Or, Just how much therapy can a person do?
January was a hard month. Okay, it wasn’t as hard as January 2019, or 2018, or 2017, or for that matter 2016–my depression often worsens in the winter–but I went into it with a stable mood and some hope for the new year, so I was expecting better. But Effexor withdrawal, unexplained stomach ache, a severe neck pain that literally forced me to lie flat on my back for most of a week, and unexpected complications from a simple medical procedure all combined forces, and I just felt lousy most of the month.
And you know, it’s not like I’m not one of those high-energy, super motivated, busy-busy people in the best of times. I’m more like–plodding. Methodical. I like to pace myself. I was one of those people back in college who started her term papers two months before they were due because I didn’t want to have to stress about it at the last minute. I like to plan. I block out time on my calendar for work (part-time, freelance), for physical therapy exercises, for errands each week. Time for breaks in between. Slow and steady.
But the thing is, in January I rarely had any sense of well-being and hardly little energy. I just couldn’t get things done, no matter what the calendar said and no matter how many breaks I scheduled in there for myself. I watched the weeks go by with zero sense of accomplishment. (Never mind those New Year’s resolutions: “I will write for at least 15 minutes every day. I will take at least a short walk every day…”)
It started to bother me, a lot, that what little energy I did have was often taken up with appointments: twice a week with E, every other week a cranio-sacral appointment, weekly with Elaine for EMDR, monthly with the nutritionist, monthly with the psychiatric nurse, weekly now also with the physical therapist, and a slot held for me with the sex therapist, even though we weren’t having regular sessions lately.
There was a time, well, honestly, most of the time the last two years, when I clung to all that support. Those appointments were my life raft on the stormy seas of severe depression and out-of-control Effexor withdrawal. But with an increased sense of emotional stability, more skills to deal with challenges, and persistent low energy, what was once a life raft started to feel more like heavy boots that was making it harder for me to swim.
To give you an idea, here’s a typical day in January: I sleep badly, tossing and turning or lying awake a lot of the night. Around 5:30 am, while my husband is getting ready for work, I drink a half a cup of tea and talk to him a little until he leaves around six. I read the New York Times online for 45 minutes, and then I sink into a deep, dream-intensive sleep until the dogs wake me up around 9:00, complaining that their breakfast is overdue. I feed the dogs and make myself a spinach and egg white omelette, look at my list for the day, maybe tackle a little work, and then fall asleep again until maybe noon. I decide this is ridiculous; I really need to get going! So I get dressed, maybe start a load of laundry or wash dishes, do 30 minutes of work, not really feeling well, not focused and concentrated. Then it’s time to drive to an appointment. I have my hour-long appointment, and then head home, maybe picking up some groceries on the way. Perhaps I read for half an hour at home, or talk to my son, or maybe work on a proposal. Then my husband comes home and we make dinner. I should try to work after dinner, but I’m exhausted, so instead I watch something on Netflix.
The only thing I really accomplished many days was whatever appointment I had. And then half the time, I couldn’t implement the physical therapy or nutritional changes or self-care routine, or I couldn’t journal about what we talked about in therapy, all because I was too drained.
I even missed some of my volunteer work, which I love and which I’ll write about in a separate post, another day.
Three times when I had appointments with E, I felt it was too hard to make it into her office, so we did them by video chat instead.
Clearly something needed to change. And while I wished that something was an angel coming down from the heavens to bless me with good health and with a high dose of energy, I didn’t see any angels headed my way. So instead I decided to slow that steady stream of appointments and reclaim some of my time and limited energy for work, writing, blogging, or just taking a walk. If I am only going to have four good hours a day, dammit, I’m not going to spend two-thirds of that time in appointments and transportation.
Like I said, I tend toward caution, a steady pace, and a don’t-rock-the-boat approach to change. I tend to make only small changes at a time. But in late January I was feeling smothered by the schedule I’d created for myself. This has got to change, and it’s got to change right now! some part of me was screaming. I needed a big change.
So I changed my nutritionist appointments to every two months, pushed the psych nurse out to seven-week intervals, stopped my physical therapy appointments (I can use the exercises I have, for now), agreed to completely give up my slot with the sex therapist, moved EMDR to every other week, and most dramatic change of all, cut my appointments with E to once every two weeks. I will still see her alternate weeks at group as well, but individual appointments will only be every other week. (That last change made me the most nervous, and we agreed it could be an experiment for the month of February. I didn’t have to commit to permanently giving up more frequent appointments.)
I didn’t know how all the providers would react, but in fact, the have all been immensely kind about it. Tabitha, my psych nurse, said, “Oh, I totally understand what appointment fatigue is like!” Also, honestly, I think they all saw my move toward less frequent appointments as a sign of increased stability and health. Maybe it is a sign of that, even though I’m telling myself it’s a response to exhaustion.
So I’m going from literally four to six appointments per week down to one per week in February. And my response to that, predictably, is a combination of Phew! Some time to do other things! and Oh my god, what have I done??