A whole new language

On March 17 (note almost a MONTH ago) I told the powers that be in my company that I knew they were hoping to have a replacement in line before um, pushing my former assistant into new ventures far away from any of us, but that things had deteriorated to the point that I could not see that happening. We knew she had picked a date to leave but was not turning in her notice (a little detective work I did totally accidentally pretty much gave it away), and hiring for that position was going to be difficult. My company has been made extremely well aware of my need to not be over-tired, my history of having to turn down overtime no matter how much I wanted it, etc. And if my telling them didn't prove it I got to spend a nice 6 week disability leave sitting on my couch 2 years ago following a few weeks of intense stress and extremely long work hours. I did great right up until the minute I started crying and could not stop. Six weeks later I returned to work with a lot more precautions. And over the years there have been a few times I have had to threaten them with the word "doctor", as in "well, if you NEED my doctor to certify that I have problems in this area of functioning and meeting normal standards is not a realistic expectation, then I can do that". It always works.

Anyway, this extra work thing has been getting more and more difficult. I am seeing a lot fewer patients, but I am still constantly running to keep up (and this week have a lot more). The pressure of being behind on things is intense, and I am unable to do 2 things at once, so I can't do progress notes while treating. And I feel like nobody is getting as much as I want them to get because I'm so tired.

I say this, and yet the absolute miracle that is my current existence continues. I'm tired but still feeling good otherwise. Which has had me sort of tricked until I thought about it.

I'm used to "tired" being a symptom. Those who treat me or who help me know when I'm trying to pretend I'm not bipolar all know that if I say "tired" I mean bipolar tired. I forgot about how bipolar tired and everyone else tired are different. Bipolar tired means so tired that I forget where I'm going or what I am doing, even as I do it. Bipolar tired means I will cry at the hint of further stress. Bipolar tired means that my body reaches a certain point and simply falls asleep and stays that way until it can function again. It is not unusual for that kind of tired to result in 20-22 hours of sound sleep, without meds. Bipolar tired means I'm doing everything I can to stay afloat, and that includes cancelling social plans, Easter, etc. Bipolar tired means not sitting down in waiting rooms for fear I'll fall asleep (which is rather counterproductive when trying to prove to the psychologist that you're handling things ok).

It's been so long since I was "normal tired". I certainly get tired without it being a warning sign from my brain, and I operate at a certain level of tiredness because the amount of medication I need to sleep leaves a touch of sedation around at all times, but it has been so many years since I worked, felt tired, sat down at home for 30 minutes and felt ok again that I literally forgot that this is what people hear when I say I am tired.

So now I must conduct "bipolar 101" for my manager, who I also realized is new and has never experienced what happens when I'm truly sick.