Should I See a New Psychiatrist for Medication?

As I wrote before, I’ve been suffering a bad spell of depression. I spend most of my day sleeping or watching TV. I only work about 3-4 hours at most. I’ve started eating junk food as a way to feel better and pass the time. I have no motivation to improve my life, my business, or myself. Oh, I should mention that I have no social life other than occasional phone calls from friends. There’s no excuse for that either. Feeling lousy doesn’t get me out of the house: if anything, it keeps me in and locks me down.

I saw a sleep doctor and completed a sleep study in July to rule out any somatic problems that might be interfering with my mental health. Among many other things, the doctor concluded that I should get to bed earlier than 3:00 AM or 4:00 AM. Additionally, he suggested seeing a local psychiatrist for a cross-consultation about my current medication regimen of Effexor, Welbutrin, Zyprexa, and Clonezapam.

So far, I have been able to walk back my bedtime. Now I aim for 1:00 AM or 1:30 AM. Going to bed earlier might see easy for some people. My problem is that my body, mood, and mind seem to perk up about 7:00 PM lasting until the early morning hours. That means when I do try to sleep, my mind is running in 100 different directions and is screaming for stimulation. As a matter of fact, I’m writing this blog at 12:15 AM. It’s hard to make a day out of feeling “good” between 7:00 PM and 1:00 AM, but that’s what my situation is right now.

At the moment I’m also getting low on Clonezapam. This medication helps me relax and sleep uninterrupted. My prescription for this medication is in USA. Therefore, my insurance only allows me a 30 day allocation per month. My parents mail the medicine to me. Unfortunately, due to their busy schedules and mail processing delays I sometimes go for 3-4 days without it. That means 3-4 nights without sleep, frequent nocturnal polyuria, and altered moods. Any time spent beyond this initial withdrawal period creates further problems: it becomes impossible to sit behind the computer, I become agitated easily, and I ultimately just lie in bed listlessly and only get up for meals.

So, instead of trying to tough out Clonezapam withdrawal, I’m thinking of seeing this new psychiatrist and getting a prescription I can use at a local pharmacy here in Costa Rica. It makes sense as a good contingency plan in the event my Clonezapam shipment doesn’t arrive on time. Unfortunately, my medical insurance does not cover any sort of medical examination outside of the USA. As a result I would have to pay cash for each visit to this new doctor plus cash for any medication he prescribes.

On one hand, I’m curious to see what he’ll say. Will he prescribe a totally new set of meds, or keep me on the current four that I take? On the other hand I’m loathe to visiting another psychiatrist because it means I’ll have to dredge up my entire mental health history again, recounting all of the lowest moments and desperate acts Borderline Personality Disorder created in my life. What if the doctor requires multiple visits before writing a prescription? Will he just use me as quick cash or will he take a genuine interest in my well being?

Finally, I’m simply just shy about putting myself in a new social situation. I get nervous any time I have to call a new doctor and coordinate a first appointment. I realize this sounds crazy: who is so shy that he/she can’t even speak up for the benefit of his/her own health? Well, that’s me. Now you know why I’m 32 years old with no wife, no kids, and no significant other.

I suppose I have two choices. One, I see the doctor and try something completely new; or two, I wait for a reprieve from my current rut of depression. Part of me can’t wait any longer for this depression to lift. It’s really bringing me down. I should be exercising more and eating less, but the exact opposite is happening because I have little motivation for self improvement.

Maybe that doctor visit is in order after all. What do I have to lose other than a few bucks and an hour of my time? Nothing really, I suppose…

I feel empty and worthless – I have no desire for life

Despite the fact my internet business had record website traffic and customer acquisition for the month of September, I’ve spent the majority of the past 2 weeks in bed, depressed and feeling miserable. Even worse, I’ve felt utterly empty, lacking any desire for life. I feel more content dreaming in bed, where my mind is free from the shackles of Borderline Personality Disorder. If there is a bright side to any of this, it’s that my sub-conscious doesn’t have BPD. Unfortunately for me, my “real time”, waking conscious is nothing but BPD, aching and painful to the touch.

Some people might ask, “What does it mean to feel empty and worthless?” After all, you run your own business, are in better economical shape than most, do what you want with your time, and have a couple good friendships. On top of that you alone have put together a substantial collection of rare and highly sought after USA paper money, enviable by most standards given the value of the collection is well into six figures.

My answer: feeling worthless and hollow emanates from a really deep place inside me, far past the material comfort and achievement layer that floats safely on the surface of my inner being. Making and saving a few bucks doesn’t do it for me. I wish it did, but it doesn’t. Instead, I am lonely, depressed, sad, and hopeless.

I’m 32, single, never married, and do not have children. By my age, most people are at minimum in a long term relationship; or at least have had a couple worthwhile long term relationships to date. I haven’t. My longest relationship was 5 months. All the others fizzled out after a month or two. Likewise, my attempts to meet people using services like fail miserably: most women I am “matched” with don’t even reply to my emails. The women I’ve loved in my past look at me like paintings on a wall. They exist in an empty gallery that no one sees except for me. They are a constant reminder of what “could have been”.

Instead, these wonderful women have pressed forward with their lives, married, and have beautiful children. The singles scene is long gone for them. They don’t come home to an empty apartment. They haven’t disappointed their family by living adrift like I have. My mother famously said last Christmas, “…I’d like some grand children…”. One of my brothers is married with a step child. Another is most likely homosexual and has a good relationship with his partner outside the boundaries of my family; and the other most “normal” brother of mine has a great relationship with a woman he’ll most likely marry in short order. He’s got plenty of time: he’s six years my junior and doesn’t cope with any of the expectations and guilt that the rest of the family puts on me as a 32 year old bachelor.

Last year I adopted an abandoned kitten off the street. I love her MOST of the time, while there are moments I despise her presence and want to forget she exists. Fortunately for her, there is a modicum of decency within me that prevents me from such indifference; and demands that I provide adequate food, shelter, and health care for her. She would like to have more people or cats around. She gets occasional feline visitors but can only interact through a window. Sadly, because she was feral, I keep her indoors except for a fully enclosed patio space where her litter box resides. I suppose she is happy living in a state of ignorance. Wouldn’t a cat be happier with another to play with or a family to keep her busy?

The way my relationship with my cat fluctuates serves as a good barometer for how BPD sabotages my life. I love her. I hate her. I want her in my lap. I want to lock her in the closet. These feelings indicate BPD is alive and well inside me. If she were human, she would have left me months ago, hating me all the way out the door. This is why I’m afraid of getting into a relationship: If I meet “the one” I’m supposed to spend the rest of my life with, will BPD make it all blow up in my face before I can put a ring on her finger?

I suppose this realization explains the empty and worthless feelings within me. If I can’t maintain the bare minimum of human existence – that being a loving relationship with another – what do I really have to live for? Surely there has to be more to my existence than feeling like shit all the time. Why do I have BPD? Why am I Type 1 Diabetic? Why can’t I just be happy, healthy, and satisfied with my life?