Bipolar 2 From Inside and Out

Posts tagged ‘bipolar type 2’

The Difference a Diagnosis Makes

I thought I had depression and that’s what I was first diagnosed with. Later, I learned that I really had bipolar disorder, type 2, with an anxiety disorder on top of it. Here’s what I learned on my journey to a proper diagnosis.

Understanding. Once I was diagnosed with bipolar disorder, a lot of things from my life started making more sense. I finally realized that some of the inane things I thought and did as a child/teen were attributable to hypomania. Being idiotically happy when I won a goldfish at a carnival, carrying it before me, grinning like a loon. Near-constant mirth when I read a novel parody, laughing long and loudly every time someone used a word or phrase that reminded me of it. Luckily, I didn’t have any money to spend, or I would have done that too, based on my later behavior. Even things I did as an adult before my proper diagnosis made more sense – flight of ideas, pressured speech, and the like.

Second opinion. Going to a different psychiatrist and finally getting the right diagnosis was, in many ways, like getting a second opinion. We don’t often hesitate to get a second opinion on matters concerning our physical health (and insurance companies may require it). Why is it different when it comes to our mental health? I’m not saying that doctor-shopping is a good idea or that a diagnosis of depression did me no good at all. It just took a different psychiatrist to put together all my symptoms in a way that made sense to me as well as to him.

The “Aha Moment.” When I got my bipolar diagnosis, it was like a wake-up call. I instantly understood that my psychiatrist was right. Once I had that insight, I was able to explore my actual disorder in various ways – further sessions with him and with my psychotherapist, reading books and reliable online sources, sharing with other people who have the same diagnosis and listening to their experiences.

Getting the right meds. I had been taking medications for depression for many years. Then I learned that I might – did – need treatment with anti-anxiety medications, mood levelers, and other kinds of drugs that specifically targeted bipolar symptoms. I still needed meds for depression, but I needed a “cocktail” of drugs that addressed all my difficulties, not just one.

Going on maintenance meds. The process of settling on that cocktail of meds took a long and difficult time, but once I had the right diagnosis and the right meds, I was able to cut back to seeing a psychiatrist four times a year to get renewals on my “maintenance” medications. The process that stabilized me also allowed me and my doctor to make “tweaks” to the dosages to correspond with increased or lessened symptoms.

A new revelation. My learning about my disorder didn’t stop with my new diagnosis. Recently I learned that my depression could be what is called “dysthymia,” a type of depression that is roughly equivalent to the difference between mania and hypomania in bipolar 2. I wasn’t sure this applied to me, as my depressive episodes seemed long enough and severe enough to be considered major depression, but after consulting my therapist and other reliable sources, I began to see how a dysthymia diagnosis actually did correspond to my symptoms.

Having hope. The most important thing that the right diagnosis gave me was hope. Properly understanding my disorder and the correct treatments for it allowed me to hope that I could achieve stability and healing from all the years when I didn’t realize I was suffering from hypomania as well as depression. I could at last look forward to a life where my disorder didn’t control me. With help from my psychiatrist and the medications he prescribed, I have been able to live a contented and productive life. Work, stable relationships, and the other benefits of having proper treatment are achievable – and I have largely achieved my goals in life.

And my new diagnosis has been responsible for it.

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Releasing Old Ghosts

I don’t know what the proper term is (exorcise? banish? reject?), probably because I don’t believe in ghosts. What I do believe in are memories – persons and situations that haunt you, follow you, and inhabit your dreams.

I’ve had my share, especially of the dreams sort.

When I first got out of a truly destructive relationship, I was undiagnosed with bipolar disorder, medicated with valium (prescribed for temporomandibular joint syndrome) and self-medicated with wine. I was not in good shape.

For a long while, anything associated with that harrowing relationship, I shunned. Rex had like blue spruce trees. I avoided them. He had collected cobalt blue glassware. I could barely stand to look at them. He gave me heart-shaped boxes as gifts. I threw away every one I had, even the ones that were actually pretty and useful. He shamed me for my cooking. I gave it up. I gave up things I enjoyed, things that had been part of me. And I didn’t allow myself to explore things that Rex once loved.

He haunted me. I would have dreams in which I was going to meet him, where I was in a place I knew he might show up. I dreamed I was in his house, with cheerful parties going on around me as I panicked. I would have flashbacks to cruel things he had said, such as an obscene song he had written “in my honor.” Times when he said I had “betrayed his honor” for something as simple as cooking the wrong dish for a gathering. Plenty of others.

Now, it seems, the dreams have faded. I have reclaimed parts of my life I used to enjoy. I have banished things that were only his obsessions. The flashbacks are nearly gone.

What has helped me banish these destructive ghosts?

Time, of course, though you’d be surprised how many years it took. And it was gradual. He didn’t vanish from my brain like a puff of smoke. At times I still remembered music in particular – festivals and concerts we had been to together, the obscene song. (As I write this, they come bubbling up again.)

People. A few even from the time that the relationship was going on, who have helped me realize that I should not have been there, that I should not have gone through what I did, that I should have left sooner. I treasure these people. They saw me at my worst, knew me as I was recovering, and are still my friends today.

Other people – friends I had from long before Rex – have steadfastly remained in or reappeared in my life. I may have been bipolar and undiagnosed when I knew them, but these people stood by me, put up with my mood swings and odd behaviors. They have been part of my support system. And new friends, who have no association with those times, but who have had similar feelings and experiences.

Psychiatrists and therapists – also important parts of my support system for all these years. Ones who diagnosed my illness and medicated me properly so that I could deal with the issues that remained. Ones who helped me realize that I had some good memories from those times, that I could rebuild myself by retaining anything that I liked, that I had tools and techniques that I could develop and use to help me do that. I had done bargello needlework for Rex. I switched to cross-stitch. He called the kind of music I liked shit. I delved even further into it, reveled in it. Having developed a love of cats when I lived with him, I’ve never been without one again.

Love. One of the people I met during the next-to-last weekend of my time with Rex is now my husband. He has been with me through the dreams, the flashbacks, and the memories and has been the mainstay of my support system. And there are other people I love, and who have loved me back.

It seems strange that I was with Rex only a little over a year and it has taken me decades to work to this point where the memories have faded, the ghosts no longer haunt me, when it all seems like simply a bad time that has receded into, if not oblivion, at least only a clog that has slowly been removed from my psychological plumbing.

Now I know the right word. It’s time to flush those ghosts that plug up our mental and emotional systems.

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When Depression Doesn’t Go Away

Back in the day, I suffered from treatment-resistant depression. (This was likely due to the fact that what I had was actually bipolar 2, but never mind that for now.) My psychiatrist prescribed me medication after medication, but none of them worked, or at least not for long. We got into a seemingly endless spiral of trying one drug, adding another, weaning me off one drug and ramping up another, then another and another.

Some of them just plain didn’t work. Others had intolerable side effects, from vivid horrible nightmares to making me feel like I was about to jump out of my skin.

All this went on for certainly months – maybe years. (Memory problems were one of the many intolerable side effects.)

Eventually, my doctor reached the correct diagnosis, and then there were months of trying medications that were targeted for bipolar disorder instead of plain depression with anxiety. Again, nothing worked, or didn’t work adequately.

Nowadays, there are non-pharmaceutical methods of coping with treatment-resistant depression, including ECT (better known as electroshock), TMS (transcranial magnetic stimulation), and ketamine treatment.

I never had any of these treatments, since my psychiatrist and I finally worked out a drug combo that brought me back to balance, with only minor tweaks in dosage over the years. Nonetheless, I’ve become interested in the alternate means of dealing with treatment-resistant depression, and here’s what I now know. (If you want a patient’s own experience with ECT, TMS, and ketamine treatment, look up Kitty Dukakis or read some of the Bloggess’s posts.)

ECT, or electroconvulsive therapy, is what used to be known as shock treatment. For a long time it went the way of prefrontal lobotomy, stigmatized as a cruel and harmful procedure. The portrayal of ECT in Ken Kesey’s novel One Flew Over the Cuckoo’s Nest and then the movie of the same name were major influences in terrifying the general public, leading to a nearly complete disavowal of its use.

It’s making a comeback, though. The theory behind it is that electric stimulation of the brain will shock the brain back into normal functioning. The American Psychiatric Association notes that it is now performed under anesthesia, with medical personnel attending the procedure. They report improvement in 80% of patients.

(ECT is the alternative treatment that I was ready to try when none of the drugs prescribed for me proved effective. Then my doctor wanted to try one last drug, and that was the one that did the trick.)

TMS, or transcranial magnetic simulation, is described by the Mayo Clinic as “a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression.” It’s also called rTMS, or Repetitive Transcranial Magnetic Stimulation, because more than one treatment is generally needed. The theory is that the magnetic pulses stimulate areas of the brain involved with mood control and depression. It doesn’t cause seizures or require anesthesia. The exact mechanism of how it works isn’t really understood, but that’s true of many other treatments for depression, including medications.

Harvard’s Health Blog reports that rTMS helps about 50% to 60% of people who did not respond to drug treatment “experience a clinically meaningful response.” They do note that treatments, “while encouraging, are not permanent,” which is true of many other forms of treatment.

Ketamine is the newest of the treatments for treatment-resistant depression. Ketamine was once known as a “party drug” called “Special K,” described by the DEA as “a short-acting anesthetic with hallucinogenic effects.” As a treatment for depression, however, it is thought to “enable brain connections to regrow,” according to scientists at Yale. The American Association of Nurse Anesthetists notes that ketamine “is not a first-line therapy for psychiatric disorders,” but then, neither are ECT and TMS.

Ketamine can be administered via nasal spray, but for psychiatric purposes (including to treat bipolar disorder and PTSD) it is often given as a series of infusions. An article in The Lancet says that “Ketamine is thought to act by blocking … receptors in the brain.” Another article by doctors at the National Institutes of Health comments that ketamine “has a robust and rapid effect on depression, which was seen immediately after the administration of ketamine and sustained at the end of 1 month.” Repeated treatments are generally necessary.

I don’t know about other patients and doctors, but after years of drug therapy not working, I was ready to give almost anything a try. ECT was next on the list, and the only likely alternative, as TMS and ketamine were not available at that time. I’m just glad that now patients and their doctors have more options when depression resists drug treatment and “talk therapy.” And I hope that even more alternatives become available for people with depression who are desperate to find a treatment that works for them.

Manicky June, Anxious July, Overwhelmed August

Once upon a time, when I was diagnosed with unipolar depression, I wished I had bipolar disorder so that at least I could get things done when I was manic. Then I met someone with bipolar disorder and learned how foolish that wish was. Her manic phase led her to begin projects she would never finish, make loud, inappropriate jokes, and have difficulty with social interactions.

I have bipolar 2, and am fairly well controlled on medication, so I don’t get hypomania often, and when I do, it doesn’t usually last very long. Last month, however, I had a manicky time, and the results of it will affect me for several months. In June I also started on a new medication – though one for my physical health, not my mental health. My primary care physician doubled my dose of thyroid supplement. It had an almost immediate effect. After about a week, I became stronger, steadier, in less pain, and – oh yes, – rather manic.

I tend to have the rapid cycling version of my disorder, so when I do get hypomanic, it seldom lasts more than a few days. This time, however, I have had a longer time to experience the hypomania in a way I can’t remember having had before.

Some good things happened and some bad things happened. I got tickets to two live music events that I desperately wanted to see, one in August and one in September. We went out to eat at least twice. I made appointments for tattoos for both myself and my husband, both also in August. I booked us for a weekend getaway vacation in August. I bought myself a pair of earrings to replace ones I had lost.

In other words, I spent a lot of money.

Then July came and I don’t know if we will have enough money to get through it all. I snapped out of the hypomania and reverted to anxiety, which is how my depression often expresses itself. I paid the major bills during the first week. I put us on a strict budget for groceries. I put a little money aside so that I could possibly get a t-shirt at one of the concerts. I determined that the tattoo studio takes credit cards. (I don’t really want to take this option, but if we run out of cash, I may have to.)

Money worries are among my triggers for anxiety and depression, along with thunderstorms, overscheduling, noise, and too many people. When August comes, I will certainly need the bed-and-breakfast getaway, because my nerves will by then be frazzled.

The real question, though, is will I have enough energy to enjoy all the plans I have made for August?

A friend, who goes to DisneyWorld fairly often, learned that he should not do what he calls the “Bataan Fun March,” trying to cram every possible attraction and experience into a single visit. Now he prefers a more leisurely Disney experience, visiting a few of his old favorites and a few new attractions, while leaving time for relaxed dining and time in the pool.

This would probably have been a better approach for me to apply to August. A few events then, a few in September.

It would be convenient if my hypomania returned in August, to allow me to do all the fun things I have committed to. But as we know, bipolar disorder is an unpredictable beast. In the past, I have missed concerts that I had no more spoons for. I have rescheduled appointments that I wasn’t physically or psychologically in any shape to attend. (Most of these were appointments with my therapist, who sometimes agreed to a phone session instead.)

But these commitments are ones that I can’t phone in. All of them require my actual, physical presence. I don’t want to cancel any of them, some I can’t cancel at all, and I can’t phone in any of them. My best hope is that my symptoms will allow me to both attend and enjoy, if that’s possible.

Maybe the new pep I am experiencing from the thyroid meds will help. It does seem to help regulate my moods a bit, as well as affecting my body. Maybe it will allow me to have more spoons for August. Maybe in September I can decompress. Maybe in October, I will be back somewhere near level ground.

On the Mind and the Body

The mind and the body are inseparable, part of the same organism. You can’t have one without the other. And each affects the way the other works.

Triggers are a good example. You see (or read) or hear or smell or touch something that unlocks an emotion in your brain. You then have a visceral reaction to that feeling – sweating, shaking, nausea, panic flight, or another physical manifestation.

These reactions are most commonly seen in severe PTSD and trauma related to abuse, but they can happen in less severe circumstances as well. Even something as seemingly innocent as tickling can put the brain in command of a bodily sensation. For example, once I was tickled to the point of pain, with the other person refusing to stop when I pleaded for him to. Ever since, my reaction to tickling is both physical and mental. My brain tells my body to shut down the physical sensation of touch. That may seem – and is – comparatively mild, and I don’t want to diminish the experiences of people suffering with PTSD and reactions to trauma. But it shows how my body and brain interact, almost in a feedback loop.

In circumstances like these, the body signals the brain and the brain tells the body how to react. It’s not like a person can choose whether to be traumatized or not by a trigger. The brain takes over.

Lately, I’ve been facing a fairly deep depression and have faced a lot of things that are triggers for me – financial problems, relationship troubles, overwork, etc. I’ve been feeling the bodily lethargy, exhaustion, psychic numbness, and neurasthenia that come with depression. These certainly affect my body, making me twitchy and nervous and unable to sleep (or to sleep too much), or unwilling or unable to face the world outside, some of the more noted hallmarks of depression and anxiety.

But after a recent visit to my primary care physician, I began to wonder if my body was influencing my brain in a rather direct way. Of course, before I got to see the physician, I had to fill out the depression screener, and as usual, I underplayed my symptoms by a bit. After all, I’m already under a psychotherapist’s and a psychiatrist’s care for it. It’s to be expected if I don’t present as all cheery and “normal.”

After chatting with the doctor about my symptoms (most, I thought, related to growing older), he ordered a bunch of tests for me. I’m to have a mammogram, a ColoGuard test, a bone scan to check my bone density, and had a whole bunch of blood tests.

The mammogram and bone scan I’ve scheduled, though they couldn’t work me in until September. (Evidently there is a lot of pent-up demand for hospital-based testing, as the hospitals weren’t doing non-elective stuff during the pandemic.)

Then the results started coming in. White and red blood cells, okay. Liver function, okay. Glucose and triglycerides, okay. Nearly everything within parameters.

I say “nearly” because I got a call from the doctor’s office saying that he wanted to double my thyroid medication. I had been taking a small amount, but now he figured I needed more.

I looked up the symptoms of hypothyroidism on the Mayo Clinic website, which seems trustworthy. They noted that that the condition may be attributed by the patient to growing older. I definitely noticed those: sensitivity to cold, muscle weakness or aches, and joint pain, all of which I feel.

Then there were other symptoms, which I had attributed either to my psychiatric diagnosis (bipolar II) or to the medications I take for it: fatigue, weight gain, thinning hair, impaired memory, and the biggie – depression.

Between the two sets of symptoms, I could see that the doctor had good reason to suspect my thyroid was out of whack and to prescribe an increased dose of the medication. I am now taking the higher dose and waiting to see what happens.

But it struck me: Maybe my symptoms were a combination of bipolar disorder and thyroid hormone deficiency. Maybe my body was trying to tell me something – that not all the symptoms I feel were caused by my glitchy brain. Maybe some of them were caused by my glitchy thyroid.

I have not been taking the new dosage long enough to see any effects, but I have hope. Perhaps, if and when the new dose kicks in, I will feel less of the lethargy, hopelessness, and other attributes of bipolar disorder.

Maybe my brain and my body have conspired to make me feel the way that I do. Maybe there is some relief to be had from treating my body with hormones, rather than just my brain with psychotropics. Maybe I’m not spiraling down into depression as thoroughly as I thought I was. Maybe a little tweak in my medication will help me to feel better.

Maybe if my body problems get worked out, my brain problems will not assert themselves so aggressively.

It is devoutly to be hoped.

Functioning While Bipolar

Bipolar disorder is a funny thing. Mine leaves me alone part of the time. Until it doesn’t.

I have had full-blown depressive episodes, with the sobbing and the immobility and the wretchedness and everything else associated with it. I have had one major episode that lasted for three years straight, plus everything else from minor breakdowns to that vague, lingering miasma that comes when you’re untreated and you don’t know that what is really happening to you is clinical depression.

I have also had full-blown anxiety attacks, the sort that leave you twitching all over, feeling like you’re about to jump out of your skin, gasping for breath, and imagining that every driver on the road is swerving into your lane. I’ve twitched and shaken and stammered. I’ve scratched myself. I’ve hidden under the covers until I can’t breathe. I’ve taken anti-anxiety meds that did nothing at all.

Right now I am sufficiently medicated and have been relatively stable long enough that I think what I have is functional depression or maybe high-functioning depression, or whatever you want to call it. I have enough wherewithal to work part-time from home, do other writing-related projects (like this blog and my other one), and do assorted tasks like paying bills and making business-related phone calls. (Occasionally, if the phone tree is lengthy enough and the person on the other end is uncooperative enough, I have a small-scale meltdown. My voice goes up in pitch and tears start rolling down my face. My husband takes over the transaction when he notices that.)

But secretly, I know depression is lurking and can rear its ugly head again with little or no provocation – a trigger or nothing at all. So can anxiety, which is how my brain usually responds to hypomania. It’s a little like those commercials for psychotropic meds you see on TV, where the person has a little sign with a smiley face and hides behind it. Except that’s not quite accurate.

I understand that high-functioning depression is also called “smiling depression.” That’s not my experience of it. I’ve almost never been able to “fake it till I make it,” slapping on a happy expression when inside I’m dying. Besides, it doesn’t work, as far as I can tell. The depression or the sorrow always leaks out around the eyes. I’ve seen this in myself and in other people.

Before I was treated, I used to have what you’d call “resting sad face.” Once a boss of mine encouraged me to smile more (and is there anything more annoying?). I didn’t feel particularly sad at that moment, though I’m sure that I had at least a low-grade depression, like a low-grade fever. But I was at my job, and functioning even then, if not very well or cheerfully.

The phrase “high-functioning” gets used a lot to describe certain varieties of autism. I don’t have autism and I’m not an expert on it, but my suspicion is that high-functioning depression is similar in some ways. I don’t always react the way other people expect me to. I feel out of my depth a lot, especially in environments with lots of people or lots of noise. But that doesn’t stop me – or lots of other people – from carrying on with what I need to do to be a functioning member of the populace.

But back to bipolar disorder. Even if someone seems to be “high-functioning” doesn’t mean he won’t have a meltdown sooner or later. Even someone who “slaps on a smile” may let it drop once she is alone. Even someone who is “coping well” may not be coping at all tomorrow or next week or next year. Sometimes you can’t tell on the surface what someone is going through inside. Like I said, bipolar disorder is a funny thing.

How Depression Sneaks Up

I had a blog post all written and ready to go. It was about my fluctuating moods and my writing, and how they affected each other. Some of what I wrote is still true. The depression I suffered during my early years and the exceedingly depressive poetry I wrote during that time allowed me to learn something about how poetry works and something more about how depression works.

I wrote about how hypomania affects my writing, and that is still true. Hypomania pushes me to do my writing, even when I don’t feel like it. In fact, at times it pushes me into doing more writing than I can probably handle. Case in point: This week I wrote three samples for a work-for-hire outfit when I should have been writing or at least outlining my WIP (Work In Progress), a sequel to the mystery I have already written and have been sending around to agents.

And last night, that’s where I hit the wall. I figured out that I have sent out about 180 or so query letters and gotten only the most minimal results – rejections that said I had an interesting premise that was not right for them. Most, though, have received plain rejections or the dreaded “no response means no.” I am now second-guessing myself and everything about the manuscript.

Last night, the depression caved in on me. I spent the night in bed, not sleeping except for nightmares, and not wanting to get up in the morning.

Because my identity is invested in being a writer, though, I did get up (late), sent a few more queries, and got to work on rewriting my blog posts, which I had determined were wretched. In the blog post that I abandoned, I had pontificated about how keeping a schedule kept me going with all the writing projects and various other work I do. 

I had also crowed about my relative stability and how that was helping me keep that schedule, which was supposed to be keeping depression at bay. I found out that I lied. The fact that I have maintained functionality for some time did absolutely nothing to prevent the depression that hit me.

Admittedly, this is probably a reactive depression, with my lack of success being the trigger. The thing is, it’s awfully difficult to tell apart from endogenous depression. In fact, I have known the first to melt into the second. At first you have a clear cause that would depress anyone, then you find it clinging to you long after what would seem to be reasonable. (This is subjective, of course. What is the “right” length of time to be depressed over 180 rejections?)

What’s left? Self-care, of course. Trying to sleep if I can, and squeezing in a nap if possible. Eat something, even if it’s only some guacamole and chips or a bowl of soup. Take my meds religiously. Try to cling to that schedule even when I don’t want to.

But the truth is, I’m running out of agents to submit to. I’m running out of energy to try. And I’m running out of the frame of mind to keep me functional. I’ll be okay, I know, but it may be a long, hard climb. 

All Mixed Up

Leigh-Prather/Adobestock.com

As I mentioned a few posts ago, my psychiatrist and I are working on a medication change that will, I hope, pull me out of bipolar depression. The medication that we changed was a mood-leveler, which sounds like a productive way to start.

We’re increasing the dose, which means it shouldn’t take the time it would for the old drug to “wash out” of my bloodstream (and/or brain) while we’re waiting for the new one to kick in. I’ve been that route before, and it’s miserable.

While I haven’t noticed my moods becoming exactly stable since the change, I have noticed certain effects. I am able to get through the minimum of what I need to do each day, though nothing more. And I have noticed that I am getting irritable. This does not happen so much when I’m depressed. When I’m depressed, I don’t care enough about anything to be irritable.

In fact, irritability is one of the ways that hypomania manifests for me, before I get to the euphoria/super-productive/reckless spending stage. I get snappy with my husband about all his annoying habits, like never giving me a straight answer to a simple question. (What are you watching? A movie. What did you get at the store? Food.) I think he thinks he’s being funny, but I find it frustrating. Not that I don’t have annoying habits too, especially when I’ve either depressed or irritable.

So, I guess in one way, the irritability is a good sign. It doesn’t mean I have level moods yet, but it seems to mean that I’m not totally stuck in the depression. (I explained to my husband what was happening with me, and he seems to understand more. Though it remains to be seen if he’ll answer simple questions informatively.)

I think what I’m experiencing is a phenomenon know as mixed states. If to be depressed is to care about nothing and mania is to care about everything, a mixed state is some hellish combination of the two. Imagine being immobilized and jumpy all at the same time. That’s what it’s like, paradox that it is.

I haven’t had mixed states too often in my life, though I have had emotions that swerve drastically from happy to depressed in an instant (which is an extreme version, I think, of what’s known as ultra-rapid cycling). This is something different, though.

Now, I use up all my spoons early in the day and nap, or I stay up but go to bed at around 8:00. Ordinarily, if I went to bed that early, I’d read for a couple of hours, but these days half an hour or 45 minutes is it, tops.

Still, I think (or hope) that this mixed state of affairs is a step along the way to level moods that are higher than the numbness and not-caring of depression. It’s not comfortable to go through, but then neither is depression or mania, even hypomania.

It’s been about six weeks since the change in my medication. Within another four to six weeks, it will likely become apparent whether the change, once set in motion, will have an outcome I can live with. Until then, I need to spend my spoons as wisely as I can and try to remember not to snap at my husband, even when he’s being annoying.

A Letter From the Future to Bipolar Me

by sosiukin via adobestock.com

Dear Me:

You’re 13 years old now, and there are a few things you should know.

You have bipolar disorder. No one knows this, not even you. But a lot of people notice that you act “weird” at times. You have decided to embrace your weirdness, which is fine, but what you really need is psychological help. And medication.

Don’t pass up any chance to get that help. Your high school will recommend to your parents that you get counseling. When your parents leave the choice up to you, take it. It will not go on your permanent record, and you will still get into a college. A very good college, in fact.

I know that at times you sit alone and cry. Other times you laugh at things no one else finds funny. This is not just “weirdness.” This is a mood disorder, called bipolar disorder, type 2. Your mood swings will make it difficult for you to make and keep friends. Keep trying. The friends you will find are worth it and will stand by you when you really need them. You will not be alone in dealing with this.

Your choice to go to college out of state will be a good one. There you will have a variety of experiences that will make you grow in unexpected ways. Your mood disorder will go to college with you, though. Leaving Ohio will not mean you will leave bipolar disorder behind. You will still feel the mood swings, and most of them will be depression.

It’s a good idea to take that year off between freshman and sophomore year. I know it will feel scary, but at that point you will be in no shape to carry on with academics. Instead, you will get a job which, while not great, will introduce you to more new people and new ways of life. At least one of those people will stick with you till you are old and gray.

Returning to school will be a good decision. Your parents will support you in that decision. They won’t object to your year off, because they know you will go back. It still won’t be easy, but you will have a core group of friends that accept you, even though you are different from them.

Your bipolar disorder will follow you back to college. It will make you miss some opportunities and choose others that will not be good for your mental health. You will be unhappy most of the time, but you will find that music helps you through it.

Try not to self-harm. I know you will feel numb and want to feel something else, but cutting yourself is a bad decision and will not help. You will carry those scars forever.

When you meet Rex, though, you will be encountering a problem too big for you to handle, and the relationship will leave you scarred as well. It would be best if you were to steer clear of him altogether. But then again, you will find some true friends in his circle, and it would be a shame to miss them. Try your best to hold yourself together, remember what I said about self-harm, and don’t give up on who you are. You are not your disorder, and you will get through this, despite everything.

I know you never gave a thought to marrying, but you will meet a man and in a few years you will marry him. This, I assure you, is a good decision. He will stick by you no matter what and help you find help.

Going into the building that says “South Community Mental Health” will be a good decision. Whatever you will be feeling at this point – most likely misery – it’s not mentally healthy. This will be the place where you will start to climb out of the hole you have found yourself in.

At last, a doctor will tell you that you have bipolar disorder – most often depression, but also anxiety. He will work with you to find a combination of medications that will help you. When that happens, you will become reacquainted with your brain and relearn how to function in the world at large. Your brain will function in a new way, one with fewer out-of-control feelings. You will experience life more fully and be glad of your new outlook.

It won’t be quick, and it won’t be easy, but you will have therapists, and friends, and work, and love, all of which will help see you through. You will have bipolar disorder all your life, but it will not be your life, though it seems that way now.

Reach out for help whenever and wherever you find it. Cherish your friends. Keep trying, even when you want to give up. Better times are on the way.

I promise.

Love, me (older and maybe wiser)

Bipolar Conversation

This morning a podcast called Bi-Polar Girl was uploaded, and I was the interviewee. (You can find it on Apple, Amazon, and other podcast sources.) Here’s a look at what was like.

  • Prepping. Before we recorded the podcast, my anxiety kicked in, and I tried to overprepare. I bombarded the hosts with emails asking what I should be prepared to talk about or what questions they were going to ask me. Basically, they told me we were going to “wing it” and have me tell my story.
  • History. The thing we talked about most was when I started showing signs of bipolar and when I was diagnosed. I explained that I was showing signs of it as early as my high school years, how I decided to seek treatment after college, and how I was mistakenly diagnosed with major depression for years before receiving the proper diagnosis and medication.
  • Meds. We discussed medication in some detail – pill-shaming, how every person reacts to meds differently (so it’s useless to “recommend” a particular drug to friends or support group members). We talked about the side effects of various medications, including the fact that the most-feared one seems to be weight gain. One particular point of discussion was how many people are afraid that taking medications to treat their disorder will stunt their creativity or turn them into “zombies.” Snowflake (one of the hosts) and I agreed that our creativity and ability to work were actually improved while on medication, because it enabled us to focus and do more creative work.
  • Family. We also talked about the fact that I have no children and my reasons for that. (We also introduced some of our pets during the Zoom call, or they introduced themselves. Just try to keep an animal out of a Zoom call.) I shared that I felt it would be unfair to a child to have a nonfunctional mother, that I was afraid of going off antidepressants while pregnant, and postpartum depression afterward. Snowflake shared her story of medications, potential side effects, pregnancy, and postpartum depression.
  • My publications. I talked about my blog and my books, Bipolar Me and Bipolar Us. In particular, we discussed gaslighting, which features in my second book, and how people with bipolar are more susceptible to it. Both Snowflake and I shared how we had encountered gaslighters in our own lives.
  • Groups. Chacoman, the other host, questioned me about whether I was involved in any local or regional support groups, and I had to admit that I’m not. Now, during the pandemic, group meetings are problematic at best, but I don’t react well to groups at any time, due to my anxiety (which is how my hypomania manifests). In my case, outreach is limited to my blogs and books, and membership in online support groups.
  • Miscellaneous. We got off topic a number of times. I don’t want to make it sound like the interview was all serious or grim. We also talked about our pets, positive relationships, college memories, and even politics.
  • Plans. I talked about how my next book will be a mystery, with a bipolar main character, and received positive feedback on the idea.

All in all, it was a good experience, worth overcoming my anxiety for. I had only participated in a podcast once before, a not-altogether-successful interview about my first book with an interviewer who had obviously not read it and was more interested in whether any of my family members were also creative. (It was supposed to be a podcast about first-time authors.)

This was not the same sort of thing at all. I told my story, as the hosts had recommended, and we had a genuine, far-ranging conversation about not just my own experiences with bipolar disorder, but with how others cope with it as well. Actually, I learned a lot about myself, from how much my anxiety – and especially social anxiety – still affect me, to how much my teen years illustrated my journey into depression.

So, here’s a big thank you to Snowflake and Chacoman for the opportunity to share with them and their audience. I would absolutely do it again. It helped me step out of my comfort zone and, I hope, will help the listeners as well. It’s a form of outreach that I had never considered, but one that I found valuable – and just plain fun!

 

 

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