doctor, doctor

My previous psychiatrist left his practice with very little warning last December, so I had to find a new one. This week I had my first appointment with the new p-doc, and I think it went very well. After the obligatory paperwork, I was interviewed by an intake nurse who asked me a lot of wide-ranging questions about my symptoms and my life in general. She seemed very organized, and made plenty of notes in the computer.

I was sent back to the waiting room for about 15 minutes, then they brought me in to see the doctor. We talked about my current and past symptoms, and how they have changed over time with the medication. I felt like I had to make a case that I still have bipolar, and he seemed to agree that even though I have been relatively stable with the meds I would be in trouble without them. We also discussed the weight gain with Abilify, and he started me on Topomax, an anti-seizure drug with a major side effect of appetite suppression and weight loss. He said several patients have had success with this combination. Finally, he gave me a little bit of Ativan to take as needed on days when my anxiety is problematic.

I was nervous the entire time, but I think I covered everything I wanted to during the appointment. I had prepared by writing up a list of symptoms, a timeline, a list of meds, etc., which helped me lay things out in an organized manner when responding to questions.

I got the impression from the conversation that he was much more friendly and personable than my previous doc. I also believe he is much more inclined to listen and be interactive, working as a partner in my mental health goals rather than just ordering me to do what he says.



I have the ability to disappear in a group of people who are supposedly my “work-friends”. I have been talking to one or two people about something, then suddenly someone else appears who becomes the center of attention. They appear, and like magic, I disappear. In the past I have tried to stay in the room and appear like I was still relevant, but lately I have just given up and walked away from the conversation with my head down.

I’m not the guy that everyone likes to have around, and I rarely get invited to join the group. Nobody gives me a jovial nickname, and I’ll never be the person everyone wants to say hi to. It’s just kind of an obligation for people to greet me because I am standing there, but I get the sense they don’t care if I am there or not. Don’t worry, the feeling is mutual.

I’m never the glue that holds a circle of people together, I’m always on the fringe. Sometimes I appear to be the common link between two groups of people, like a single electron that forms a bond between two molecules. Then the bond is broken, and the molecule goes spinning off without me. Does that make me a free radical, or just pathetic? It makes me not want to try to be part of the group next time, therefore I isolate myself further.

I want to make more friends, but two things prevent me. One is the social anxiety that makes me fear being around people; being forced to interact with others drains me and sucks all the energy from my soul. The second, closely related factor is a deep lack of self-esteem that makes me feel inferior and inadequate in nearly every situation. I don’t feel like I have anything worthwhile to give another person, so why would they want to be friends with me?

If I just had bipolar disorder, but had an otherwise normal personality, I would be fine. I would trade everything to have a different personality, but as a wise philosopher once said, “I yam what I yam, and that’s all that I yam.”

signs of bipolar

I had symptoms of bipolar disorder as far back as maybe 11 years old. Even at that time, I knew something was wrong with me. I definitely had depression, long periods where I would be in a crappy mood all the time and I wanted to isolate myself from people. During high school I had deep recurring depressive episodes that grew worse.

On the other hand, I realized I could anticipate when a hypomanic episode was on the way; I almost felt like I could hear it coming in the distance, and I knew it would cause me problems. I called it a “dangerous mood”, and it was during those times that I said and did stupid and hurtful things without regard for consequences or safety. I also developed a lot of obsessive thinking and rumination during that time. While that is not necessarily a symptom of bipolar, it was another facet to my struggle with undiagnosed mental illness.

My symptoms became worse as I moved into my 30s. When I was mistakenly diagnosed as having unipolar depression, I believe taking the anti-depressants made things even worse. Soon thereafter I went into the hospital, but the roller-coaster ride continues to this day.

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dumped by my doc

I found out yesterday that my P-doc has moved to another city, and I have to find a new provider. It is a pain in the ass for me to find someone new, but it is no emergency. In a city this size, you would think there would be more doctors accepting new patients, but apparently not.

I don’t know how I am supposed to feel about this. I know it can be traumatic for some people with mental health problems when the need to change doctors. I’m not in a crisis mode, so I have time to wait while I can be scheduled (March, one potential new doctor said). But what if I was feeling bad, or needed someone right away? I know there are the crisis centers or the hospitals, but it’s not like having a relationship with someone who knows you.

Despite the inconvenience, I had been wondering if it was time to look for another pair of eyes to review my symptoms and get a different perspective. I guess that time has come.

the bipolar gender gap

I have noticed the bipolar blogging world seems to be populated by more women than men. I don’t really know why there seems to be many women blogging about mental health, but maybe I can guess why there are fewer men here. I think there is a greater stigma among men for mental health problems, more so than women.

I think there is a different process for men when they come to terms with having a mental illness. Based on my own experience, I think went through phases of anger, sadness, anger again, denial, suicidality, defeatism, a little more anger, and shame … but also a little bit of strength and resistance on the good days.

I wonder how many guys make the effort to reach out for help to a doctor, or a friend, or a wife/girlfriend; maybe they don’t for various reasons. My perception is that men are less likely to write journals or talk about feelings and fears in any semi-public manner (like support groups or blogging). Those men that do write about their mental health range from angry and defeated to strong and uplifting.

I think some guys are a little more in touch with the more emotional and introspective side of ourselves, and those are the men who are more likely to write about their own mental health. I don’t think that makes us less masculine in any way, even though we may experience depression in a stereotypically feminine way.

I think everyone has their unique experience with mental health issues, and it has little to do with being male or female. I realize I may be criticized for laying out several stereotypes here, but this is just my perception of the gender divide among bipolar bloggers. Let me know if I’m right or wrong or somewhere in between.

the costs of bipolar

I’ve had bipolar disorder since I was a pre-teen. It has cost me several important relationships, educational and job opportunities, and tens of thousands of dollars over the years. It has nearly cost me my life on multiple occasions. Besides the monetary cost of the medicine I take, there is the weight gain associated with the Abilify, which causes me problems such as high blood pressure, the potential for heart disease, lack of mobility, and embarrassment. It may one day cost me my intellect, if the potential for early dementia becomes a reality.

My bipolar has also inflicted a toll on the family. My wife has stayed with me despite 25 years of instability and unpredictability, and it has cost her happiness and many sleepless nights ridden with fear and anxiety. She constantly feels like she has to work harder to make more money to pay for the medical bills, so she works at a physical job and always has sometimes debilitating aches and pains.

My son and daughter grew up in a home riddled with turmoil, which in my opinion has caused them both psychological issues which remain unaddressed. My defective genes surfaced in my daughter, who had first been diagnosed with bipolar, and now schizoaffective disorder. Her illness has cost her most of her friends, dreams of a normal life, two potential career paths, and many thousands of dollars in medical bills for us to pay.


We will be headed down to North Carolina again tomorrow. The plan is to spend a few days at the beach, a few days visiting with our son Dan, and drive home next Sunday.

I don’t know if everything will go according to plan.

Nicole has been a little unstable the past week, not dangerously so, but just enough that all of us have noticed it. My prediction is that the first few days at the beach will go fine, but when we get to Raleigh she will start being first agitated, then depressed, then in tears. She will be out of her comfort zone, she will miss her cats, and not even the anime convention will make her want to stay. She will be further upset because (I also predict) that Dan will not have much time to hang out with her because he will prefer to hang out with his friends at the anime convention. I bet that we end up going home one or two days early, and everyone will be stressed out.

It is tough to plan anything due to Nicole’s illness. She sleeps at random times, she changes her mind about going places, and she resists keeping appointments with doctors. She won’t wake up when she needs to, but she gets mildly angry when she misses out on something. She chooses to not go out for dinner, but she insists we bring home food for her. It gets frustrating and stressful for Mrs. Fish and I to arrange our lives around her mental state.

Unfortunately, we are staying in a hotel near the beach instead of like last year when we rented a house on the beach. I don’t think it will be quite as enjoyable or relaxing this time, but a little beach time is better than no beach time at all.