 3 hours to prepare for a polypectomy and a Dilation and Curettage. My gynaecologist is searching for uterine polyps because, “I see something suspicious on your ultrasound.”

October: My neurologist is sending me for a CT scan because she says, “Your numbness, tremor, and tingling are probably just anxiety but let’s rule out any sort of brain lesion.” 

November: I’m naked again, freezing again, waiting for my gynecologist to scrape my cervix because he says, “Cervical cancer is rare, but you never know.”

December: Everyone’s on Christmas vacation.

I don’t want to know all these terms and symptoms and yet here I am. I’ve never been diagnosed with any of these diseases, but sometimes I live like I’m preparing to die.

5 Hacks for Bathing When Depressed

It has been ‘sweat dripping from under my boobs, behind my knees, and between my fingers’ weather and daily showers have become mandatory. I’ve always been pretty good at sudsing up, but it’s been a challenge this last week. My depression has been following me around like an annoying younger sibling and I’ve noticed my showers are starting to happen later in the day and zapping all my energy. 

 

I understand the shame of not showering or brushing your teeth for a week (or two). I feel like such a failure when I can’t muster up the mental or physical energy to do something as basic as keeping myself clean but that’s the dirty truth. However, when I can eventually force myself to bath there are some hacks I picked up. The goal is to always make it as easy and enjoyable as possible. Possible being the operative word.

 

1)When and how. When do you have the most energy to lather up? Do you want a soak in the tub or a quick shower? I’m usually awake by 6am and have a limited number of hours where I have energy to shower so it’s one of the first things I do. Generally I’m a shower girl but if standing for 5 minutes feels like slogging through mud, I chose to have a bath instead. 

 

2)Be prepared. What do you need in the shower/bath and after the shower/bath? I lay my purple towel on the toilet beside the shower, set out my leggings, sensible undies, and tank top, and make sure that the shampoo and Ivory soap are where they’re supposed to be. It’s so stressful to get in the shower and then have to chase the soap into the corner of the bathtub where it inevitably escapes again. It belongs in its conveniently placed dish. Ditto with the shampoo. If it helps, buy one of those hanging shower caddies.

 

3)Make it easy. What takes the least effort? I only wash my hair 2 or 3 times a week and use a 2-in-1 shampoo and conditioner. I haven’t used this before, but I heard dry shampoo works well. Or if your hair has been in a messy bun for a week and your brush refuses to do its job there is always detangler. This may seem silly, but I wash my body in the same pattern each time because it takes the least amount of physical and mental effort. I start at my feet and legs and work my way up, so I don’t have to bend down twice. When I’m really tired, I follow my husband’s advice: “You don’t need to wash your feet because that’s where all the soap is anyway.” He’s a brilliant man.

 

4)Make it enjoyable. What will motivate you to get out of bed and into the shower/bath? Sometimes, the only thing that gets me in the shower is the knowledge that my shower head will massage my aching shoulders and back. I haven’t invested in a massage shower head but I might just do that. Also, it can help to use shampoo and soap that smell good. I’m a lavender, coconut, and vanilla kind of gal but some like it fruity. There is a whole industry dedicated to you breathing a sigh of relief when entering the bath; bath bombs, bubble bath, bath beads, aromatherapy oils, etc.

 

5)Desperate times call for desperate measures. What if you’re really unwell and haven’t bathed in a couple weeks? I set an alarm so that I know I’m only going to be in there for 5 minutes and then dive back under the sheets when I’m done. I understand how deep down exhausting it can be to even stand up. So, we deserve a break after. The last weapon in my arsenal is to have my husband come into the bathroom and talk to me while I’m in the shower. This distracts me so that the 5 minutes don’t feel so long, and I don’t feel so lonely. 

 

These tricks may or may not work for you, but I hope it helps a bit. Even knowing that you’re not alone in this horrible, exhausting, depressive episode can be huge. What tricks do you have when bathing feels impossible?