My psychiatrist, Dr. B, is closing his practice. I have been working with him for eight years, and I have both appreciation and sadness to contend with. I feel he has guided me well, and gone the extra mile to assist me in all of my mood states. I did this painting with him in mind.

I have chosen to see a provider online with Talkiatry.com. We had our first appointment today, and I really enjoyed working with her, but I have some reservations. She is a bit more of a task master than Dr. B. That’s mostly because they are not in-person providers; she explained that Talkiatry is for patients who are stable. Well, that hasn’t been me of late – but since we found the culprit (atomoxetine), we are more confident that I will remain stable, so she agreed to take me on as a client.

Because our sessions are not in person, I would have to go to a hospital if my episode was severe. Most of my episodes are mild, and thanks to my support system, I have never needed to go to the hospital. It does give me pause, so I will just proceed with caution, and check in with my safety net of people on a regular basis.

Dr. B was attempting to help me improve my issues with attention, focus and memory by carefully trying the addition of a stimulant. Had we continued working together, he was going to try Adderall as a next step, but my new psychiatrist said that stimulants are a no go for me. I can’t blame her; my last two mood episodes were the result of adding a stimulant. So if I continue with her, I will have to be satisfied with my current level of functioning, and just cope with my inattentive, foggy brain. Dr. B trusted me to be aware of early signs of my mood changes, so we gave it a try. We worked well as a team to figure out our next steps. But I think it’s for the best to steer clear of Adderall now that I am with an unfamiliar provider.

My new practitioner wants me to stay on the Olanzapine, add in Vraylar, then taper off the Olanzapine, which has caused weight gain. Then she will add Lamotrigine, which is not typically associated with weight gain as a side effect. All of this will be done very gradually over the course of several months.

I also had to agree that I would not drink alcohol at all, or she wouldn’t take me on as a client. It was refreshing to have a firm line in the sand, one that I have been attempting to impose myself and failing miserably. It will be a struggle at times, but confirming that I would adhere to her guideline strengthened my resolve. I’ve now had a doctor directly tell me don’t do that. It gives me an easy out to those who press the issue. Doctor’s orders!

I felt saddened as I answered her questions about mood episodes, hearing voices, and suicidal ideation. Ticking off boxes and talking frankly about very excruciating times in my life, in a very rational conversation about all things not rational, was a bit overwhelming. Emotions bubbled up to the surface, and I felt I might go have a good cry once we ended our session, but the feeling passed, no tears were shed. I just talked to my husband about my experience, and settled in to write and draw this evening.

I skimmed through many of my blog posts to find the timeline of my various episodes in preparation for my appointment, and I am humbled by the comments, guidance, and support that I have received as I write this blog. Thank you for following along and encouraging me with your words.