I am still managing things a moment at a time. Sort of the bare minimum to keep going, but I am actually managing that. Like I am getting up by 11 everyday. I am eating most meals. I am running errands and going places with my parents. I am not going to bed before 11. I am exhausted and overwhelmed, but I am managing.
I had a psychiatrist appointment today that I was dreading. I missed my last appointment because I was exhausted and had a headache.. this was before detox. She called shortly before I got out of hospital and left a voicemail asking how I was doing because I missed the appointment. I never called back because by then I had already made another appointment, and I just didn't want to explain at that point what had happened. She mentioned it today and I just said that I basically wasn't functioning at that point. I explained about detox. I explained that they changed my meds. I lied a bit about my drinking.
She asked if I had any other questions or comments.. so I brought up something that's been bothering me. My discharge paperwork from the hospital has my diagnoses listed a couple places.. and I am not sure which is the diagnosis of that psychiatrist and which might be the diagnosis from the ER. Anyway, in one spot it lists major depressive disorder, which is my usual diagnosis.. well, it's major depressive disorder, recurrent, severe. It mentions alcohol use disorder, which is obvious. Then in one spot it lists Bipolar 1. I have NEVER been diagnosed Bipolar 1. I have had doctors go back and forth over the past 10 years about whether I have treatment resistant depression or bipolar 2 with hypomania, but I have never had a true manic episode.. so this bothered me.
Anyway, I pointed it out to the doctor and asked her about her opinion. In the hospital, I had been a bit upset that the psychiatrist said the priority was relapse prevention and not depression.. like the alcoholism was the primary problem. I ranted to at least one person about how the depression predates the alcohol use by about a decade. I self medicated with alcohol. I was pretty broken, so I just took whatever meds he chose to give me. Today, my doctor brought up a diagnosis that hasn't really been mentioned since around 2007.. borderline personality disorder. She took out her copy of the DSM 5 and read the diagnostic criteria to me. I fit about 7 out of 9 currently, and I have met all of them at some point in those past 10 years (2007 is when I was first put inpatient for suicidal thoughts and when I was in treatment for bulimia the first time). She says that it often gets confused with bipolar.. the emotional instability. In the hospital this time, I was basically alternating between joking and laughing with other patients (which was more normal happy than it was manic) with severe depression or anxiety (sobbing, worrying, or no motivation to do anything but stare into space). My mom attributes any manic behavior (fidgeting, rapid speech) to anxiety and not mania. The current medication is meant to even that out.
I suppose it doesn't matter what the diagnosis is if the treatment is working. I have generally always been on a mood stabilizer as well as an antidepressant, which could treat either depression or bipolar. So I have been told before the diagnosis doesn't matter. Now, I am on a larger dose of Seroquel (quetiapine) and an antidepressant, which can be a treatment for depression or borderline or whatever. I don't know why I care so much about the label. I think because the treatment generally hasn't worked, and I have it in my head that if they could just all pick the right diagnosis, they could finally fix it. Except, I don't think I know what fixed feels like. This has been going on so long that I only know that I don't feel right now. I do feel better than before the hospital, but I am having to fight to believe that I can maintain this. I of course also got the talk about how DBT is important and AA is important and basically I have to do the rest of the work. Oh and alcohol is only one more thing for the medication to fight against, so that won't help.
I wish I could say I wasn't drinking. I really have been struggling with that, and it's dumb. I haven't been drinking enough to do anything except convince myself I am ok. I have taken a few swigs of cooking wine. I have drained those last drops from all the empty bottles in the trunk of my car. All just to convince myself I was fine.. somehow not drinking is so scary that a few drops of vodka and that taste or that burn in my mouth is enough to make it ok. I logically know it isn't doing anything. I finally bought a bottle today.. and yeah. I went to an AA meeting mildly intoxicated. It was a speaker, and it was helpful. She talked about how she didn't have a progressive history of alcoholism. There was never a "first drink." It was always about being drunk. That's how it is/was for me. I never liked the taste. It was never social. It was always about changing the way I felt. It was never about making me happy. It was always about being numb or blacked out or otherwise removing feelings. It still is. I know that therapy is supposed to teach me another way to get through bad feelings, but I worry that any feeling is intolerable for me.
I did finally mention briefly in conversation with my parents the worry about my health insurance next month. They said they will pay for it if I can't. They don't want that to be a factor in me continuing treatment (my meds, my psych, therapy). I had wanted to ask them because I made this DBT appointment and then realized that I might not have insurance or any way to continue. I mean even if I get the bank job, I won't get insurance immediately. I just didn't want to ask since they're probably paying for the movers to get stuff out of my apartment.. I am finally making some progress packing. I owe them a lot of money now, and I can't pay it all back immediately because I owe money to a lot of hospitals and such too.. but I honestly need the insurance if I am going to make any progress now. I might be able to find other ways of paying in the future, but it would be too easy to abandon all of it because I can't pay.
Anyway.. this is a lot of rambling. I am just lately bothered by the whole idea that I have a severe mental illness, I cannot say with 100% certainty what it is, and I have no specific cause. People always want to suspect abuse, but I have nothing to blame but luck or fate or myself. I have an addiction, and the cause there is my mental illness and general inability to regulate or tolerate any feeling. I now have to set all that aside and focus on the present and what I can do. I can take my meds. I can go to appointments. I can pack up my apartment. I can get out of bed everyday and go to bed every night, and I can try to manage. That is what I can do. I cannot change the past. I cannot predict the future. I can only take it a moment at a time.
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