Where the dogs of society howl

Lots going on.  Mainly feeling lost.  I’m still on FMLA per my psychiatrist.  I’ve been off all this month and won’t be going back until next month.  I’m having a hard time keeping my medications down and we’re not sure why.  My moods are cycling rapidly and I’m thinking it’s because they aren’t being absorbed properly since the surgery.  I’m worried about having all this time off, how it’s going to affect my job.  It gets more interesting: I have an interview for another job next week.

I reached out to a friend of mine regarding a possible job opportunity in a private practice setting.  I was doing some research and found that working midnights with bipolar disorder is a no-no.  Apparently most people working midnights – mainly those in the healthcare field like nurses – with bipolar disorder have circadian rhythm issues, leading to shift-work disorder (which I’ve been diagnosed with).  This triggers mania and many times, hospitalization.  Sound like anyone we know?!  

So I got freaked, reached out to a friend and asked if she knew of any job opportunities.  She reached out to her boss who reviewed my resume and offered me an interview.  I miss doing therapy.  I remember my old supervisor said to me ages ago while I was in training after graduate school and doing therapy in an underprivilaged area with substance abuse clients.  I was burning out hard, between the clients and the administration I couldn’t seem to meet anyone’s expectations of me and wanted to quit doing therapy altogether.  I told him that I wanted to work in a hospital doing intake assessments and case management to take a break.  I said that it would be “one and done” – I’d never see the people again after they left; no need to build rapport and no need to terminate; they couldn’t accuse me of abandoning them if I’ve known them for 20 minutes.  He told me that I was an excellent therapist and working in a hospital setting was “a waste of my talent.”

He burned out too and moved out of state.

I didn’t listen and got a job doing assessments.  The population I work with tend to abuse the system.  I often see the same faces – sometimes 3 times a week.  I’ve had some people discharge because they tell me they are not suicidal, turn around in the parking lot and walk directly back into the hospital stating they are suicidal and homicidal and want 3 sandwiches.  The record turnaround is 7 minutes – I actually counted.  It is rare that I assess someone that actually needs help.  I got into this profession to help people.  Will I have better luck doing so in private practice?  I think so.  I think I will because people are paying to be there.  Sounds messed up, but it’s true.  This is your “managed” care/health system at work, USA.  I have “managed” in quotes because there is nothing manageable about it and you, my dear reader, know it.  I’d be ignoring the system by leaving, but I’m not single-handedly going to overhaul the health care and mental health system – I know that.  Contrary to popular belief by many recent graduates in my field, you cannot change the world.  You can only make a dent.

Here’s where my trepidation lies.  I would have to file quarterly and withhold my own taxes.  What a pain in the ass.  I’d also have to go on the exchange for health insurance.  God please no.  Right now every doctor I work with is in network because they all work for my employer LOL.  If I go on the exchange, there’s no guarantee they take that insurance and I’d have to pay astronomical premiums.  It would take several weeks to build a caseload and get paneled with insurance companies, which means I would not be paid by the patients or insurances for those weeks.  Weeks.  Flipping WEEKS, man.  I’m torn.  Do I liquidate my house fund to pay my bills while I’m not paid for those few weeks – if I’m even offered the job?  Do I leave my awesome co-workers because I hate the population I work with?  The population, the crushing rules of administration and low wages are what keep me from wanting to stay are my job.  I know once I get a full caseload as a private practitioner I could rake in double what I’m making now, but I’m afraid.

I’m terrified.  What if I’m not good enough?  What if I fall on my face?  What if I messed up my taxes?  What if my clients don’t like me and I end up without anyone and I’m broke?  My psychiatrist told me it takes a while to build a caseload too.  How do I work both jobs to cover my butt?  Work midnights and days?  I freaking can’t.

And Mom’s going into surgery.  They said it’s going to last 8 hours and due to the definite blood loss, she had to sign a waiver permitting them to give her a blood transfusion.  So I’ve been scared about that.  Lately her voice has been irritating me for some reason and I’ve been blocking out most of what she says, but I think it’s me being irritable because of my mood cycling.  I apologized to her if I had been short or curt with her and explained I had been tuning her out.  I told her I’m scared shitless about her surgery next week.  I wish she didn’t need it.  She’s going to lose 20% functionality of her back in all directions.  She seems excited she’ll never have to load the dishwasher again.  Lucky.  Not the way I would want to avoid that chore, but still lucky.  I’m just scared – I keep telling myself not to tune her out.  Not to put this bed vibe out there in the Universe, but if her being annoying is the last thing you ever hear her say, hear it anyway.  I try to remember that and listen to her give me instructions about how to feed her fakakta fish.

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message from a.c. lerock

They fucked up and let me see some of my  chart. Lordy lord… this is what I bug the husband with in the middle of the day. 

And he stays. 

And I misspoke. There’s a space under the diagnosis that allows for clarification, as being depressed all the time negates a bipolar diagnosis but what people fail to realize is depression is my baseline.  

Sorry. My lack of chemicals, since a very young age, is all I’ve come to know. I’ve started back in therapy and I went back to the source: my childhood therapist. I worked with her from age 5 until my sophomore year in college, when I was raped. She said that I disappeared too soon – I had only scratched the surface in dealing with the rape and given my presentation, it seems that my mind hasn’t recovered. 

My body is now paying the price. 

So I spent a week between that session and the next thinking about everything: the rape, the aftermath, my life since then – my progress, my failures, my detours – everything – and it all made sense. My therapist was right: I stopped taking care of myself long ago.  I can’t do that anymore. I have a family, I have a husband. I have a life. I have a life I don’t want to lose. 

I told her that I have frequent suicidal thoughts with plans and access and means. But I have a huge protective factor: my husband. I told her that my husband lost his mother when he was 22 and he crawled inside a bottle to numb the pain. A year later, we started dating – he had one foot out of said bottle. I told him he’d have to stop drinking for us to date (at the time, I was a tee-totaler) and he quit. I will never send him back to that life. I will never leave him destroyed like that. He told me once that the only reason he attempts to get better paying employment is because of me, otherwise he would just live at home working a dead end job with no purpose. That leaves me to believe that I give him purpose. He gives me purpose and hope. 

I was hospitalized so many times during the first 2 years of our relationship that my own family stopped visiting. My (now) husband visited everyday, without fail. He never missed a day. Even when I didn’t want him there, he came. He’d sit through my nasty attitude and come the next day.  I finally thought to myself: Stop. Just fucking stop. This guy sees something in you. Something that’s good; something worth saving. Isn’t it worth it, perhaps, to stick around and find out what it is?  Otherwise you may never know. 

I still want to know. But if I keep hiding behind this trauma, I’ll never know. So it’s time to process it and move from victim to survivor. 

The only way around in this life is through.