Bipolarland, Texas part 8

 6

I don’t have to confess everything, even though I could just say I’ve been taking them all along but they made me suicidal, and that it got so bad that I stopped taking the pills just now. But I don’t like to lie. Lying doesn’t pay. At least lying to nice people you care about doesn’t pay.

“Oh, dear. Why didn’t you tell me about this as soon as it started happening?”

“I guess my issues that we were talking about were more important, then.”

“I’m going to speak to Dr. Birch right away, today, as soon as he’s available. Come with me.”

It turns out Dr. Birch, the psychiatrist, is available immediately.

“Have you been doing anything lately, while still on the Celexa, that one might consider manic?” he asks, stopping his note-taking to study me.

“Well, come to think of it, I went on a 400-dollar spending spree with my Dole money… I bought nice clothes with all of it,” I confess. And I’m surprised at how shamelessly I can confess this. “Then because of that I had to eat my friends’ food, but they didn’t notice. I just took a tiny bit of food from each friend and went to food banks. Then I sneaked into the recreation center’s outdoor pool area, because I really needed to go for a swim like RIGHT THEN. I climbed over the fence. Unluckily, this janitor guy lives there and heard me splashing around and came out and kicked me out. I had to lie and say I was a member there. Then I got off the Celexa after one month on it, and planned more spending sprees, and broke into someone’s house to see if they had anything better to eat that was better than food bank food… they had nothing, unfortunately, but luckily I didn’t get caught.”

Both Dr. Barnes and Dr. Birch try to say something, perhaps to ask how I broke into the house, or to tell me that I acted very foolish because I could have been shot, but I continue. I love talking. I can’t stop talking.

“Then I took a homeless girl home with me, then lay in bed for three days doing nothing.”

“Now that you are off the Celexa, do you have any more suicidal thoughts?”

“Not any more.”

“That could be because the Celexa is wearing off. However, it seems to be taking longer for the mania to go away. I’m starting to suspect that when you are on the medication… you are bipolar. You think like a bipolar, you talk like a bipolar, you act bipolar. Have you had any grandiose thoughts, ideas, plans…?

“Nope. Nothing big. I was just planning on remodeling my kitchen. Is that bipolar?”

“No,” he says with a smile, “but tell me about that.”

So I tell him that I plan to make my kitchen look like a morgue, that I already have an autopsy table as the island counter, that now we just need a bunch of autopsy instruments we can find on Amazon.com, and that a lot of pathologists order their knives from restaurant companies anyway, and we also need a fridge with morgue drawers but that right now we’re at a loss for how to make or find one.

“Hmmm,” he says, writing something down. “Bipolar people are very creative. I think it’s quite possible that you are suffering from rapid-cycling type three bipolar disorder. Type three bipolar disorder is brought on by medications. Now, Anne-Marie, do you think you need to be observed for a few days? I mean, it would happen at the NeuroPsychiatric Center. I assume you’ve been there before? Have you ever been on their inpatient unit?”

I answer the second question with a nod and the third with a shake of my head. Most of us have been to the NPC, to be assessed, prescribed meds, and referred to the nearest Mental Health/Mental Retardation Authority outpatient clinic to where they live, or where they hang out on the street, or whatever. But not me.

“I want to keep you on the Celexa, because I believe these symptoms will pass, but I think you need to be in an environment where a suicidal person is safe. In the meantime, that is.”

“You mean a place that’s nasty to suicidal people to discourage—?”

“Oh, no, there is no nastiness. It’s run very professionally.”

“Do they punish you for making suicide attempts?”

“No; no punishment, or I am sure I’d have heard about it. I have and have had many patients who have been in the NPC’s CSU, and many of them were suicidal.”

“What’s the CSU?” I ask, suddenly getting very agitated, irritated and annoyed at this diversion. Now I’ll probably forget the question I was going to ask, all because I don’t know what some initials stand for.

“The Crisis Stabilization Unit. It’s—”

“Do they put you in physical restraints, if you— do they put you in physical or chemical restraints or isolation ever?”

“They do have seclusion rooms, but usually if someone is rowdy they simply pull them off the person they’re attacking, or take them away from the place they’re disturbing, and give them an injection. Just to calm them down.”

“Some people complain about chemical restraints.” My panic is mounting. Is he going to have me committed involuntarily if I don’t go quietly? Or is he not going to give me the option of going voluntarily and at least looking like I’m voluntary, looking like I’m not so pathetic that I had to get my rights trampled on “for my own good and safety”?

“That is something you will have to take up with the rights committee and the NPC’s authorities. I’ve had a lot of patients in the ten years I’ve been working here. Ninety-nine percent of them said their medication—even emergency medication—made them feel better. Now, the NPC is completely voluntary.”

Forgive me for wanting perfection, but I’m thinking about the other one percent.

Completely voluntary? There must be a catch somewhere.

“But bear in mind that being voluntary on almost any psychiatric unit does not mean you can leave when you want to. Once you sign yourself in, they may keep you for as long as they feel is necessary, or transfer you to another institution. But that rarely happens. I see patients all the time, homeless patients, who are discharged to the street. They weren’t emotionally functional enough to be able to ask for help with a place to stay or a job, but they were still kicked out after the seven-day period, so… it’s low risk. And I really think you need to be there.”