It seems like you actually do a good job at describing what's going on--at least here. I get that it's easier because of the difference in who's the audience. It's not that hard to fool a pdoc when you have some sense of insight and control (a lot of them say "they're not blatantly disorganized/not functioning/out of control/etc, and they're not telling me anything to be concerned about, they must be okay enough to get by"), so when things are rough you have to figure out a way to convey that--however you can. Lately I've been journaling a lot and have been sort of summarizing the big picture before appointments, just to give you an idea.