I distract her with the 4 year mood/medication chart I've drawn up. She is surprised by the winter peaks and the summer lows of my annual cycle which is the antithesis of what you'd expect. It's certainly in contrast with SAD and most typical depressions. She wonders if any other bipolar folks share this pattern. Anybody out there have winter highs?
I show her the pitting oedema on my legs and we discuss my request for Aripiprazole again. Looking at my chart and noting that my moodswings have been milder since staring Depakote in March 2007 she is loathe to change it unless I feel very strongly about it. I tell her while I don't want to remain an oversized depakote whale, I will continue to take it a bit longer.
She gets back onto the demon drink and drones on... well it would be interesting to see how your mood was without alcohol. Hmmm. Even if you could reduce it by one unit a day. I have been mostly monosyllabic throughout the meeting and my eyes have been focused on a dodgy looking stain on the carpet. Now I decide there's probably not much point in participating further. She is not motivating change. She is not doing the old textbook stuff like rolling with resistance. She is only annoying me, Christ I could use a drink right now! So I sit silent like Elton John doing his finest prima donna, albeit in a more subdued manner.
So she moves on to my mood which is 4/10 at the moment. What can I do to prevent relapse? I explain I feel quite fatalistic about it, my mood goes where it goes regardless of my actions. Don't my daily walks help? No they help me burn calories but I still hate going out and feel anxious and pukey throughout, there is certainly no sense of mental well being on return. What about friends, is there someone you could meet up with. No, apart from the odd email I have very little contact with any of my old friends, I haven't been to the pub for over three years. How about music, could you plan to spend time writing and playing. No, these things happen spontaneously when I'm feeling good and I have no inspiration when I'm down so nothing comes out, I have complete block. I tell her it sounds like I'm being deliberately awkward (half expecting a comforting rebuttal)... "Well, are you being awkward?" ... "errr, no". I don't elaborate as I was just trying to be honest. In retrospect I don't think I should have been so honest, I could easily have lied, told her what she wanted to hear and said something like "yeah, that's a really good idea, I'll go home and play my guitar every day". I've often misjudged situations and hurt people by being honest in the past. I'm not sure how to get the balance right between engaging and sounding positive while trying to give truthful responses. Positivity and honesty are not mutual entities for me, how do you chose which card to reveal?
Thankfully there is a silence indicating that we're done for today then Moonstone pulls out her diary. When shall we meet again, she ponders, she says she's busy for the next 3 weeks so it's 4, 6, 7 or 12 weeks from now. Which is best she asks... I don't mind... well pick whatever suits you... I'm happy for you to decide... come on, this is team work... Ok, four. What Moonstone says next takes me by surprise "Four what? Months, years?". Silence... she stares at me waiting on an answer... is it just me or is that not just the height of sheer fucking rudeness. I felt like telling her to fuck off for four fucking lightyears but I am acutely aware that I have just abandoned my last shrink and inside my head I hear a well known phrase for paranoids bellowing through my head "There comes a time when you have to accept the whole world can't be wrong". So I swallow my obscenities and smile sheepishly replying "four weeks". I feel pathetic, I envisage John Wayne sneering down on me "call yerself a man, yer yeller!". And with that parting thought I crawl home on my belly.
I am now starting to wonder if maybe Moonstone was just breaking me in gently and now the honeymoon is over. Is she in cahoots with the pirate? Are they all out to get me and make my life hell? Am I paranoid? Am I just not cut out to engage in any form of therapy? I am certainly starting to have doubts about what I thought was going to be a positive step in treatment for me.
"You get down, real low down
You listen to Coltrane, derail your own train
Well who hasn't been there before?"