Around the time that Scott and I officially became girlfriend and boyfriend, he told me he wanted to go to a psychiatrist.
This is an example of why being the second wife is better. The reasons that got you divorced the first time around become the things that you try to fix the second. Sarah, the first wife, had wanted Scott to see a psychiatrist for years. He went, but reluctantly and half-heartedly. The antidepressants made him feel anesthetized, so he stopped taking them. He mixed the Klonopin with beer. Follow-up appointments were canceled and never remade.
Scott had quit drinking right around the time that our relationship turned from platonic to romantic, which was good because it meant he was no longer trying to die. But the things that had once been deadened by alcohol were now screaming inside his brain.
SUICIDE.
RAGE.
PARANOIA.
DEPRESSION.
INSOMNIA.
I was patient with him because I’d been through this. Sobriety brings relief and then, after a while, a new madness. It’s all part of the process. It takes time. It gets worse before it gets better, but eventually it will get better. These things may sound cliché, and they are cliché, but this is also the truth.
We prepared for his first doctor’s visit together, making a list on a Google doc that included all his symptoms and concerns, the fact that there was a history of both suicide and mental illness in his family, and his propensity for addiction. I told him to print out the list and bring it to his appointment. The morning of, I reminded him: This is a process. It takes time. You’ll probably have to try multiple medications before you get better, but eventually you will get better.
He left the doctor with several weeks of samples – Latuda, an atypical antipsychotic, and Lunesta, a sleeping pill. He came out to California to see me shortly thereafter, looking better – both physically and mentally – than I’d ever seen him. He was sleeping, he was calm, and most importantly, he was no longer suicidal.
I was relieved, but I was also jealous that I was wrong – that one visit could make him better, when it took years and years of new medications and bad side effects for me to get it right. Even though I loved him, even though I didn’t want him to suffer, it wasn’t fair for it to be that easy.
Except, when Scott went to fill the prescriptions, his insurance wouldn’t cover them. A month’s supply would be close to a thousand dollars. The earliest appointment he could get to discuss new medication was the following month, so the doctor gave him more samples in the meantime.
A month later, the Latuda was switched out for Abilify and the Lunesta for Restoril. (I’ve taken Restoril before. It’s great for getting high but only so-so if you want to sleep.) For Scott, the Restoril didn’t work for sleep at all.
I liked his re-found insomnia at first. It meant there was never a time when he couldn’t talk to me. 2 AM, he was there. 8 AM, he was there too. But soon I changed my mind. Scott started to cry on the phone. He started to look like this. He started to talk about the New River Gorge Bridge.
I read an article on the Internet shortly after Robin Williams died. It said something about how the way we talk about suicide is wrong. We act like it’s something the person did. We act like it’s a choice they made. The truth is that mental illness can be deadly, and suicide is the end result of ongoing symptoms. Cancer kills when it spreads so much that the organs can’t function. Mental illness kills when the urge to die becomes louder than the urge to live.
Most people think insomnia is annoying, something that plagues you sometimes and makes things more difficult, and eventually it goes away. But sleeplessness, in large doses, leads to psychosis. Sometimes, insomnia is deadly.
When I was fifteen, I went for two weeks with an hour or two of sleep each night. I couldn’t concentrate. Nothing made sense. I started hallucinating, seeing dead bodies and skeletons floating from the ground and walls. I started hearing noises that weren’t there. I thought people were spying on me, that strangers had installed cameras in my bedroom. And then, eventually, I tried to kill myself by ODing on my newly-prescribed psych meds. At the time, it didn’t seem like a choice. At the time, it felt inevitable.
I (obviously) lived through the overdose. It turns out that it’s hard to die from pills. It is, however, very easy to die from jumping off the third-highest bridge in the country.
“You need to call the doctor,” I told him. “You need to tell them what’s happening. This is serious.”
Scott tells me that he did call the doctor. He says he did explain. There were simply no other appointments available.
What I am thinking is different than what I say.
I am thinking:
I don’t believe you.
You just need to be more persistent.
You need to get over your macho bullshit and admit to them that you’re suicidal.
You’re obviously just afraid of getting committed.
And you know what? Maybe at this point being committed wouldn’t be the worst thing.
But more than any of these, I am thinking:
I don’t want you to die.
What I say is this: “You told the secretary you hadn’t slept more than a few hours per night for a week?”
“Yes.”
“You told her you wanted to die?”
“Yes.”
“You told her you were planning it out?”
“Yes,” he says, annoyed now.
I am thinking:
I don’t believe you.
You just need to be more persistent.
You need to get over your macho bullshit and admit to them that you’re suicidal.
You’re obviously just afraid of getting committed.
And you know what? Maybe at this point being committed wouldn’t be the worst thing.
But more than any of these, I am thinking:
I don’t want you to die.
Instead I say: “I don’t understand. There’s laws about this kind of thing. Emergency appointments. Cancellation lists. They have to help you.”
“Juliet,” he says. “This is not California.”
This pisses me off, but I pretend that it doesn’t. In my head, I am thinking: Yeah well, West Virginia isn’t California, but West Virginia isn’t a third world country, either. How fucking different can it be.
The appointment finally comes. He calls me afterward. His voice is flat. He didn’t see the doctor. He saw an intern instead. The intern can’t write new prescriptions, only has the power to renew existing ones. So he went home with more Restoril.
“Are you fucking kidding me?” I say. It is now two months until our wedding day. I am trying to be patient, but I’m about to move from my hometown across the country to a city where I know no one. I might be mentally and emotionally stable now, but from past experience this balance is precarious. I want to be able to handle Scott at his worst, but part of me is afraid that living with someone as sleep deprived as Scott will be too much for me. For my sake, I need him to get medication that works. For my sake, I need him to sleep.
He tells me the doctor got called away, he doesn’t want to talk about it, that I’m just upsetting him more.
Part of me is thinking, again, that he is lying. Part of me is thinking he simply doesn’t want to tell me the truth, which is that he missed his appointment, or he went and pretended nothing was wrong.
The other part of me believes him, that he did go to the appointment and was honest about how bad it was and that he truly did the best that he could. The part of me that believes him is also the part that is selfishly scared. Scared to move to a place where you won’t get help, even if you say you’re suicidal.
A couple weeks pass. Scott continues to not sleep.
One morning I wake up and there are over thirty new texts on my phone, all from him. While I was sleeping, we got into an argument, made up, and then started fighting again, all without my knowledge or participation. Right now he is breaking up with me.
IM AM OBVIOUSLY NOTHING
YOU ARE WHATS IMPORTANT
YOU
YOU
YOU
YOU
YOU
YOU
I want nothing to do with you Julia.
I call him.
He screams something about pizza and how I wouldn’t give him a slice. He screams that he can’t fucking trust me. He screams about our relationship being over.
I try to be patient, but then he starts insulting me and so I hang up the phone. He texts me, saying things like he never wants to hear from me again, and I am trying to remind myself that this is all sleep deprivation-related but it’s so hard to believe that after a while, and then I start crying, and then when that happens I tell him I’m blocking him, and then I block him, and I’m sitting there praying that doing so doesn’t send him to the New River Gorge Bridge.
After a few hours I unblock him, but he doesn’t respond to my texts or calls. I message Chris, his roommate, asking if he will check on him. He’s sleeping, he writes back.
Finally.
Later Scott apologizes. He tells me that he has almost no recollection of any of this, except for being mad and some dream about a pizza.
Sleeplessness, in large doses, leads to psychosis.
Eventually he sees the doctor, who puts him on Seroquel. Which is what I’m currently on. The Seroquel does for him what it does for me: puts him to sleep, enables him to feel calm, lessens his temper. Our relationship goes back to ‘normal’ immediately. We get married. I move to West Virginia. We are happy; we are together; every night we drift to sleep easily, thanks to the same antipsychotic.
A few weeks into our marriage, however, I start having weird muscle twitches all over my body (later I find out this is due to a vitamin deficiency). “I’d be worried it was the Seroquel, but my psychiatrist just gave me the test for that right before I left and I was fine,” I say to Scott.
He looks at me like he has no idea what I’m talking about.
“Your doctor doesn’t give you that test?”
It’s a simple one, involves doing things like opening and closing your mouth and tapping your foot as fast as you can.
Seroquel has side effects similar to most psychiatric medications – it can make you tired, it can make you fat. There’s only one side effect you really have to watch out for, which is involuntary muscle movement. Tardis Dyskinesia is the clinical term. If this develops, it’s permanent.
Scott’s doctor didn’t give him the test. Scott’s doctor hasn’t even told him about that side effect. Scott’s doctor hasn’t told him about any side effects. I don’t know what the fuck is wrong with Scott’s doctor, but there’s no way in hell I am going to Scott’s doctor.
In California, there were dozens of psychiatrists within a couple miles from me. I could have my pick. I went with mine because I didn’t hate her based on the photo on her website. I ended up liking her because when I told her I was having anxiety, she showed me some breathing exercises rather than handing me another prescription.
When it comes time for me to find a psychiatrist in Beckley, I Google “psychiatrist Beckley.” Scott’s psychiatrist comes up. The internet says he sees 60 patients a day.
I now understand what the fuck is wrong with Scott’s doctor.
There are a couple other clinics in Beckley. Their numbers are worse.
I look for psychiatric offices in cities that are 30, 40, 60 minutes away. I call numbers. No one picks up. They’re all mysteriously away from the phone right now. I leave voicemails. I wait to hear back.
One office calls back. One. It is for a doctor over an hour away.
“The doctor only takes select patients,” the receptionist tells me on the phone. “It’s a small private practice and she doesn’t want to be overworked.”
This sounds perfect.
“Our appointments are booked well into the future. The earliest we can see you is in three months.”
I tell her this is fine.
She asks me about my “situation.” I tell her my story: that I was diagnosed with Bipolar Type I at 15, I’m stable as long as I take my meds, and, after learning the hard way, I always take my meds. I feel like I’m in a weird job interview, one where you need to sound crazy but not too crazy.
I’m doing well, it seems. The receptionist sounds happy. She tells me again that the doctor only takes “select patients.” She doesn’t like “acute cases.” She doesn’t accept patients who are “in and out of hospitals, that kind of thing.”
In short: If you really need the care, you won’t receive it.
“Have you ever been hospitalized?” the woman on the phone asks.
“Yes,” I say carefully. “Twice as a teenager. And then there was an outpatient. I had a bad doctor who gave me the wrong medicine.”
I feel the job interview quickly slide downhill.
“When was the outpatient?” the woman asks.
Maybe I should lie, I think. Maybe I should pretend it was years ago. The truth suddenly sounds much too recent.
It is probably stupid, but I tell the woman the truth.
“January of 2013?” the woman says. “Hmmm. I’m not sure about that. I think we’ll have to call you back.”
