My Medical History & Me, Part 1

On average, manic depressives wait eight years, & four doctors, from the time symptoms show up to the time the psychiatric world makes an accurate diagnosis. I got there in nine & six, but count me lucky anyway: I spent only 24 hours under hospital lock-&-key, received some relatively effective treatment for the depressive end of things, & got a chance to see the sausage factory that is American mental-health-care up close.

At the risk of becoming permanently self-referential, here's a bit of my experience with the insanity industry.

As I've noted before, my crazies struck early, but they waited until I was 23 before they started breaking to the surface (in the form of drunken antics unusual even for a drunk). They waited another four years to make their formal appearance.

When they did, they showed up first as insomnia: I went at least one night a week, sometimes two, sometimes two in a row, without a wink of sleep. Some nights I got in my car & drove around for hours; other nights I watched TV in bed (I firmly believe Homicide: Life on the Street reruns staved off insanity), gave up around 3 a.m. & brewed a pot of coffee; others I drove to my office at 4 a.m. & worked all night through the next day.

Next came the anxiety attacks. These weren't full-blown panic attacks, with all the physical symptoms, but they weren't far off. I typically ended up hyperventilating & dysfunctional, or pounding the holy living Christ out of my dashboard at every red light; driving during these things usually ended with my throat raw from screaming through the windshield at anything that moved.

My first stop: the endocrinologist who treated my diabetes at the time. He had nothing to offer for the sleeplessness, not even a psych referral.

A couple years later, during my first year of law school, I met with the student-health-service "shrink." She was a real psychiatrist (as far as I know), but student health-care in this country is an oxymoron. Campus clinics tend to attract bottom-of-the-barrel medical talent, & student-patients are treated as whiny spoiled annoyances. The urban legend at my undergrad college (& most others, I assume) held that male students routinely had to undergo pregnancy tests before they could get any medical help. The school where I met the shrink has a top-notch teaching hospital, but ironclad rules prevent university students from using it without a referral from the student clinic (which almost no one could get) -- whether or not their insurance would pay for hospital treatment.

So not surprisingly, this psychiatrist was a touch out of her depth. She agreed I probably suffered some degree of depression, but didn't think it was worth doing anything about it. She even suggested my insomnia (which by this point was chronic & repetitive) was a good thing because sleep deprivation is sometimes used to treat depression. It is, but typically only in severe cases, & even then only by psychiatrists who know what they're talking about.

My next try for help was in Manhattan, where I was a summer intern between my first & second years of law school. I happened to be there for the rainiest June in the city's history, & by the end of it I was loopy. I drank for the first time in three and a half years, and strong suicidal ideation crept in.

This time I decided to go with the nearest emergency room. Big mistake. The place turned out to be an assembly line for the sick poor who live around Columbia University. The triage nurse sent me for an interview in the psych ward, which could obviously handle only severe cases of mental illness -- the kind of cases that require cops, restraints & massive amounts of drugs. I could still walk & basically function, so they told me I'd have to wait at least a month or two for an outpatient appointment with a shrink. I didn't really expect to live that long.

And best of all: The "social worker" who interviewed me in place of the on-duty shrink actually asked how often I masturbate, in a way that suggested I should do it as often as possible because that would make me feel better. I don't know about you, pal, but a good wank isn't quite enough to get me down from the window ledge.

There's more to come in a later post . . .