A new doctor – thank goodness

In 2011, shortly after I received my bipolar diagnosis (which I got from a psychiatric hospital the week of my first and only psychotic break), I started seeing a psychiatrist outside of the hospital. He was quirky, and he helped me think critically about how to manage my illness. He gave me ideas for how and when to take my medicine so it didn’t hinder my every day activities (at first, I took both my medications at the same time and would be asleep by 7 pm). He answered all of my questions and I felt safe in his care.

In 2018 or 2019, he left his practice in my metroplex to take a job at a US embassy, either in China or South Africa. His office hired on a nurse practitioner to take some of his patients. By that time, I only went in every four months for a med check.

How are you?

Good.

How are your moods?

Good.

Anything out of the ordinary?

No.

Then done. Ten minutes, at $150 a pop. Was I ever honest about how I’d been doing? Not really. My moods eb and flow and I’m used to the current by now. I never go more one night with less than five hours of sleep. Nothing ever happens to my moods that phases me—I know by now various tricks to get back on track—and my worst fear is that someone is going to try to change my medication. I’m never dishonest, I just never tell the whole truth. Especially since shortly after my psychiatrist left, the NP said I only needed to come in every six months. A lot happens in six months. No way I’m going to regale the entire thing. I see my therapist every two weeks, and she gets the updates and stories.

In March, I got married to a man I’d met thirteen months before. We both want children, so naturally, I wanted to talk to my psychiatrist (NP) about it. I had an appointment in February, where I mentioned our upcoming wedding and asked about getting pregnant. She was relatively noncommittal about changing my medicine, and she said if there was a change, she’d want to monitor me for six months on whatever the change was before she’d feel comfortable with us trying to get pregnant. Pretty standard, I assume. It sounded like a good idea to me. My husband and I wanted to wait, anyway, so it worked out.

Shortly after our wedding, I decided that if any changes were going to be made, I wanted to make them well in advance to give ourselves the most flexibility possible. I called the psychiatrist to make an appointment in June. I mentioned I wanted to talk about pregnancy and medicine. I went into the appointment, and she did her standard check with me. Nothing to report on my end. She went into some studies about pregnancy and the medicine I’m on and was once again noncommittal about everything. She said she’d feel best if I went to one of their colleagues who specializes in prenatal care for psychiatric patients. Then, she told me that once I met with that doctor she could consult with them, and I could come back and see if any changes needed to be made.

This all rubbed me the wrong way. They had me come in and pay $150 just to give me a referral to another doctor. I knew I wouldn’t be going back, at least as long as the new psychiatrist agreed to take me on as a patient. I reached out to the person they suggested (Dr. J) and had my first appointment with her in June. I was impressed by her knowledge and deep understanding of psychotropic medicine and pregnancy.

Thankfully, she said she’s confident I don’t need a med change if I want to get pregnant. I was ecstatic because it meant I didn’t need a six month or longer buffer to see if everything was stable before getting pregnant—which is tough on all women’s brain chemistry, anyway. I can just go about as normal. I’ll have to take folic acid or whatever, but I’m pretty sure every pregnant woman does that.

Our first appointment wasn’t a med check. It lasted an hour. Always one for a captive audience, I told Dr. J a truncated version of my story, consisting mostly of things that happened around or after my diagnosis. More than once, Dr. J said it sounds like I’ve done a lot of work and that I’m in a good place. I noted a slight hint of surprise—a well-adjusted patient with bipolar disorder, who knew?? All the credit for that goes to my first psychiatrist—who scared me shitless into staying on my medicine (which I’ve done for the past 12.5 years)—and me deciding to start therapy in 2018, and of course me taking seriously the work therapy entails. Dr. J seemed more than happy to take me on, so all the work is doubly worth it.

Since my diagnosis, I’ve had a lot of bouts with hypomania—something that has calmed down significantly over the past three years—and some mild depressions, which manifest as sleeping a lot more and not wanting to exercise (which I always do anyway because I want to eat ice cream and not get fat). I’ve had struggles with suicidal ideations, which got stronger after starting therapy and digging into trauma from my childhood I’d never addressed, and then waned after being in therapy for a year or so. I’m easily the healthiest I’ve ever been and in tune with everything my body tells me, both emotionally and physically.

Dr. J made me feel like all the work I’ve put into myself is worth it—and, of course, it is. And who doesn’t like impressing medical professionals? I take great pride (maybe too much?) in my journey and how I came through some of the hardest times, not only intact, but often stronger and better than before.