Fuck. Schizoaffective?

The last few weeks have been chaotic for me. I’ve been in a mixed episode, and starting last week, I’ve been hearing voices. Whispers, chatter, and someone calling my name. All either alone, or only with my partner nearby, and she’s confirmed that they aren’t things that she’s heard. I’ve also been feeling like the crows that wake me up in the morning are mocking me. I’ve known for months that something like this was inevitable, but it’s still jarring to experience a psychotic episode for your first time.

Up until now, the diagnosis was Bipolar II. Alright, bipolar sucks, but what can ya do? I get some depression, I get some hypomania (which I love, and makes me super-productive), and it’s manageable. Lamotrigine helps a lot to keep my moods from swinging too wildly, so it’s ok. I can live with this.

Now back to today. I’m in my psychiatrist’s office, pissed off because 1) I have no money for bus fare, and had to walk 90 minutes to get there, 2) The traffic lights are mocking me too, refusing to change for me to walk, and 3) My psychiatrist is 30 minutes late. And I was already irritable and agitated before any of that. I’m a nervous wreck, telling him about the symptoms I’ve had the last week. He comments on how well I was doing the last time I saw him, and what a change this was. Did I mention I’m telling him all of this in front of a clinical student? Normally I’m fine with this, but this is one time I really wish I didn’t have to have people listening in.

Don’t get me wrong here – I love my psychiatrist. Not in a transferrence-i-want-your-babies sense, but he’s a good psychiatrist. Listens to me. Doesn’t push pills. Makes sure I’m well-informed, even though I usually do all the research on my own well before seeing him. And when it comes to medication or therapy options, he lays out all the facts and then lets me decide for myself what my next step is going to be. Oh yeah, did I mention he’s queer- and trans-friendly? All-in-all, I damn well lucked out.

So I’m sputtering away all my symptoms and when they started and what the details were and, and, and… while he jots it all down. He answers a blur of questions, and I answer them. Sometimes I run off-topic, and he brings me back to telling him what he needs to know. I’m honest, and don’t leave anything out, even though I’m afraid he might admit me to the psychiatric ward. I tell him about the psychosis, the suicidal thoughts, the self-harm. How my partner had to pin me down to keep me from hurting myself.

At one point, as I’m going on about my symptoms and what’s going on in my life and what’s been triggering things, he says something to the effect of “Well, I could discuss the difference in philosophy between bipolar I with psychotic features and schizoaffective disorder…” Wait, what? Schizoaffective??? I knew the former was coming for sure, but the latter just floored me. Next thing I know, we’re talking about Seroquel and Abilify and how sedating atypical antipsychotics are, and quality of life… it’s overwhelming. We decide on Seroquel because I took it at a low dose for anxiety/sleep before. How should I take it? Start with 50mg (the most I ever took it at before), and work your way up as quick as possible to at least 300mg, until your psychotic symptoms disappear. *sigh*

Next, it was time for…. *drum roll please* The sample packets. This was the fun part. He comes back in with a plastic shopping bag full of big packets, each of which have only 2 pills. Wide-eyed, mouth gaping (ok not literally, but you get the picture), I ask how many I’m to take with me. “All of them. Here, take the bag.” Shit. You can even clearly see through the bag what the boxes are labelled. Uh, that’s ok. I can stuff them in my purse. They almost don’t fit, but I like the privacy, and the fact that I can zip it closed. Never mind if anyone stops to search my purse (unlikely, at least) I’ll look like a dealer. He shuffles me out the door after a 30 minute session. Huh? I had an hour scheduled. Oh right, he was late. So I have to give up the time. Arrgh. Another thing to add to my irritable mood.

Ok, walking home again. One word is now repeating in my head. Schizoaffective. Schizoaffective. Schizoaffective. Ok, I can do this. I have friends with Schizoaffective. One is a good friend who I met here on QueerMentalHealth.org. Oh right, I don’t necessarily have it, I remind myself. Not that Bipolar I with Psychotic Features is any better. The treatment is the same each way, why quibble with words? I’m not about to play Oppression Olympics with myself here. Still, the word rings through my head over and over. More words join in, and a party gets started. Psychotic Features. Quality of Life. Atypical Antipsychotics. Sedation. Fuckfuckfuckfuck… my life is ruined. I think.

I’m walking home again, so I have plenty of time to process this in my mind. I turn to stop at a park I used to enjoy, and sit on a tree that long ago fell over, and then started growing upright again, on the curve of the trunk as it raises, a perfect spot to sit and think. I call my partner. I’m depressed. Don’t know what to say. Just want to hear her voice. I don’t even need her to tell me it’s alright, her voice is comforting enough. After we hang up, I sit there for a while. Have a cry. Have a not-cry. Have a numb.

Then, I get up and head home again. The trip home seems so much shorter, despite the time I spend sitting on the tree. Actually, the whole trip home feels like a blur. Much like the rest of my day so far. Then, I get home, and my partner just hugs me and holds me tight. We don’t say much, there’s a whole lot of silence. That’s ok though because neither of us really know what to say, other than a whole lot of I Love You. She’s about as numb as I am at this point. When we finally do get to talking, it turns out she’s taking it harder than I am. She’s overwhelmed too, and has her fears. Don’t worry, I tell her. We can get through this. We can learn how to deal with this. Suddenly a light bulb turns on in my head – hey, that’s right! We CAN deal with this! We find comfort in each other’s arms.

But I’m still overwhelmed by all of this. I know I can manage this. Heck, I don’t even know I have Schizoaffective yet. I have friends with Schizoaffective and Bipolar and Schizophrenia anyway, and I see the productive lives they live. This isn’t a death sentence. It’s just another challenge to face.

Now if only I could bring myself to tell my family that.

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