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“I just have to take a few details, Derek, and then we can have a chat. What is your date of birth?”
“Er, February the fourteenth, 1996.”
“Valentine’s Day!” Nursey just stared, unimpressed, at the doctor, who smiled a little sheepishly. “Happy birthday for Tuesday.”
“Sure,” he replied stiffly. Being in the doctor’s office a few days before his sixteenth birthday wasn’t what he would describe as ‘happy’.
“And you are a student at Phillips Academy?”
“That’s right.”
“Are you sure you would not rather have a teacher in here with you?” The doctor glanced at Andy.
“I’m sure. I don’t want to talk about this in front of either of them.” Derek nodded his head in the direction of the waiting room, where the two teachers who had brought them out of school to come to the doctor’s office waited.
“You would like your friend to stay, though? Brother?”
The noise Andy made almost made Derek crack a smile. They didn’t look anything like each other. They weren’t even remotely the same ethnicity.
“Friend, and yes.”
“Okay. Tell me what the matter is.”
“I feel tired all the time. Or not even tired, but I want to sleep. My dorm buddies have to practically drag me out of bed every morning. I just don’t want to do anything. Nothing’s interesting.”
He saw, in the doctor’s eyes, the moment she decided that Derek was wasting her time. “That is a perfectly normal feeling for teenagers of your age,” she started.
“No, you don’t understand,” Andy cut across. “We live in a dorm with ten other people, so I know teenagers our age. This is more than is just a normal amount of sleeping in, or apathy towards classes. He doesn’t care about anything anymore. Not even hockey, and he loves that shit. And compared to the beginning of the year-”
“Sir, I promise you, this might not be something everyone feels, but I see a lot of teenagers who have gone off a hobby they used to have.”
“At the beginning of the school year, he was interested in everything. He wasn’t sleeping, because he had too much to do. He was happy. Almost too happy.”
“Yeah, there were times it got really scary,” Derek agreed. Tears pricked in his eyes. He never cried in public, but the past few weeks he had felt more and more sensitive. He bit on his lip until it hurt, and the urge to cry disappeared.
The doctor’s attention had been caught, now. “How long did this enthusiasm last?”
Derek and Andy shared a look. “A few months, maybe. It started when it was still the summer, and by Thanksgiving, I’d mellowed out.”
“He was back to himself again in November,” Andy said with a nod.
“And this recent dip in mood, when did that start?”
“A couple of weeks ago,” Andy said. “I know that’s not really long enough to get a picture with things like this, but it’s been long enough to affect his schoolwork and hockey, so I persuaded him to let us bring him here anyway.”
The doctor hummed thoughtfully. She reached for a thick book on the shelf behind her, and flicked through it until she found something. “I would like to ask you a few questions, Derek. I want you to answer with your own thoughts and feelings, not influenced by what you think I should hear, or what your friend might think or want to hear.”
Derek nodded. “Okay.”
“The first questions, I would like you to answer with how you have been feeling the past couple of weeks. If you could reply with whether you have felt it nearly every day, on more than half the days in those couple of weeks, just on some days, or not at all,” she told him, and then she started asking the same questions Derek and Andy had found on a site about depression a few nights before. Derek let out a shaky sigh before he started to reply. He had done this test online, and come out as severely depressed. He could see the doctor’s lips growing tighter as he answered ‘nearly every day’ for each question, until he told her that he had not had any suicidal thoughts and she relaxed almost immediately. It wasn’t completely true, but given that even if he had had the energy to act on them, they had only been fleeting notions, he and Andy had decided that the best thing would be not to mention them.
“Okay, it sounds like you have been suffering from a depressive episode, and given what you were telling me earlier, I have some more questions about what you experienced at the beginning of the school year.”
This, Derek hadn’t expected. His mouth dropped open a little, but he nodded.
“You can just answer these with yes or no,” she told him. She asked a string of questions, nearly all of which Derek, with barely any hesitation, answered yes to. “You were more interested in sex than usual?”
“Oh, no,” he said easily. She seemed a little surprised that he had actually answered negatively, but without pressing it, she moved onto the next question.
“Do you have any family history of bipolar disorder?”
Derek frowned. “Uh, I don’t know. I don’t think so?”
She smiled softly. “I will have to ring your parents for consent to prescribe you any medication, so I can ask them myself. Do you know what bipolar disorder is?”
Derek shrugged. “Like mood swings and stuff?”
“Not really. It is a mood disorder, but it does not ‘swing’ in the way people think. It is characterized by manic and depressive episodes. These can each last months, or for some people even years, and there are usually periods in between where you are not suffering any sort of episode, and these periods of normality can also last between months and years. The fact that it has only been a few months since your last manic episode may suggest rapid cycling, so I would like to get you on mood stabilizers as quickly as possible. Because of the nature of the disorder, I would also like to set up regular meetings with you.”
“With you? Not a therapist?” Andy asked in confusion.
“With Derek’s description of his feelings, I can be fairly certain bipolar is the correct diagnosis, but it will be easier to tell if anything else changes, or if the episodes of hallucination and dissociation worsen, if I am monitoring him myself. Those are psychotic symptoms, and while they are an aspect of mania for some people with bipolar, they may indicate another issue. Similarly, the fact that he reports no change in his sex drive—”
“He’s fifteen.”
“Which is exactly the age I would expect more fluctuation in interest in sex, whether combined with an affective disorder or not.”
“But he’s-”
It was as if something snapped inside Derek. “He’s right here,” he hissed. “Why does it matter if I don’t care about sex? Isn’t that supposed to be a good thing considering it’s not even legal for me to have sex yet. And I live at school. It would be kind of weird if I was attracted to anyone I live with, or wanting to masturbate or any of that shit.”
Andy was staring at him with a strange look on his face, now.
“Okay,” the doctor said softly, as if Derek was some fragile child who needed to be handled with gloves. “I have some booklets you can read for more information, and while you are looking at those, I will ring your parents and we can see about getting you on some medication, okay?”
Derek bristled, but nodded.
Andy came into his room that evening after dinner, while Derek was lying in bed, staring at the new pot of pills on his desk.
“Hey, there.”
Derek didn’t reply. He just shuffled across so that there was space for Andy to slide under the covers next to him.
“How are you feeling?”
“The same. A little confused. Totally overwhelmed. Like I should have cried by now but nothing’s happening.”
“It’s a lot.”
Derek wanted to scream at Andy that he had no idea. Instead, he pressed his lips together and turned his face into the pillow.
“I do have a question.”
“Yeah?”
Andy took a while to formulate what he wanted to ask. Derek almost started to drift off to sleep. “Were you serious? Have you never had a crush or anything on anyone here?”
“I’ve never had a crush on anyone. Except maybe in elementary school, this one girl, but I don’t think kid crushes count. I don’t want to think about people like that. Not here.”
“Yeah, but it’s not like you can control how you feel about people.”
Derek frowned. He didn’t know what Andy meant, or where he was going with this.
“I just— Never mind.” They lay there in silence for a while. Finally, Andy seemed to decide he couldn’t let the topic drop. “Just most people do have crushes on other people at school. It’s normal. It wouldn’t be weird if you did.”
Something about the conversation set Derek on edge. It had already been a difficult day, and all he wanted to do was sleep. “But it is weird that I don’t. That’s what you’re trying to say, isn’t it?”
“For God’s sake, stop being so sen—”
Andy cut himself off with an intake of breath. They stared at each other warily.
“Stop being so sensitive?”
“Shit, I’m sorry. I don’t mean that. I know it’s been a horrible day. You have a right to be upset right now. It’s not a bad thing if you’re feeling a bit touchy, or if you don’t have any crushes, or if that never changes or anything. I’m not saying it’s weird. I’m just— I don’t know what I’m trying to say.”
His eyes darted upwards, which Derek knew was a tic of Andy’s when he was lying. He bit his lip and rolled over. “I just want to sleep, okay? You can stay if you want, but I want to sleep.”
There was a soft sigh, and the brush of fingers over his hair before Andy settled his arm around Derek’s waist and they fell into silence.