A week ago, I saw the psychiatrist and therapist at the same time. Together we talked about things like my transition, my general mood, where things are going, and how things have been.
The hallucinations have officially stopped. I’m grateful for that, but I can’t help but keep wondering when they’re going to show up again. Generally, I have to say that things have improved. I’m sleeping better (though it’s taking me a couple hours to fall asleep again, up from 20 minutes or so when I first went on the meds). I don’t have any compulsions right now, so that’s good. When we discussed those, the psych seemed to agree that they were OCD like. She encouraged me, next time I notice one, to push past the anxiety and let the anxiety happen until it goes away.
My mood has been, well, flat. My mom first identified it over the phone the night before the appointment. I repeated it to the therapist and then again to the psych and we talked about what that meant. I’m not excited, can’t get happy or feel sad, and generally don’t really care. I want to care and be excited and eager and all that, but I can’t. The big word that popped up here is depression.
I’ve known that depression is a possibility, but it felt so real for them to say it. Thinking about it later, it made sense. The psych wants to wait and see what’s happening, give it time to manifest or whatever and decide on medication when I see her again in a month.
On the note of medication, she also wanted to reduce the dose of the antipsychotic. I was taking 2mg of risperidone at bedtime every day. She bumped me down to 1.5mg. Since doing that, I’ve noticed no change, so I’m going to stick with it.
The psych also wanted to talk about my transition a bit. She wanted to know why I wanted to transition and how I saw that working. I talked about how I’ve always felt, how I’ve always leaned towards the masculine and roleplayed the boy in games. How I always picked boys clothes first and fought wearing the dresses. I talked about feeling okay about myself, but uncomfortable wearing flattering clothing anyway. About how I’ve always been more comfortable when perceived male. I mentioned that I wanted to have a baby or two later down the line and that’d be okay. And I talked about being excited for top surgery (getting rid of my breasts) which should happen in the next year and a half. I don’t know what she thought of it all, but I’m glad I got it out.
Today, I had another appointment with the therapist. We continued the conversation from last week, going more into the flatness and general emotion state. I talked about how I haven’t done the dishes or cleaned the living room in a while and that’s a problem. We talked about how I’m always well groomed when I go out (and I do shower regularly even without expectations from somewhere else), but my house is a mess. We talked more about how sleep is an issue and I’m sleeping more but it’s harder to fall asleep and I’m still tired all the time.
She wanted to know about my plans for having a baby and how they fit in with my transition. She had no idea anything related to transgender care, so I’m happy to educate. I told her about the possibility of birth defects if you get pregnant while on testosterone. I talked about the wait time between going off the hormones and trying to get pregnant. I talked about how I’m really after the secondary sex characteristics (facial hair, deeper voice, no chest) that stick around after hormones have stopped, so stopping them will be no problem for me. Having a baby is something I’m excited about, it’s something I look forward to. I’m sad I won’t be able to breastfeed, but I know it’ll be okay anyway.
We also talked a lot about my future, what I want to be doing and where I want to go. She asked me, if I could wave a magic wand, what would it fix. I told her I wouldn’t have any more issues with money. Money seems to be a big issue. Last month I was playing “pick two” where the three I had to pick from where meds, rent, and food. I’m still really tight on my budget and not sure how I’m going to make ends meet properly with enough to spare to save for the vacations I really want to go on, but I’m sure I’ll figure something out.
The therapist says there’s lots of stressors, lots of reasons to be feeling anxiety between work and school and future plans and transitioning. My life’s in turmoil right now and it makes sense for me to be in turmoil mentally.
She gave me homework, and I’ll have to think about it. She wants me to write out (since writing comes easier than speaking) what I want out of life, where I want to be.
This afternoon, I saw the counselor at the college. I gave her a brief overview of how things have been going with mental health and the psych and therapist and where we’re at there. Then we got into the meat of her appointment.
We started where we left off last time, with the “addiction” to the internet and how that’s an issue. I said it wasn’t really an issue anymore. It isn’t, really. I can stop any time I want, I’m just not motivated to do anything else. And really motivation is the big problem. We talked a lot about motivation, that was the big heart of what we talked about.
Right now, I’m really externally motivated. I do my homework because it’s for a team project and if I don’t do my part, others suffer. I go to work because my manager and coworkers expect me there. I go to class because there’s a team meeting every class. I go to appointments because the person I made the appointment with expects me there. I’m not motivated to do anything for me.
We talked about the self care issues that I’ve got, with the apartment a complete disaster and mold growing in the dishes. It’s completely not healthy to be living like that. I’m not motivated to cook for myself when it’s like that because it requires too much effort. If it were like that and someone were to come over, I’d spend the time to clean up in preparation. I’d clean up and do the work to make meals for someone else, but not for me.
I want to want to care, but I don’t.
After a lot of back and forth, the counselor narrowed it down to the idea that I don’t think I deserve the best of care. She said, if I were a nanny for myself, I’d be fired. It’s true, I would. But what I need to do is start treating myself as I would someone I were caring for, or like a team project. A team project with me, myself, and I is a good analogy. I’s the slacker, always making excuses. “I don’t care,” “I don’t want to make the effort,” “I don’t want to,” “I can’t be bothered.” If me and myself can make it work despite the I, maybe eventually, we’ll get I on board.
My homework from her is to start telling myself “I deserve the very best of care.” I’m to start thinking about providing that care, but the important thing first is to make sure I know that I deserve it. Right now the phrase seems awkward and uncomfortable, maybe that will change.
I feel like I’m on the right track with all this. I’m going to see the counselor again and keep working on things with her. Because I seem to be working on different things with the counselor from the therapist and psych, I don’t mind continuing to see them both. It kind of makes sense. I’m still overwhelmed by everything, anxious about how things are going, are they going fast enough or too fast. I wish I wasn’t so flat right now, I want to get excited again. We’ll see, I guess, maybe things will get better.