Field of Meds

Well. That was a cry for help. Not sure if it was from me or from the medical profession.

I went to the doctor's office yesterday for a med evaluation. I've been depressed lately. Really depressed. And my therapist/dietitian/ed specialist suggested I go in and get my meds evaluated. I've heard of such a thing as “Prozac Poop-Out”.  It's when depression medication wears out. Perhaps I am suffering from it.

I've been diagnosed with depression and bipolar since I was 17. I was medicated for a beat. And then not. And then again, since I was 21. And, right now, I'm depressed. I know it. I know my moods. I know when I'm depressed, I know when I'm manic. I've known it since I was 17.

Right now, I'm depressed. I'm sad. I'm exhausted. I'm over-sensitive. All I want to do is sleep. I can't figure it out. I don't want to ride my bike. I don't want to run. I can't get out of bed. This is what my depression looks like. And I really struggle with my eating disorder.

My therapist suggested I go to the doctor and get my medications adjusted. 

First let me begin by saying medical professionals need a crash course on eating disorders. Hell, I'll create it and present it to them. Eating disorders are so prevalent now, yet it seems doctors every where still don't know how to handle us. I feel like it's the biggest symptom, yet it's getting blatantly ignored because they don't know how to handle it. I understand eating disorders are complicated, that's why I see a specialist, but there should be a protocol for handling those of us with eating disorders. And it should be well known, because there are plenty of eating disorders out there.

My first experience with a doctor ignoring my eating disorder came when I was 15 or 16, right around the time I was getting really addicted to purging. My mom was worried about my weight loss and lack of energy and accompanied me on a doctor visit. It was a routine physical needed to participate on the high school dance team. At one point the doctor felt my swollen throat, looked me inquisitively in the eye and said, “And you've lost weight?” That's it. That is all he said. I know the doctor knew I'd been throwing up, and didn't ask my mom to step outside, didn't ask to see me privately. Didn't say a word about it. I know it's a sensitive subject, but it should have been addressed, who knows, it might have saved me years with my head in the toilet.  

A few years later in college, I went to a counselor when I was the deepest in my struggle. I told her my symptoms; I couldn't eat, and everything I did eat I forced myself to throw up. She told me to keep a journal and drink less coffee. At that point I'd never met anyone else with an eating disorder and thought I was completely alone in my struggle, completely crazy, and walked out completely hopeless, surrendering to the vicious thoughts in my head. Keep a journal and drink less coffee. 

At the doctor's office yesterday, I addressed that I've been feeling depressed and lethargic. I'm normally a highly energetic person, with lots of light in my eyes and can remember months past when I couldn't wait to get out of bed and greet the day, and this hasn't been the case for months. 

I read a study once that people who go to the doctor with symptoms of depression leave feeling better just because they leave with hope. Just addressing their symptoms gives them hope, talking about it with a doctor makes them feel like someone cares. Often these individuals leave feeling better before even beginning their meds. This was not the case with my appointment yesterday. 

The doctor told me that she, herself, didn't feel comfortable doing anything to my meds and that I need to see a psychiatrist. Fine. Ok. Made me feel a little crazy, that a doctor couldn't handle me anymore, but fine, I'll go see a psychiatrist. But she didn't have any recommendations for who to see! Her response was, "I know, it's so hard in Tahoe." And then she suggested we check my thyroid. That that could be why I'm depressed. I almost started crying. She didn't ask me any questions or seem to care at all about my current state of depression or the fact that I'm struggling with my eating disorder. It didn't come up at all, when in fact, it's a huge piece of my moods. I was insistent on her upping my antidepressants and she did. She is insistent on me seeing a psychiatrist and I will. 

I've experienced the medical profession as someone with an eating disorder for years now and have learned a few things:

• You have to fight for what you need
• I've had to argue for potassium infusions, even with a prescription, even when I'm a liability for a heart attack
• Believe in yourself and what you need, and deserve, and do not be afraid to ask for it. Yesterday, I did not leave the doctor's until she adjusted my meds, because I know it's what I needed
• Doctors, nurses, receptionists, etc are going to tell you you look healthy
• When I mention I have an eating disorder I get the response, "Well, you look healthy." My eating disorder hears, "Well you look fat." I have to hear these comments and shrug them off, not run with them. Healthy means my hair is not falling out. Healthy means my skin is glowing, Healthy means my eyes have life in them. Healthy does not mean fat. 
• Don't step on the scale
• I calmly ask if we can skip the scale and rarely the nurses have a problem. If this is an issue, I explain my history with the eating disorder and this usually puts the issue to rest. Even the sound of the scale is triggering to me. Even someone else knowing my weight is triggering to me. They can claim they need it for insurance purposes, and I can explain the relapse risk it poses to me. I know I am willing to walk out of a doctor's office if they insist on weighing me. I will not step on a scale. 

I have to keep these things in mind when navigating the medical profession with an eating disorder. It seems there is no sensitivity and I have to stay self-aware in what I need and not let doctor visits be triggering. My next goal is to find a psychiatrist who specializes in eating disorders. Tall order, I know. A new goal of mine I'm going to try to incorporate into my life is to help educate medical professionals about eating disorders. Another life long goal is to continue to stand up for myself, knowing what I need, and help others learn to navigate their way through the doctors and medical professionals to get what they need.