Thursday, November 15, 2007

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 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.


jcat said...

that's a good rating system, more meaningful than most. Just crap that even feeling better is still way down for you.
I'd score myself as being 2-3/4/2/1 and 9. If the time I sleep in the bath counts too....
Doesn't stop me from laughing at some really weird stuff, though. Although I still haven't gotten to the gym. Need to shave my legs first, how useless is that!
I understand what you mean about being scared about not seeing p-doc when you are well, because I worry about that too sometimes. Then I remember how sweet it would be to walk in and tell him I feel amazing, and how happy that would make him, and I figure that that would be way nicer than seeing him every week as a miserable loser.

Aqua said...

I don't think sleeping in the bathtub counts:>) and shaving your legs is a valid excuse (in my books) for not going to the gym. If it is any consolation, my legs are finally shaved and I still haven't gone to the gym. Also, when my mood shoots up to 7 or 8 I love going to see my pdoc. The look on his face is priceless. Usually he's hard to read, but I see the happiness in him when I feel good.

Polar Bear said...

I am terrified of losing my therapist if i become "better" or "well".

It's good that your therapist said it's OK to see him even when you are well.

Aqua said...

Polar Bear,
The reason he thinks when I am well is a really important time to keep seeing him is because when well I will be better able to do the activities that make me and keep me well.

It is important that I have support to keep those things up and to address anything that gets in the way of my staying well. If I manage to get well, staying well after an MDE this chronic will be hard work. It's good to know someone will help me with that task.