herveryown

Something Old, Something New

In our house, a day without a (generally unfortunate) diagnosis is like a day without sunshine.  Of course, a day without sunshine describes about 90% of the available days in the greater Seattle area, so maybe that simile doesn't totally work.

Well, whatever.  I've racked up a fresh one.

Fear not, it shouldn't have any direct impact on Fitz-Hume and Millbarge's overall wellbeing, it's just another item on the long list of things currently fucking with me.

Several months ago, I decided to make an appointment to see my favorite shrink, mostly to discuss Lithium, more specifically why I didn't feel like going back on it during pregnancy.  Since a shrink's primary function is to prescribe drugs, it may have seemed stupid to waste the time (and spend copious amounts of aggravation) seeing a shrink with the express purpose of saying 'I do not require your assistance', but checking in with a shrink seemed advisable.  When you're Manic Depressive, you can usually gauge how well you're holding your shit together by the shrink's overall demeanor and his or her recommendation on the frequency of your future appointments.

When I finally got an appointment (existing patient, full insurance coverage, two month wait) I scored a "Come back in six weeks or so," which is generally a good sign.  Six weeks means you didn't eat any wallpaper during the visit and are considered pretty self sufficient and Able To Hold Your Shit Together, or are at least capable of putting on a pretty good act.

There was, however, a little hitch.  After ten years of being told by shrinks "You're not crazy, you're just a little unwell," and having all my problems (crazy-wise) solved by modern pharmaceuticals, I was told that I need to start seeing someone. 

I don't mean dating someone new, I mean seeing a Psychologist, the kind of crazydoctor that does not prescribe anything, the kind I've never had any truck with in the past.  I found this somewhat alarming, but I could totally see the shrink's point.  Recently something had changed, something that didn't appear to have anything to do with the Manic Depression and seemed to have much more to do with The Worst Year Ever (or what I sincerely hope was The Worst Year Ever, because if that much shit ever transpires again in such a short time frame, I think I'm going to run away from home).

I made an appointment with a Psychologist, or what I like to think of as a non-shrink shrink.  "So, what brings you here today?"  "Well, I'd really like to stop having the nightmares.  I'd also like to stop reliving the last weeks of my father's death at really inopportune times."  "Tell me more," the non-shrink shrink said, so I did.  "Interesting," the non-shrink shrink said.  "Did you have any trauma in your childhood?"  "My childhood?  Pfft.  My childhood was wonderful.  Idyllic.  Spiffy, even.  Well, I mean, there was this once incident that involved a lot of screaming and ended with disfiguring scars, but other than that, nothing!"  "Yeah, see, that's kind of what I meant when I asked about 'trauma'," the non-shrink shrink said, scribbling furiously on his little notepad.  "Oh," I said.

"You have Complex PTSD," the non-shrink shrink finally said.  "Oh," I said. "Yeah, the shrink said PTSD, too.  I know what PTSD is, but what do you mean, complex?"  "I mean that there's a lot going on here, enough so that it's impossible to point to a single cause."  "Oh," I said. "Can it be fixed?"  "Probably."  "Will the nightmares go away?"  "Probably not."  "Well, that sucks."

I must confess that I was starting to suspect something of the sort long before it came out of the non-shrink shrink's mouth, as it seemed somewhat odd to be making distinct negative progress such a long time after the initial events.  I had deliberately tried to avoid this diagnosis, as I had a secret hunch that admitting to such a massive failure in my ability to deal with last year would be letting my father down in some unexplainable way.  I find it oddly amusing that I perceive PTSD in others to be a legitimate reaction to trauma, but in myself, I perceive it to be evidence of some sort of failure to cope with life.  I suspect this impulse is similar to the way many women will insist that your miscarriage was an unpreventable random event and clearly no fault of yours while privately harboring a theory that their miscarriage(s) had a cause that could be traced directly to their own door uterus.

I also found it interesting that the ability to disappoint one's parents (or the perception of it) survives death.

"So, can you come back next week?"

Hmm.  'Next week' is code for You're Really Screwed Up, or possibly Your Insurance Covers This.  "I guess."

This feels kind of weird.  I don't think I've ever had Capital I Issues that couldn't be solved by medicating my faulty brain chemistry into a normal state.  It seems odd that for once I'm chemically normal (or close enough) and still totally fucked up.

Remind me to ask the non-shrink shrink if he thinks this can be cured by dating Hugh Jackman, because I am nothing if not dedicated to resolving this issue, whatever the personal sacrifice.

Looks Like I Picked The Wrong Week To Stop Sniffing Glue

Dear Dr. BrightEyes,

I love you to death in a totally platonic way and always follow your medical advice to the letter but why did I have to stop Lithium a whole month before stims when everyone else on the medical planet said a couple of days would be find and dandy like sour candy?

Whyyyyyy?

See, I just don't think it was a good idea to discontinue the Lithium at the same approximate time as:

1. The end of ABC's visit and Sam's resulting post-visit spiral into depression.
2. A period of massive stress at work.
3. A really bad car crash.
4. A really bad car crash that necessitated immediate negotiations with three insurance companies and a body shop and two car dealerships (including not one, not two, but seven different car salesmen, not one of whom was able to get me into a car today).
5. A really bad car crash that resulted in the total destruction of a car that had special meaning for me and my father (who, for readers coming in late, just died).
6. My having to eat a radioactive egg salad sandwich.
7. My crushing disappointment at being told I would not be developing super powers as a result of said radioactive egg salad sandwich.
8. The San Francisco Giants valiantly fighting for last place in their division or region or whatever you call it.
9. That whole SCOTUS thing.
10. That whole Virginia Tech thing, which aside from being a terrible tragedy, brought out the crazy people who are screaming for all the crazy people to be locked up and/or shot (possibly both) which always makes me a wee mite edgy.  Let's stick with the issues, shall we?
11. My mother's sudden illness.  And then recovery, yay!
12. And then there was the discovery of another sudden illness, boo!
13. And then there was the discovery of another sudden illness, WTF?  And then it turned out that they were totally wrong and everything is okay, yay!  But jumping Jesus on a pogo stick, what is it, Sweeps Week at my mom's hospital?

I miss my Lithium.  So much.

Love,
Akeeyu

P.S. Sam totally misses my Lithium, too.

Just A Little Off The Crazy, Please

I got my IVF calendar last night. 

All week I've been in this weird funk about starting again.  It's not an "I've changed my mind" kind of thing, it's just that suddenly all the memories that I've been suppressing have been coming back up in a rush.  Hey, remember how many times I got delayed for cysts?  Remember how I had to quit working by Day Seven of stims because I was So. Fucking. Big. and then I couldn't go back for weeks?  Remember getting up every two hours around the clock to pee because of the OHSS?  Remember the screaming in pain?  Hey, for that matter, remember the miscarriages?  Weren't those a fucking hoot?

Everything's got an overlay these days.  There is my life and then the there is memory of how my life was then.  It's not just the discomfort agony I remember, it's who I was back then.  I was a much more optimistic person a year ago, which is kind of a sad thing to say, beause I've always been a pessimistic little fucker.  I'd only had one miscarriage.  I was relatively physically healthy.  I still had two parents, and a fantasy of seeing them hold a grandchild.  Things have changed.

I'm not really depressed, I'm just kind of sad.

I guess I'd been working on some pretty good denial (that shit is better than heroin, or so I hear) about the OHSS and life in general, and I guess denial has an expiration date of "Whenever the hell you're looking down the barrels of another fresh cycle."

Also?  Because I have a calendar, I have a concrete date to go off the Lithium.  Unfortutely, I already told Sam what it was.  I realize now that it would have been much more entertaining to just stop taking it and see when he noticed, like when you get a haircut and prance around for two days saying "See anything different?" except with craziness.

"We've secretly replaced this man's wife's psychiatric drugs with Folgers Crystals.  Let's see if he noticed."

Care And Feeding Tips

Dear Doctor Anybody,

It is entirely likely that someday you will have a Manic Depressive patient (or as they are more commonly known, Crazy Person) walk through your doors.  Here are a few tips to ensure that the appointment moves along smoothly.

1. Try to resist the urge to scrutinize the person's physical appearance and demeanor to determine whether or not they 'look crazy'.
2. Okay, try harder.  You suck at this.
3. Don't pretend you're a psychiatrist.  You aren't.  Do not ever prescribe an antidepressant, antipsychotic or mood stabilizer to a Manic Depressive unless it has been previously prescribed to your patient by a real psychiatrist.  Odds are, you don't know enough about brain chemistry to effectively treat Manic Depression.
4. Treat the patient, not the disease.  Try to think of Manic Depression the same way you would think of any other chronic physical ailment.  Try to imagine it to be similar to Asthma or Diabetes in that it is something that must be carefully managed, chiefly by the patient, but it isn't something that has to control every aspect of life or be the sole focus of all medical discussions.
5. Don't assume that the Crazy Person in front of you is just like the last Crazy Person in your office/on that episode of Law & Order/in the paper last week.  Crazy People are like snowflakes.  We're all unique and special and really annoying in large numbers when the weather is shitty.
6. Don't assume that all Manic Depressives have the same cyclic triggers.  You may want to consider the radical idea of asking the person in front of you if s/he knows what her/his triggers are.  Odds are, s/he does.
7. Do not automatically discount your patient's decisions regarding psychiatric medication.  The medications that Crazy People have to take are frequently very dangerous and unpleasant.  Some of them can be lethal.  If your patient is refusing a particular treatment plan, it may be for valid health reasons and not just because, you know, s/he's Crazy. 
8. When you say "You're holding up so well," we know that means you're just amazed that we're not eating the wallpaper.  This is not the compliment you think it is, as many Crazy People are capable of going for months at a time without so much as nibbling the wainscoting.
9. Do not treat your Crazy Patient like a child.  If your Crazy Patient can hold down a job, maintain health insurance, make appointments and motivate her or his own self to said appointments, that probably means that they are competant to join in the decision making process regarding health issues.  Do not make blanket decisions about treatments or medications without consulting with your patient.
10. Don't be a dick.

It doesn't look hard, does it?

Bitching About The Normals

Well, it happened.  To Dr. SoFarSoGood, I have made the inevitable transition from 'person' to 'Crazy Person'.  I confess that I am surprised, since I've always been quite up front about being Manic Depressive and she's never had a problem with it before.  My demeanor at my latest appointment was the same as it ever was.  Somehow, writing a Lithium script was just too much for her, and she started giving me That Look, which is so tiresome.

Worse still, she made treatment plans based on 'My Mood'.  "I don't want to prescribe Blah, because it might affect Your Mood."  Yes, fascinating.  Of course, if she'd have asked, I'd have cheerfully told her that Blah had always affected My Mood quite positively.  She didn't ask, so I told her anyway (I'm helpful like that), not that it changed her mind.  Instead, she prescribed something she considered suitably harmless, but had the ironic side effect of causing insomnia.  Insomnia is my primary trigger for unpleasant mood changes.  This ought to be good.

What I find so amusing is that Dr. SoFarSoGood hasn't been particularly troubled by my being a Crazy Person during the two years I've been unmedicated, but goodness, once I popped a couple of Lithium it was the direct train to Nutsville.  Technically, shouldn't I be considered more sane and socially acceptable now?

Incidentally, my ATAs have gone from 'High' to 'Damn, Girl.'  I'd be more upset about it, but it's something I feel surprisingly indifferent about.  I consider my thyroid and my immune system to be somewhat like a pair of dogs fighting it out: It is best not to get between them. 

Hide and Go Crazy

There is one nearly universal truth about psychiatric offices: They are ridiculously hard to find.  If they are in a large office complex, they will be underground, in the basement, at the end of the hall, around the corner, possibly behind the janitor's supply closet.  If they are in their own building, they will be at the edge of town, surrounded by one way streets, and/or offer no available parking.  If they are attached to a medical facility, they will be on the very edge of the hospital's campus or sometimes at a separate location altogether, and they will always be incredibly poorly signed.

I don't know why this is true, although sometimes I suspect it's an attempt to weed out the really really fucked up patients, the ones who walk around with tin foil on their heads and have long conversations with their elbows.  All I know is that the elbow people never would have been able to find the office I went to today.

The office's directions were incomplete at best, it was nearly impossible to find street addresses on any of the buildings, and just for fun, signs pointed left when the building was actually on the right.

One of the more entertaining moments was the elevator.  When I walked into the building, a small note said "Patients of InsanelyBusy Psychiatric Services, please take the elevator to the first floor."  Upon stepping into the elevator, I saw that my choices for floors were G, 2, and 3.  No 1.  Since I had entered the building on what appeared to be the ground floor, I was completely mystified.  The doors swished shut, and I just stood there for a while, staring at the buttons with my head cocked.  G, 2, or 3?  "But what the hell am I on?" I muttered, and then answered my own question: "Nothing, dumbass.  That's the problem."

I should probably clarify something.  The post from the other day talking about seeking psychiatric medicine was describing an event that took place quite a long time ago.  It's been a while since I was on Lithium, not because I don't adore the stuff, but because it carries certain risks in the first trimester, bla bla bla.  I have been off of it for a fuck of a long time, and while I can usually just hang onto the world by the skin of my unmedicated teeth, there is a limit and I've hit mine.

We canceled the cycle so that I could stay with my parents for a while, which is what I'm going to be doing.  This is somewhat incredibly stressful, not because of my parents, who are wonderful people, but because one of them is terminally ill, so I decided that I should probably go back on Lithium for the duration. 

This is why I spent today not only trying to get crazy drugs out of an HMO, but trying to get crazy drugs out of an HMO that is currently denying the existance of my coverage.  I am getting better at it, though.  What took several weeks two years ago took just under twenty three hours today.

My father is dying, and nothing can change that or make it better, but the medication will hopefully, as I told my mother, "make me able to be as miserable as a normal person."

Crazy Talk

"Why didn't they get help?" is a common refrain when a crazy person Sanely Challenged American does something particularly sanely challenged, like eating wallpaper or driving off a cliff or wearing platform espadrilles.

Now, I don't claim to be a representative of all the different colors and flavors of mental illness, but I am your friendly neighborhood BiPolar Type II Blogger (crazy, but doesn't eat too much wallpaper) and as such, I'm here to tell you how much fun it is getting mental health care in America. 

Before I tell you about one of my more exciting annoying adventures, I should tell you that I had four really big, important things going for me when I set out on this particular quest:

• A previously documented diagnosis of Manic Depression
• Health insurance that covered mental illness
• One of the milder forms of Manic Depression
• A supportive family

The quest itself was quite simple: I needed to refill a prescription for Lithium, a drug I had taken without complication for several years.  I was working part time, so I had plenty of free time on my hands.  I also had a roof over my head, no children in my care, unlimited access to a car and a phone, a fair amount of patience, and most of my wits about me.  Sometimes when I look back on this experience, I wonder how different the outcome would have been if any of the previous variables had not been in play.

"Good Afternoon, Uncaring Insurance MegaCorp, how may I direct your call?"
"Hi, this is Akeeyu Buttmansion and I just moved to this area.  I need to establish care with a Psychiatrist.  I tried to get my Lithium refilled through my General Practioner, and he said he couldn't help me."
"Oh.  Well, you'll have to talk to Uncaring Insurance MegaCorp Behavioral Health."
"Can you transfer me?"
"No, just call the number on your insurance card."
"Thank you."

"Uncaring Insurance MegaCorp Behavioral Health, how may I direct your call?"
"Hi, this is Akeeyu Buttmansion.  I need to see a Psychiatrist to establish care."
"Why do you need to see a Psychiatrist?"
"I'm Manic Depressive and I need a refill on my medication."
"Are you depressed right now?"
"Um.  Kind of."
"Do you feel like hurting yourself?"
"No."
"Do you have access to a gun?"
(...the hell?)  "...No.  I just need a refill on my Lithium."
"You'll want to call Random Therapists for an appointment.  Their number is-"
"Do they have Psychiatrists on staff?"
"No, just therapists."
"I don't need a therapist.  I need a Psychiatrist who can write me a prescription."
"Hold, please."
(elevator music)
"Okay, I have three numbers you can call to see a Psychiatrist."
"Thank you."

"Uncaring Insurance MegaCorp Behavioral Health, how may I direct your call?"
"Hi, this is Akeeyu Buttmansion, and I called yesterday about seeing a Psychiatrist, and you gave me three numbers?  One of them doesn't take my insurance, one of them isn't accepting any new patients, and one of them can't see me for two months."
(crickets)
"And I need a refill on my Lithium...?"
"Well, we don't have anybody else.  Maybe if you call back and tell them it's an emergency, they can see you sooner."
"But it's not an emergency.  I just need Lithium.  I mean, I guess it'll be a lot worse pretty soon, because I've only been off it for a week, and it doesn't usually get bad until I stop sleeping."
"Are you depressed?"
"Uh, I guess I am now."
"Do you feel like hurting yourself?"
(I didn't before I got on the phone with you) "No.  Look, I guess I'll just call the last office again."
"Okay."
"Thank you."

"Really Terribly Busy Psychiatric Offices."
"Hi, this is Akeeyu Buttmansion.  I called before about seeing a shrink?  And you said you didn't have anything available for two months?"
"Yes?"
"Do you have any emergency appointments?  I just need to see a shrink for a refill of Lithium."
"Are you completely out?"
"Yes."
"You should have called before you ran out."
"Well, see, I always used to get refills from my GP, so I made an appointment to see my new GP before I ran out, but it took me three weeks to get that appointment, and then he wouldn't write me a refill, and now I'm out.  Do you have any emergency appointments?  I didn't feel too bad before, but the idea of being unmedicated for two months is kind of scaring the crap out of me, and I really need to see someone sooner."
"If it's an emergency, maybe we could see you next month," (!) "or you could call Shiny Happy Mental Health Associates.  Maybe they can see you sooner."
"Do you have their number?"
"555-HAHA."
"Thank you."

"Shiny Happy Mental Health Associates."
"Hi, this is Akeeyu Buttmansion.  Do you take Uncaring Insurance MegaCorp?"
"Yes."
"Oh, good.  Are you accepting new patients?"
"Yes."
"Oh, great!  Do you have a Psychiatrist on staff?"
"Yes."
"Oh, wonderful!  Can I make an appointment with your Psychiatrist?  I need a refill on my Lithium.  I ran out about a week ago."
(sigh)  "We can have you come in to see our intake therapist in two days."
"Can he prescribe Lithium?"
"No."
"But I need to see a Psychiatrist.  For Lithium."
"You can't see a Psychiatrist yet."
"But I need one."
(even bigger sigh) "Well, the way it works is, you see our intake therapist first, and then he decides whether or not you can see our Psychiatrist.  He's only here two days out of the week, so he's very busy."
"But...I...need...a....um.  In two days, you say?"
"At 11am."
"...Okay.  How do you get to your office?"
(ridiculously convoluted directions to an office incredibly far from my house and out in the middle of nowhere)
"Thank you."

"Hi, I'm Skeptical Skip, the intake therapist."
"Hi, I'm Akeeyu Buttmansion."
"You look upset."
"Yeah, well, I've been off my Lithium for almost two weeks, and I can't sleep anymore, and I'm starting to freak out.  Yesterday I spent the entire day sorting my husband's childhood Lego collection into tiny little bags."
"I see."
"I mean, I sorted them into Ziploc Snack Bags by color and type of block, and he had two five gallon buckets of Legos, which is kind of a lot of Legos, so...I think I'm going into a hypo-Manic state, which happens when I can't sleep."
"I see.  Have you ever been diagnosed with anxiety?"
"This isn't anxiety.  This is Manic Depression."
"But have you ever been diagnosed with anxiety?"
"Yes, before they diagnosed the Manic Depression."
"And what did you take for that?"
"Valium."
"And did it work?"
"Work?  I don't know.  It made me sleep a lot.  Then they diagnosed me as Manic Depressive and put me on Lithium, and everything was fine.  I haven't had any problems with anxiety since then."
"I see."
"Well, no, actually, first my old GP put me on Paxil, and I kept forgetting to take it, which sort of made me suicidal, so that was really bad.  I can't take Paxil anymore.  Then a shrink put me on some other antidepressant, and it made me not sleep.  Like, ever.  And I refinished the kitchen table.  And then they tried some other antidepressant, and it didn't work, so they put me on Depakote, and that was kind of okay.  I took it for about a year and a half, but when I was on it, I just wasn't interested in anything, so I asked for something else, and they put me on Lithium.  Lithium works.  I need a refill of Lithium."
"Have you tried other antidepressants?"
"Yes.  I took Wellbutrin, and it made me hallucinate.  I took some other thing that started with an A, and it made me so sleepy that I almost rear-ended a propane truck."
"I see.  Well, it sounds like you have some problems with anxiety."
"Um.  Okay."
"And I'm not entirely convinced that you're BiPolar."
"My last three Psychiatrists felt that I was.  They felt that the way I respond to antidepressants is indicative of Manic Depression.  Also, I have a family history of Manic Depression.  Also, I do really well on Lithium.  I just need a refill of Lithium."
"But you might just have problems with anxiety."
"I get depressed."
"A lot of people get depressed."
"It's cyclic."
"Have you heard of Seasonal Affective Disorder?"
"Yes.  It's not that."
"Well, I feel that you have an unaddressed problem with anxiety."
"Um.  Okay.  So, can I see the Psychiatrist here?"
"You can make an appointment with the receptionist on your way out."
"Thank you."

"Hi, I'm Dr. OhThankGod,AnActualShrink."
"Hi, I'm Akeeyu Buttmansion."
"What can I help you with?"
"I'm Manic Depressive and I need a refill of Lithium."
"Do you have your last prescription bottle?"
"Yes."
"Wow, that's a really low dose."
"I know."
"Why didn't you just get this from your GP?"
(insert the face from Munch's The Scream here) "He wouldn't give me a refill."
"Oh.  Really?"
"Yes.  He said he didn't know enough about Lithium."
"I see.  What's to know?"
"I guess he was worried about monitoring Lithium levels and stuff."
"I see.  Well, at a dose this low, I wouldn't even bother.  You're not going to reach toxicity."
"I know.  I told him that."
"You should probably go in for a liver panel and a lithium level in a couple of weeks, but it's just a formality.  You know how to titrate up to your dose?"
"Yes.  Can you write me a script for the extended release kind?  I never remember to take all of the other ones."
"Sure.  How's your thyroid?"
"They checked it last year.  It was okay."
"Why don't we check it again?"
"Okay."
"You know, you should really be able to get all this done through your GP."
"Thank you."

"That'll be thirtynine fiftysix."
"Um, but I have insurance?  See, here's my card?  And my prescriptions are always ten or twenty dollars?"
"This prescription isn't covered."
"I don't need the brand name kind."
"It's generic.  It's not covered because it's the extended release tablets."
"Um..."
"Do you want me to call your doctor and have it changed to the regular kind?  Those are covered."
"No, I never remember to take all of them, so they don't work for me."
"Oh.  Then it's thirtynine fiftysix."
"Um.  Well, I only have twenty dollars until I get paid next week."
"Oh."
"Can I pick it up next week?"
"Yes."
"Thank you."

"Mom, I hate it here.  It took weeks to get a refill on my Lithium, and now I can't even afford to buy it.  It's forty bucks a month, which means I'm going to have to spend $500 a year on one lousy prescription.  That's almost a whole paycheck!"
"Oh, honey, I can send you the money."
"No, it's okay.  I'll just wait."
"Well, I'm sure Sam would lend you the money."
"I know, but it's embarrassing to have to ask him for money for psychiatric drugs."
"Don't be silly.  He won't mind.  Just ask him.  Okay, honey?
"Okay."
"Are you sure you don't want me to send you some money?"
"No, I'm okay."
"I love you, sweetie."
"I love you, too."
"I'm sending you a big hug."
"Thank you."

"Sam?"
"Yeah?"
"Can I borrow twenty dollars?"
"Sure, why?"
"Because my fucking insurance company won't cover my fucking Lithium and I don't have any fucking money and I can't fucking sleep, and I just want to sleeeeeeeep."
"Shhh, don't cry, honey."
"I feel like craaaa(hic)aaaaap."
"Don't worry, honey.  It'll be alright.  Of course you can borrow twenty dollars.  Hell, just take it out of our joint account and consider it money well spent, okay?"
"Thank you."

"Can I help you?"
"Hi, my name is Akeeyu Buttmansion, and I need to pick up a prescription."
"How do you spell that?"
"B-u-t-t-m..."
"Oh.  It looks like they returned that to stock.  We're kind of busy right now.  It'll be ready in about an hour."
"Thank you."

"Ms. Buttmansion?"
"Yes."
"Your prescription is ready."
"Thank you."

"Why didn't they get help?"

Separate/s

This is what separates us, me from you, me from Sam, me from everyone, or nearly everyone.  Close enough, or rather far enough away.

It's what makes things harder, and what makes the time stretch out so far behind me and so far ahead that I can no longer see the end on either side.

Manic Depression isn't really a diagnosis anymore, it's just a punchline.  It's a plot twist.  It's an excuse pulled out by lawyers who can't come up with a better defense.  It is all these things, and yet it is still a diagnosis, still my dianosis, day after day, joke after joke, one dreadful Law & Order episode and idiotic newspaper article after another.

Julie's post, the one that I loved but that unfortunately drew out those somewhat-less-than-charming comments about whether or not Manic Depressives should be allowed to do IVF, whether or not we should be allowed to breed, whether or not we were all destined to drown our theoretical children in the bathtub (and on and on and on) fades into the archives, into the short memory of the Internet, but I don't forget it.

I don't because I can't, anymore than I can forget being Manic Depressive.  Actually, I do pretty well at putting that out of my mind (pardon the expression) when I'm medicated, but I haven't been for quite some time now because we're trying to get me pregnant, and I just can't justify the risk right now.  This is not to say that I think everybody should forgo Lithium when trying to get pregnant, or even that I am certain I am making the right choice, but it is the decision I'm making right now.

Sam is not enjoying it, mostly because he has to live with me every day, the poor bastard.  I do not envy him.

I also do not envy myself.  Being Manic Depressive is not as exciting or fun as it seems in the movies, and it doesn't go away when the house lights come up.  I have tried to come up with a proper analogy, an explanation that would suit, some way to express how wretched and tiresome it is, but nothing ever quite fits.  I worry that this permanent failure on my part to convey the reality of this disease will make people turn away, click onto a happier link, one with pretty graphics and cute pictures and funny stories, and who could blame them? 

If I could write a nicer story for myself, I would.