She must have sat up all night thinking about our session, because she bombarded me with complicated questions for the next half hour. My brain, stuck in low gear, rendered thinking and speaking difficult. Focusing on her words required huge amounts of concentration, which was difficult because my neural network was still on the fritz. My head throbbed, as I answered her questions. My eyes floated toward the pastel colors of her wall prints, calming against the sage colored walls. As she grilled me, I resisted the urge to drum my fingers on the arm of the sofa and remind her that we already discussed and analyzed my depression to death. That would have been rude.
The minute she stopped talking, I refocused my eyes. This was my opportunity to inject an explanation.
"Karen, yesterday you saw the end of an episode. I guess a better description would be the upside of a mild episode, because, for the most part, I could function. My condition was not even close to rock bottom. I know that I said some awful things to you yesterday, but when it's over, I can't clearly recall details. I don't black out. I just feel separated from my actions. So please forgive me, and I will try not to let it ever happen again."
I melted into the back of the sofa and exhaled, my body softened, relieved to be past the apology and explanation. As I leaned back, Karen lurched forward in her recliner with an odd expression on her face. Upset or perplexed, I couldn't decide. "Karen, this incident surprised you, and I can't understand why."
"I know what you told me, Maggie, but what I saw didn't match my image of your depression, and I never expected all the distorting. Seeing an 'episode' has put your description into a whole new context."
So much for my communication skills, I thought.
She launched into an explanation of the term "distorting." I couldn't gather much from her speed talking except a vague understanding that distorting involved perceiving something to be true which had no logical basis, in reality.
"I don't get it, what does 'no logical basis, in reality' mean?" I asked.
"Let me think about the best way to explain this." She sat quietly for a second, face contorted in concentration. "Okay, in the session yesterday, you said 'the only reason I got into Pitt's law school was because I'm female, and they needed to fill the quota.' Do you really believe that to be a true statement?"
"No," I said, shaking my head. "I worked really hard to get into law school. Good grades and a good LSAT score got me accepted to Pitt."
"Exactly, Maggie, what you were thinking and saying had no logical relationship to the truth. But, now, you broadsided me when you said that you couldn't remember the details."
I slowly shook my head. "No, I don't recall the details, but since you reminded me of my words, I can remember. It's like I need help retrieving it from my memory. But, Karen, if every awful moment of every episode remained sharp in my mind, waking up in the morning would be agonizing. Forgetting is a gift."
For the first time since we walked into the office, she looked relaxed in her chair. Her expression baffled me. It bordered on being smug. "As a therapist, I can't diagnose, but Maggie, I have a very strong hunch you may have bipolar depression."
An imaginary hand smacked me across the face. She said the word bipolar as if it was a good thing. I straightened in my seat as my stomach plummeted to the floor, pushed out of its spot in the middle of my abdomen by an ocean of rogue waves. Bipolar? What the hell was she saying? I wanted to scream, or run, but my body refused to comply with my impulses. Suddenly, my mental wiring system woke up and alerted me that bipolar definitely qualified as a mental illness. I averted my gaze and tried to keep my heart from pounding its way out of my chest.
"Maggie, calm down, there's no reason to get upset. Let me explain."
I nodded and squeezed my eyes shut for a second. Tears continued building behind my eyelids. She proceeded to launch into a description of the symptoms of Bipolar Disorder and explained the difference between uni-polar depression and bipolar depression. According to Karen, my episodes seemed to fit the symptoms of Bipolar 2 Disorder.
When I had walked into her office that morning, I felt better than I did during our last session, but still a long way from normal. Now, each of my senses ceased functioning--frozen, unable to process any information. Karen continued to rattle off medical details while the words "mental illness" banged around my skull.
Karen ended the speech with a question. "Maggie, do you ever have periods of hypomania?"
I frowned. "I don't even know what hypomania is." And under my breath, I added, "I'm not sure if I want to know."
She explained that Bipolar 2 sufferers didn't experience true mania. A condition called hypomania characterized the high side of the disease. She rattled off a description of it, and I almost laughed in her face.
"Karen, you just recited a perfect description of what I refer to as a "good day."
She smiled and then asked another question. "Maggie, is your brain noisy?"
Too embarrassed to admit that I had no idea what the hell she was talking about, I shook my head. "No."
Then I heard her softly say, "Maggie, it's completely treatable. You just need different drugs."
As she talked, she reached over and pulled one of her business cards out of the shiny brass card holder on the table, and wrote something across the blank side. "This is the name and the phone number of a psychiatrist. I want you to call today, and tell Linda, his assistant, that I said to give you the earliest appointment available."
I took the card and, without a glance, stuffed it into the back pocket of my jeans.
"I mean it, Maggie, call today. It's the first step toward ending the episodes."
I floated mindlessly down Shrink Row up the stairs, across the lobby, and out the front door. The fresh air jolted me back to the present. As I walked to my car, I thought about her words. It was pathetic to hear your therapist say that you need a psychiatrist ASAP. I opened my car door and tossed my bag onto the passenger seat. Sliding behind the steering wheel, I grumbled to myself, "Earliest appointment." It wasn't like I was bleeding to death or needed 911-rush service to the psych ward.
During the drive back to campus, I mulled over the possibility of being Bipolar 2. I'd always considered my depression to be a misdemeanor in the mental health legal system, just like panic attacks and compulsive hand washing. Bipolar Disorder, of any type, was definitely a mental health felony.
I located a secluded spot in the library and booted up my laptop. Each website I found contained tons of info on Bipolar 1 but barely a sentence about Bipolar 2. It appeared that Bipolar 2 enjoyed the honor of being the neglected step-sister. Shit, I can't even get a regular form of the disease.
It was startling to find that the symptoms really did fit me perfectly. People with Bipolar 2 were more likely to experience the really low, lows. But the upside was not as extreme as true mania. According to my screen, my "good days," the ones where I would go crazy cleaning, cooking, and dancing around the house, the days that Sam loved me the most, were really hypomania. At least, he loved part of my disease.
I got really pissed off when I read the description of depression. It was so sugar-coated. The webpage defined it as "a depressed mood, loss of pleasure, low energy and activity, feelings of guilt or worthlessness, and thoughts of suicide."
Obviously, written by an over-educated, politically correct shrink. Not wanting to shock everyone in the library, I controlled my urge to scream out, This asshole should spend a few months inside my brain or let me write the damn definition:
Depression is a daily battle against an enemy that controls your only weapon--your ability to think. It's a paralyzing pain of no known source that engulfs the entire body and soul. At times, violent self-loathing manifests as a fiery orange rage that surges through veins and arteries. As self-hatred gouges every cell in your body, a mortal enemy, named Uncontrollable Thought, commandeers your brain space.
This enemy, at the minimum, will try to convince you that you are God's biggest and only mistake. But
most of the time, Uncontrollable Thought stabs against the inside of your brain with taunts designed to convince you that your death would make the world a better place. Also, the saying, "an ocean full of tears," is a gross understatement.
After that, I slammed the screen shut and huffed to myself. I spent every day of my life fearing my own brain. This author was clueless. If he had any comprehension of the disease, he would have understood that his definition was like calling a cruise ship a boat. "Loss of pleasure?" What a joke. My curiosity overrode my anger, and I turned the computer back on and kept reading.
I got so absorbed in the words on the screen that I almost missed my three o'clock class. Physically, I made it to my seat on time, but my mind remained focused on the information that jumped off the computer screen.
After class, I played mental tennis as I walked to my car--call the psychiatrist today or wait until tomorrow morning. I set my bag and computer on the passenger seat and pulled the card out of my pocket. I stared at the name and number for a few moments. Dr. Graham, the name sounded familiar. Then it hit me, Dr. Graham was the name of the kindly doctor who saved the little girl from choking, in the movie Field of Dreams. I pulled my cell phone from my bag and whispered a silent prayer. I punched in the numbers and hit the send button. For a brief moment, I dismissed the mental illness stigma and felt hopeful.
CHAPTER 6
Messages from my TV and a Hospital Waiting Room
After two rings, a pleasant-sounding professional voice answered the phone, "Good Afternoon, Dr. Graham's office."
My mouth turned into a wad of cotton. I swallowed hard and choked out the words, "Hello, my name is Maggie and my therapist, Karen Mulligan, said I needed an appointment as soon as possible."
"Hello, Maggie, my name is Linda. Dr. Graham doesn't just schedule appointments. We have an intake procedure that must be followed."
A bit fearful of the answer, I pushed forward anyway. "Oh. What do I have to do to make an appointment?"
"Appointments are scheduled after the intake procedure has been properly completed. You need to answer a few simple questions, and he will review your answers. Once his review is complete, he will assign you an appointment time. Then I will call you with the time and give further information regarding what you should bring to the first appointment. During the scheduling phone call, I will ask for your insurance information."
It was painfully obvious that she'd given the speech more than once.
"Oh," I replied. "Can I answer the questions now? And, how long will I have to wait for him to review my answers?"
"Yes, I'll ask you the questions now, and Dr. Graham is extremely efficient. His policy is to review the potential patient's responses on the same day. He still has two more patients to see this afternoon. So I suspect he'll read your answers this evening and have me call you with the appointment time tomorrow."
"I was hoping to see him tomorrow," I said.
"That is impossible for me to predict." Her clipped voice took on a tone of annoyance. "It's all about your answers and how he perceives your current state of mind. He may choose to squeeze you in tomorrow afternoon, or he may decide there is no urgency, and you can wait until next week."
I stared at the wall of the parking garage as she spoke, wondering if she wanted a bribe for an earlier appointment. Quickly rejecting the idea, I paraphrased her words back just to confirm my understanding. "So if I am really crazy, he'll see me tomorrow, and if I am only a little crazy, the appointment will be next week?"
"Maggie, please refrain from using the word crazy--it's derogatory and not appropriate to the treatment process. But to answer your question, yes, depending on your responses to the questionnaire, the appointment will either be tomorrow, or next week."
I inhaled, sat up straight, and clenched my free hand around the steering wheel. "All right, Linda, start the questions."
I heard her rifling through papers.
"Question number one: Do you receive messages, intended for only you, from billboards or your television?"
Not exactly a question I was expecting. "No, Linda, billboards do not send me messages and neither does my television."
"Do you ever engage in bizarre behavior?" she asked.
"Define bizarre, please," I replied, seriously hoping I didn't do anything bizarre.
"Acting socially inappropriately, including the neglect of personal hygiene, talking to yourself, or any other behavior that is not typical for you." I detected a hint of exasperation in her voice.
I shook my head. "I don't think so. But sometimes on weekends when I have a lot of homework, I forget to shower."
"That does not qualify as bizarre, Maggie, just lazy. I'll put your answer as 'No.' Next question: do you experience troubling nightmares, recurring thoughts or flashbacks?"
"No, but sometimes before an episode, I get fixated on something, a book or a song," I replied.
"I'll make a note of that. Question five, do you feel sad or depressed for days or weeks at a time?" she asked.
"Linda, I've felt sad or depressed for almost every day of my entire life." The moment the words left my mouth, I felt relief--a sensation of lightness. Every day, I fought a battle to function like everyone around me. Every day started with the same goal, be normal, but I never succeeded because something dark and ugly always lurked just under my skull.
Linda continued with the interrogation. "Do you ever think of killing yourself?"
"Not now. I used to," I replied.
Her breath sounded heavier after hearing that answer. "Explain, please."
"When I started taking Zoloft, three years ago, the desire to kill myself went away." In the background, I heard her fingers clicking on the keyboard. "Now," I continued, "on my rock bottom days, I pray for a fatal disease or a car accident. I don't think about doing it to myself."
She proceeded to the next question. "Do you ever have trouble sleeping or sleep too much?"
"Yeah, I sleep too much. It shuts off my brain," I replied. At this point, someone beeped in on my call waiting. I only heard part of the next question. "Could you please repeat the question, Linda? My call waiting beeped."
"Fine, Maggie, I'll repeat the question. Do you ever have trouble falling asleep?"
Sleep turned into a sensitive subject for me after I moved in with Sam. He hated when I disappeared into bed for days. No matter, how many times or ways I tried to explain that when the brain shut down, the body followed, he didn't get it. During the rare times falling asleep became difficult, he had no problem voicing his annoyance with my tossing and turning. I always ended up migrating to the couch.
"Sometimes, Linda, my body's engine revs too fast, and random thoughts inundate my brain, then sleeping becomes very difficult.
"Maggie, do any of your family members have a mental health issue?"
I tightened my grip on the steering wheel and squeezed the phone, because for some unknown reason, the term mental health issue kicked up a queasy feeling in my stomach.
"Hello, Maggie, are you still there?"
"Yeah, I'm still here," I replied and noticed a strange tightness in my throat. "My mother also takes Zoloft. She's been on it since my dad died."
"Last question," Linda said, after a rather loud exhale. "Would you consider yourself as currently being in an emergency state?"
"No," I replied, pleased to hear the end of this interrogation was near. "The emergency occurred last week, so I don't expect another emergency for at least four to six weeks."
"That is the end of the intake questionnaire. Thank you, Maggie, for your honest answers. Dr. Graham will review the information before assigning an appointment, and I will notify you of the date and time."
It sounded like she was reading from a cue card. "Thank you, Linda. Have a nice day."
"You, too, Maggie."
Reaching up to scratch my suddenly very itchy scalp, I forced myself to breathe. My hands quivered a bit as I stared through the windshield at the cinder-block wall of th
e parking garage, unnerved because I found myself hoping to be crazy enough to get an appointment tomorrow.
The next morning, I jumped out of bed, showered, ironed my shirt, and paced the hallway an hour before the phone rang, at promptly nine a.m. In her clipped voice, Linda informed me that Dr. Graham had scheduled my appointment for the following Tuesday. Damn, so much for being emergency level crazy. It's going to be a long weekend, I thought and hung up the phone.
Later in the day, an unsettled feeling plagued me. Instead of concentrating on my homework, my mind returned to Linda's question, "Do any of your family members have a mental-health problem?" I gave up on the homework at about ten o'clock and went to bed.
Saturday morning, while eating my cereal and reading the online version of the newspaper, it occurred to me that my mom and I hadn't discussed Zoloft in over a year. She crashed into a deep depression after my dad passed away. I had no idea if she was still taking it or not. I dialed her number and got her voicemail. "Hi, Mom, give me a call when you get this message. I need to ask you a question about Zoloft."
She called back in the early evening, and I asked her if she was still taking it.
"No," she said. "I stopped taking it about six months after I married Ed."
My dad died of an aggressive form of cancer in October of my senior year of high school. Ed was my father's best friend. They golfed together in the summer, bowled in the winter and played tennis all year round. After my father died, he spent hours drinking coffee in my mom's kitchen. While mourning together, he realized why he never married--the woman he loved was married to his best friend. I missed my dad every day, but I was happy my mom had Ed. Odd as it might seem, them being together had kept my dad's memory alive.
"Mom, does anyone else in our family take an anti-depressant?"
"Not on my side of the family, honey, but I don't know about your father's side. Call Uncle Roy, maybe he knows something."
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