In Sickness and In Health

And now, a few words about bipolar partners. Or more accurately, partners of people with bipolar.

You’ve already read the story of my young BP friend, Jesse. Well, after a marathon texting session the other night during which I did my level best to talk him out of cutting, he texted me around 1:30 AM and confessed that he’d done it after all. He “wasn’t strong enough”, as he put it. Afterward, his wife was understandably upset and wouldn’t really talk to him for a while; but then last night she glimpsed the incisions for the first time and wept over them, thus beginning the healing process for them both.

Which got my husband and me to talking on the way home from our daughter’s place tonight about how strong and brave one must be to love—and live with—a partner who’s mentally ill. Seriously, these folks must be candidates for sainthood…..I know my dearly beloved is one. So is Jesse’s wife. And so are the millions of men and women who live every day with the uncertainty involved in loving someone who may very well not be there the next.

What’s more, they often battle the stranger within us for years before ever learning the bastard’s identity. My husband says it’s been a lot easier for him since we discovered that there was a name for my problem, and he’s been instrumental in my treatment, even though there have been many bumps and obstacles along the road to recovery. But until Jesse told me how sad his wife was at the sight of his self-inflicted wounds, I’d never really considered the damage I’ve done to my man’s psyche over the years.

I tried to imagine what life would have been like had the situation been reversed and HE was the one with the illness. I wondered if I could have handled going to work in the morning and never knowing whom I’d come home to that night: the warm, loving person I fell in love with…..the weepy hot mess who wants to die…..or the irrational, raging demon seed who delights in making my world a living hell?

I also tried to picture how I would respond to his threats of self-harm, and how frightening it must be to know that I could lose him to suicide at any moment in time. To see him spiral out of control and head for a place where I cannot reach to pull him back. To stand by helplessly and watch him soar with the eagles before crashing to the earth in flames.

And I couldn’t. I don’t have that kind of resilience, let alone that kind of intestinal fortitude, and I know it.

To everyone who has ever vowed to care for a bipolar spouse “in sickness and in health, till death do us part”, I salute you for your patience, your endurance, your support. We literally couldn’t make it without you, no matter how hard we sometimes try to push you away…..or deny our desperate need for your loving presence in our lives.

Pledges and Seashells and Meds, Oh My!

As I may have mentioned before, my psychiatrist is a kick in the pants, and yesterday’s session was so full of fascinating discussions that I could probably write several posts on just this one visit alone. However, in the interest of not boring my readership to death, I’ll stick to the highlights…..after all, nobody but me really cares about his wife’s mission trip to El Salvador where she’s chaperoning eight teenage girls. (Although that’s an intriguing story in its own right.)

Now, I don’t often get this excited about a doctor’s appointment, but being well for the first time in years and reporting on my newly-employed state made me feel like a kid again, eagerly showing off the “A” I’d gotten on a spelling test. Of course, as my biggest cheerleader he was pleased as punch, and actually stood up and applauded. But then, true to shrink form, he became serious and began questioning me about any ambitions I might be entertaining in the area of management.

Well, after my recent job-related flameout, I’m not the least bit tempted to work my way up again; and as I found out during this session, I am forbidden to do so unless I talk to him first. Even then, he would establish strict parameters as to how much responsibility I’m allowed to take on… other words, he’ll insist on accommodations for my illness. And as I recall, accommodations were what got me kicked to the curb at my last place of employment.

That was when he told me to raise my right hand and repeat after him that I wouldn’t “volunteer” for any projects or duties that weren’t mine to take on. (That also meant taking on other peoples’ issues, which is something I would NEVER do…..heh.) I felt silly as hell, but he was totally serious about this procedure and I figured I’d better humor him. Besides, he’s 100% right about my tendency to bear the weight of the world, even though that’s never really worked well for me.

I also got in a spot of trouble for my habit of not reporting in when I start ramping up. As I’ve noted previously on this blog, I have to be about two steps away from being admitted to the psych unit before I call about a mood episode, and he made it clear he’s had enough of that. He also knows that I love the ‘highs’ just a little too much, but by the time I acknowledge that I might be manic, it’s already out of control. So again with the pledge: I am to call him the instant I feel myself getting over-amped so he can do something about it.

In retrospect, I have a sneaking suspicion he thinks I’m already a touch hypomanic, although I don’t think I am. I feel great, yes, and I suppose he might be a bit skeptical because he’s never seen me in as healthy a state before. OK, so I may have seemed a little excited, but I was drinking a Red Bull, for Pete’s sake—half a can gives me a raging case of verbal incontinence. That’s probably why he decided to leave me on my current antipsychotic dose for the time being, even though he’d wanted to decrease it after that acute mixed episode was over with; now it’ll be three to six months before we review that. I’m still on a baby dose, but he wants room to bump it up if I go bonkers again.

Sometime during this dialogue, I noticed that the seashells I’d brought him after my beach trip were still in the same little cubbyhole on his computer table. This has been a subject of much amusement to me, simply because nobody would ever suspect a psychiatrist of being particularly sentimental. This one, however, is an equine of an entirely different hue, and he confessed that he keeps them there to remind himself, when he’s having a lousy day or a patient is giving him a bad time, that someone appreciates him.

And I do. There, I said it. No matter how much crap he throws at me sometimes, no matter how much I dislike being called out on my denial (which is less often these days because the guy’s got my number and we both know it), I’m in this good place because of him. Hell, I’m ALIVE because of him, and I told him so yesterday. He rather liked that.

That’s why I don’t understand those so-called religions whose followers rely only on prayer to cure them of medical conditions—not that I don’t engage in it myself, because I credit God with all the good things in my life. But I know you can’t pray away something like bipolar disorder; besides, I believe God also works through human beings. And I have a sneaking hunch there are a few whom He uses as guardian angels, even though they’re quirky, profane, passionate, and have a low tolerance for my bullshit.

Fupped Duck

WARNING: If you are easily offended by the use of a certain profanity that rhymes with “pluck”, you may want to find something else to read this evening, because I’m going to use that word (and possibly a few others) in the next few paragraphs.

Now, for tonight’s story (ever notice that bipolars seem to do all their writing at night?) I present my good friend Jesse, a young man of thirty whom I’ve known for about five years. He had the misfortune of being drafted into the Manic-Depressive Club not too long after I joined. He is an extremely intelligent fellow whose life was basically screwed from the start, and yet he’s managed to attain a college degree in occupational therapy while wrestling with his demons and trying to maintain his marriage and home life. Naturally, he doesn’t give himself half the credit he deserves for those accomplishments, which makes me sad no matter how well I can relate to it.

He is—as he so eloquently puts it—fucked up. Horribly. He suffers the tortures of the damned when in a depressive state, which is a special sort of hell I’ve never even seen (and pray to God I never do). He does have some hypomania, hence his Bipolar 2 diagnosis, but while most of my mood episodes are either hypo- or full-on manic, most of his are the opposite, and they are SO deep and dark that he almost has to have daylight piped in to him.

Though I’ve got enough years on him to be his mother, I serve as both a friend and an advocate, and nothing about that is considered odd by anyone in our circle of influence. Nor should it be. I think sometimes he makes me out to be this great bipolar guru, even though I’m badly damaged myself—I’m just older and better medicated. TOWANDAAAAAA!! (Oops, sorry for the accidental paraphrasing of a line from the movie Fried Green Tomatoes…..sometimes my mind just works like that.)

Happily, Jesse and I don’t seem to cycle together—one of us will be up while the other’s down, or one will be stable while the other one struggles—so we support each other through our various crises and meltdowns. Our spouses are OK with this, because they can’t possibly understand how our disordered brains process stimuli and are probably only too glad to have us two crazies talk to each other about our craziness. Sometimes we feel really sorry for our loved ones, because it must be incredibly unsettling to live with someone with whom they can never let their guard down for fear that we might actually do something crazy.

And we do have our crazy moments. Jesse self-injures. I shop till I drop, and I’m an ex-drunk. Different sides to the same coin…..we both do these self-destructive things to ease our feelings of inadequacy. And we do them because deep down, we think we deserve to suffer pain on account of the stinking, rotten cesspool that we fear exists at the very bottom of our souls.

I apologize if the reader is shocked or put off by any of this. But when you’ve grown up being told that you were a mistake, that you’re irredeemably defective and no one with an ounce of self-respect would want to be associated with you…..well, it’s a mind-fuck of staggering proportions.

That’s only a fraction of what Jesse (and I to a lesser extent) live with. The fact that he made it through his formative years without committing hara-kiri is proof positive that people with mental illness are made of some pretty durable stuff.

I sincerely hope he gets the chance to read this, because he really needs to know what an awesome human being I think he is and how much he is to be admired…..not only for surviving his nightmarish youth, but simply for making it through every single day with this illness.

They’re Coming To Take Me Away (Ha-Ha)

Readers of a certain age will doubtless remember the silly song from the 1960s, about a rather insane fellow attempting to hide from the “nice young men in their clean white coats” who were coming to take him “to the funny farm, where life is beautiful all the time…..” et. al.

As someone who’s barely escaped hospitalization twice now due to severe mood episodes, I no longer am quite so amused by this little ditty. For one thing, the term “funny farm” isn’t, and for another, you have to be in a world of hurt to be admitted to a psychiatric unit in the first place, and that’s not one bit humorous either.

I’ll be straightforward: The idea of getting sick enough to need a hospital stay scares the living daylights out of me. Maybe it’s that ubiquitous fear of the unknown; all I know is what I’ve heard from others who haven’t been quite as lucky as I, and what little I learned from my psych rotation in nursing school. (What I do remember of that experience was actually kind of cool, though—I got to sit in on a drumming circle, and I think that was more relaxing for the patients than the drugs.)

I simply can’t imagine being in a place where I have little or no control over what happens to me, where I can’t have my coffee and cell phone, where I’m not allowed even to go outside when I feel like it. I’m on the verge of senior-citizenhood, for Pete’s sake… long has it been since I had to ask permission to do ANYTHING!?? I spent four hours in jail about 35 years ago, and that was more than enough confinement for one lifetime; so as you can see, liberty is a very precious thing to me.

That’s why I almost panicked when I was in the process of having my meltdown in April, and my pdoc semi-threatened me with hospitalization if I didn’t take immediate medical leave. He asked if I wanted to be ‘forced’ into it, or merely ‘strongly encouraged’. Thinking my boss might be less upset if this news came from my doctor and the need appeared dire enough, I said “OK, ‘force’ me”.

To which he replied, “That means we lock you up downstairs.” (“Downstairs” is where the psych ward is located.) Instantly I realized my mistake: “Oh HELL no!” I protested. “I’d rather be ‘strongly encouraged’, please.” He agreed and began to type out a letter for my supervisor, but reminded me that the medical leave was strictly that—no stopping by work to check in, no phone calls, no nada. It was either that or go inpatient… choice.

As things turned out, the move cost me my job, but in retrospect I think I still did the right thing for myself. Inpatient would not have only traumatized me, it would have cost me my job AND made it necessary to report the event to the state board of nursing, due to the effect my illness had had on my practice. That would’ve been the trifecta of suckage, to say the least.

So now I’m well, thank God, and to date there is no 5150 (involuntary commitment form) on my record indicating that I’ve been in a psychiatric facility against my will (and you can bet your ass, your cowboy hat, and your house cat that ANY visit to such a facility would be against my will). Nope, they’re not coming to take me away….not today. And tomorrow’s not looking so good for ’em either.

This Is The Land of Confusion

We interrupt this blog to bring you a special report on a phenomenon that apparently affects only certain bipolar patients. It’s known familiarly as The Mixed Episode.

For the uninitiated, this is a combination of symptoms from both ‘poles’—mania and depression—and it is pure, unmitigated HELL. I was so screwed up during my recent dalliance with it that I didn’t know whether to pick my watch or wind my nose. I was running around the house, unable to stay still for more than a few seconds; I had the attention span of a flashcube; and I was cleaning everything that wasn’t red hot or nailed down. (Note: I DON’T CLEAN. My stay-at-home husband does most of it, and what he doesn’t get done…..doesn’t get done.)

OK, these behaviors usually give me the idea that I might—just might—be a wee bit manic. But then, I couldn’t stop crying either…..or thinking sad thoughts…..or feeling like there were worse things than death (namely, going on like THIS). There were several nights in a row when I just sat up in my bed and wept silently for hours on end, swinging one foot and rocking back and forth to try to comfort myself with the rhythmic movements, even as my mind raced and tumbled wildly like squirrels in a cage.

I was confused. I was manic. I was depressed. And I was terrified.

One night about two weeks in, I almost called the suicide hotline. Not that I really wanted to die, only that I wanted the pain to end, and I was half-afraid I wouldn’t be able to resist the temptation to gobble the 90 Ativan tabs I’d just gotten refilled. But I was even more afraid of that someone would call 911 and the police would show up at my door to take me to the hospital in handcuffs. So with the last of my resolve (and a promise to myself to call my doctor in the morning), I forced myself to lie still and try again to sleep.

This is a good time to have a psychiatrist who always returns my calls the same day, because he’s good like that. He also knows that I call him between visits only when I’m in big trouble, so it wasn’t more than about 20 minutes before he called me back.

“I’ve crashed and burned,” I sobbed into the phone, and went on to describe my collective symptoms in a manner that could probably best be described as tangential. When I finally finished, he told me that he didn’t see this as an uncontrolled mania since I was able to channel the energy constructively, a statement that instantly made me feel better. But once again I was puzzled: what about the crying jags? The catastrophic thinking? The overwhelming anxiety?

Long story short, what I was experiencing was the dreaded mixed-mood episode, which according to the books is a feature of Bipolar 1, which is NOT the kind I signed on for. Now, I’ve heard of people with BP 2 or even NOS being upgraded to BP 1 with the advent of a defining episode; this one may very well have been mine, even though we haven’t yet talked about changing the diagnosis. (There’s that damned OCD thing about getting hung up on numbers again. Will I ever learn??)

The good news is, doubling the dose of my antipsychotic took care of matters swiftly and relatively painlessly. The bad news is, I obviously NEED an antipsychotic for maintenance as well as acute mania, because not only did I get better, I’ve continued to improve to the point where I don’t feel bipolar at all anymore.

This is not an exaggeration—I haven’t been this healthy in YEARS. And for some reason, it doesn’t feel like a temporary respite from the hell of continuous mood episodes; this is a sense of well-being that I suspect is going to stick around for awhile. There is none of the urgency of hypomania, nor of the feverish drive to move and go and do (even though I have plenty of energy to do whatever I wish). What’s more, I’m coping well through an intensely stressful time due to the deterioration of my sister’s health to the point where I have to put her in an assisted living facility.

So I’m really, REALLY motivated to do what I have to do to stay well. That freaking mixed episode was more than just a blip on the radar screen—it’s as scary as anything I’ve ever been through, and if I never have another one, it’ll still be a day too soon.

We’re All A Little Mad Here

The day I was diagnosed as bipolar, I drove home from my doctor’s appointment feeling as though someone had slapped a bright red-and-white sign across my forehead warning people to stay away from me. “Danger, Will Robinson! Psych patient walking!” Suddenly I was completely alone in the world…..even though there were a couple of family members whom we all suspected of having the same condition, it seemed at that moment that I was the only “official” bipolar in the universe.

I was certainly the only person in my immediate surroundings who carried this diagnosis. I still am, even in a family loaded with alcoholics, depressives and OCD’ers. But while searching for meaning in these distressing circumstances, I discovered a whole world of people who knew exactly what I was going through……and some of them were as close as my Facebook friends list.

This is, of course, NOT your basic dinner-table conversation (“So, Betty, how did you plead on that shoplifting charge from your last manic episode?”). But little by little, I found fellow sufferers among former co-workers…..members of a nursing forum I’ve belonged to for over a decade…..even acquaintances who have since become close friends because of the common bond between us.

For the reader who doesn’t have this disorder, I have to explain how friendships can be problematic for the bipolar individual. First of all, because we tend to isolate ourselves during times of low mood—and be abrupt and even aggressive when ‘high’—we may not have many friends to begin with. We aren’t the most reliable of friends ourselves for the same reasons. And most of us have also had trouble sustaining relationships because we chose the wrong types of people as friends and/or lovers. So when we find a true friend, a bipolar ‘partner in crime’ if you will, that person becomes our port in an unceasing storm……and we are theirs.

I’m happy to say that I’ve been extremely fortunate in this department. Not only is my family incredibly supportive, but I have a fairly large network of friends whom I can lean on when life seems like nothing more than a huge cluster$#%! and I’m ready to chow down on a bottleful of Ativan. Serendipitously, it always seems that at least a couple of us are euthymic when someone else is struggling, and are thus able to help sustain each other through mood episodes.

We chat about the rest of our lives too, as we are all multifaceted human beings who have more than just bipolar disorder in common. Most of us are nurses or other healthcare professionals; but some work in other fields, several are retired, one serves on the council of a mid-size city a few states away, and another just got her Ph.D in education. We know each other’s quirks and foibles, we know who has issues with alcohol or drugs, we know when one of our group is in trouble…..and we rush to her/his side as we are able, by phone or online, or even by our physical presence.

Yes, we’re all a little mad here….but in our world, that’s perfectly OK.

The Paws That Refresh Us

To add a bit of variety (and a dose of fun) to a blog that deals with some pretty serious issues, today’s entry is about cats. My cats, in particular, who are quite possibly the cutest, craziest, and most talented felines in the universe….but then, I’m not biased or anything.

Like me, all three are quirky and overweight, and they have a death wish that manifests itself in some very strange ways. The boy kitty, Mickey, loves to throw himself in front of me as I’m zipping around the house in forward motion, forcing my feet to come to a screeching halt while all the other body parts continue in the original direction at the original velocity. And the girls, Rosie and Casi, have a habit of launching themselves off the headboard of my bed in the wee hours of the morning, and landing squarely on top of my full bladder. (Come to think of it, maybe it’s karmic retribution for all the times I’ve kept people up half the night with my own disruptive behaviors.)

They also seem to lack an appreciation of the fact that I have been performing my own toileting and grooming routines for 50+ years without benefit of feline assistance. They HATE it when I insist on going into the bathroom alone and will try almost anything in order to be admitted to the sanctuary, including scratching and/or yowling ceaselessly at the door for the express purpose of annoying me so I’ll let them in, just to make that infernal noise stop.

Then there’s the thing with their food idiosyncrasies. Each one of these critters prefers a different diet. I mean, they don’t agree on ANYTHING: one will only eat canned cat food, another only dry cat food, and the other wants to chew on me—fingers, toes, chin, whatever he can get hold of at a given moment. I know he eats other food when I’m not around—this fat-cat weighs at least fifteen pounds!—but when I am, he grabs the closest part of my anatomy in his teeth and begins to chow down, ignoring my yelps and cries of “YOWCH!! Dammit!!”

But for all the ways they can be a pain in the patoot, they make up for it in unconditional affection. There’s nothing quite like the cozy feeling of a soft, warm kitty curled up between my husband and me in bed, purring contentedly…..or being greeted by three enthusiastic fur-kids at the end of a hard day. And they don’t care whether I’m manic or depressed, or mind the fact that taking proper care of their humans sometimes involves licking the tears off my face or ‘helping’ me rearrange my sock drawer in the middle of the night.

These are the paws that refresh us. Who are yours?

You Know You’re Bipolar When…..

…..You think that your spouse is being ridiculous when he demands to know why you’re rearranging the sock drawer. At two-thirty in the morning.

…..You can’t imagine why your BFF isn’t amused when you phone her in the middle of the night to debate the merits (or lack thereof) of Obamacare.

…..You sit on the edge of your bed till the wee hours, staring into the dark and letting one leg swing back and forth, back and forth, like a pendulum. Like your moods.

…..Nobody can figure out if you’re serious, or sarcastic, or ticked off…because you can be all three within the space of five minutes.

…..You laugh hysterically while watching Andy Dick pose as Zorro on Dancing with the Stars, then find yourself sobbing over a dog-food commercial two minutes later.

…..Your mood chart resembles an abnormal EKG tracing.

…..All of your friends can spot an impending mood swing three days before you do.

…..Half the names in your day-planner have “MD” behind them.

…..You call your AM meds “Breakfast of Champions” and your PMs “Handful of Sanity”.

…..Your psychiatrist is on speed dial, right behind your spouse and ahead of the closest pizza joint.

…..You wonder why people sometimes look at you like you’re crazy, when in fact, you are.

…..You catch a head cold and someone warns you to bundle up, saying that you’re going to get pneumonia and die—and you ask, “When?”

…..It seems perfectly normal to pressure-wash the front porch for four hours.

…..You actually LIKE being hypomanic and wish you could stay that way for the rest of your life.

…..Quitting your job, moving to Bora Bora, and living in one of those little stick houses out in the shallow part of the ocean seems like a logical idea.

…..You haven’t a clue why people are staring at you as you pull up to a traffic signal with the radio turned up full blast, drumming on the steering wheel and singing Bon Jovi’s “Livin’ On a Prayer” at the top of your lungs.

…..You write a letter to the CEO of a company, criticizing them for their latest advertising slogan, because you’re offended at their offhand use of the term “crazy”.

…..You get angry because the CEO isn’t as outraged as you are.

…..You use a Grumpy Cat avatar that says “Yeah I’m Bipolar, But Right Now, I’m Just Pissed Off. Learn the Difference!”

…..You have completely different sets of clothing for each mood.

…..Stuff like this cracks you up because you can identify with pretty much everything on the list!

A Weekend in Ensenada (and Other Stupid Things I Do When Manic)

Way back in the day when I was a newly-minted 21-year-old, I once threw some clothes in the back of a friend’s pickup truck on the spur of the moment and went to Ensenada, Mexico, over the long Labor Day weekend.

I didn’t say a word to anyone in my family that I was leaving, let alone that I was going out of the country. Didn’t even let my close friends know I’d be gone all weekend. Nope, I just hopped in the truck with two of my co-workers on a late Friday afternoon and drove down to Ensenada, arriving at a cantina in what was definitely the bad side of town around 10 PM.

The last thing I remember before passing out—just as the sun was coming up—was dancing on the bar with a bottle of mescal in one hand and a joint in the other, playing to the crowd and generally whooping it up. I came to about 24 hours later in an alley in back of the bar, with a donkey nosing me and snorting in my face, and the sun boring into the back of my skull like a laser. My ‘friends’ were a little further down the way, and they too were hung over out of their gourds, crawling around on their hands and knees and vomiting tiredly into the dust.

And I had the nerve to be surprised when I finally made it back home Sunday night to find my phone ringing off the hook: “Where the HELL have you been?!” my sister demanded. “Do you know you’ve scared the crap out of all of us? What’d you do, go out of the country or something?”

Uhhh…..yeah. And I’ve done some other crazy things during manic episodes, even long before I knew that’s what they were. One time I got a wild hair and decided to send for a $200 kit that would get me started in direct mail marketing….for what, I never figured out. Another time I stopped at Wally World on the way home from work to pick up a couple gallons of milk, and came home with a thousand dollars’ worth of merchandise.

Then there’s the ever-popular all-nighter, during which I’ve been known to call my friends and family and wax philosophical about love, sex, death, politics, and other matters of consequence. (I used to do this when I was drinking, too, which is not the only parallel between mania and alcohol abuse I’ve run across.) I’m sure they love this as I tend to be so witty and articulate during these conversations, and I always argue my positions with passionate conviction. The fact that perhaps they might not think this is such a hot idea at 1 in the morning never crosses my mind.

There is, however, an upside to manic episodes, and that is this: they intensify one’s personality. Not only that, they enable one to share the very best of her/himself with a world that demands conformity and often punishes uniqueness.

And I can just hear it now: “Yeah, that’s great about intensifying your personality and all…..but what if you’re an asshole?”

Shrink Wrapped

And now, the down-and-dirty on my psychiatrist.

Let me be clear: I did NOT go to my first appointment willingly. I went because my primary care physician thought I had something more serious than he could handle, wasn’t going to prescribe yet another type of antidepressant for me, and referred me for a psych evaluation. I thought he was sending me to a therapist. When I found out I’d been referred to an actual psychiatrist, I flipped out: “I’m not crazy, Doc,” I told him, “I’ve just had really bad mood swings for forty years!”

But it took all of about 30 seconds for a tall, slender, and relatively young man with a receding hairline and intensely kind eyes to make me feel safe, and for someone with trust issues, that meant a great deal. It didn’t take many appointments for me to feel totally comfortable confiding things my own husband didn’t know about; my pdoc turned out to be incredibly nurturing, but even better, he had a warped sense of humor that matched my own. You’ve gotta love a guy whose favorite movie is National Lampoon’s Christmas Vacation.

This is, by far, the weirdest relationship I’ve ever been involved in. He respects me as both a patient and a nurse; I admire him for having served with the Army in both Iraq and Afghanistan. There isn’t much the man can’t do—he does acupuncture, performs magnetic brain stimulation procedures, AND cans his own homegrown fruits and vegetables. He is arguably the coolest individual I’ve ever known, and frankly, we adore each other—not in the carnal sense (ewwww, can we say ‘professional boundaries’!?), but as close to friends as a doctor and patient can ever be.

It could have a lot to do with the fact that we ARE both clinicians and speak the same language; I know about his colonoscopy results, and he asks me about my arthritis. We chat about his latest batch of blackberry jam and his troubles raising teenagers; we also BS about football and my garden. We joke around in between serious discussions and tease each other at every opportunity (“YOU? Stubborn??! Oh yeah, let me write that down!”). We even use bad language and talk about religion and politics….none of which are particularly approved of in every other domain of life.

By now you’re probably wondering if he does me any good, and the answer is a resounding YES. He is one of only a tiny handful of people who don’t co-sign my bullshit, and I respect him tremendously for that because I am an extremely persuasive, and even manipulative, human being. He’s my cheerleader, my mentor, even my job coach……and he’s taught me, at long last, to believe in myself.

Granted, I pay my psychiatrist serious amounts of hard-earned cash for his services, but he goes so far above and beyond the call of duty that I don’t begrudge him one thin dime of it. I hear so often about patients who see their doctor for 15 minutes every three to six months for medication management, and they pay the same fees as I do for sixty full minutes of therapy monthly (or more often if I need it). Never once has he allowed me to leave that office without feeling better than I did when I walked in. And he even keeps the seashells I brought him (after the trip to the beach that he ‘prescribed’ for me in April) right by his computer keyboard.

No, this is not your typical pill-pushing nerdy Freud wannabe scratching out notes on a pad while you lie on a couch; this fella is your basic metrosexual with a flair for business-casual dressing, who does everything he can to be unobtrusive with his note-taking (he’s still pissed about having to type his notes during sessions because the transcriptionist was laid off last month). And the “couch” is a comfortable loveseat, with only a glass table with a box of Kleenex on it as a barrier between doctor and patient.

But what it all boils down to is, the man saved my life. I wouldn’t be here if it weren’t for his prescribing the right meds in the right combinations, being available when I was in crisis, saying the right things at the exact time I needed to hear them…..and $267 per visit doesn’t even BEGIN to cover that debt of gratitude.