Behavioral Health Unit at Kaiser

The bench I always occupy at the Behavioral Health building is disgusting. There is bird poop in two distinct splotches and this makes it difficult to sit comfortably. Yep! Those wet gray and white splash ones. There is not enough space to sit on either side of the mess, and sitting in the middle means risking touching either one. Ugh! I look around. All the other benches are occupied by other patients in their own reveries, except one. I am determined not to sit on that one because it is not in the sunlight. I woke up to a down swing and sunlight is my only saving grace. So I delicately perch myself in the precarious middle between the splotches. I eye the culprits as they fly and silently chastise them for making such a mess. For encroaching on human territory. I think of how human territory is such a relative term. Then I think how being sane or presenting sane is also relative.

I perch strategically on my favorite bench. I check again to see if I am equidistant from either splotch. I debate if I should re-position myself so that I become equidistant so that there is less chance of accidentally touching either. I am exhausted and not enjoying the reason I came outside. This whole ordeal has occupied thirty minutes of my time. I know I won’t last long here because I am not entirely comfortable knowing I am perched between these two splotches of excrement. If I accidentally brush either splotch I will have to return home and shower and do laundry and… Wait. It took me ninety minutes to pick out clothes this morning. This means I will miss my doctor’s appointment and then the doctor won’t check my dosage and liver function. And then this mood swing will last forever and then… Maybe I won’t live to even cross the road back to my apartment.

This minutiae that overwhelms the function of my brain combined with me as a person with a slight tendency towards obsessive compulsiveness equals my current predicament. Stir into this a diagnosis of mental illness and you have me at the junction of a mood change.

Here, any thought has the ultimate possibility of becoming obsessive and distracting me from enjoying life in the moment. Take for example today, the beautiful spring day that is showcasing lots of rays of remarkably gorgeous sunlight interrupted only by the branches of a couple Oak trees and the overhead lattice ceiling propping up vines. Lots of birds cheerfully sounding out their welcome and of course, depositing poop everywhere. But all this beauty surrounding me, something I purposely sought out today, is no match for my brain at the edge of a cycle change. The ability of the minutiae to take over complete control of my thoughts and to snowball them into an avalanche of negative thought and paranoia, is where it’s problematic. This is where it becomes chemical.

I have been feeling better after four days on the new medication–Lithium. Doctor added this to the others because they seemed to have failed me last week when I had the psychotic break. The nurse started me on it after I was discharged. Today it feels like I am unraveling all over again and this Lithium isn’t working. Doctor wants a blood test to check on my liver function. He says this medicine is not good for my liver. So I ask: why am I on it then? He says it’s the one that will work the fastest. He says it will regulate the mood swing immediately. Yeah right! He thinks he’s doing me a favor. This will help you return to work faster, yeah? Well that’s not necessary; I work for myself, I say. Oh ok then, how about we just get you back to functional, he says.

Imagine having to explain these swings to an employer? How often could I call off before it looked like I was a joke? And what do I say when I call off? Emm…I know I had the flu last week and then it was gone and now I have it again? I will be away for a few days, again. I was raised a strong opposer of people who used any diagnoses as excuses for their behaviors. That was then. Now I get it.

I don’t “get it” in how one minute I am flying high and can be mayor and the next minute I could care less because I am sure I am going to die before the day is over. I just “get” how because of this rapid cycling I can’t focus on any one thing. I “get” how someone will have to call off because of these swings. I still don’t “get” the chemical piece of this whole thing. And you know what? I think neither do the doctors. It’s a shot in the dark and I’m sure it differs for each person.

I used to be against pharmaceutical regimen because it changes the chemical make-up of your brain, you know? I know that there has been a loss of memory and a drastic change in my recall of words slowly over the seven years since I was diagnosed and began treatment, but this is in exchange for walking into the lagoon with rocks in my pocket every three months. Doctor has me on three medications now promising that this combination will help regulate the mood swings. Prevent them from being so frequent. But there is no cure. They prescribe Talk Therapy in addition. They prescribe an exercise regimen. Taking long walks. Writing. Joining the local BP group at the hospital. But I think the latter means I am really looney so I stay away. Identifying with others is the last thing I want to do.

I live in fear of anyone finding out. Only two of my closest friends know. Well, them and my latest psychiatrist. I’ve had a few in the seven years… Can you keep a secret? I think I know my illness better than they do. Yep! I try one and if they don’t work, I fire them and start over.

My family definitely doesn’t know. They don’t believe in doctors and psychiatric diagnoses. They say American doctors will tell you anything to take your money. They are African immigrants who work hard. They say “Happy yourself!” “Laugh more!” “Banish negative thoughts!” “Pray! It heals everything!” I get tired of saying I have tried everything, so I just don’t tell them when I’m swinging. Or sometimes when I’m feeling foolish I say I have the flu. Yes, I got it a bit late in the season and yes, I get it about every three months on schedule. Yes, I will make sure I tell all this to the doctor next time I go in. They say, “Maybe you are not eating well, eh? Or sleeping well, eh? You must eat o!” So I nod on the other end of the line and promise to talk to the doctor next time I go in for the “antibiotics”. In the meantime I live with the weight of the week: being on Suicide Watch, practically dancing in circles and counting backwards from 200 in the ER while waiting to be admitted, the side effects of the latest medication tweak, my muddy sneakers from wading in the lagoon, and the paranoia just crossing the street brings.

A bird swoops lower than the others causing me to sit up. I’ve almost forgotten I am perched between these two splotches of excrement, agonizing in detail over them and my interaction with them. Last week’s psychotic break seems so far off. The sun has shifted. The other birds have disappeared. I stand up carefully. I have made it thus far without touching the splotches. Victory! I look up and see you watching me move gingerly. You smile blandly at me. I wonder how long you’ve been watching. I stare back. I think in my head: I look like you. I don’t look like the people who sit on street corners in tattered clothing speaking to their demons. What you don’t know won’t cause you discomfort. You avert your eyes and continue on the path. I smile to myself and watch as a bird takes my spot on the bench.

This is only the first quarter of year seven. There are 3 more to go this year. Always, my only prayer is for safety even though I know that is the last thing guaranteed with this illness. Oops! It’s time to go in for my appointment. I walk into Suite 110. I sign in on the clipboard and wait to be called.

The Bench

April 2012