checking the yes box

this is going to be a difficult entry to write. i've just come back from the doctor's office (actually i've really just come back from the drug store but more on that in a bit) and while i have suspected that i am not doing well, it is another matter when it's confirmed by a medical professional. i went into the appointment in one of the lowest moods i've been in in some time. i broke down a few times as we reviewed my condition and he shared his concerns and perspectives on what he feels may need to happen.

in a nutshell, my depression has progressed to a very serious level so much so that my doctor shared he was very concerned and that my mortality rate at this point is equivalent to individuals who have acute heart disease and are at risk for a severe heart attack or stroke. based on a consult he had with a psychiatrist right after my appointment, i have been prescribed a course of treatment with lithium (hence the pharmacy visit) and will need to follow up with the psychiatrist tomorrow to make an appointment for a more thorough assessment (in his phone call with me my doctor shared the psychiatrist is also very concerned and is moving things around to accommodate getting me in as soon as he can). finally, my doctor shared  that it is likely that i will have to be admitted for inpatient treatment in the near future, the sharing of which resulted in more tears. he shared the only reason why he was not calling an ambulance right at that time and having me admitted immediately is that he felt i was being honest with him about my condition to the extent that i had shared that i had suicidal thoughts. if not for that i would be sitting in a hospital emergency room right now going through intake (meanwhile, i am bound by a pledge that should things get any worse i will go to the nearest emergency room myself) .

it's funny what one thinks of when one is presented with this kind of information. i thought of my job and how this illness may derail all that i've built over my career because who would trust me to be able to manage effectively. i thought of how my mother would not be supportive of such a diagnosis, believing that such things are "of the devil" and would likely blame it on my sexual orientation and god's abandonment of me as a result. i thought, "well i guess there goes my friendship with sean because i can't imagine he will want to engage with me in this kind of condition." i thought about my desire for love and companionship and how that was now unlikely because again mental illness is not known to be high on the list of desirable characteristics for a partner. and most strangely, as i was driving home from the pharmacy, i thought about the fact that if i am admitted for inpatient treatment i'm going to have to check the yes box to that question on every medical questionnaire i complete for the rest of my life.

my doctor is such a good and kind man. he shared with me all the reasons that i should be optimistic that i will be able to get through this - i am in good health, i have no additional serious mental illness, i have no addictions to alcohol or controlled substances. and he committed himself to ensuring that he and the psychiatrist and my therapist would help me through all of this.

i would love to say that i feel encouraged but depression is not the best state from which an optimistic attitude naturally emanates. i think scared and acutely vulnerable would be a more accurate description of where i am right now. oh, and very, very, very sad. i don't imagine this will be a very good night. then again when in the world was the last time i had one of those?