Tuesday, March 9, 2010

it's more productive...

and you might say it's self-indulgent
and you might say it's self-destructive
but, you see, it's more productive
than if i were to be happy...
-Bad Habit, The Dresden Dolls

I met a new psychiatrist today. Her specialty is mood disorders related to reproductive life cycles, including pre-menstrual dysphoric disorder (PMDD). The doctor I see at school said "it's clear to me that your mood is being affected by hormonal and situational triggers, and I think it's important to see someone with a knowledge of the hormonal effects on mood," and so now I have two doctors. One for situational triggers, one for PMDD.

Except we didn't really talk all that much about PMDD today.

This new doctor was incredibly thorough. We talked about everything...being molested when I was 8, feeling like I was never good enough to make Dad happy, the 6-month-long period that had me suicidal by the end of it, the various health problems Mom has had to deal with, the bipolar boyfriend who first triggered my restricting, the way I deal with things now by pretending I'm someone else, the cutting.

And this one said "You definitely have at least some of the symptoms of PTSD." The acronym threw me off for a moment. "What's that?" "Post-traumatic stress disorder."

I wasn't expecting to hear that. I was never involved in a natural disaster. I haven't witnessed a murder. I haven't fought in any wars. I was molested, true, but it wasn't full-out rape. My life hasn't exactly been calm, but I never thought it met the criteria for 'traumatic'.

I'd told her, at the beginning, that I wanted to be able to handle my PMDD symptoms without needing to stay on zoloft forever. And she said that would likely be possible, but that I need to be realistic; that point is at least 3 or 4 years away. There's too much going on right now for me to go off the zoloft. I'm constantly being triggered by my everyday life, and I need to deal with the situational side of things before I can really tackle the hormonal triggers.

And she came up with a long-term plan. I'm getting a referral to start trauma therapy, with both individual and group sessions. And I'll continue seeing her once a month to check on things, and seeing my doctor at school every week. And once I've developed ways of feeling safe, even when I'm in a stressful situation, then I'll work with her more to develop techniques to deal with PMDD.

I'm a little overwhelmed. I really had no idea I was so messed up. I don't let myself feel things. I'm afraid of feeling things.

She also said she'd recommend increasing the zoloft, that studies have shown that trauma patients benefit from the use of medication like zoloft to allow them to cope as they begin to deal with their trauma. She said that might be hard for me, because 'hyperarousal' is a symptom of PTSD, and some patients don't want to give that up because they feel like they're losing their 'edge.'

And that does scare me a little.

I am defined by my edge.

I hate a lot about me. But I love that my body and mind are constantly on alert, ready to do whatever I need to do at a moment's notice. It's exhausting, sure, but I love that I can function perfectly well in extremely stressful situations, on little to no sleep, with little to no support. I work well under pressure, I thrive on stress. I push myself incredibly hard because I know I can get away with it; my mind will still function and my body will still hold me up.

I really think most of what I have accomplished, I have only been able to do because I haven't had a calm life.

Can I be happy and keep my edge? Can I keep the adrenaline that stress gives me without succumbing to the panic attacks that crop up every now and then?


  1. What a wonderful psychiatrist. It sounds like you're in really good hands with her. I LOVE how she is working with you to develop a long-term plan and not just make you feel better in the short-term.

    I know it is hard to worry that you'll lose the thing about yourself that you like (the edge), but here's how I think of it: You can increase the zoloft and, if you lose your edge and you don't like it, then you can decrease the dose again. Nothing is permanent. This is how I originally decided to take the zoloft. (And, as you know, I do have a bit of mixed feelings about this...) But I took the zoloft to make my thoughts stop going on repeat. True, when it comes to controlling the ED, having an obsessive, on-repeat, overthinking brain is not helpful. But one of the things I like best about myself is how thoughtful my brain is. My overthinking brain sets me apart from others. IT makes me a good brainstormer. IT helps me in my job and in school. I was afraid I'd lose that. Finally, I realized that I was avoiding the zoloft because of all these "what ifs." i finally realized that I could take it and, if I noticed that I was losing a part of myself that I liked, then I could reduce the dose or go off of it. And, You might not lose as much of your edge as you fear.

    It sounds like this psychiatrist really has your best interest at heart.

  2. This psychiatrist is absolutely amazing. She practically glows empathy and understanding. And something about her eyes is very comforting, it's almost like the way you can look into the eyes of a pet and know that they will absolutely stick with you no matter what.

    And I am really grateful that she spent so much time working on me as a whole, not just the aspects of me that fit into her specialty. I was actually nervous about seeing her, because my PMDD-related symptoms have basically disappeared since I started taking the zoloft, and I was worried she would realize that and say something like I was wasting her time, I didn't need her, I don't have any symptoms anymore. It was irrational of me to think that, I know, but I was worried nonetheless.

    So I do feel like I'm in good hands. I'm just overwhelmed. I feel like I've opened up Pandora's box, and my first instinct is to just slam it closed again, but I know it will be better for me in the long run if I keep working on those things instead of keeping them buried.