It’s a countdown till I next see my pdoc. I see him once every three or four weeks, during which time I download as much as I can in 25 minutes about what’s going on with my meds. Oh yes, he does take my insurance, but he wants more on top of that for a full 50-minute hour. So I have short appointments.

This Wednesday I’m going to bring up ADD. This isn’t quite true, though. He brought it up last time I saw him and complained of lack of focus, never getting anything done, hardly leaving the apartment, etc. So he said something like, “Did you have trouble sitting still and concentrating as a child?” I knew he was beginning the diagnostic part of the session (who wouldn’t know what was going on, with that question?). I hemmed and hawed. I was a focused kid, driven, and concentrated well. It’s just now that I’m feeling the symptoms of ADD, which may explain the countdown feeling I’ve got: he may not diagnose me, and then where will I be? In the “just do it” world of the therapist I fired last Spring. His advice was just … a bit rich. He very nearly said to me once, “baby steps.” I could see the words forming themselves in his head.

I don’t want to go back to that. I want to be evaluated clinically and try medication. I’m always up for medication tests, because who knows what’ll work and plug yet another hole that’s sprung in the dam?

This is a search term that led someone here the other day. I was sorry it didn’t make a direct hit with that exact sentence somewhere in the blog. What is the hierarchy of needs for someone with bipolar? We’re so used to Maslow’s Triangle, which starts with physiological needs and progresses up to self-actualization, that I’ll go with it.

For bipolars, you have to switch these around a little. Ok, keep the physiological needs where they are – we’re animals, not robots or dislocated souls bouncing around the internet, even though it may feel that way most of the time.

But then, Safety. Safety is tinged with the idea that the bipolar person is somehow out to do some harm to themselves, either directly or indirectly. That saber tooth tiger is now us: we’re the ones who get the adrenaline going, out of nowhere. We can sometimes be the threat. The only thing that can overcome this better than medications is Love/Belonging. They need to come before Safety. And Understanding must be added, or Love and Belonging can’t happen.

Esteem… whew, this is like climbing a mountain, or a very huge, very slippery triangle. What do you mean self-esteem? That went away a long time ago, when we discovered we weren’t in control of how we were feeling most of the time, and most of that time was taken up with self-recriminating depression. We may have to skip Esteem and jump straight to Self-actualization.

I believe that Self-actualization is possible without loving yourself first, which is why bipolars spin wildly from action to action, project to project, looking for something, when nothing will make itself apparent until one day we get lucky and a vocation comes along to reconnect us with the world. So – food and shelter, or Physiological needs, then Love, Belonging and Understanding. Then Self-actualization – having a creative mind, using one’s intelligence, working on things successfully – and only then can bipolars achieve self-esteem. But this is the top of the triangle, so it’s the hardest to get to. Because we can be in the middle of flow, of total immersion in the here and the now, and suddenly be laid flat by crushing depressions. And first to drop out from under us is our self-esteem … what little we had to begin with.

So, from Safety on up, we find ourselves in trouble, but it’s not impossible to make it to the top. Or maybe not impossible to get there, fall down a little, get back up there again, fall … the rhythm conducted by the rotating weirdness inside the bipolar person’s mind .

I was going through my photos on my computer when I came across this shot I took during a bike ride along the Hudson. As it came out, the waves look frozen, and I emphasized the blue of the whole image to match what I felt was its tone – immobile, overcast, with unearthly blue replacing the reds and oranges of a regular sunset.

I think I stopped at that image and stared at it for a while because it reflects what I’m feeling. Instead of a photo making me feel something, I just saw myself in it. Cold buildings, cold water, frozen in place.

I left the apartment today. Massive effort, but so worth it. I felt like everyone was staring at me and some could look inside my mind, but hey – going to have some weirdness with the good.

Just came back from a trip to the Apple store to see what is going on there today. At the closest one to me – the 14th Street and 9th Avenue store – there were three news satellite trucks with attendant reporters, several dozen post-it notes on the doors (which I didn’t get close enough to read but can imagine had tributes written on them) and one dude camped out, waiting for the new iPhone to come out. I wonder how that super-fan felt yesterday when the news broke?

The store was a busy as usual, in other words packed in the middle of a work day, with people walking out carrying laptops and iPhones. I feel like I did the right thing, getting out of the house and visiting a site touched by the inventor who has influenced me so much.

Once again, doing nothing with myself. I think I’m depressed. Not emotionally, but intellectually. I’m apathetic, deeply apathetic. Is it possible to be depressed without the emotional component? For me, it’s all about getting something done – I’m off work this week, and rather than starting a staycation, I’m sitting around, staring at the computer, doing nothing. I should be writing, reading, watching good movies and TV, going out to explore the city, but I’m not. I don’t want to do any of those things, and I nearly don’t care if I don’t. The couch calls out to me for naps. I wake up early, raring to go – but go where, and do what then? Motivation is something the meds do not provide. They’ve got my sadness, loneliness, hopelessness covered very well. Those horrible emotions are squashed. But the get up and go? Nowhere, nothing.

I think real depression, the keep-you-in-bed-weeping kind, when it leaves, leaves you with some bad habits of mind. In my case, it’s a torpor. My previous therapist could only say, “just do it,” not realizing that he was quoting the Nike ads. He almost uttered the phrase, “baby steps.” I could tell he wanted to say it.

I know what the solution is. Take on one small project per day, give myself a gold star for doing it, then move on to the next day, and the next, and before I know it, I’ll be moving and doing. But the initial inertia is so difficult, the habit of mind so ingrained, I don’t care about making the first step.

Perhaps a sunny self-help book? First, I gotta get up the motivation to go to the book store and read the fucking thing…