I'm not looking for sympathy, and I'm not looking for anything in the way of giving me your thoughts and prayers. In reality, if anyone says anything to me in the genre of their "most heartfelt thoughts and prayers," I'm much more likely to tell them to go fuck themselves than to express gratitude. As it turns out, they're not the reason I'm depressed, and they're not the reason that I have felt like there is no point to life anymore. It's better to saying nothing to a depressed person than to recite an empty platitude. That's not to say that people who express true concern aren't welcome, as well as incredibly important. A friend of mine called me on Friday as I was dealing with a lot of this stuff--she's amazing. I lost touch with her at one point many years ago, but we reconnected a while back, and I hope I never lose touch with her again--she helped me to feel a little bit better and I'm very thankful for that.
The simple fact, though, is that none of any of what has been going on this year is normal, and it does a disservice to the whole world to pretend it is. I've sat through meetings at work with people in management spouting off how it's going to be so much better when we're back together in our physical offices (a return was said to be in October in this one specific instance), and I've rolled my eyes so far into the back of my head, I'm not entirely sure how they came back. I started working from home full time when everyone else did in March. We were so naive at that point. We all thought this would be a thing that would be a couple of weeks, or maybe a month, and then it would pass and we'd be back to normal lives. We worked in suboptimal conditions--perhaps my setup was better than most since I'd already been working remotely once or twice a week, but it wasn't ideal. I threw my back out from sitting too much. I ordered a fully motorized sit/stand desk, which arrived a couple of weeks ago, damaged, but usable. The replacement is supposed to get here this week. I started working on actually creating a usable office space, and all of those parts and pieces of furniture will probably arrive before the end of the month. If we had known better at the start of the pandemic, I would have set these things in motion sooner, but we kept living in the belief that there would be a miracle, that social distancing and masking would arrest the spread of COVID-19, and that we would go back to normal. There was talk of a new normal...there seems to always be talk of a new normal. Maybe there would have been a new normal if the United States had actually locked down, masked, and socially distanced, but that's an argument for countless threads on Facebook.
At what would turn out to be my last appointment with the psychiatrist I've had for the last few years, she suggested the possibility of electroconvulsive therapy, which might be warranted, or it might not be--I don't really know. What that conversation did do is it was the proverbial straw that broke my back. I've been dealing with a series of issues at work that made my daily life hell, and all of that was wearing on me. It was all eerily similar, though not identical, to the same set of issues that caused my crash a year and a half ago. In the few days that followed that, you could say I spiralled downward, you could say I crashed, you could say I snapped. The only clear thing that came out of it was that my mental health issues had become so severe that I decided I would be better off unemployed and broke than wired up to a machine that would literally fry my brain with electricity in the hopes that it would reset the processes responsible for mood and maybe not cause too many side effects. The procedure for ECT has evolved quite substantially over the years, and the incidence of severe side effects are much lower than they once were, but that doesn't change the fact that by doing something like this, you're entering into an unknown and it's an unknown that can't really be undone.
I had an appointment with my therapist, and he suggested that I should go out of work on leave for a couple of months, to give me time to recover. He also suggested that my psychiatrist be the one to actually put me on leave, presumably because that might be more prudent than to have a psychologist do the same thing. I'm not really sure about that, but she took me out of work last year, so it made sense to me. I called her, left a message with her office and dropped off the paperwork to start the leave process, but what happened next was utterly and completely unexpected.
She called, and was angry. She spent what might have been twenty minutes scolding me over the phone. She made it evident that she didn't remember the details of the alterations to what she had prescribed me over the past year, which isn't too surprising since she probably has more patients than it would be feasible to remember. The bigger problem was that she also made it obvious that she hadn't reviewed her notes prior to calling me, and as she dug through them while I was on the phone with her, that she hadn't even recorded my history correctly. I'm not at the top of my game right now--my thought process is clearly running slower than normal. I tried to respond. I tried to figure out what she wanted to do to treat me better, to fix this problem. She got it in her head that I was against psychotropic drugs, and she was not going to let me change that opinion of hers. I haven't had any bad side effects to adderall, and I've remained on that, but she made it very clear that increasing that drug would not help my depression, and then went off on this tangent that she apparently believed that I demanded to get off of my antidepressant against her advice. The reality is that she supported my gradual taper off of wellbutrin earlier this year, and also when I stopped it entirely. In retrospect, that phone conversation should have begun and ended with a statement something like "It was a mistake to get off Wellbutrin, let's put you back on that." Instead, she spouted off that I should double my dose of adderall, taking me up to the daily maximum, and wouldn't respond about why that was directly contradictory to what she just said. She seemed to have forgotten that she said I should be on antidepressant, so I asked about that. She hesitated. She was angry. I still don't understand why, but eventually told me to resume a low dose of wellbutrin. I hung up the phone and didn't know what to make of all of this.
The next day, it settled in how fucked up that encounter actually was. Wildly inappropriate? Yes. Unethical? Perhaps. Rude and unsettling? Without a doubt. The only thing that made sense to me was that she no longer wants to treat me as a patient, and instead of just saying that, she concocted this story of me being a non-compliant patient. Going forward, her attitude basically said that she wasn't going to try anymore, and I came to the conclusion that any treatment I got from her would never again be what is best for me as a patient. It would never be her expertise in the field that she works in guiding her decisions with information provided to her by me about how I'm doing to help her make those decisions. She actually screamed at me "What do you want to do?" at one point on the phone, in relation to trying to determine what drugs are working and what drugs are not.
I effectively fired her. I asked her office to pair me with another psychiatrist, and I don't yet have a new doctor as a result of that, but having a bad psychiatrist is often worse than having no psychiatrist at all. In the meantime, I've tried to piece together this whole mess, and I've decided that I won't bump up the adderall--she contradicted herself, and anything that came out of that phone call has to be treated as suspicious. I happen to know that adderall in high doses can actually exacerbate or even cause depression, which is not a risk I want to take. I will have to work that out with my new psychiatrist, whoever that is and whenever I can get in to see them, which is weeks away, if not months. Hopefully, I will find a way to bridge that gap, however long it may be due to increasing demand in the field of mental health these days.
None of this is a "new normal" and nobody should be in the position that I'm in. This isn't about accepting the reality of the pandemic--this is about not being able to cope with my life in the context of the pandemic. The idea that we can all suddenly start working from home and be locked down with minimal interaction with others and not have it impact the quality of our work, the timeliness of our work, or the severity of difficulty we have in dealing with opposition is laughable. The idea that society can somehow go on normally without normal support structures in place, and without normal activities is preposterous. We all need to admit that this is just fucking abnormal.
Your kids may be unhappy about having to learn remotely, and I'm sorry. I know it sucks. They may hate it, and they may start crying, or they may have a temper tantrum about it. Let them. They need to express their emotions, and so do you. No one wants to be where I'm at right now, so talk about it, and learn what the signs are for a more serious problem, and please get professional help if needed. If it does get bad, earlier treatment is better than allowing whatever those issues are to pile up--you don't want to snap, and you don't want to be on a downward spiral.
My marriage, my work, and my friendships are all suffering now, and I'm sorry. I can only hope that people can find a way to forgive me.
