The In-Between

The time in-between the ER and my follow up appointment at the mental health center was…tense.

Going Home 

Driving home from the hospital I called my mom (she was out of town), and explained what had happened. Despite understandable worry, she was very supportive and grateful I was finally getting help. (After all, she had witnessed the downward spiral in my mental health over the past few months.)

My boss was also incredibly understanding, and gave me the rest of the day off to take care of myself (I had called on my way to the hospital to say, more or less, “I’m losing it, on my way to the ER, won’t be in this morning…”)

About an hour later the Xanax kicked in, and I finally felt relief from the gripping anxiety that had plagued me all morning.

There’s something about being in the hospital that makes me feel a desperate need to shower, so I took another one, and put on the comfiest clothes I own. Typically I love TV and movies, so I turned on the TV to try and relax.

But then anxiety came creeping back…

TV was suddenly overwhelming. Science Fiction is my favorite genre, but the thought of watching anything even remotely upsetting was too much. I kept thinking how ridiculous this was, and worried I would never be able to watch my favorite shows and movies again.

I tried not to focus on forever.

Almost There 

I only needed to make it 3 more hours. If I could find a movie I was able tolerate, that would take care of most of the time. So I put on Trolls, because I love it, it’s upbeat, and I’ve seen it a thousand times.

It always makes me happy.

…No dice this time. I was too distracted, too worried about how strange my thinking still was, so I turned the TV off.

I then decided to try and distract myself with cleaning; my house has a tendency to reflect my mental state, meaning it can be quite chaotic at times. Physical mess furthers my mental distress, and cleaning usually helps (if I can bring myself to do it).

Thankfully, this time it worked.

Eventually it was time to leave for my appointment, and I drove to the mental health building 45 minutes early, as requested, to complete intake paperwork.

Now throughout this process my main concern was the type of doctor I was seeing: in the ER I spoke with a psychologist, and now for my follow up appointment I was meeting another psychologist.

Don’t get me wrong, psychologists are amazing and I absolutely need one as part of my treatment team, but I wanted to see a psychiatrist. Currently there are only 5 states in which psychologists may legally prescribe medication: New Mexico, Louisiana, Illinois, Iowa, and Idaho; I live in California.

In contrast, psychiatrists are medical doctors, and can therefore prescribe medication. So while a psychologist would help me feel better about what I was going through, in my mind, a psychiatrist would be able to start more tangible treatment.

But for now a psychologist was the only mental health professional available, and I was just happy to have someone to talk to who would understand what I was going through.

**A note here on people to talk to in a mental crisis: Most often, I can reach out to my  family, and they are enough to get me through a bad mental spot. But in my opinion, a mental crisis (like my breakdown) should only be handled by a professional.

(I will talk more about crisis situations and what you can do in a later post.)

The Appointment 

The appointment was primarily about gathering information. We went over my trip to the ER that morning, my history with depression and anxiety, and any major concerns I had moving forward.

After his assessment, my therapist agreed with the ER psychologist that it sounded like I had the symptoms of Bipolar Disorder. He suggested the best course of treatment would be a combination of medication, psychotherapy, and group therapy.

I told him I had taken SSRI’s (selective serotonin re-uptake inhibitors) before, and they only made things worse. Namely, Lexapro gave me an immediate panic attack, and Prozac gave me even crazier mood swings.

**This is purely how they affect me, please don’t assume they will affect anyone else this way. These are incredibly effective treatments for many people.

Anyway, he reassured me there were other options besides SSRI’s. For example, if I was in fact bipolar, mood stabilizers were an option, and there are also other antidepressants that are not in the SSRI category. We then discussed my anxiety medication, and he advised I ask my primary doctor to increase my Xanax dosage so I didn’t have to take as much.

By now I felt hopeful as more of a treatment plan took form; I could work with this. My life felt manageable again, and I was feeling more and more relieved I’d asked for help, instead of just trying to tough things out on my own.

A Start, But No Solution (Yet)

Since my therapist was unable to prescribe medication, he put a note in to the mental health department to schedule a medication evaluation with the first available psychiatrist.

At this point, I still didn’t have an official diagnosis.

You see, it can take several sessions with a psychologist and/or psychiatrist before they can figure out what’s really going on. This is partly because comorbidity is so common in mental health disorders.

But in the meantime, I was advised to continue taking Xanax as needed, and given a print-out of the group therapy schedule. We scheduled a follow up psychotherapy appointment in 2 weeks, and now I just had to wait for the phone call to schedule with the psychiatrist.

By now it was late afternoon and I went home feeling drained, but stable at least, and shortly after, I took my dog for a walk. Anxiety can trap you indoors and twist your body in painful ways, and it felt good to get outside and stretch my legs.

That night I was finally able to watch TV again, but I re-watched my favorite show just to be safe (it’s The Magicians, if you’re wondering), and things were finally feeling close to normal.

After eating a sandwich and experiencing another brief anxiety attack that I quickly quelled with Xanax, (food often makes me nauseous, which triggers my anxiety; more on this later…) I still felt “off,” but calm enough to finally fall asleep.

The time in-between the ER and my follow-up appointment the day of my breakdown was definitely trying…but I had survived, and the day from hell was finally over.