CHAPTER 17

My meds are not working.

I hate having to keep changing them. I feel like a failure, not being able to find a combination of medication that would keep me stable.

I had five good days after I painted my face on a canvas for Hayden. Then, I crashed.

I have three things to do today: 1) get to my appointment with Dr. Emily – I'm still severely low and urgently need an intervention; 2) get to the gallery to put in some hours, just in case my depressive episode plummets even further and I have to ask for some time off; and 3) get to my meeting with Hayden to show him the painting.

I asked Daniel if he would drop it off. He said he would rather wait for me to ease out of my low and have me take it to Hayden. Something about this process being as ‘fuss-free' for Hayden as possible.

I decided today is as good a day as any to go and see Hayden.

But first, my psychiatrist.

"Levi," Dr. Emily says when I enter her office. She rounds her desk and comes to stand in front of me. Her smile makes me happy in some elusive way. I am happy for this person who works so hard to keep my brain together. I just can't . . . feel it.

She looks at my carry bag. "Do you want to put that down and take a seat?"

My nod is an effort.

"Okay, let's take a few minutes to recap. In the last month, we had a low. Low enough to have suicidal thoughts. That lasted about a week. Then, manic quite quickly after that, with five stable days followed by another low."

"Yes."

"Any suicidal thoughts in the last week, Levi?"

"No. But the usual intrusive thoughts are there."

"Alright. Let's evaluate. The last prolonged manic episode lasted about five months, starting back in October. That ended in financial distress."

"Yes."

My one-word answers are not judged here. She knows it isn't that I don't want to answer her. She understands the effort it would take to give her deep, detailed explanations.

"We've had prolonged stable months in the past, Levi. We know it's possible."

I press my lips together, my best attempt at a smile. "I know."

"Laura and I discussed your low from David's wedding."

"Okay."

"We know, Levi, that anything can trigger an episode. I think the anxiety of meeting with your family again in such a public setting may have triggered the low. What I'm very pleased about is how you handled it."

"Yeah, I – my phone died, but I managed . . ."

Dr. Emily allows me to consider finishing my sentence, and then speaks. "I know. You managed. That's what's important. I believe you went to the gallery. Then, you went home. And you still managed to do some work the day after."

"Yeah."

"Which is why we waited before we reassessed your meds."

My heart sinks to my shoes. Changing my meds is a whole separate cause for my anxiety. Changing anything is a cause for anxiety. Besides feeling like a complete failure for not being able to stay on my medication, even small changes to my life is hard. Major changes can send me into freeze mode. And besides, how long before I'm so hopped up on ineffective meds that I'm not even one version of myself? I swallow thickly.

"Okay, so now . . .?" Please don't say Lithium. I"ve heard horror stories about Lithium.

"Now, I want us to make one small change because I'm worried about how close to each other your dips and peaks have been recently. Obviously, the concern about your suicidal thoughts persists. Even when you're stable, on solid ground, we'll always be on the look-out for that."

I nod. "I'm afraid of mixed episodes. I don't think I can handle that again."

"The last mixed episode was about three years ago."

"Yeah."

"You ended things with Lukas at that time."

"Yeah. Is it possible that the constant change of meds might trigger a mixed episode?"

"It's hard to tell. Every person is different and there are so many things that can contribute to any type of episode. I'd like to make one more change to your meds. My goal is for us to get to at least a year without an episode or a change of meds. We've come close before. Let's keep going."

"It's – it's not Lithium, is it?" I ask.

Dr. Emily gives me a kind smile. "No. It's not Lithium. But Lithium isn't something to be afraid of, if it came to it."

I'm afraid enough of Lithium to muster a response. "Except for the fact that it'll mean that I've finally unlocked the highest level of crazy. And from there, there's no hope."

"There's always hope, Levi. And Lithium isn't a death sentence."

I nod because I'm too tired to argue. But I don't believe her.

She goes on to explain what changes she'll be making to my meds, mentioning unpronounceable names, which I will be pronouncing with exceptional ease in the weeks and months to come.

I'm dead inside. If this concoction of medication doesn't work, then I might as well just fucking die. What is the point of living when this is what life is. Thank God it's not Lithium. I would much rather die than be on Lithium.

"What's in the bag?" Dr. Emily asks with smile, after we've gone through the changes to my medication.

"A painting."

"I'm happy to hear you're painting. What's it about?"

"Uh, just . . . just a painting." I don't even have the energy to shrug.

She leaves it at that. "Okay. Let's see each other in two weeks. Laura and I talked about you seeing her every week for the rest of the year. Is that okay?"

"Okay."

I leave with my prescription and take the short bus ride to the gallery.

"Hey, you low?" Daniel pops his head into the backroom a few minutes after I get in.

"Yeah."

"Okay. We're pretty quiet today. I can get you on some admin or you can pack up some paintings for Shawn's delivery tomorrow."

"Can I do the admin?"

Daniel gives me a thumbs up. "You got it." He steps inside. You can't miss the worry in his eyes. "Let's schedule that Hayden meeting for a week from now. Two weeks, even."

The meeting with Hayden is the only thing providing me with a sliver of hope that something will pull me out of this fucking low.

The thought of losing the meeting makes my chest constrict anxiously. Still, my words come out in a low monotone, and my face is a blank slate when I respond. "No. He's . . . he's like, super busy. I heard you can't mess with his diary. I'll be okay. It's not like a consultation, or anything. I've already done the painting. I just need to drop it off."

The worry in Daniel's face persists. "Shawn can do it."

"I told him I have Bipolar Disorder," I blurt out. "So, he knows, and I think he's fine with it."

"I'm sorry, Levi. It's not what I meant—" he says.

"I know." I also know that Bipolar Disorder is not an innocent bystander. Depending on how far I spiral, I could ruin business for the gallery. I'm not offended by Daniel's concern. He does his best to be there for me.

"What did he say?" Daniel asks.

"He – well, he didn't say anything."

"Should I come with you?"

"No." The answer comes out faster and more forceful than I intended. My ears burn with embarrassment. "Sorry. No, it's fine, Daniel. I can make it. I'll manage."

"Okay, you can work in my office. I'm going out for a while. Shawn will be back soon with the car. You okay to drive out there?"

"Yeah. I'm okay."

Daniel leaves me alone after that. I work through a bunch of mindless administrative tasks. Shawn arrives at the gallery after about three hours and drops off the car keys with me. At five o'clock I'm being buzzed into Hayden's estate.

My body feels like lead. My mind is a dull ache. But even through this exceptionally difficult low, my heart lifts at the thought of seeing Hayden again.