I went to the psychiatrist this past Monday. And writing those words suddenly reminds me of the classic Charlie Brown cartoon, where Lucy sits at the lemonade stand with her offer for psychiatric services at
$0.05 a pop.
Not that I think my psychiatrist is Lucy. But admitting to a visit to a psychiatrist feels like coughing up that nickel for Lucy’s sage words of wisdom, which if I remember correctly, were always things like hit yourself in the head with a baseball bat.
Don’t get me wrong – I am not ashamed to admit I’ve been to a psychiatrist. I would stand up and give a speech on the merits of psychiatric care in Times Square… if I didn’t think that doing so would probably mean a transfer from outpatient psychiatric care to inpatient. And wearing one of those nice white jackets with the extra long sleeves…
And I do believe in psychiatric care. That’s why I wasn’t nervous about meeting with the doctor on Monday. If anything I was excited, and slightly relieved. Maybe now, with his help, I will find a combination of medications that will soothe my overactive anxiety… and help with the excessive sleepiness… and set me on the path to calm living.
So, I wasn’t nervous, but it did feel like I was sitting in an interrogation room getting grilled by cops… only the interrogation room was a cozy office with cartoonish art gracing the walls. And I wasn’t sitting on a steel chair, but a soft, over-stuffed couch. And the first part of the interrogation was filling out the stack of forms.
On a scale of 1 to 5, with 1 being never and 5 being all the time, how often do you feel:
Worthless, unloved, and alone?
Like the world would be better without you?
That you have no friends or family?
I haven’t felt any of those in a long time, but I had in the past. And the fact I am not the only one – as evidenced by the questions being on this form – is always a sweet reminder that none of us are truly alone. Yes, I stand by that. None of us are truly and fully alone.
Next up: the sleep questionnaire. Okay, here we go…
On a scale of 1 to 3, with 1 being never, and 3 being most days, rate the truth of the following statements:
I can fall asleep while sitting quietly and doing something still like reading a book. Yep, that’s a 3; I have done that a lot, actually.
I can fall asleep with a TV or radio on, or with lights on. Yep. 3 again.
I feel tired during the day, even though I slept a full night the night before. Is there an option for every day, rather than just most days? Can I mark a 4 maybe?
I have fallen asleep while driving. Okay, that has never happened, but I am worried now that it is a real possibility based on these other questions???
I can fall asleep during the day and sleep for several hours. Oh yeah, total 3. A short nap for me is four hours…
I can fall asleep when I’m in the middle of something, like watching a movie. I probably hold the record for the number of movies started but not finished due to sleep. If you want to know how a movie starts, give me a call.
I have been caught sleeping in unusual situations, like at work or in public. Well, not caught per se… but does taking a nap on my couch at work one day because I was soooo tired I couldn’t even hold my head up, count?
So, I wrapped up that form, and I had an awful lot of 3s. As the psychiatrist was very quick to point out when I finally met with him.
But before we get to that part, there was the initial meeting. He takes me into that office with the over-stuffed couch and cartoon art, and asks me to take a seat. He himself sits opposite me, in front of a laptop, and after the brief introductions (hi, my name is…), the interrogation begins:
How old are you? Old.
Where were you born? In a hospital.
Okay, the first two answers were really 33 and Santa Monica, but he did fire them off like rat-tat-tat-tat. I was dodging fire from a machine gun, here.
Did you grow up in Los Angeles? No, my family moved to Houston, Texas when I was 2-years-old…
How far along have you gone in school? I have a master’s degree.
In what? Library and Information Studies.
We did eventually get to the sleepiness thing. He was vocally shocked by my score on the questionnaire, and admitted he had never treated a patient who scored so highly on it before. We spent most of our 90-minute meeting reviewing that questionnaire, and why I selected the scores I did. I explained that I feel bone tired… a lot… and it is befuddling because I sleep like a dead man every night. I explained that I lay down to take a nap, and I can sleep for 4, 5, or 6 hours easily. And still fall asleep that night. I explained that sometimes I wake up in the mornings feeling so exhausted, I can’t even get out of bed. I’ll call in sick to work, and then spend the entire day sleeping.
Dr. Psychiatrist quickly ruled out depression as a cause since I didn’t score very high on the depression form.
So with that card tossed in the trash, it became a game of what-is-causing-this-hmmm…. And to make a long story….. not as long as it is already, we walked away with no clear answer, yet. Dr. Psychiatrist prescribed Nuvigil, a medication for patients who suffer from sleep apnea, narcolepsy, or shift work sleep disorder (people who have sleep problems because of their job’s odd shifts or changing shifts). The psychiatrist was very clear that I do not suffer from any of those, but he wanted to try Nuvigil and see how I respond.
It’s Day 3, and so far so good. I haven’t felt this awake in years.
And in the course of all the sleep talk, alcohol came up. Naturally. Dr. Psychiatrist asked me if I drink as part of the analysis on my sleep problems, and I told him I had just given it up.
Why did you give it up? I can’t control myself when I drink, and I’ve have had too many bad episodes.
How much did you drink? I was up to a bottle of wine per day.
Oh yes, that is a problem. Why did you drink? Good question. I know that I would always start with a glass of wine at night to help me relax, but as you well know, tolerance builds, and I was having to drink more to get the same feeling.
Did the wine help you relax? I liked the physical effects. The first drinks of alcohol and the softening sensation in my muscles, the tension releasing, always felt good. I have a hard time replicating that feeling without alcohol.
Did something happen to make you give it up? Yes, a few weeks ago, I got so drunk at a friend’s house, I threw up all over her couch. And then I proceeded to throw up all over my other friend’s brand new car. I can’t be like that. So I decided to give it up. And this time, give it up for good. I have had “dry spells” before, but I always thought one day I would go back to drinking again. But always, when I went back, it was with this thought that I would be a grown up about it.
You thought when you went back that you could control it? Only drink so much? Yes, exactly. But, of course, that never happened. I would start off great. One glass of wine here and there. And then before I knew it, I was back to a bottle per day, and sometimes I was drinking more than that.
Hmm….mmm… okay, alcohol use disorder.
And, like that, I have been diagnosed. I have alcohol use disorder. So in a few weeks, when the craving for wine starts crawling back in, I need to remember this. Alcohol use disorder. That has a very serious ring to it.
I walked out of Dr. Psychiatrist’s office with diagnoses of hypersomnia (excessive daytime sleepiness) and alcohol use disorder, the prescription for Nuvigil, an instruction to find out if my insurance will cover a sleep study, and an admonition not to drink at all. I am also scheduled to go back for a follow up in early November after I have exhausted my first round of Nuvigil pills.
Not bad for a first visit, right?