Listen

I sat on the kitchen floor.

Four days ago, I had an idea. I was going to run a business. I researched for hours. I hadn't slept in four days. I applied for loans to finance my business. I decided on a name. I began writing a business proposal. My business idea was revolutionary. I was going to change the world. My idea was genius. I didn't sleep. I barely ate. I paced the floor and told my husband over and over and over about my ideas, repeating the same sentences and jumbling together my words. I had to keep talking. I had to keep telling him. I hopped up and down on the porch and grinned from ear to ear. I was going to be famous. My idea was incredible. I was unstoppable. I skipped three days of work. I skipped three days of classes. It didn't matter. I was going to be famous. I didn't need that job. My degree was pointless.

And then suddenly, after hours of research and writing and obsessing, it stopped.

Just like that.

I blinked, and every ounce of creativity, desire, excitement and determination, had left.

In rolled the fog of depression. My familiar foe that had haunted me since I could remember. By mid-afternoon, I was sitting on the kitchen floor counting the minutes until my husband came home from work. I wanted to kill myself. I couldn't think of a way to painlessly do it. Knives sounded like a good idea, but isn't that usually not final? We didn't have any pills except regular cabinet medications. There was nowhere in the house strong enough to support my hanging body.

So I sat on the kitchen floor and waited.

*****************

"Honey, I think you are bipolar." He said as he handed me his phone.

"What? No I'm not." I rolled my eyes.

"No, read this. This is you." And he shoved the phone in my face.

Bipolar Type II. The article listed symptoms. I read them. And I read them again. And again.

My heart thumped. I began to sweat. I clicked on another link, and another. I read articles and lists of symptoms and personal accounts. In detective novels, there is a moment where the lead detective discovers a key piece of evidence that suddenly solves the crime. In that moment, he gasps and says "Oh my god" as he realizes the truth.

"Oh my god", I gasped, like a detective. "That's me! This is me!" I began to cry. And I read more articles and links with each one I saw myself more and more. The depression. The obsessions. The "intermittent ADHD", the obsessive cleaning, the writing, the delusions, the sleepless nights, the days that I couldn't get out of bed.

The more I read, the more I realized that this has been me all along. My whole life. My phobia to vomit, my severe anxiety, all of it was connected and intertwined.

"What do I do?" I asked. I had been researching all day. It was dark.

"I don't know. Go see a doctor I guess." He hugged me.

****************

"Have you been feeling excessively sad, every day, all day, for longer than a two week period?" She asked. The lights were dim. She yawned. Her computer screen was turned away from me. She didn't make eye contact.

"Yes." I said. With each question, I lost faith. I had waited four days for this assessment.

"Have you lost interest in activities, lost desire to complete school, work or household duties?" She yawned and stared at her computer screen.

"Yes, but sometimes I become obsessive." I said. I had to save this appointment. I had to do something.

She looked at me and raised her eye brow. "Four more questions", she said, and clicked her mouse.

The questions continued. I knew them by heart. Yes, because I had gone through this same depression questionnaire countless times with other therapists, but also because I knew them by heart. The list of symptoms was memorized because my heart felt these symptoms over and over again.

"That's it." She said as she clicked her mouse. "You seem to be experiencing some depression. I will schedule you with a doctor to begin medication."

That can't be it. There has to be more.

"That's it?", I asked. "There aren't more questions?"

Her computer powered down and she stood up, gathering her jacket and purse. It had been an hour. She yawned.

"What do you mean?" She said as she began to open the office door.

"There should be more questions. Sometimes there are other things. Sometimes I am so hyper I can't sleep. I think I might be bipolar."

She raised her eye brows and sat her purse on the chair.

"Do you abuse drugs?"

"Well, no..."

"Have you ever been arrested?"

"No, of course not."

"Have you ever done anything dangerous or spontaneous?" She asked, picking up her purse again.

"Well, once I drove to the ocean in the middle of the night."

She opened the office door and said "That's not that unusual. Bipolar is very obvious. You've never been arrested. You aren't a drug user." She headed down the hallway. "Let's get you set up with a doctor so you can begin a medication regimen."

**************

I sat in the waiting room. A woman next to me rocked and moaned in her chair. Every few rocks she would whimper. I wondered what the doctor would look like. My stomach was in knots. I had waited two months to see him. This time, they would listen to me. Whoever this doctor is, they would listen to me.

I made sure they would listen, I would force them to. I had spent an hour the day before listing out my symptoms. It was two pages long. I included my history, the anxiety at age 4, the depression at age 11. The business ideas, the noises I heard that weren't there, the hypersexuality, the delusions, the sleepless nights. I had the stapled papers folded neatly in my purse. I would make the doctor read the list. I would make him listen.

"Sarah?" An old man poked his head through the door. I smiled and followed him. He left behind a trail of cigarette smoke smell as we walked down the hallway.

"Sorry to keep you waiting, I am a very busy person." He said as he entered his office.

I sat down in the chair across from his desk. "It's fine," I smiled.

"Well, what are we here for, depression?"

I swallowed. "Well, yes and no."

"What do you mean?" He asked with his eyebrows raised.

"Well, I really don't believe that I just have depression. The woman I saw before you did an assessment for depression, which I have, which I have ALWAYS had, but I think there is something else going on."

He sighed and logged in to his computer. After a few moments he said "Well here it shows your diagnosis as Major Depressive Disorder."

"I know", I said. "But I really don't believe that's accurate. I started having anxiety when I was four and sometimes I don't sleep and..." I stopped. I pulled out my list. "Will you please read this?" I handed over the list. I was shaking.

He sighed, leaned back in his chair and folded his arms. "You're really overestimating my reading capabilities" he said as he leaned forward and snatched the paper.

His eyes scanned the pages. He flipped the first page and quickly moved on to the next.

"Do you have a criminal record?"

"No." I said.

"Do you abuse drugs?"

"No. Well, I do smoke marijuana."

"How often?" He asked as he handed the papers back to me.

"Once a day."

He scooted his chair back towards the desk and folded his hands. "Well, this could all be attributed to drug use. Do your relatives have mental health problems?"

"Drug use? I just started smoking three years ago. I've been this way my whole life." I sighed. "My biological father left when I was an infant. But my mom said he had severe bipolar, as did his brother and father."

"Any hospital visits, what medication was he taking?"

I was growing frustrated. He wasn't listening to me. I wasn't being listened to again. "I have no idea. Again, he left when I was an infant. He is a stranger and I know nothing about him."

He leaned back in his chair and put his hands behind his head. "Listen," he said, "Your symptoms could be due to drug use. I have patients come in all the time that complain about hallucinations but pop positive for amphetamines. You have no criminal record. Your history is irrelevant because I don't have any documentation to prove it. Your mother believing your father had bipolar is irrelevant because you can't tell me what medications he was taking. I don't know what you expected when you came in here. I am not a magician. I can't prescribe some magic pill to make you happy with your life."

I was shocked. "How is all that irrelevant?" I stammered. "I'm not asking for a magic pill. I am happy with my life. I am very happy with my life."

"Have you ever been hospitalized for a manic episode?" He said.

"Well, I"

"Yes, or no", he interrupted my explanation.

"No", I said as I slumped in my chair.

His brow furrowed. I could tell he was getting angry. "I think you have a personality problem. And you are emotionally immature. There aren't pills to fix that. What I can give you is the lowest dose of an anti-depressant and then I will see you in three months. Please close the door on your way out."

*************

"Hello, may I speak to Sarah?"

"This is her," I said into the phone.

"Hi Sarah. My name is Allison. I am a clinician for the dual-diagnostics program. I was hoping to schedule an appointment with you."

"Dual-what? What's that?"

"Dual-Diagnostics. It is a program for people that have mental health problems and struggle with drug use."

"But I don't do drugs. Unless you count coffee, now THAT I am addicted to."

She laughed, "Okay, let me pull up your file. You were referred to me."

After a few moments she said, "It shows here that you have Major Depressive Disorder and Cannabis Dependency?"

"What? Dependency? I do smoke marijuana but I'm not addicted."

"Okay, how often?" She said.

"Once a day, maybe. Depends." I said.

"Alright, I wonder why the listed you as dependent then." She said. "So you are experiencing depression?"

"Well, yes, But that's not all. It's so much more complicated than that." I said.

"What do you mean? What else is going on?", she asked.

And I told her. I listed out the symptoms of Bipolar Type II not because they were listed, but because they were what I experienced. She asked me questions, she asked for examples. We scheduled an appointment for the next day. I didn't have to wait anymore.

**************

"Hello", she said. Her smile was infectious. She reminded me of honey and rainbows. She seemed like the type of person that liked to give a lot of hugs.

I sat down in the chair in her office. On the walls were encouraging quotes, pictures of mountains. She had a bookshelf full of books that were titled with psychology related words. She smiled.

"So where were we?", she said.

"Well, on the phone we were talking about my symptoms. I know I have depression. I really don't want to talk about depression. I am tired of talking about depression. I know the symptoms by heart because I have all of them. But I really feel like I have something else going on."

She listened to me. I told her about my "intermittent adhd", the delusions. the noises, the obsessions, the outbursts, the anxiety, the panic attacks. And she listened.

We spent the next few days, over the course of three appointments, discussing my symptoms in depth. She pulled books out of her bookshelf and read passages to me to see if I could relate to the descriptions. She quizzed me about symptoms for disorders I had never heard of, which I didn't relate to at all. I didn't count my steps. I didn't hear voices. I didn't challenge authority. Each symptom we discussed would circle back around to one disorder: Bipolar Type II.

"So, it appears that you are suffering from Bipolar Type II and you have been for a very long time." She said. "You have every symptom, more than required for diagnosis. So I am going to update your diagnosis, okay?" She smiled.

She pointed to the computer screen. "There, see?" Listed below my name was "Bipolar Type II/Generalized Anxiety Disorder". I smiled.

"I wanted to tell you something, but I don't want you to take this the wrong way. Let me think of how to put this without offending you." She said as she sat in her chair quietly.

"Ok," she said. "So I think the problem is you come off as much much higher functioning than you are. You are pleasant, friendly, very well spoken, educated and you appear to be very well adjusted. You are much lower functioning than you appear and it only becomes apparent after talking to you for a while. I think that's why you have had such a hard time getting people to listen to you because you appear to be just fine." She paused.

"I think this is from suffering for so long and your desire to hide your symptoms. You were not raised in a mentally supportive time period so you trained yourself to hide your symptoms and pretend to be normal. I think this is why you have had a hard time getting help. Of course, this does not excuse the doctor's behavior with you, but it might explain why people have not listened to you. You appear to be fine, but you are not." She smiled. "I think it would be a good idea to set up another appointment with the doctor with this new diagnosis to be sure you are receiving the correct medication. Also, lets get you set up with weekly therapy appointments with me. What is a good day for you?"

****************

My appointment was at ten. It was 10:45 and I had not been called in yet. Finally, the old man poked his head through the door. "Sarah?" he asked. I followed him down the hall. "I am a very important person here, hence the delay", he said.

We arrived to his office. He didn't sit down. Neither did I.

"Why are you here? I saw you three weeks ago. Is there a problem?"

I was shaking. I was terrified.

"Well", I said. "I have been thoroughly assessed by a therapist and she and I believe that I have Bipolar Type II. Her recommendation was to follow-up with you to ensure that my prescribed medication would work with this more accurate diagnosis."

"Who is this that you saw?"

"Allison Lastname", I said.

"Well, I am much more qualified than her. As you can see from the degrees on my wall, I am an expert and she is not at all. I have already prescribed your medication, it has only been three weeks. I am an experienced professional and I do not agree with that diagnosis at all. I suggest you leave my office and find another doctor that will be willing to work with you because I am not willing to work with you."

I didn't say anything. I was trembling.

"Leave my office."

I held back my tears until the waiting room where I filled out a request to change doctors.

******************

Allison told me she was proud of me for seeing the doctor again, for the last time. She congratulated my courage and determination. She listened to me again. I found a new doctor to see, and each week I also meet with Allison as I begin to heal.

Allison listened to me and that was all that I wanted. Just listen to me.