Bumming Myself Out: Fear and Dread on the Couch
I recently ran out of one of my anti-depressants. I coudn’t make an appointment with anyone nearby in a timely fashion, and I don't have a regular psychiatrist so I ended up having to make an appointment a thirty dollar Lyft ride away. The importance of the chemistry between a patient and their permanent psychiatrist can be hard to overstate but I was only ever going to see this psychiatrist once as a stop-gap measure before I found a permanent psychiatrist and therapist closer to home.
So the psychiatrist and I came in with different expectations and different agendas. I just wanted a refill on the medications I’ve been taking for ages before I had to go without. She saw me as a new patient and asked the kinds of questions you ask someone whose mental health you’re going to treat on a theoretically ongoing, permanent basis.
When I sit down with a psychiatrist for the first time, something I do a fair amount as a middle-aged, lifelong depressive whose health insurance situation is regularly changing, I’m pulled in antithetical directions. I have the insecure emotional exhibitionist’s need to tell my life story in a compelling, succinct fashion that will entertain my new shrink and endear me to her (all of my psychiatrists and therapists have been women) but also a deep distrust, even revulsion towards that instinct to tame the complicated, swampy morass of my past and turn it into a series of snappy anecdotes and well-rehearsed one-liners.
When you have as much history as I do, and I’m guessing some of y’all do, it’s hard to know where to begin. Do you start at the beginning, with my birth on April 24th, 1976, and the mess that followed? A mess that, incidentally, continues to this day? Do you begin with the parents, that primordial source of so much dysfunction? Do you begin in the Carter era? Fast forward to the Reagan years? How much detail do you go into? Do they have to hear the whole sorry spiel? Christ, I’ve written three fucking books about my fucked up history and rampaging personal demons. How am I supposed to condense all of that craziness into a ten minute rundown of formative traumas and medication taken?
You know you’re not hitting it off with a psychiatrist when you find yourself thinking, “Wow, this person is really nosy. What’s with all the intrusive questions? Christ, do you need to know everything about me? I don’t even know you! I’m never going to see you again”, as I did during our session.
I never know how long or short to go when telling stories, whether to give in to my natural inclination to be as verbose and long-winded and self-indulgent as possible, or to fight that instinct and get right to the point. So I ended up telling this psychiatrist enough about myself to bum myself the fuck out.
Sometimes telling my story is empowering. It makes me feel like a survivor. It makes me feel like I’ve overcome obstacles and become a man of character, a man with stories. But sometimes telling my story is depressing and dispiriting. It makes me feel less like someone who has struggled and overcome than someone whose destiny is to always struggle.
I was having a bad day, so I think that colored both my mood and the nature of how I shaped my story. Some things are tough to sugar-coat, however. Take my relationship with my mother. She abandoned me as a two year old. I sought her out as an adult and was chagrined with what I found. She abandoned me a second time. I reconnected with her son/my half-brother about two years ago and discovered she was even worse than I imagined. Then she died. Not a lot of upside there. Hard to be positive about that particular relationship. There's nothing happy, just a lot of ghosts, a lot of sadness, a lot of damage. That’s far from the only area of my life where that’s true.
Our relationship with the past is ever-changing, ever-shifting. It’s affected profoundly by our actions in the present and our fears and anxieties about the future, which were flaring up that day. I’m in a better place as I write this, so even though my history obviously didn’t change I think I would relay it in a markedly different, more positive way to the psychiatrist if we had our session today.
In the end, my past and my history are both a source of tremendous pride, identity and happiness and something that brings me pain and fills me with me regret. It’s a perpetually shifting combination of happiness and sadness, contentment and despair, optimism and anxiety that will only end when my life does.
We don’t just have a story. We have stories. And the way we tell those stories changes as we change so I think it’s probably best to accept that, depending on the day, and the mood, we can be both inspirational triumphs over adversity and total fucking train wrecks. I know I’m a combination of the two.
So while I’m never going back to that psychiatrist, there’s a good chance that the next time I tell my story to a psychiatrist for the first time it’ll be a more cheerful and less despairing narrative because heaven knows I’ve got an awful lot to be grateful for as well. Some days it can just be easy to forget that.
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