I am a very good depression patient — as I said yesterday. I know the signs, I know what to do for myself, and I am good about asking for help — especially from doctors. My big hospital suicidal ideation fiasco came about, partly, because I didn’t report symptoms clearly enough (or, you could argue that I wasn’t asked about them clearly enough), so I try to get every possible thing out there. I make myself vulnerable. I use correct language: hypomania and not mania; thoughts of suicide and not suicidal ideation; SSRI, contraindicated.

And so yesterday when I went to my new doctor she got a very thorough and responsible report. I told her about all the terrible things that went wrong five years ago and also about the recent the fogginess and the despair and the weeping. I told her that I wasn’t having thoughts of suicide, but I was having thoughts of not getting up — which is sort of the gateway place to suidical ideation. I told her that Effexor is bad for me because of my mood disorder and that Zoloft doesn’t work. I told her that I had been on Lamictal but I was not anymore. She asked me if I used Lamictal off label. To which the answer is yes, because it is usually prescribed for seizures which it seems to me would be obvious since I was telling her about mood management. But I thought ok — she’s not a psychopharmacologist — I gave her the benefit of the doubt.

She typed everything I said into a little computer. All of my sordity and sadness and askings for help. She typed for quite a long time. She is probably thinking, I thought. Maybe that computer program will spit out something good, I thought.

Then, she asked me if I wear my seatbelt. Also if I had recently updated my tetanus immunization. It’s very important to do this, apparently, whooping cough is on the rise in adults and there’s a whooping cough component to the new tetanus. She told me that there have been outbreaks at the school I work at — of whooping cough. I said I would think about it. She argued a bit. I said again that I would think about it. I reassured her that I do wear my seatbelt. What about the mood, then, I asked — what do you think?

Why don’t we wait a month on your mood, she told me — let’s see if it improves. From what, I thought? The days getting even shorter? The temperature even colder? I did not say this, but I did ask about meds. What do you think, she said?

Which was the end of her benefit of the doubt.

What did I think? I thought that I am sitting here in a freezing room in a fucking paper johnny spilling my shamefully depressed past and asking for help and you’re a fucking doctor so why aren’t you telling me what we should do?

I thought depression is crazy common and this is the way we treat people with it?

I thought that I hated her pleated wool pants and wool socks with sandals and that I wanted to go home and who needs a doctor anyway.

I thought I would just bootstrap it again.

Which is maybe what she intended, but I don’t really think so.

Then, she typed some more for awhile. Then, she looked up. Have you made a living will, she asked? There’s a website you can go to. It makes your executors feel better, she advised me, if, you know, you sort things out ahead of time.

Then, she told me I could get dressed and go home.