Searching for Someone to Fix Me - My Family Doctor (1/4)

My anxiety crisis began in October 2021, but during the summer I had warning signs of the storm that was brewing.

Several events triggered early alerts. Deaths in the family and the approach of fifty, with the prospect of being seventy in twenty years, began to erode my mental barriers and started me ruminating on death and the end of life.

Disturbing thoughts began to intrude. On the street, I’d tell myself that everyone I passed would be dead in 100 years. I could see their faces wrinkle, age, then putrefy. Young and old alike, they decomposed before me. Their faces withered, then melted like hot wax. My delusion didn’t stop with the living. Inanimate objects became troubling too. I’d tell myself they would outlive me. Those small Tupperware containers scattered in the bottom drawer of my kitchen cabinet would still be here for decades, and someone would find them in my apartment when they came to pack my things after I was gone. I began to fixate on my body, on my fingernails that I cut, which were literally part of me. Those small pieces of me ended up in the toilet or the trash. The thought unsettled me deeply.

Fall arrived. These thoughts calmed down, but I realized I had become darker, more stressed. Nothing interested me anymore, I saw nothing positive ahead. My daily life was repetitive. I had the sense that I’d lived the most exciting part of my life, and the rest would be a slow decline. I’d finished climbing the steps of the slide, and now it was just the descent to the end.

Two weeks on vacation with friends to the Canadian Rockies pulled me out of it. Getting away did me good. My mind stayed so occupied that I didn't have time to dwell on my existential crisis. The question of what to do with the time I had left could wait until I got back. Nature, and especially big mountains, have a way of putting things in perspective and a real calming effect on the mind. It's one of the “lost connections” Johann Hari talks about in his book, as he climbs Mount Tunnel near Banff, in the Canadian Rockies. A place I climbed myself during that same trip.

During my stay I began to experience intestinal troubles, my long-time companion. Whenever it tightened, whenever it cramped, I’d imagine a tumor slowly taking root. Thanks, health anxiety.

Back home, I made an appointment with my family doctor to discuss it.

On the personal finance side, I was under pressure too. For years I’d been investing in crypto, without much success, but in recent weeks bitcoin had taken off and broken records. The total of my investments had almost hit 100k, and I already saw myself buying an apartment with that down payment.

The bubble burst. My dreams with it. I didn’t sell in time, and within days the price collapsed. My assets dropped to 10k. I had to resign myself to selling to save what was left, which was less than I’d invested. I became extremely self-critical. An idiot. I should have sold earlier, secured my gains along the way, followed simple rules. I compared myself to others, watching kids on Twitter display their massive gains while I managed to lose everything. “What an idiot, what a fool, this was my last chance to escape poverty and have real adult things, a car, an apartment of my own” looped in my head. Without realizing it, I was moving toward a breaking point. I felt anxiety grow inexorably, and the smallest physical symptoms, added to my intestinal issues, only worsened an anxiety that fed on itself. I was pouring gasoline on the fire constantly, without even knowing it.

I began to feel like I was losing control, terrified that my stomach pain was cancer. I spent my time searching Google for reasons to hope, but they weren’t enough. I’d question them and was only satisfied when I found signs of an obviously serious illness. I went from reassurance to panic, from panic to reassurance, in a loop.

With hindsight, and my current experience, I can identify the thoughts that triggered this anxiety and fed it. Some external events were unavoidable, but my attitude, my reflections, my thoughts shaped and pushed my mind in the wrong direction.

I’ve known my family doctor for ten years. She’s a beautiful, middle-aged woman, energetic and charismatic, always in a good mood, the kind of doctor who tries to cheer you up just by walking into the room. She takes her time, genuinely wants to help, and by now she knows me pretty well. I’ve always had a thing for female doctors. They reassure me and put me at ease. My mother was distant and not very affectionate, so I suppose I’ve always looked to other women, especially doctors, to fill that gap.

My doctor reassured me, but still made a request for a colonoscopy, since I was approaching fifty and that was the protocol. The explanation was logical, but I still asked her if she had reason to think I had something. I asked her directly if she felt anything during the physical exam.

To help me while I waited for the appointment, delays being several months out, she prescribed antidepressants. It’s always double-edged when you get prescribed antidepressants. On one hand, you’re relieved. A possible solution. Your problem taken seriously. After all, you go to the doctor for treatment, and if you leave empty-handed, you wonder if this doc knows what he’s doing. But on the other hand, you have confirmation the problem is actually serious. Getting prescribed an antidepressant is crossing into the world of the sick.

I left with my new status as a mental patient and started taking my doses. Unfortunately, one of the first side effects when you start antidepressants is increased anxiety, which only made things worse. I didn’t have the patience or resilience to wait for it to pass, for the medications to eventually work. I went back to see her. We tested other molecules. It was absolutely irrational, in a few weeks I tried five or six different ones without giving enough time to verify their effectiveness. Looking back, this dance of medications seems completely deranged. At the same time, she prescribed Ativan, a benzodiazepine, telling me to take it during panic attacks or acute anxiety crises. I was hesitant. I know benzodiazepines. I know their danger. But she tried to reassure me, it was a baby dose. I also got antipsychotics, which at least had the benefit of knocking me out and making me sleep.

I didn’t touch the benzos at first. I spent the following days trying to hold on while I waited for my colonoscopy appointment in November. I took my medications, I spent hours completely anxious, imagining a tumor growing inside me. I could almost feel it, visualize it. I was completely paralyzed by this thought, unable to shake it. When I was calm, it took just a stomach cramp to fire up the fear machine again. I was hypervigilant. Every body sensation was amplified and connected to a serious diagnosis. Occasionally, I started taking an Ativan here and there, only when I couldn’t take it anymore.

The appointment finally came and of course everything was fine. The colonoscopy showed nothing. My anxiety disappeared and everything went back to normal. But a week later, I began to feel waves of dread wash over me when I woke up. I had no anchor anymore. My anxiety was no longer focused on one specific issue. But obviously, my brain needed a cause. It decided this time that I was going crazy or that something serious was happening in my brain. The intensity of the fear I felt could only mean a serious cause. I started leafing through the DSM5, the diagnostic manual of mental illnesses, and decided I was bipolar. Then borderline. Then I had major depression.

I remember going to the clinic reception, pleading my case. Please give me an appointment, it’s an emergency, please can she see me now. I can't believe now how self-centered I was, convinced I deserved to be seen above everyone else in the waiting room because my mental state was so desperate. I gave the receptionist every detail I could think of to justify being seen urgently, yet at the same time I spoke in a low voice, ashamed, not wanting anyone in the room to hear me. I remember a kind receptionist who checked on me several times while I waited, making sure I was okay and trying to calm me down.

The clinic visits kept multiplying. At some point, my doctor told me she couldn’t keep being the person I ran to every time I was in crisis. I needed a therapist or a psychiatrist, someone better equipped for this. Beyond prescribing antidepressants or telling me to take benzodiazepines, her options were limited. So she put in a referral for a psychiatrist.

She contacted me a few days later, told me she’d found a psychiatrist, and gave me his number.

I made the call. His secretary told me I was lucky to get him. He was known for finding the right treatment fast, “a pill magician” she called him. Hope came back, and I was eager for that first appointment.

Let’s call him Mr. Hope.