Earlier this year, my primary care physician did my annual thyroid check. He keeps tabs on my hypothyroidism and prescribes the Synthroid as he sees fit. He has always been my thyroid guy.
My PCP knows my PsychNP. He recommended her to me when my previous psychiatrist was retiring. His reason for liking her is that she doesn't over-prescribe. She focuses on using the least amount of meds to get the job done. I honestly can't remember how long it has been since I started seeing her. But, when I did, she changed my diagnosis to Bipolar Depression. I'm not sure if she kept the anxiety in there, but since I'm still taking Ativan, I'm thinking she did.
So, a pretty significant med cocktail rehaul took place. Then, Electroconvulsive Therapy was added to the list of shit-to-try-to-fix-me. That was 9 months of being put under and having electrical stimulation of the brain. The hope was a reboot of my brain to make me more responsive to medications. Uh, not so much. The average course of treatment with ECT is 6-12 sessions. I was going 3 times a week in the beginning, so those average numbers were blown away and I still went 2 days a week, eventually working down to about 1 a week, and, I think it may have been an every other week thing in the end. Given I don't remember pretty much the entire year of 2016 (ECT can wipe your memory from periods before treatment, during treatment, and kind of fuck up after, too) I'm not sure how the tapering worked. Shawn was pretty much the one to put the stop to the treatment. He didn't see that I was benefiting, so my last treatment, against the Psychiatrist's recommendations, was December 23rd, 2016.
The ECT Psychiatrist also knew my PsychNP. He would be in regular contact with her throughout my treatment. I didn't entirely agree with her about my diagnosis and some of the meds I was one. Um, okay, what should I do? He doesn't do psych work other than ECT. So, it wasn't like I could start seeing him.
I've stayed with my PsychNP. It's been a few years at this point. She doesn't take our insurance anymore, so I see her less often. She is quite frustrating, but finding another mental health provider is a very stressful process. There's the "FUCK! I have to start at the very beginning!" then there is the "Are you kidding me? I've been being treated for something and you don't agree?" and the starting over on a different course of meds. The meds part is the worst. Breaking in a new medication means trial and error; may it doesn't work; maybe it works but needs a higher dose; and, of course, new side effects.
As often as he can, I have Shawn come to my appointments. He can provide insight as to my special kind of crazy. This last appointment, he came. It was probably be good because I was extremely frustrated. There's her excessive lateness, for one thing. The last few months she has screwed up my Ativan prescriptions with the pharmacy. She is SUPER married to my drug cocktail even when I tell her things are off. This time, she looks at my thyroid report and the dose of Synthroid and decides she's taking it over. She explained that the thyroid issues and the bipolar issues can sometimes cause problems when trying to dose the Synthroid. She said my PCP is very good, but not experienced enough with treating both things. WTF???? I've been on thyroid meds since you started seeing me. Why wouldn't you just take them over from the beginning. Then she brings up that the problem with two of my meds could be the generic versions I'm taking. She said it could be that we need to specify that I get them from the generic company I had gotten from before the switch a few months ago. I know generics are hard to deal with, especially when coming off the name brand, so I agree that this could be the reason for my issues these last few months. So, we're changing from one generic to another for a couple of drugs. We are changing the Synthroid dose, which is so frustrating because I have months worth of dose I was put on earlier this year. But, then there is the one med that she hates that I'm on the generic version. She brings it and mentions Canada. We've been through this, Canada wasn't any cheaper. I'm not paying hundreds of dollars a month for a name brand med. She doesn't like that I make money an issue. She says she's not concerned about money, she's concerned about my health. I tell her my anxiety isn't going to be addressed by excessive amounts of money being spent that we can't afford. She then looks at Shawn and asks if money's really that much of an issue. Now that was some bullshit there. We do not have hundreds of dollars a month to spend on name brand because she swears by it....must have a deal with the company. I was pissed during and after.
Here I am. A few months of major mood issues. I've been breaking down in the same conversation I had just been goofing around during. I simply cry. Just cry. I drive and cry. I work and cry. I sit in an office working on files at work and cry while Abby, my office mate cat, just chills out with no empathy whatsoever (Did I mention she's a cat? Who would expect empathy?). There's also some rage mixed in followed by exhaustion. The exhaustion also comes from putting on a show, doing some of my best acting in social situations without bawling my eyes out. Hopefully all of the drug changes will change things. Hopefully I'll figure out a new shrink. Hopefully I simply will.
Then there is Shawn, through all of this...
...and I'm not sure I will ever understand why.