So, I had my appointment with my Primary Physician on Thursday morning. It actually went very well. It was awkward at the beginning but I am really glad I went in and cleared the air as I feel lots better and have brought my relationship with my PP back to a functional status.
We spent quite a bit of time talking about my depression. Something that was interesting was how we talked about it. With the Art Therapist, talking about my depression seems to be about the whys and hows and feelings. With my Psychiatric Nurse Practitioner it is about the whys and hows but without the depth of the emotional processing. My PP…well…With her I talked about my experience of being depressed, no whys and not much on the hows. And my PP asked different kinds of questions than the other two…Which led to a frank discussion about suicidal ideation.
Of course, the first thing the nurse did at the appointment was hand me a fresh PHQ-9 and asked me to fill it out. Since it has been a rough week or so, I didn’t score very well. I am not sure what I got as I didn’t get a chance to tally it before my PP came in, but I am guessing it was lower than when I took it in April. (It asks about how you have felt for the past 2 weeks….so if it’s been an ugly couple of weeks, the score will reflect that.) And of course, when presented with the last question, “Over the last 2 weeks, how often have you been bothered by any of the following problems? …..Thoughts that you would be better off dead or of hurting yourself in some way.” I had to give it a “more than half the days” answer, which my PP honed right in on.
So, we talked about it. First we talked briefly about self-harm, and then more at length about suicide. She asked me why I wouldn’t kill myself. I said because of dh and ds. She asked if I have a plan. I said yes (I have a plan for everything in my life….this is no different.) Then she asked me what my plan was. I haven’t been asked that before, so I was a bit taken aback. But, I told her my plan would be to overdose on pills. Then she asked me if I stockpiled pills. (I’ve also never been asked if I have prepared for my plan.) I felt like it was one of those pivotal moments in life…where I had a choice as to how much of myself to reveal…How much do I let this person in? I kind of hesitated…I mean how crazy do I want her to think I am? As uncomfortable as it made me, I answered her.
I told her that I had stockpiled pills but that in February, I was having an exceptionally bad low so I threw away all of my stockpile so it wouldn’t be tempting to me. (What I didn’t explain to her was that when I was having that low in February, I was also having one my episodes of agitation. Feeling utterly depressed and agitated was scaring me and I felt like I was at a high risk of making a poor choice regarding my stockpiled pills…So, I threw them all away.) She asked if I have a new stockpile, which I don’t. Then she asked me if I have guns in the home. I told her that we don’t have guns and that I would never use a gun to kill myself anyway.
The other thing we talked about is that my level of functioning does not reflect my level of depression. Up until February, I had been working full-time, running our home, and managing all the day to day things of life. Even now, the only thing I can’t manage is working full-time. I shop, I pay bills on time, I am clean and groomed and I am socially appropriated with my appearance and actions, I maintain a façade of complete normalcy. You wouldn’t know, unless I told you, that I am depressed and often severely depressed. My PP said that she thought it was important to note in my chart that while I may look good, I am actually “suffering” (her word, not mine), so that the other providers will know to check in with me about my mood when I have appointments.
The end result of my conversation with my PP is that she wants to be a more involved part of my mental health team. I am totally in favor of that. I am a strong believer in interdisciplinary communication and collaboration. She is going to reach out to my PNP and the AT and she also would like to see me quarterly instead of once per year for my physical. (Remember, I said it is hard to get sick calls with her? So that means that unless it’s my physical I really don’t get to see her.) It all makes sense to me. And I already have my next appointment scheduled.
Okay, this is long-winded enough for today. I might follow-up tomorrow about my thoughts about suicide…but I’m not sure yet.
And just so as to not be too dreary, here is a picture of some Black Eyed Susans in my yard. Black Eyed Susans just shout, “Summer!” to me. I love them!
Oh…and I have been fiddling with my Pocket Peace too!