30. 30
30
Chastity lurched up from the tufted lounger and paced the room. “You’ve got to be kidding me.” She spat, more to herself than him. “This is bullshit .”
“Sorry to say, but it isn’t B.S., it’s reality. I know you only came to me to get a second opinion, but I’m afraid I have to agree with your last therapist.” His voice was even, almost disinterested.
“Not my reality!” she snapped. The anger inside of her was so tempestuous she feared she might set him aflame with the intensity of her stare. But a moment later, her snarl soon faded away to a hopeless regret. She knew she was feeding into the diagnosis, the stigma, but she couldn’t seem to control her emotions. They always seemed to have a mind of their own. This moment was no exception.
Dr. Brown, contrary to his name, was a balding white man, though his clean-shaven face made him look younger than the age his crown of gray hair suggested he was. His hands rested in his lap near his bulging waistline, the button of his coat tilting up as the material stretched. His leather swivel chair creaked as he twisted this way and that in an attempt to follow her.
“So, that’s it, then? I’m for sure bipolar? So now, I get to slap a warning label on my forehead for the rest of my life?”
“Based on what you’ve told me, you have had this for a long time. You have a name for it now. And that name comes with a world of options. You can start planning an attack, combating the extremes, leveling out your impulsivity, and so forth.”
Chastity’s eyes angrily roamed his office, one decorated with emotion-inducing paintings and several confidence-inspiring plaques, diplomas, and awards hung on the wall with care.
“How do you know for sure? You spent, what, an hour and fifteen minutes talking to me, and you just… know ?”
He watched her pace. “You sent over your records from the college counselor. I reviewed them carefully. I’ve listened to you talk about your emotions, your mood swings, your impulsive behaviors. It’s not a guess. I didn’t get all those diplomas out of a Cracker Jack box. My DSM-V isn’t just a bulky paperweight. I’ve been doing this almost longer than you’ve been alive.”
She plopped back down on the chaise, collapsing into herself, the stubbornness of her denial the only thing keeping her upright.
“So.. now what?” A rush of emotion overtook her. Unable to hold them back, tears fell and spattered against the thighs of her torn jeans. “What do I do now?”
Dr. Brown leaned forward in his chair, his hazel eyes softening with some genuine compassion. “You have two options: you can continue to suffer manic highs and depressive lows, or… we can finally try something different. The choice is up to you.”
“I just don’t get it. I’m not some explosive person who has to be medicated to oblivion just so I can be more palatable to other people. I’m not that bad.”
“It’s not about making you socially palatable. It’s less about your propensity for angry or tearful outbursts, more about how you feel .”
“I feel fine,” she lied.
“How have you been sleeping?”
“Fine,” she said so weakly he almost couldn’t hear her.
He tilted his head, giving her a discerning look. “I cannot help you if you aren’t honest with me. The only person you’re hurting here is yourself.”
She sniffled. “You want honesty? Fine. I haven’t slept more than three or four hours at a time in well over a month.”
“And how has your mood been?”
“It’s been good. I’m staying upbeat, considering the circumstances.”
“Spending a lot of money?” he asked with a cocked eyebrow.
She laughed. “I don’t have much to spend. I barely had enough to cover this visit.”
“You do any gambling, street-racing, sex with strangers, self-harm?”
She waited a while, then finally nodded. “Yeah. Sex.”
“All of them?”
“No, the sex. Some… one-night stands.”
His expression never changed, as if he was expecting that answer. “Anything else? Substance abuse?”
“Occasional alcohol. A little weed.”
“What about abrupt changes?”
“Like what?”
“Like, say, dying your hair all the colors of the rainbow?” He offered a small, knowing grin.
She twisted a strand of hair around her finger and laughed. He had her dead-to-rights. “Mayyyybe.”
His grin grew into a humored smile as he swiveled back to his computer, the screen illuminating his face with a cold, blueish hue.
“That would be the mania. Right now, you might even feel like you’re invincible. Bulletproof. Maybe you think that rules don’t apply to you or that you have your life perfectly under control. Depending on where you are at, in a month or two, maybe longer, a low will come.”
A pit opened in her stomach, and she suddenly felt drained of all color. It felt familiar, like something that routinely came and passed.
“Level with me, Ms. Erikson. How bad do the depressive episodes usually get? Do you swing in the opposite direction and sleep like it’s a full-time job? Do you have very little motivation or difficulty keeping up with hygiene and showers?”
She nodded.
“Maybe you considered harming yourself?”
She thought back to the last time she felt down in the dumps. She’d been sleeping fourteen hours a day and considered the world might be a better place without her in it. She wondered if her friends and family might be relieved to no longer have her dragging them down with her.
A thought popped into her mind, flicking a switch in her that raised a brick wall of denial.
“I’m sorry. Dr. Brown, I know you think you know this kind of stuff, but I think you’ve misjudged me. I can hold down a job. I won awards in high school. For a while, I was acing my college classes. A sick person can’t be that productive.”
“There’s a cycle of this disorder called overachieving that might sound familiar. You’re productive, getting so much done that you continue piling more and more things on your plate. Then, because of the load, you start to fail, dropping those things and the plates. Then, that usually starts a cycle of depression because you can’t seem to do all the million things you were doing a month ago. Then, you stop being productive altogether, feeling hopeless or useless until you slowly build yourself up again, gathering steam until the manic cycle starts up again.” He looked over his shoulder at her. “Sound familiar?”
She winced as the pattern struck her like a blow to the temple, making her feel dazed as she reflected on her last few years in college and high school, both a blur of productivity followed by over-commitments to after-school clubs and advanced placement classes.
After a while, she would find herself skipping after-school meetings and struggling to turn assignments in on time.
“Maybe,” she finally said. “But I don’t flip out at everything . I’m not violent . I don’t just snap.”
“I don’t know where you got this notion that bipolar means you’re some kind of aggressive, raging beast. Bipolar people can be some of the nicest people you’ve ever met. Many of my favorite patients are bipolar. A mood disorder doesn’t make you a monster.”
She dug her nails into her palms in an attempt to distract her from the lump in her throat. Angry tears threatened to fall. She fought desperately to contain them, not wishing to seem any more the caricature of the disorder than she already felt she was.
“Now, if you want to treat this and get a handle on it, first, we need to set you up with regular appointments, either with myself or a counselor, so that we can assess your progress and help you monitor your moods. Cut out the alcohol and the weed. You don’t need that stuff. They’re masks for a problem, not fixes. We need to get you on a healthy diet… and sleep,” he darted his eyes over to her, “sleep is very important.”
“As far as medications, I will write you a script for an anti-psychotic that works well for this sort of thing. We can also start you on an antidepressant to help bring up those lows. There are quite a few with minimal side effects. Then, we can also try a mood stabilizer. One I like to start with is Lamotra—”
“Whoa, whoa, whoa. I never said I’d take medication. I’m not signing up to be some sort of emotionless zombie.”
Dr. Brown’s expression flickered with frustration and then returned to the unaffected demeanor he’d maintained before.
“Medication can help, Chastity. Let’s not forget you’re in control here. If you don’t like the way something makes you feel, then we stop it and lower the dosage or switch to something else. You tell me how you’re feeling and how you’d like to feel, and then we can move toward that goal together. Nobody is forcing you to take medication… just like no one is gonna stop you from leaving. You are here voluntarily. My patients come here to make their lives better, not worse. That’s all I am interested in. Now that your diagnosis has been re-confirmed, you get to decide how your future looks.”
Chastity nodded and snatched her purse from the floor beside her. “I need some time to think about all of this.”
“Absolutely. I completely understand.” He pressed a button on his keyboard and spun to face her. “I’ve sent all three prescriptions to the pharmacy you put on file. They’re all low doses. If you decide to give them a try, we can go up or down as you see fit once you decide to give them a whirl.”
She nodded and slung her suede purse over her shoulder. “Okay.”
“Oh, and one more thing. If a depressive bout hits and you need help, please call me here at the office. Reach out. My door never closes for patients. Even the stubborn ones.” He smiled. “If I’m not immediately available, leave a message with my staff, and I’ll return your call.”
Despite his clinical disposition, Chastity saw the glint of humanity in his eyes, a disarming warmth that made her realize he wasn’t out to beat her down about her impulsive past. It had been him, and only him, who offered her the option for a wildly different future.