Mental Health: Guilt and Golden Retrievers and Headaches

Another day, another bout of random, crippling depression.

I texted Rick asking him to please bring Apollo (XXL golden retriever) to the city with him when he comes back from playing golf on Long Island because he brings me great comfort and joy. When I’m having a blue day like today, to hug and snug with Apollo for just one day (before he returns to the wide reaches of a yard a dog his size deserves) does wonders for my mood. When Rick confirmed Apollo was coming into the city for the night I walked around smiling like a nut. In case you’ve somehow missed it in my writing so far, I am, indeed, nuts.*

I woke up with a gnarly headache. Again. I’ve been especially suspicious of booze lately but, save for a 1/2 tablespoon of Triple Sec used in the strawberries romanoff recipe, I haven’t had a sip since a friend’s wedding Rick and I attended last week.

Yesterday evening I had my first visit to an acupuncture / medical massage place that not only accepts my insurance, but that I also have unlimited visits to. After years of being wrecked by migraines that stem from stress and tension, a lot caused by my all night teeth clenching, this was a huge W in an effort to curb my headaches. After my ridiculous psychiatry bill, I feel like my emergency deep tissue massages were our second biggest expense.

My headaches are unruly and relentless. They’re unresponsive to sleep, caffeine, and Excedrin. They often bring me to nausea and, sometimes, when everything is really magical and the stars align, vomiting.

When Rick and I were in Mexico for a dear friend’s wedding, for whom I was a bridesmaid, one of the days I was completely knocked out due to a migraine. After fighting through a speech, I had to leave the rehearsal dinner early before I hurled or something. We returned to the boutique hotel that had no TV, so I passed out while I imagine Rick just kind of sat there staring into the dark void. Poor Rick.

The first Christmas Rick ever spent with my family, we’d gone to my great aunt’s house and my headache was so bad I had to lay down, leaving Rick with a bunch of people he’d just met. While he enjoyed going to visit my great aunt and uncle’s herd of cattle, a comically exaggerated way for someone to be introduced to Texas, it was still a little uncomfy for him. Poor Rick.

I had a terrible headache the day of my prom and, as the night wore on, it morphed into a migraine. My boyfriend and I had to leave early. He was a metal dude who didn’t really want to be there in the first place, or else I’d say “poor boyfriend”. He was probably thinking about Slayer or Hands of the Few or something, but I was thinking about how crushed I was to miss a chunk of prom.

When I am laid up with a migraine, I get frustrated about missing, well, life, and my mood plummets. I hate to be more high maintenance than usual, which causes me to then become more guilt-ridden than usual. With general clinical depression, I am often plagued by a baseline of guilt. I do my very best, but there are some days when it feels like a herculean task to just get out of bed. No matter how productive a day I might have, I always feel bad about not doing enough. Regularly being laid up with a splitting headache exacerbates this feeling. In my dark moments I try to remember that depression lies.

Guilt, guilt, guilt. Plummet, plummet, plummet.

One time I saw a psychiatrist here in New York who looked like Einstein. He’d written a book about Catholic guilt and kept trying to peg my issues on Catholic guilt, even when I told him repeatedly that I wasn’t Catholic. I didn’t see fake Einstein for very long, but I suppose he was onto something.

Does guilt accompany your mental health issues? If so, how do you deal with it?

*I was singing “You are so Beautiful” to Apollo and he stalked out of the room mid-line. Upon further thought, I don’t blame him.

Written on Saturday, June 1, 2019.

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Mental Health: Psychiatrists

There are some things every person should know about people who seek psychiatric care.

STIGMA

Look, not all of us with mental illness are eating other people’s faces on the side of a highway in Florida. I mean, some of us are, but most people who seek or are in need of psychiatric care are average folks you interact with regularly: your colleague, your grandchild, your mail person, your stepdad, the person two people behind you in line at the grocery store, or you.

Unfortunately it’s common for a lot of people to suffer in silence and confusion. Not only do they need care, but they also often have no idea where to begin in terms of finding the right doctor, are overwhelmed by the expense, and have to deal with the crippling, unnecessary stigma attached to mental health issues. This stigma holds us all back from achieving ideal health and an optimal quality of life.

COST

My psychiatrist, like most psychiatrists, has chosen not to deal with insurance companies due to their overcomplicated nature, but without a psych I am unable to access the meds I desperately need. So, this dissonance then falls on the person in need of care, in this case, me.

Can you imagine that in New York City it costs me $400 to see my psychiatrist for 50 minutes? Aside from our car payment, my mental health is the biggest monthly expense for me and Rick. You may be wondering, “Why doesn’t she just seek out a psychiatrist her insurance covers?” Let me back up a moment.

CONNECTIVITY

Finding a psychiatrist you connect with is like dating, only the stakes are higher. Not only are you looking for someone you get along with personally, you’re searching for the right fit medicinally. You want to be in someone’s care who takes more than 20 minutes every four months to understand the inner-workings of your mind and know what meds would best compliment your brain chemistry. The consequence of faulty prescription can be lethal.

Couple this ideology with the fact that a new psychiatrist means a fresh emotional upheaval. You’re having to rehash everything that may be helpful to the doctor to assess your mental needs, and that requires a verbalized excavation of traumatic experiences. It sucks. The longer you’re with a psychiatrist, the harder it is to leave them because you’ve been so productive throughout your sessions, digging deeper and deeper. The better they know you, the better they can help you. Psychiatrists can brief other psychs on incoming patients, but no memo can take the place of hours spent doing deep dives into your head.

ACCESSIBILITY

HOT SPORTS OPINION ALERT! Another disconnect that, to me, causes an egregious margin of error in the specific realm of medicating mental illness is the psychologist / psychiatrist team up. This model has a patient regularly seeing a psychologist who then communicates their thoughts to a psychiatrist, who then prescribes meds back to the patient. Psychologists cannot prescribe meds and are often cheaper and, therefore, more accessible. It’s certainly better than nothing, but to me this kind of two step care leaves too much room for poor communication and subpar RX.

BRAVERY

It takes a lot of guts to go into a room and figure out how to be comfortable being vulnerable in front of a stranger. It also often takes months to review what a patient may perceive as “obvious” issues before moving onto to unsuspecting things in life, which are sometimes the most insidious and medically informative. It takes time, and it takes gumption. And remember, if the doc is a bad fit, the person seeking care has to start all over again with a new doc. Speaking from experience, this redundant process contributes to mental strain.

It’s so important to normalize the discussion of psychiatric care and to be empathic and encouraging toward those who seek it.

What have your psychiatrist or psychologist experiences been like? Have you had any particular hang ups? Comment below.


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