A Session with a Good Psychiatrist

In my new home town of Pueblo Colorado, I don’t have to drive fifty miles to see a psychiatrist so I went to see one. This was because I’ve long had doubts about my original diagnosis of paranoid schizophrenia made in 1964 and to insure a supply of antipsychotic medication should my primary care physician become skittish about prescribing it. It turned out to be a lengthy  very good session-much more productive for me than my early sessions with psychiatrists in my youth.

Decades ago psychiatrists seemed to regard their patients as defective specimens to be studied and probed. I don’t recall any of them attempting to engage me on a person to person basis. They asked questions, took notes and divulged nothing of what they thought. It took me thirteen years to learn my diagnosis from a social worker.

Also in those days I was much less open and communicative with the Doctors than I am now. I am a much better participant in these sessions now than then. Another factor is that the nonsense writings of Sigmund Freud are not the powerful influence over the psychiatric community that they were then. What my psychiatrist was saying was much easier to accept than the meagre utterances of the past.

From this engaging young lady of today, I learned a great deal. I gave her a detailed description of my history and of my symptoms.

Her considered and well qualified opinion is that I am a classic bipolar 1 with psychotic features. After starting a blog entitled theunashamedschizophrenic, I learn that I’m not schizophrenic. Go figure.

I have had the good fortune to be part of the small percentage who experience more mania and psychosis than depression. Many people with bipolar struggle mostly with depression. Even more than psychosis, depression is literally a killer. A good therapist I had for years used to say now and then that if he were suffering from depression and didn’t believe it could be effectively treated, he would commit suicide. I’ve never experienced the excruciating, debilitating agony I’ve heard described. There have been long periods of being sad and vaguely depressed and short periods of being very down. But that’s it. I didn’t need a professional to tell me that as crazy people go, I’m one of the very,very lucky ones.

She said that a maintenance dose of haldol is a common treatment for bipolar disorder. Until me the lowest dose she had heard of was four milligrams a day. I’ve been taking two and a half for nearly thirty years. I described some of the brain malfunctioning that occurred when I went off it a couple of years ago. She insists that although I didn’t get psychotic and might have my doubts, the haldol is not a placebo.

The bad news is that my recently discovering myself to be pre-diabetic is probably a side effect of the haldol. Coincidentally, another psychiatrist I occasionally golf with told me the same thing on the links just a couple days before my session. He was commenting on the similarities between diabetes and serious mental illness and I mentioned being pre-diabetic. This is something I never noticed in the pages of possible side effects I occasionally read. The effect is cumulative so the longer I take haldol, the more certain diabetes.

There are other meds I could take that don’t have this problem, but the best of them are effective fifty percent of the time. I know haldol works for me. I fear few things more than another psychotic episode, so changing meds is not a consideration.

I talked some of the problems with cognition I’ve observed in myself for a time after episodes. The psychiatrist said that a psychotic episode is very similar to a concussion in it’s effect on the brain. In effect, I’m a survivor of multiple concussions. {This has all the markings of a very convenient excuse  that I can use over and over.}

She asked me if I was aware that I talk out of the side of my mouth and if I knew why. I said that in addition to that, I am slightly numb on the side with the droopy lip from the top of may head to the bottom of my foot. It’s been this way for a very long time. Either I’ve had a stroke I absolutely never was aware of or it was a shock treatment gone wrong. I described my memory of a very distressed student nurse who didn’t notice right away that I had regained consciousness after a treatment in Middletown and could hear her.

Because the records from Middletown State Hospital that I was able to get nearly thirty years ago were incomplete, I recently tried to get records from both stays by my mother and myself. Like so many psychiatric hospitals, Middletown has closed it’s doors. I found out who had the records from the hospital but none exist for as far back as I was seeking.

My psychiatrist said that I should get an MRI as I should know whether or not I’ve had a stroke.

Tomorrow I see my primary care physician. I need to ask her if she thinks losing twenty to twenty-five pounds will stave off diabetes or should I start taking a med for it. She had prescribed diabetes education classes but they revealed little in the way of possible positive life style changes. I also need to ask if an MRI would reveal the cause of my pervasive numbness and is there any value in knowing after all these years. I really have always wanted to know if they did screw up a shock treatment back in 1964, but MRIs are expensive for somebody just to satisfy curiosity.

The best news is that I now have a more certain more believable diagnosis. I know much more about the adversary I have fought all these years than I ever did before. Nothing is more powerful than knowledge.

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One thought on “A Session with a Good Psychiatrist

  1. Joe: A well-written and well-deserved diagnosis, one that provides a lot of relief. and as for the possibility of diabetes, the disease has many levels and it likely would not be the full blown variety given that it could be a reaction to the haldol, to someone who is reasonably fit except maybe for his putting.

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