So this afternoon i headed out with Josh to my appointment with my new shrink. The appointment was for 2:15, and i'd been warned that a ton of paperwork was likely to need filling out, so i went in a few minutes early just in case. Josh made sure i was in ok, then went off to get gas and get the car washed.

So, i get in and im handed the obligatory slew of paperwork. After filling out the bits i knew, and worrying about the bits i didnt, i gave the paperwork back to be countersigned. At this point, i should say that this was the SCARIEST waiting room i have ever sat in. It smelt faintly of wee, there were about a million fishtanks and the walls were that "tacky swedish sauna" kind of fake wood. So, nervy and scared i sat back down. There were 3 other patients in the waiting room at this point. There was a really old guy who looked a bit like Leo from That 70's Show, and had an awful-sounding cough, there was a woman who was talking loudly about bras all the time to anyone who'd listen (and at one point, when someone's car alarm went off outside she shouted "well the car's horny, what about the driver?!") and there was a guy about my age with really red eyes who stared unblinkingly and quite hostile-ey at everyone. I didnt want to feel judgemental and "omg crazy people are scary" but when i get anxious i get PARANOID so it was pretty hard for me not to be scared. I went to sit in the corner and await my appointment. About 30 minutes after my appointment time i was called to the front desk; my doctor had seen an emergency patient earlier, as a result she was running late, was it ok if a different doctor saw me? At this point, just wanting to be seen and go, i agreed. So i sat. Starey-eyed guy left, then Loud Lady was seen, then Leo. Others came and went, i stopped looking and stared at the fishtank nearest me. By now it was over an hour past my appointment time, and i was getting antsy. I looked at my fingers and saw they (and my arm) were covered in blood. Apparently i'd been idly picking scabs off some healing SI scars and now they were all bloody, so i did my best to clean them up. I was literally twitching with anxiety by now, convinced i wasnt going to get seen at all that day. Well, finally i was called back to see the shrink, Dr S. He was a nice guy, had a very abrupt, distractable nature that i liked well enough but i know on an irritable day that guy would annoy the piss out of me. He asked me what i was taking, and when i told him carbamazepine he actually blinked in shock. He asked me to repeat for him, i was taking CARBAMAZEPINE? Uh-huh, i said. He blinked again, exhaled and then told me he hadnt written a script for carbamazepine since before the millennium. He went on to tell me that it is such an unpredictable drug most doctors dont even bother with it anymore, favouring newer anti-epileptics instead. I told him how it hasnt worked for me, all its done is taken away my euphoric manias and replaced them with dysphoric hypomania, mixed episodes and depression. Not my idea of a cup of tea. He asked me what i wanted to do, and i said i wanted OFF that drug, but i didnt mind staying on Seroquel, as i like being able to sleep.

So, we have a new game plan now. He's taking me off carbamazepine and replacing it, straight-swap stylee with Trileptal, which i've never heard of. And i'll be taking a higher dose of the Trileptal than i was of the carbamazepine. We may, or may not be also adding in Lamictal, he gave me the titration kit but said give it a week or so before i start it. He's upping my Seroquel to 100mg at night, and given me a sample of Saphris (another antipsychotic) to try in the instance of intrusive thoughts/ psychotic epidsodes. Im unsure as to whether or not he wants to eventually replace Seroquel with Saprhis or not, he wasnt exactly clear. Oh, and just like every new psych he wants about a million blood tests etc done.

So, there we go... my first visit to an American psychiatrist. I'll keep you posted on the new game plan, and how it works/ doesnt work etc.