In Search of a Diagnosis in Recovery

By Sevasti Iyama 02/05/18

What I did not learn in AA was that after a person gets sober, co-occurring disorders surface like the evils that flew out of Pandora’s Box. Instead of wanting to drink, I wanted to die.

A woman from the back at the beach.
I often wondered if I was talking to a human being or the robot from Lost in Space. Photo by Jonatán Becerra on Unsplash

As far back as I can remember, I have suffered from depression and anxiety. When I was young, I believed that my misery was the sacrifice that I had to make to become a successful writer. As the years went by, however, my mental disorders began to control my life. My dreams of becoming a published author dissipated which made me feel even worse. I could not balance my checkbook, which usually included overdraft fees, let alone write a sentence. Sometimes I was so depressed that I slept for days on end and I would stay up all night like a vampire. Other times, I was so anxious that I would confine myself in my house performing aimless rituals for hours. I remember when I was a server at a coffee shop in the Hollywood Hills. During my break, I would drive back to my house in Hollywood, which was a short distance away from the restaurant. There I would step on and off the bathroom scale for about 15 minutes before I headed back to work, delirious and apprehensive. When I was not working, I isolated inside my apartment, feeling as if there was a glass wall that separated me from the outside world.

Then I discovered alcohol, which gave me relief. I told myself that many writers, including Dorothy Parker, were alcoholics. Unlike Parker, however, I still could not write. By that time I didn’t even bother balancing my checkbook, because I was always broke. My drinking lasted well over a decade.

One day, I saw the famous photograph that Richard Avedon had taken of Dorothy Parker on June 17, 1958. Under her eyes were sunken bags. On her face was a look of defiance, as well as defeat. Staring into Parker’s eyes told me that I needed help.

Despite this realization, my drinking went on for several more years. By this time, I was living in the Antelope Valley and my life had become a nightmare. After I got fired from a job at a local newspaper, I lost my small house in Rosamond and ended up, along with my dogs, squatting in a house in Palmdale. By that time, the relief that I obtained from alcohol was replaced with the depression and anxiety that I had tried to escape.

On November 27, 2011, I drank a gallon of wine and took some Vicodin. Thankfully, I threw up and then collapsed on the bedroom floor with my dogs huddled around me. That was the last time I drank.

What I didn’t know at the time and what I did not learn in AA was that after a person gets sober, co-occurring disorders surface like the evils that flew out of Pandora’s Box. Instead of wanting to drink, I wanted to die. After I moved again, along with my dogs, to a small house in Palmdale, I became obsessed with renting DVD’s from the Palmdale Library. I stayed up for hours, smoking like a fiend. I watched every episode of The Sopranos in less than one month. My mind spun like a blade on an electric fan at the highest setting.

Before my drinking escalated, a psychiatrist in Los Angeles diagnosed me with obsessive-compulsive disorder, along with depression. He prescribed Celexa, and then added Cymbalta. I saw this doctor for 15 minutes, once a month. I did not tell him that I drank. During the first year of my sobriety, I still saw him even though by then I had no insurance. I was supposed to make monthly payments, but I never did. While I sat in the waiting room in his fancy office, surrounded by wealthy clients, I felt like the Little Match Girl. Ironically, I became too depressed to drive down to L.A. in my unreliable T-Bird to see my shrink.

I no longer could get Celexa and Cymbalta, so a friend gave me her Wellbutrin, which she had stopped taking, and I became more agitated. During AA meetings, I often joked about my suicidal ideations, even though I was dead serious. There were countless times when I was told, usually by an old-timer, that I had to get off my pity pot, work my steps and learn to be of service to another alcoholic, preferably a female. My favorite reply was: “I can’t transmit something I haven’t got.” Usually, the old-timer would retort back with something like: “Even if you remove all the rum, you still have a fruitcake!”

I often wondered if I was talking to a human being or the robot from Lost in Space.

Later, I discovered that Bill W. suffered from depression, and sought help, even though his course of action made some AA members cringe. During that time, he participated in clinical LSD experiments which were done in a medical setting, way before the sixties when psychologist Timothy Leary promoted the drug, along with the mantra, “Tune On, Tune In and Drop out.”

Armed with that knowledge, I went to a general physician at the local clinic, who prescribed Prozac for depression. I then made an appointment to see the clinic psychiatrist, who, during our first meeting, said that I had OCD, just like my previous shrink. After she prescribed Luvox, which I dutifully took, I felt like a sleepwalker. I can’t quite remember what was prescribed for me after that, but a few appointments later, she diagnosed me with bipolar 1 disorder with rapid cycling. She prescribed Lamictal, which helped. Besides Lamictal, she prescribed Celexa, Cymbalta and Restoril. Oh, and she threw in a little Xanax for anxiety attacks. Since I was in recovery, she prescribed ten 1mg pills for 30 days. I was curious as to why I was not previously diagnosed with bipolar disorder. She told me that bipolar disorder is often challenging for clinicians to diagnose in people with addiction, because alcohol and drugs often mask and even mimic symptoms. In other words, sometimes it’s hard to tell if the symptoms are a result of alcoholism, bipolar disorder or both. After someone becomes clean and sober, they often experience Post-Acute Withdrawal Syndrome (PAWS) which includes mood swings, depression, and anhedonia; all symptoms that accompany bipolar disorder.

During AA meetings, I listened to members, particularly women, who shared about how they had learned to take direction from their sponsors because they could not trust their own thinking. Luckily, I found a sponsor who believed in taking psychiatric medications for co-occurring disorders.

Then I moved to a small town in Kern County, and once again, everything changed.

Not only did I get a therapist, but also I got a new psychiatrist, located God-knows-where. Inside an office, I experienced the wonders of telepsychiatry. During our first meeting, the psychiatrist asked me a lot of questions, while I rambled my replies. I was more concerned with figuring out the angle at which I should position my head so that he could see my eyes because from another little screen it appeared that I was staring at the ceiling. Should I look into the lens or at the screen? Honestly, did it matter? After an hour and a half, he gave me the verdict. I was not bipolar, he said, but rather I suffered from PTSD, severe depressive disorder and “pre-psychotic anxiety.”

“What in God’s name is pre-psychotic anxiety?” I asked.

“It’s a term I made up. You’ve had a lot of trauma in your life. Drinking provided temporary relief, but then made things worse. You’ve never been able to build a solid foundation. You keep walking on quicksand, and your anxiety is not getting better.”

He increased my Lamictal dose, replaced Celexa and Cymbalta with Prozac, and included Propranolol for anxiety, as well as Latuda, an antipsychotic. A month later, the psychiatrist took me off the Latuda because the medication gave me an intense sense of dread. Besides that, the damn Latuda knocked me out.

Today my medicine cabinet looks like a pharmacy. I probably should see another psychiatrist because I do believe that I have bipolar disorder. Additionally, I plan to move away from Kern County because it depresses the hell out of me. Finally, like I did with AA, I have realized that I should trust my intuition when it comes to medications. There is one AA motto that I do like, which illustrates how I feel about this chaotic series of events:

To thine own self be true.

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Sevasti Iyama has written for Cycles of Change Recovery Services, AfterParty Magazine, the Antelope Valley Press and the Kern Valley Sun. Her short stories have appeared in Adelaide Literary Magazine. She’s also the co-author of How I got Sober, 10 Alcoholics and Addicts Tell their Personal Stories. She is pursuing a Masters Degree in Creative Writing from Southern New Hampshire University. You can find her on Linkedin.