Daily Archives: November 25, 2013

Healing / Meet Dr. Forster



I just spent some time going over old emails that I have exchanged with my psychiatrist, Dr. Peter Forster. Wow. That was a worthwhile experiment to gain some perspective on just how far I’ve come. I’m surprised at how powerful I found that exercise to be. Perhaps we should all review some old emails to see how we’ve evolved?


I think I have a revisionist sense of history, because I tend to consider the last two years as having gone really well overall. However it seems in reality there was a lot of adjusting and maturing taking place. Embedded in the correspondence were some true and genuine moments of suffering, confusion, some physical challenges, medication adjustments, triumphs, and as many wonderful life experiences as challenging ones. I feel really fortunate to have had the *right* therapist with me during this time, and going forward. I’ve had a safe base and stability in that relationship, which was exactly the calm yet directive voice I was hoping for, and requiring.


So let me introduce you to Dr. Peter Forster, for those of you looking for a psychiatrist in the Bay Area. He’s been consistent through-and-through. He’s not judgmental about personal matters, he remembers every detail about me (which I never expect), but most profoundly I feel like I haven’t been strong-armed into any treatment, but rather my personal boundaries have been very much respected. That is not to say that I haven’t been told directly what will help, because I have, even when I’m at my most stubborn, but I view this as a required duty in this sort of relationship. So I tend to expect some very appropriate push-back.


He’s taken all my feedback about the medications I’ve tried and worked with it to find the best approach for ME. That’s a difficult process for anyone, be it Rx writer, or Rx taker. Actually, this latest fine-tuning of my medication has left me feeling more solid than I have ever felt — in my entire life. I’m not fogged, I’m productive, engaged, emotionally present, and HAPPY! I’m not perfect, but I would take this me, over the me that walked into his office two years ago, hands-down no questions asked.


The most important outcome of my treatment is simple to me: Am I the best mother, and wife, that I can possible be? Is this process helping make those goals a reality? The answer is, yes. I suppose the relief I feel is also worth mentioning, but really, my goals revolve around those other people that live in my house, both short and tall.


I like how Dr.Forster can move between quoting peer-reviewed papers, and life experience. He’s very human, social, and approachable. There is no doubt however that he is a physician. Lately, I feel like he’s my trusted friend. Maybe I’m not supposed to? It just seems that after two years of propping me up, and literally saving my life, it’s kind of hard not to be overwhelming thankful and appreciative. Lately I realized that I have “good patient syndrome” however. My husband pointed it out. He thinks I tell Dr. Forster all my positive accomplishments and leave out some of the more troublesome events because I don’t want to be a problem for him. I have vowed however to be more direct, and I thought maybe others do the same thing, and therefore it was worth mentioning.


I guess the purpose of this piece is not only to endorse Dr.Forster and the exceptional care he’s given me, for those who may be searching for help, but also to relay to others what I feel a functional and productive therapist-patient relationship should feel like. Safe and full of mile-stones.


Thank you Dr.Forster for your patience, dedication, and clinical insight. I’ll finally order all those books you’ve suggested… no really, I will… today… I’m doing it now… I swear. ūüėČ


Dr. Forster does Skype/Google Hangout appointments, which I must say has been a wonderful perk occasionally… you know when your pipes are leaking, or your child is home sick, or the dog has eaten raisins (again). You can find Dr.Forster here:
www.gatewaypsychiatric.com/dr-peter-forsters-practice

The Neurobiology of Bipolar Disorder



This is some light reading.


http://www.ccnl.emory.edu/greg/Bipolar%20AJMG%202003.pdf

Living With Bipolar ‚Äď Guest Blogger

If you don’t read the¬† “Her Fitness Journal,” you should. The writer, Sonya, ensures her blog covers a wide array of interesting and important topics. Sonya asked me to be a guest blogger covering the topic of living with bipolar disorder; I was happy to oblige. You can find my post today on her blog by clicking HERE.

 

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Divine Avoidance

I haven’t had the nerve to open my mailbox in four days. I don’t know why. I go into avoidance mode during the seasonal depression. Today I have been ignoring all calls and texts. Just people wanting something from me when I have nothing to give. My stomach has been upset for a week now because the stress of it all is taking a toll. I have NO ONE in my life who understands or even makes a half ass attempt to be supportive. That leaves me to bond with people on line and even that is stilted by my illness because I never want to talk. I have nothing good to say. I have nothing interesting to say. There’s just nothing good or interesting with me.

So the depression tells me. It seems reinforced by those around me who only want me to cheer up and do their bidding without regard to what I am going through.

My own father is the worst. He’s on me to get a job. Like if anyone would hire me I wouldn’t be on it like white on rice. Guess he wants me to get a gun and force a manager to hire me? What can I say? I’m unstable because I have an illness but NO ONE cares about your “excuses”. They simply don’t. There are no allowances made. No empathy. NO understanding. So while I am make an effort and am willing to work, no one will give me the chance and at this juncture in time…I dont disagree with them at all.

I never know who I am going to be when I wake up these days. Will I lay in bed shivering under the covers and nursing a nervous stomach that is agonizing? Will it be one of the days I spring up and actually want to get on with the day?Or will I be sad and weepy? Oh, the angry irritable days are good, too, when I am pissed off at all and have no idea why and no amount of subterfuge or fake smiles can mask it because it comes out anyway.

And the last week has been a lot of that. To be expected with a med change.

New shrink (I think I like her a lot) put me back on Cymbalta, said we have to find a balance between that and the mood stabilizers. She’s the first who’s had the intelligence to think that. She left everything else the same. I actually had panic attacks from hell going in (grabbing walls, the nurse seemed to think I was bonkers) but I came out of a shrink appt feeling good for once. And it wasnt just relief at being done.

But since the Cymbalta was reintroduced my lithium numb is gone and I am all over the place emotionally. I’m happy, I’m sad, I’m mad, I’m bored, I’m restless, I feel nauseous. There is no constant now and it is rattling me big time.

Part of why I haven’t answered the phone today even tho I know I will get my ass chewed for it. I feel very irate and hateful and angry and that’s never a good mind frame in which to deal with people. Now if I could explain this and be understood, I wouldn’t need to avoid. But the moment I try to explain and get the “suck it up” speech, it’s like primer and gunpowder. Not good. So I avoid.

Not healthy but I don’t know what else to do.

It makes me anxiety ridden no matter what  I do.

I just feel like a fish out of water and I am flopping about on land.

It’s like…I’m uncomfortable in my own skin right now. It’s too tight, it doesnt fit right, the texture is all wrong…It’s my skin but it feels alien…

And I don’t know if that is depression or the new med stirring the pot.

But in a sea of shit..a new doctor who actually listens seems something to be positive about.

Or so I tell myself. The mental illness doesn’t want me believing anything positive though.

Thank god I spent years perfecting the art of telling others to go fuck themselves.

Yeah. The depression needs to that.

 


Stigma: A Family Tradition, Part Two

I got so excited writing my last post that I forgot to mention the “family tradition” part! ¬†So here it is, in all its sad gory. ¬†Yes, that’s what I wrote: sad gory.

Let’s start with the unfortunate fact that the first time I heard anything whatsoever about my family’s mental health history was when my mother came to visit me during my first psychiatric hospitalization. ¬†That’s when she chose to open up about the fact that her own mother had been hospitalized countless times for depression, and had hundreds of ECT (Electro-Convulsive Therapy) treatments, many of them AT HOME, where my mother and her sister had to hold their mother down on the bed while the doctor administered the treatments. ¬†Apparently at that time they did not anesthetize the patient, but just let ‘er rip with the voltage.

Then poor Nana got hooked on Miltown, and after that, various barbiturates, which the doctors later switched over to benzodiazepines. ¬†When she was put in a nursing home, her dose of Librium was limited to doctor’s orders, far less than the dose she was used to. ¬†”They didn’t want her to become addicted.” ¬†She already was addicted, the fools. She used to get other people to sneak her a stash, which she always put in the drawer of her bedside table, and the nurses’ aides always confiscated. ¬†Then she would call me (I was a med student at the time) and beg me to prescribe her some more. ¬†I always had to say the same thing: “I’m sorry, Nana, I can’t do that. ¬†I would if I could.”

I felt bad for her, since she was really an addict, and why should they deprive a 90 year old woman of her comfort?  Benzodiazepine withdrawal is a terrible thing.   Luckily Tricyclic Antidepressants came along and saved her some suffering.

And now for my father’s side of the family. ¬†The first to come up was my Great-Uncle Benny, who was my paternal grandmother’s brother. ¬†He was a doctor, and the two siblings had escaped from the Ukraine just before the Bolshevik Revolution, when terrible pogroms were decimating Jewish communities. ¬†Their parents sent them to America to escape the atrocities. ¬†Unfortunately, Benny “had a breakdown” sometime after reaching New York, was put into Rockland State Hospital, and was never heard from again. ¬†The family just shut the door on him and assumed that he had lived there till he died. ¬†That’s what my mother told me, anyway.

But. ¬†On a hunch, I looked him up in Ancestry.com and by using all the data that I had about Uncle Benny found a living son, in California. ¬†So it seems that the man the family threw away DID get out of the hospital, and went on to have a life and a family. ¬†But to MY family, Uncle Benny went into the black hole of the hospital and never came out. ¬†And I don’t blame him for not getting back in touch with them!

And then there was my Grandpa on my father’s side, who married Benny’s sister. ¬†Grandpa became overwhelmingly depressed at the age of thirty or so, and never recovered. ¬†His doctor, who was a cousin of my grandmother’s, (and actually a urologist, if the truth be known), advised that he spend winters in Florida instead of upstate New York (where they lived), and knowing what we now know about light and its effects on depression, that was good advice. ¬†But Grandpa was never able to work, never able to do much at all. ¬†He had no treatment whatsoever for his depression. ¬†He lived a miserable life until the age of 91. ¬†I have great pity for him, having to live so long in that hell, even though he was very unpleasant to be around.

Speaking of the doctor who was a cousin of my grandmother, who would have been Uncle Benny’s, um, second cousin once removed, or something like that–anyway, one of his sons committed suicide.

So here I was, in the hospital, having felt terrible literally my entire life, and I do not exaggerate here–I cannot remember a time when I did not feel terrible, as a baseline, with episodes of euphoria that unfailingly got me into some kind of trouble–and only then was I told that the genetic cards had been stacked against me. ¬†And I was forty-five years old.

I felt as if a closet had been opened and a whole family’s worth of skeletons came tumbling out with a crash and a shattering of bones, some of them mine.

Why had I not been told? ¬†The impact on my life was so profound. ¬†If I had known, then I could have sought help as a young adult, after I left home, at least–since my parents believed in psychiatry only for other people, not any of us: that was for crazy people, and they drugged you up and you were a zombie. ¬†Well, that may have been true, for some people, because the medicines they had back then were crude. ¬†But they certainly did have psychotherapists back then, and I sure could have used one. ¬†At the very least I would have had some insight into why I felt terrible all the time, and not have to feel like I was some kind of freak.

But our family history was seen as an embarrassment to be hushed up and stuffed into the closet, skeleton by skeleton, and the door wallpapered over and that part of history as good as erased.  Until I came along and broke up the party.

I will never forget the shock I felt, after I had lost my medical practice and had a serious breakdown as a result, and my first hospitalization–I ran into a bevy of my mother’s friends in a parking lot, and they all started cooing about how my mother had said my practice was flourishing and how well I was doing. ¬†I had a moment of mental white-out and then said, “Well, actually, no. ¬†I’ve lost my practice, and just got out of the mental hospital.” ¬† Then I turned on my heel and walked off, noting with satisfaction their jaws resting on their shoe-tops while flies flew in and out of their big mouths. ¬†But it really wasn’t their fault. ¬†They were just told a pack of lies.