Ranting at the psychiatrist

What's it like when a helpful med is no longer tolerated, because of a medical problem? For bipolar patients, the news can be agonizing. Blondzila at Sanity Optional shows us her frustration, fear, and turmoil:

I said well, if the valproic acid is causing my liver problems...

You interrupted: I doubt that it's the valproic acid.

Why?

Because it wouldn't cause your spleen to be enlarged as well.

WHAT!?

Your test results show moderate (technical word for spleen enlargement). That wouldn't be caused by the valproic acid. I've NEVER had a patient with those kind of results so I really don't think it's the Epival.

My head was immediately full of static. White noise. I couldn't think, I couldn't concentrate. DONT YOU UNDERSTAND? Do you NOT realize how people like me think? Do you NOT know that this kind of information, and dropped on my head in the manner you did, will make me obsess on it until it is all I'm thinking of, to the detriment of most other things including sleep?

So, you said. What do you want to do with your medication?

white noise
can't think

I don't know. You have to understand that I'm also starting a new job on March 1. I can't have myself be unstable. I need to be sure I'm on an even keel.

What do you want to do with your medication?

white noise white noise white noise

I turned my head to look out onto the dark street below and watched the snaking line of brake lights heading up the hill.

I'll tell you what my suggestion would be, you said. Let's cut the valproic acid in half (WHAT?!?!?!?) and see how you are.

white noise gets louder and panic drops in from the sky - meds in half means i'm gone

My leg starts jiggling up and down, my fingers tapping against my knee. Wind it up baby, you're winding me up. And somewhere I think you know it too, you dusky little leprachaun. You were pushing my buttons because I'm not fitting into your mould of a good compliant patient. My body isn't reacting to the medication the way all your others are and you don't like being wrong.

What do you want to do with your medication?

white noise STOP white noise
dammit I'm scared

The panic was getting worse but I knew I had to say something. I measured my words and tones carefully, like a conductor trying to slow down a runaway orchestra. I could feel the tears in my throat, backing up and up. I could feel myself vibrating inside like a tuning fork, ready to get up and sprint out of there.

Did I wince when I read this? Oh, yes I did. Very much. How many of my own patients have had the same thoughts, and kept silent?

Thank you, Blondzila. In my clinic, I'll be listening for the white noise...