So last Monday it all came to a head. I had an appointment with my Psychiatrist followed immediately by an appointment with my therapist. Wife came to both to help out.

I had some pretty comprehensive notes so I wouldn’t forget anything. I had it broken into four sections: Physical, Work, Mental, and Suicidal Ideation.

Physical. Bunch of side effects from going on and off my latest meds, all per doctors orders. Also, the memory and cognitive issues.

Work. How it’s affected me and how my condition has affected it.

Mental. All the stuff in my head – both real and hyperbole. I had just spent some considerable time alone in my head and that didn’t help much.

Suicidal Ideation. Not to go into too much detail, but someone somewhere said something like “I don’t want to end my life, I just don’t want to live this way.” That really resonates, and sometimes it feels like “live this way” won’t ever change, and that’s what makes you want to give up. Here’s the suicide hotline, if you need it. I haven’t ever called it and don’t quite understand it. If I’m ready to go, I don’t get why there would be enough of my to call someone for help. That’s the whole point – you can’t imagine help or a solution. So why am I going to ruin my last moments cranking up my social anxiety having to call a stranger?

I was really honest. Possibly the most honest I’ve been with a psychiatrist, and definitely my wife. It was a wonderfully concise summary of the issues, but I wasn’t holding back, either. It was a little dark.

The general consensus was that I have a loving and supportive wife, and that’s what kept me out of the hospital. I hate having to put that on her, but appreciate it to the moon and back. So rather than checking into the “grippy sock hotel” I’m starting the partial hospitalization program again. Same place, same program, only this time it’s virtual. Which will be interesting. I really liked the neutral environment of the PHP in house last time. On my initial intake I asked if many people do the program more than once. The woman on the phone said “oh yes” with a bit of a chuckle. Not in a negative way, but in a “yeah, don’t worry about that, we got you.” sort of way.

We’re also going to loop back to my ECT doc, and see what he thinks we should do on the “electricity shot into your head” front. The ECT likely helped, but it wasn’t immediate or even quick to help. So we’ll talk about TMS.

Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven’t been effective. This treatment for depression involves delivering repetitive magnetic pulses, so it’s called repetitive TMS or rTMS.

Much like ECT, the summary of the procedure involves phrases like “why [it] works isn’t completely understood” and “appears to impact” and “seems to ease” and of course “techniques may change as experts learn more” so it’s literally a magical magnetic medication for your malady. I’ll give it a shot and we’ll just see what happens.

And for the PHP and potentially some of the TMS, I’m taking a leave of absence (short term disability) from work. The clock started ticking at 4 weeks, and the fuse to this dynamite is all of my PTO. So I’ll be PTO bankrupt when I go back to work. RIP paid vacations. That said, if the short term disability comes through, that will help quite a bit on the financial hit of this whole thing. As I write this I’m all of 4 days in and the mere thought of work gives me a low grade panic attack. Which is pretty often. I’m hoping I start to forget about it at some point.

It’s not that I don’t like my job, the company, or the people. It’s my memory issues making me lose confidence that I’m doing it right, and the cognitive issues make the diagnostic/ part of the job a nightmare. And I don’t want to not do a good job, so the pressure hurts.

So yeah, we’re back to where we started, possibly on a faster timeline and spending less time lollygagging and going right into it all. It doesn’t make it feel any better (yet) but it’s something.

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