Once upon a time, I got diagnosed with Bipolar I Disorder. At the time I was diagnosed, I was working 40 hours a week while taking 15 credits of classes, I was commuting by bus, I was exhausted, I was stressed out, and I could tell I had become “unbalanced”. I was struggling with depression mixed with undependable bursts of energy and insomnia, and I just couldn’t handle it anymore. I had been to a psychiatrist who had started the process of diagnosis, but I hadn’t been able to continue because she was not covered by my insurance. Therefore, I went to a regular in-network doctor with my concern. At the end of my half hour visit, the doctor said I needed to be on medication for BP I before I “did something that would harm other people.” (I had not described a single even potentially harmful scenario to him.)
I was given a prescription for lamotrigine with instructions on how to gradually up my daily dose until I hit 100mg (4 times the normal starting dosage at that point in time), and told to come back in two months. After about six weeks I developed a skin rash, which can be a sign of a lethal side effect of the drug. When I called in to make an appointment, my doctor got on the phone, ordered me to stop taking it, and then called a prescription for lithium and fluoxetine (Prozac) into the nearest pharmacy. I never even got to see his face, nor was I given a chance to ask about alternatives (For the record, there are many) since I think both lithium and Prozac are every kind of awful.
I never filled the prescriptions, and I never went back.
“Oh. My. God. You did WHAT?” I can hear the collective gasps all the way over here in my living room. Everyone knows that if you go off your meds terrible things will happen. If you stop seeking assistance, terrible things will happen. You must stay on your medication at all costs. (And, I am going to take this moment to say that 99 times out of 100, this is absolutely valid advice. Talk to your doctor if you have questions, but STAY ON YOUR MEDS until you are told when and how to stop.)
In my case, I was the exception, not the rule: Nothing terrible happened. Nothing at all happened, actually. The medication had not yet kicked in to relieve my “mania”, so continuing to struggle with it didn’t bother me a bit. In fact I only had two true consequences (so to speak) of stopping: the rash went away, and my creative drive came back. Gradually I worked my way out of depression. Soon enough it felt like a bad dream, and I decided I’d figure it all out later.
So what does all that have to do with the price of tea in China?
Well…let’s fast forward three years. A few days after I started my new job, I was sitting at my computer when I felt a very familiar wave of “nothing and nowhere” wash over me. I felt distant, indistinct, disconnected from the world. It felt like there were eight million violins shrieking their highest notes in my mind, and I was cold and couldn’t get warm. When I interacted with the world around me, it seemed like someone had pulled a gray veil over my face, or enclosed me in a bubble. I felt like I could take on a lion bare-handed and come out on the upper hand….and yet I also felt like a single would topple me into oblivion.
I recognized the sensation; it was what my doctor had told me was mania, and I hadn’t experienced it (at quite this level, anyway) in over two years. I couldn’t afford to have it happen now of all times! I was pregnant and exhausted. I had a new job I needed to do well at. I needed to clean the house. I needed to call my old job and settle some final details. I needed to pay the bills, and we were short on cash. My husband wasn’t feeling well, and neither was my mom. I had so much stuff going on…I couldn’t afford to have it all come crashing down because of one ill-timed session of crazy face.
I freaked out. I posted on Facebook about what was happening, begging for someone to help, to keep me from doing stupid things. Thankfully I have an out of state friend who became a therapist, and he saw my post. He contacted me privately, and told me that it was likely I was having a panic attack. He coached me through how to cope with it. I’m sure he violated some kind of code of ethics by helping me like that, but the important part is that he did help me. Not only did he help me get over the panic attack, he helped me see something I had taken for granted in an entirely different light.
What I took away from that day was that what my doctor had classified as mania was not. If what I was feeling was not mania, then I cannot be diagnosed as Bipolar I. So why do I struggle so much where others do not? In the months since then, I think I’ve finally pieced together the puzzle, and in the process have come to terms with myself in a way I never have before.
The first part of the puzzle is straight up depression. It has consumed me since my early adolescence. I had grown so used to it hovering over my mind-scape that I assumed it would never go away. It finally cleared up around the time I met my husband. For the most part I have been healthy in body and mind since then, and apparently the difference in my behavior and outlook on life is a welcome change. I still get random comments from people telling me that they “really like the new M.” (For the record, I also like love the new M!)
The second part of the puzzle is anxiety. I don’t mean the “oh I hope this goes well” kind of unease…I mean soul-consuming, fact-destroying, emotion-crushing anxiety. The constant inner diatribe telling me exactly how many ways I’ve screwed up everything I’ve ever done or tried to do. The dialogue of “what ifs” and “maybes” (usually) keep me from going on “adventures” or making decisions that could have long term impact, and generally make life miserable. Anxiety rules my world, controls my existence, causes my panic attacks, and keeps the clouds of depression constantly brewing on the horizon.
The third part of the puzzle is ADHD. My family has a long and complex history with ADHD, which I had dismissed out of hand as having no relevance to me. Why? I think simply because I wanted to be “normal”. Unfortunately, the “normal” train took me straight through Crazy-Town and into all-out bat country, so I’d say that idea backfired on me. However, I read a book about ADHD recently that changed everything. It described aspects of ADHD that I did not know existed. Despite my family history, I truly thought that “being ADD” just meant being scatterbrained and hyperactive, and I joked about it just as freely as they did. I didn’t know that people with ADHD could be extremely impulsive, or that they had social problems, or that they could not only fail to focus, but they could also hyper focus. I have struggled with every facet of ADHD for years, and I had no clue!
I have not been to a therapist to confirm my theories about how these three issues conspired to screw my life over, but I simply cannot get past how well it all links together to create the perfect illusion of manic-depressive cycles. The physical symptoms of a panic attack mixed with the hyperactivity and lowered inhibitions of ADHD perfectly mimic the clinical definition of mania, and then depression and general anxiety were there to complete the manic-depressive picture. The one thing that would have blown the entire thing out of water is this: the fact that although I FELT like I could take on the world when I was “manic”….I never acted on it. I actually had MORE impulse control when I was “manic” (due, I suspect, to high levels of anxiety) than when I wasn’t. I also did no great harm to others, took no major risks, and even when I was going off the deep end I was utterly dependable at work. In short: I do not meet the qualifications for a manic episode. I never have.
I am intensely angry at that doctor for treating me the way he did. I feel that by not taking the time to ensure I was given the correct care, he actually made my situation worse. His misdiagnosis certainly threw my life off track for a long time! Some of it was my own fault; in my desperation for a cure, I was willing to agree to pretty much anything, and I’m sure that didn’t help. However, I cannot get past the thought that if he hadn’t been so intent on prescribing medication, he would have identified the discrepancies between what I was experiencing and what he was diagnosing. If I can do it…why couldn’t he?
I plan on going back to a therapist at some point to get his diagnosis overturned (I acknowledge that it is entirely possible that the therapist will uphold his opinion, but it seems extremely improbable). I also plan on seeking counseling (but not medication) for my anxiety, because it makes my life hell and really is the one aspect of myself that I would change if I could. I think doing that will help keep the depression at bay. As for the ADHD thing….that’s what makes me who I am. I am an artist. I do weird things, many of them without realizing it. Plus, if my thought processes changed…so would my creative process. I like those aspects of myself, and I would not change them for all the consistent, focused productivity in the world. I have coping strategies that I utilize when I’m at work or doing something Really Important, and they have been fairly effective. I see no need for any greater intervention.
So….there you have it. Another of my little epiphanies. It’s probably not that big of a deal to the world at large, but for me it is. For me, it means that in the innermost inner shell of my soul I no longer consider myself incurably unbalanced, and that I have even more hope than I thought I did.
As an afternote: In the course of writing this, I had to look up lamotrigine/Lamictal to remind myself of the specifics of my prescription. When I was taking it, I was told that a) it was the only drug other than lithium proven to be effective against BPD and B) that it had no side effects except potentially the rash I mentioned. I see that both of those statements have been proven false since then….and I can’t say I am surprised. I was on that drug for almost two months and the only effect it had on my brain was to kill my creativity when I needed it most. Yuck.