I really don't remember what my emotional state was last week, but it got bad enough that my husband felt the need to take me to the ER. I was a mess by then. I couldn't take the constant mood swings everyday, it was wearing me down, and I wanted to just go away. And I did go away...to the same short term IP hospital I'd been to twice before, that I hated, that I swore I would never go back to, but that was the only option at the time. I was admitted late Friday night

I did get something out of it: the best psychiatrist I have ever had in my life. If it weren't for the fact it was Thanksgiving week, I would have stayed through Friday just to get longer care from her - 3 days was not enough. I unfortunately arrived on time for the weekend, where you see the psychiatrist only on Saturday who is basically just a warm body until the real psychiatrist shows up. Two days wasted.

But this psychiatrist did a lot of explaining to me that just "made sense". i was admitted with a diagnosis of being in a mixed episode, which explains the constant, rapid mood changes throughout the day. She agreed that I should have NEVER been given Wellbutrin during my last stay in the hospital, which sent me on my worst manic and mixed episode I have ever experienced. She explained that being on one or multiple antipsychotics would not be helpful for me. Because my primary issues are my constant mood swings, it was more important to be on multiple mood stabilizers, possibly up to three. Whether this is the right course of treatment or not, it made sense to me! She also felt good that I had appointment to see a psychiatrist at Duke School of Medicine for December, because she she felt my bipolar disorder was just too complex to be treated by local people.

One of my friends told me she was appalled I had never seen an MD level psychiatrist since I was diagnosed with bipolar 10 years ago. I have only seen NPs and PAs. And this psychiatrist said that while NPs and PAs are good for treating depression and simple bipolar, my illness was too complex and needed to be treated by a psychiatrist with years of experience. It was helpful to be reaffirmed that my bipolar disorder IS severe, I'm not just making this out to be worse than it is. But boy, it is also devastating to know a psychiatrist with many years of experience herself knows my illness will be very hard to treat.

But she was great, almost worth the hell of experience. I did have a lot of down time during the weekend to write in a composition book they gave us, about coping skills, changes I want to make that will help me get through my life. Like getting on a regular schedule (for sleep, meals, and meds) as well as spending time every week to meal plan and meal prep to save time and money. I also wrote about more personal topics that I will need to discuss in therapy, such as why I have a hard time recognizing my limits, why I compare myself to my successful friends, why it actually pisses me off when therapists tell me I "can accomplish anything" because it gives me unrealistic expectations for my illness and will only make me feel worse when I am unable to achieve them. The journaling REALLY helped, I'm glad I have so much (about 20 pages) worth of info to go back to.

Other than those 2 things, I wish my husband would have never taken me to our ER. The majority of the patients were for substance abuse, we only got group therapy, which always came back to substance abuse issues. I got upset during one group talking about negative thoughts because it again got focused on a substance abuse patient, and I didn't feel comfortable talking about how my negative thoughts make me suicidal in front of a large group. They get NA, AA groups, nothing for us there for mental health issues. I got pissed watching them complain about filling out forms for free rehab, when I have no idea how I'm going to increase my therapy, pay additional copays, and manage the gas money to drive 90 minutes to see a competent psychiatrist. They got picked up from the facility to go to rehab, I have to pray I hold it together until my Duke appointment on December 18. Then some stupid girl snuck in a heroin needle during visitation, which caused all of our rooms to be searched and us to be strip searched. If they want to be a substance abuse facility, be one. But don't stick me in there where my mental health issues get ignored. At any rate, I made my displeasure very well known to the social worker who called to follow up about my stay there - LOL. And I will make my concerns very clear when I talk to an administrator on Monday, about what my husband saw which may have been how the girl got her drugs smuggled in.

Whatever. I am done with that place. I feel almost as bad now as when I went in, but hopefully I have enough coping skills to make it until December 18. Even the crappy NP I see now didn't even TRY to get me in soon (I'd been able to see a pdoc within a week of being hospitalized) and instead told the social worker she would see me at my scheduled visit on December 14! I am so done. No wonder I still feel terrible.

Anyhow, just wanted to give a (long) update. Thanks.