Think that is an understatement these days. I walked away from session this morning trying to tease apart all the moving parts and figure out what is going on up there. I can try to break it down piece by piece though I’m not sure I have the insight to complete that task. Here’s what I know and beyond that what I think of it all.

Email came in and I read it. Now here it gets complicated. There are a million different directions my mind went though I think on the most superficial level it is about meds.

Okay, so we have the medication issue. At face value it is just a choice in a long line of choices. I don’t like them. Don’t like the drugs. That is pretty easy to identify though it has a bit more to it than that. There is the feeling of losing control and lacking choices. The cumulative effect of years of feeling like I have no option but to comply and take them, even when they scare me and when I don’t want them. Dig a bit more and we have the overall feeling of powerlessness and the view that this is just an endless road. From one to the next. To refuse would be to sabotage my chance at normal, at stability. To know that if I refuse I have somehow failed myself. Distorted, yes. for sure. I know that. But isn’t there just a bit of truth to it? If I have “x” option and it is the so-called best option by refusing it I am in a way harming myself, or at least not providing myself with the best course of treatment. So there may well be free will and choice but is there really? If I refuse the best option and end up in a heap or dead, one can easily say that was my fault. I didn’t listen. I failed to take the wisest course and that what happened could have been avoided if only I complied. Don’t think for a second I don’t understand that. I do. The psychopharm’s words were not lost on me. What they drove home is how little choice I ultimately have. But that is only the beginning.

We have to dig a bit more and we arrive at his words echoing and deeply touching how very powerless this journey has left me at times. To be harmed in the pursuit of stability is nothing new to me. Incredibly sad to think about. I understand the desperation to even the keel when everything gets so brutally dark. I can see that. Most of all how much that is compounded when you add all the years we have spent trying. I know I have been impulsive to the point of almost lethal. I have brushed up against the very edge and not even considered the harm I was doing in those moments. I know it has happened a number of times. I understand with each terrible experience I have statistically brought myself closer to the morgue. That isn’t lost on me either. I know that when choices are made to try to alter the course they are done out of the all out desperation to halt the slide and stop the impulsivity. So while none are done with the intent to harm, and all are in my best interest since suicide would be worse, when I survive and walk away from an episode I am left grappling with what has happened. In some cases that is forever. don’t know how to forgive and forget. Ultimately it is my fault to begin with as it is my impulsive behavior that triggers the whole cascade of events. Were I not so fucking sick these would not be issues. If I had never strangled myself it wouldn’t be this way. There would be no full court press to shift the course. I’d be like every other depressed person that just gets by on some SSRI. That changed a long time ago. With each drug we have dosed our way across the pharmaceutical landscape. From fairly benign to where we find ourselves today. Knee deep in nasty atypicals and fast approaching Depakote. That didn’t happen overnight and I realize that. I’m here because we have exhausted the other options. Trileptal has been good to me, but not good enough. Ultimately it is my behavior and impulsivity that drives this endless 20 year path of medication after medication. I know that. But I think we have to go a little further because like I said, it isn’t just drugs.

I have spent almost 20 years being defended and protected by you. That isn’t lost on me either. I have seen you hold your ground against the worst my family could dish out. The more they questioned and bullied you remained. In my world I only understood a mother that would run. I’d never seen one circle the wagons. Instead of flight I saw stubborn perseverance. The more I pushed, or the family pushed the more evident it became. I came to understand that I didn’t need to live every day waiting to be abandoned. I did not have to guard myself so strongly and that I could show you “me”. It was indeed lost on me at 20. It is not now. I see the value and the necessity of it as I left the scared kid I was behind. It helped me grow and mature. There is a bond that cannot be denied. But in that bond is also a complexity that overshadows everything else. To have a strong maternal figure was critical to me, and continues to be. I believe we have indeed bumped up against that in this psychopharm debacle. It isn’t about drugs and free choice, not at its root. It was about betrayal and it was about losing faith. I have not felt this way since after ECT when all I could think of was why in god’s name would she let them harm me. I felt lost and let down. I felt abandoned. This is a bit different, though some of the same emotions seem to be stirred. This is about watching you give away your power to someone else. To defer to some prick and to let me see it. I don’t understand, but I know that you knew that this email would kick up some dust. I think more than anything you wanted me to make the right choice and take the depakote. Your desire to save me forced your hand a bit. When dangling the life minus seroquel carrot didn’t quite work you let someone else kick me when I was vulnerable. and kick me it did. Though in the final analysis yes, his words may well make me arrive at the right decision. What is left is my wondering why in the hell you’d do it that way. I think you know me better than anyone (short of Beatrice), so I can’t help but wonder why you would hurt me unless of course you felt it was the only way to get me to accept the medication, thus saving me (maybe). Just as you allowed them to do ECT without objecting because ultimately it was to save me. It circles back to my behavior, and my impulsivity. It colors everything, even the most important relationship in my life. am I to accept that I will be hurt because it is in my best interest? I guess I would have to come to terms with that, were it the case. Though I think that just leads us just a bit deeper.
In your failure to abandon me you have allowed me to see you as something more than human. Something perfect and ideal. The mother I never had and always needed. In that bold stubborn loyalty I was able to produce an idol. that isn’t lost on me either. Though I do think when there are mistakes they clamor off the richter scale because the vision of perfection is suddenly altered. In my mind the world tilts a bit and I find myself swimming in fears of abandonment because maybe, just maybe you might not be who I think you are. What if I made a mistake? Interesting to see how fast my mind is willing to give up an impeccable track record for some minor perceived slights. Though there I think we tread into my disordered personality and away from the bipolar. Hard to imagine I wouldn’t fall back on what was mirrored for me all those years growing up. I too am flawed, and I too recoil at injustices and slights with the blink of an eye. thank you mother. In the shadow of that I am indeed struggling now though I know, just as I recovered after ECT, I will once again find my way back. That is where the issue lies. I cannot continue to hold you there on high. It doesn’t work. you are as human and fallible as all the rest. The sooner I accept that and move on the easier it will be to cope when events like this happen. There is always be drugs, side effects and outside consults. Always. the past 20 years has proven that. There will be more challenges, and yes, more mistakes by all of us. I can and will accept you as less than perfect. I somehow managed to do that with all the rest of the people in my life. So we can keep going.

Love. I think that we do both love each other. We have such a long history. From the best of moments like college graduation and finding soul mate to the darkest of moments when I let go of this life and looked beyond it. I think ultimately we both need to accept that and seriously contemplate whether it creates too great a bias when it comes to my care. Is the instinct to protect too strong now? Is the desperation to save me too great? I can’t answer those questions as the reside with you. Is this willingness to defer to someone else a reflection of that deeply personal bond? Would it somehow allow you to obfuscate the guilt if it were someone else’s medication choice and I took my life? I know you don’t want to lose me. I don’t want to lose me. I do need to know that you are alright owning the decisions regarding my care. That we are not too close now.

I am not a shrink so I am only writing what is in my head, most is probably useless. I understand there is some intense stuff going. I just want to try to understand it all better so I can ward off land mines like this one last week. There is no blame here. No judgement. Sure there is anger but that is my default setting when shit gets too intense and unrecognizable within the swirl of thoughts and feelings. I know it is so important that we figure this out. We can do that, right?
B