Rating my Mood

"I think you are telling me you are feeling better than you actually are". When Dr. X spoke these words in my session last week they struck me as funny and I started to laugh. Why would I do that? It seems more likely I would tell him the opposite; that I am feeling worse than I am, out of fear that I would be told I was better before I felt ready to take on more responsibility.

I thought about it. I am so afraid I will lose his support; or that he will become so bored with my ongoing struggle and my seeming inability to motivate myself to actually DO something to help myself. Read: socialize, call my sisters', exercise, eat well, i.e. no more bowls of cereal at night, mashed potatoes, chocolate, chips, bread, all those things that are threatening to pack on the pounds, but seem, at the moment I eat them, to fulfil some void inside me.

At the moment he suggested I may be sugar-coating how I feel I thought maybe that was the case. The past three weeks I had come into my appointment, sat down and told him I thought, while my irritability (hostility/rage) and anxiety were worse, I felt my mood was a bit better. Immediately upon stating this I would start to cry uncontrollably. It did not seem far fetched that I was I was trying to protect him. To give him hope. To protect myself by telling him I was on the road to recovery.

We talked about this again in my appointment this week. I no longer think that is what was happening. I think there is a component of my mood that is feeling a bit better. I measure my mood in very strict terms, rating 5 things: mood, anxiety, irritability, fatigue and sleep. Each of these has a clearly defined rating system:

Mood: 1 suicidal, 2 suicidal thoughts, 3 severely depressed, labile or cycling mood, 4 depressed, 5 flat/apathetic, 6 feeling okay, (Target = 7...Feeling good most of the time with moments of feeling great), 8 feeling really high, 9 hypomanic, 10 manic

Anxiety: 1 panic attacks, 2 severe anxiety attacks, 3 severe-moderate anxiety attacks, 4 severe anxiety(no breathing problems), 5 moderate anxiety, 10 none

Irritability: 1 rage, 2 hostile, 3 agitated, 4 irritated, 5 moderate, 10 none
Fatigue: 1 extreme, 5 moderate, 10 hyperactive

Sleep: Number of hours

When I review my mood since I have been taking 800mg Tegretol I notice 2 things: my "Mood" fluctuates between 3 and 4, whereas for most of the last 6 years it has been sitting mostly at a 2 and occasionally a 3...so it is up a bit. Also, I have noticed my mood has not been cycling as much. This is a relief. So I think, although my mood is not good it is clearly better than it was. That too is a relief.

If I am so relieved, why do I burst into tears upon telling Dr. X I think I am feeling a bit better? I believe it is for two reasons. I cry because it is safe to cry in his office. He accepts me, so the crying is like me relieving all those tears that build inside me throughout the week. All the tears I cannot cry. The other reason is because I am afraid. I am afraid that getting better means I will lose Dr. X and his support. I need to trust him when he says I can see him when I'm well. He even says that may be the most important time to see him.