It's been a long time, in bipolar terms, since I experienced a real depressive episode. But I remember, now that I've been going through it again, that depression sometimes presents as organic illness. I start to feel sick. Feeling sick is not my normal state. This feeling sick sends me to my internist. And in the early phase I might have some mild and transient illness that can either be treated or waited out. But I don't bounce back. Feeling ill lingers. Not sick enough to simply stay in bed, but not well enough to want to do much of anything. It's a headache that's hard to get rid of, or a bowel disturbance, or low grade fever, or a slow, creeping stupidity that scares me more than anything. It's the transitions from one pole to the other that are the most dangerous. It's when we, the bipolar, realize depression is bearing down on us and we still have the energy to do something about it, that we know we can't stand it again. That's when we think about suicide. If I were suicidal, I would not be talking about it, so relax. I'm not suicidal. But I have been there, more than once. It's why I don't fear death by cancer or heart disease or a fatal car accident.
In Salt Lake, under the umbrella of medicare, we have Valley Mental Health. And within Valley Mental Health is a group called The Master's Program. You have to be bipolar and over fifty to qualify. I think calling a program for the old bipolar patients The Masters Program is both funny and apt. If you've lived past fifty and you are bipolar, you're damn special. You have survived a very difficult life. And I'm always amazed how many of us there are. We are often treated for substance abuse(self medicating) which might result in a bit of trouble with the law, especially for men. Men are more likely to be incarcerated than women, since men are more likely to be violent against others, where as women are more likely to be self destructive.
We can be extremely charming, and we can be horrid. I would not choose a bipolar friend to hang around with. In my opinion many of us are more trouble than we're worth. And in transition we can be seething with barely suppressed rage. In a manic phase we can seem as if we're taking large doses of amphetamines--motor mouthed and loud. I sure wouldn't chose to spend my time with anyone like me. But for the person experiencing a bit of mania it's damn fun. We all live for the hypomanic phase of the illness. But, like the way down, the way up is also dangerous.
All this to say, I called The Masters Program today, got through the gate keepers to the psychiatrist's nurse. She said she would get back to me tomorrow when she'd had a chance to talk to Dr. Issabela, whose booked two months out. So I was instructed to call Fred, my therapist, set up an appointment on a day Dr. Issabela will be in the office. She will look in on me between appointments, consult with Fred and between them they will decide if I go off Doxepin Hydrochloride and back on Zoloft. I have over the course of my life dealing with this monster illness found that not that many of the drugs to control my illness are tolerable to me. They all have some side effects. And some are worse than others. This drug gives you tremors and this drug makes you fat, this drug makes you stupid and this drug steals your dreams. Go ask Alice. I'm guessing she was bipolar.
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