Last week I went to the doctor for a follow-up due to a
medication change. (I have depression; I take meds.) My former prescription
lowered my metabolism and made me sleepy and hungry – unfortunate combo! – so when
my doctor got a look at my chubby ol’ self at a recent appointment, he
switched me to a different medication.
The new meds have required some adjustment. For one thing,
weaning off the old medication is not as straightforward an affair as one might
hope, and a few days after the switch I was sitting at my desk at work crying in between bouts of strongly disliking my coworkers. Seeing as how I have a
fabulous job and wonderful coworkers, it was clear there was an issue with this
new medication and I called the doctor. His nurse, understanding the weaning
situation, gave me something extra to take, as needed, to help me be more
rational and less volatile. It’s a small prescription with a small dosage; I
take it only when I want to kill and/or maim people, and all is well.
The other important adjustment is that while I was extremely
sleepy and tired on the old medication, the new medication can have the
opposite effect. Thus, I never feel sleepy, I don’t take a nap every time I sit
down, and I am a (comparative) ball of fire. The trick is, I am very used to
being tired and am mistaking not feeling constantly sleepy with not actually being
sleepy. Obviously, since I fall asleep as soon as I lay my head, the medication
is not keeping me awake; I just don’t feel sleepy like I used to do and I often
forget to go to bed at a reasonable hour.
The third item at issue is not exactly an adjustment, but
more of a temporary lifestyle change. This year is my 40th class
reunion. 40th!!! (Oh my gosh, I'm old!) It’s also the first year since the 10th
reunion that anyone has had a clue how to find me (hello, Facebook!), so this
is the first time I’ve heard from or about any of my high-school classmates in
30 or 40 years. It’s fun. It’s funny. I stay up late chatting on Messenger or
on the phone. I do not feel sleepy. I do not go to sleep appropriately.
So, picture this, at 8:00 a.m. last Tuesday:
Doctor: How is the new medication is working? Are
you transitioning well? Any problems making the switch?
Jackie: It’s mostly fine. I’ve been a little
moody sometimes, but the extra med is helping with that.
Doctor: "A little moody.” What do you
mean, exactly? How often are you moody?
Jackie: I get cranky at work and things just tick
me off. You know, little things upset me. But the meds are helping with that.
Doctor: How often do you take them?
Jackie: Every day last week at work, but only one
per day, usually in the afternoon, and I’ve been fine. I haven’t been crying
anymore and I haven’t wanted to kill or maim anyone. Hahaha. (laughing; this
was a little Jackie-joke.)
Doctor: Crying?
Jackie: Yeah. You know, the day I called and your
nurse gave me this second prescription, I was crying. Bad day. Hated my job and
all my coworkers and all the horses they rode in on. Very emotional for no
reason. Just not a good day.
Doctor: And how are you sleeping? Are you getting
eight hours of sleep every night?
Jackie: Oh, yes, I sleep great! I’m not getting
eight hours, but that’s because I don’t feel sleepy so I stay up talking to
friends on the computer or on the phone. It’s my 40th reunion this year; I’m
talking to folks I haven’t talked to in years! Wow, is that ever fun!
Doctor: How much sleep are you getting?
Jackie: Four or five hours per night? More if I’m
not on the phone, of course.
Doctor: Your inability to sleep is troubling. Also
the crying.
Jackie: (interrupting) No, the crying is all
gone. And, I sleep fine if I will just go to bed! Really, it’s more that I’m
all excited about talking to these former classmates and writing on Facebook and
stuff, and I get wound up and don’t feel sleepy. But I sleep fine.
Doctor: But you’re not sleeping very much.
Jackie: No, but that’s totally my own fault. I
mean, I don’t feel sleepy so time gets away from me. But when I see it’s late,
I go to bed and go right to sleep and sleep just fine.
Doctor: How is your sex life?
Jackie: Um . . .
(blushing), I’m divorced? No sex life?? (looking out window, thinking,
“What???”)
Doctor: (putting down his pen and leaning forward
to face me with a Very Serious Face.) I have to tell you that I am very concerned
that you may leaning toward bipolar.
Jackie: (shocked) Bipolar?!?
Doctor: Yes. Crying, inability to sleep, these are
definitely the signs or precursors to bipolar.
Jackie: But I’m not crying with the extra medication
and I only need that at work and only once per day! And I sleep fine if I will
just go to bed! Bipolar??
Doctor: I’ve been seeing you for several years,
and the behavior you are describing is not the Jackie I know. That does raise a
red flag for me. It’s my job to make sure you are receiving the correct
treatment.
Jackie: (getting panicky and needing one of those
calming pills, like, right freaking now.) I am fine. I take a pill if I start
getting crabby at work, and it takes the edge off. I sleep fine and I will
sleep plenty if I will just stop talking on the phone at night.
Doctor: Okay, I am going to trust you on this for
now. However, I want you to be very aware of your emotions and feelings and sleep
patterns. In particular, I need you to pay close attention to these three
things (ticking them off on his fingers):
Sleep – it’s a warning sign if
you are not sleeping at least six hours per night.
Shopping – pay close
attention, especially if you find yourself shopping more than usual, and most especially
if you are buying things that are unusual for you to buy.
Sex – be aware of any increase
in your sexual appetite, any increase in how often you have sex or want to have
sex. Increases here are a warning sign.
Jackie: (still blushing) Okaaay.
Doctor: I want you to call me immediately if you
notice any of these things. Fewer than six hours of sleep, increase in desire
to shop, increase in sexual activity or desire. Okay? It is important that you
let me know right away if you experience any of these. The three S-words: sleeping,
shopping, sex.
Jackie: Gotcha! Three S-words! But, really, I’m fine.
(I have condensed this and I doubt there is any way I can get the feel of the conversation right, but that’s the general synopsis.
If you’ve ever seen a therapist, you probably know just how
this went.)
He then walked me out of his office and sent me to the front
desk to make my follow-up to the follow-up appointment -- which I need because
I may be unexpectedly bipolar -- and I started grinning. By the time I was back
to my car, I was cracking up. I mean, seriously, I’m 57 years old and I was embarrassed because my shrink was asking about my (nonexistent) sex life. Are
you kidding me? And wait, he seriously was asking me to monitor how often I want
to have sex? He wants me to call him if the current situation changes? And he thinks
I may be about to become bipolar?! What the ----??!!! I could NOT stop
laughing. I went for breakfast after this appointment and I’m sure everyone in
Panera thought I was a complete nutcase because I was sitting at a table, all
alone, eating a breakfast sandwich, drinking hazelnut coffee (yum, by the way),
and chuckling away to myself.
I also had a dentist appointment that day. A friend of mine
works there. I told her this story. We both laughed until we had to mop our
eyes.
So, word to the wise, be aware if you sleep fewer than six
hours per night, have unusual shopping issues, or experience an increase in your
libido. You may be bipolar.
P.S. I am not making fun of bipolar disorder or of being
bipolar. I have known people who suffer with bipolar and “suffer” may not be a
firm enough term. It’s awful.
However, I am not bipolar. I am merely a diagnosed-as-depressed
(but, really, with drugs I am fine), divorced old lady who definitely got a
hoot out of the most unusual conversation I think I have ever had with anybody.
Hilarious way to start the day.
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