I am not my disease. I hope.

For some reason this feels like I need to make it an AA-style confession, so here goes:

 

My name is Chrysta, and I am Bipolar.

 

I have been afraid of this ever since I was old enough to know what “manic-depressive” means.  Or, at least, what it means for my grandmother, who, as far as I can tell, is a classic case of Bipolar Type I Disorder.  Although I have struggled mightily with depression ever since I was a teenager, I never thought I was “like my grandma,” because I don’t have the kind of mania that she has.  I don’t get super happy and expansive and extra confident.  Except for a few rare occasions in my early twenties, I don’t become the “life of the party” type.  I also don’t suffer from extreme paranoia and delusions, like Grandma.  Instead, I have Bipolar Type II Disorder.  For me, the depression is prevalent, and I have short periods of HYPOmania. 

To help you understand what that means, I have copied and pasted the diagnostic criteria below, with my particular symptoms highlighted in red:

 

DSM IV Criteria

A) A distinct period of persistently elevated, expansive or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual non-depressed mood.

B) During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

1) inflated self-esteem or grandiosity
2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
3) more talkative than usual or [feeling of] pressure to keep talking
4) flight of ideas or subjective experience that thoughts are racing
5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
6) increase in goal-directed activity (at work, at school, or sexually) or psychomotor agitation
7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C) The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.

D) The disturbance in mood and the change in functioning are observable by others.

E) The mood disturbance not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.

F) The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication or other treatment) or a general medical condition (e.g., hyperthyroidism)

 

Most of the time, the hypomanic episodes just seem like I am “starting to get back to normal” after the incredibly overwhelming physical fatigue, mental fog, and emotional numbness of the depression.  I’ve spent the majority of the last three years in a state of major depression, occasionally getting a short burst of energy (the hypomania, but I couldn’t label it yet), and occasionally “falling off a cliff” into the deep, black hole of severe depression.  Though I’ve had bouts of depression periodically before, I’ve thought that this latest, three-year-long go around was post-partum depression that was just being really stubborn, even though I’ve been on three different anti-depressants since my last child was born 18 months ago.  Each time my medication has changed, I’ve thought, “This is the one that will work.  This is the one that will get me my life back.”  What I didn’t know is that for someone who is bipolar, taking anti-depressants without an accompanying mood stabilizer can make it all much worse, often in the form of rapid cycling. 

“Rapid-cycling” is defined as cycling back and forth between the manic and depressive states at least four times in one year.  How about four times in one month???  Would you be confused?  What about the people who are stuck living with you?  Before I was diagnosed and entered treatment a few weeks ago, my husband could not understand why even though I was on meds, one minute I seemed fine, the next I could barely get out of bed, the next after that I was biting his head off for no apparent reason and scrubbing the kitchen like a madwoman (ha!), and yet the next I was sobbing uncontrollably.  And if HE couldn’t (can’t) understand, I shudder to think what kind of emotional chaos my three young children have been experiencing.  (No abuse happening here; please DO NOT call child welfare services.)

 

I’ve been doing a lot of reading about this disease lately.  Several things I have read stand out.  The first is a little chart that shows mood:

 

I tend to spend most of my time on the spectrum above at the point labeled “Mild to Moderate Depression.”  I experience periodic “jumps” up to the level of “Hypomania,” and periodic “falls” to the level of “Severe Depression.”  In the last many years, there has been very little time spent at the level of “Normal”/”Balanced” or “Joyfulness.”  To me, hypomania is what feels like “maybe I’m starting to get back to myself again.”  And severe depression is what I call “falling off a cliff.”  Sometimes, I experience what are known as “mixed” episodes, which include aspects of both depression and mania.  For me, those are especially unpleasant times,  and particularly distressing symptoms appear.  (Which I may detail at some point, but for now, that is between me and my doctor.  It was a spectacularly bad mixed episode that got me into treatment almost two months ago.)

 

Another thing is from a book called Bipolar Disorder Demystified by Lana R. Castle.  She writes of language, and how the way in which we speak of something can connote stigma or acceptance, and lists several reasons people with this disorder may put off treatment:

“FEAR – Your brain represents your very essence and identity.  And virtually no one finds the term mentally ill a compliment.  “Brain disorder” takes away some of the sting, yet it’s still terrifying to realize that something is wrong with your mind.

STIGMA – You may worry about what others will think and be concerned that you’ll be labeled “crazy.”  You may fear that others – even family members and close friends – will reject you.  …  It’s true that many people still don’t realize that mood disorders are physical illnesses just as deserving of treatment and respect as other medical conditions.  But we’re slowly educating our society on that fact.”

“All too often people confuse the term depression with merely feeling “down” or having the blues.  A more accurate name for mood disorders might be hypothalamic-pituitary-adrenal disorders.  But that’s a bit too tongue-twisting for everyday use.”

In another book, Living Well With Depression and Bipolar Disorder, the author, John McManamy, writes:

“…a psychiatrist confirmed what I had known but what I had been afraid to face up to all my life – that I wasn’t like the other 96 or 97 percent of the population.  I wasn’t normal.  Never was.  I had been lying to myself all these years.  Ironically, having accepted that I’m different, it’s much easier these days to pass myself off as normal.  But first I had to get through grieving the loss of the person I could never be.”

For the first time, I am finding that there are others who truly know what it is like inside my head.  Mostly because I am reading what it is like inside of theirs.

There are many aspects to this disease that I have been thinking of writing about, but I’m having a hard time putting all those thoughts into one post.  (Shocking, right???)  I’m sure I will write shorter posts in the future that contain those more specific, narrow thoughts in a given area.  For now I just want to get it out there that this is where I have been.  This is what I am dealing with.  The grief I am feeling over the loss of who I can never be is very real.  I am trying hard to work with my doctors to find a treatment regimen that will keep my symptoms under control and enable me to live a stable life somewhere in the middle of the spectrum above.  Mostly, I am tired of pretending that everything is fine, that it’s all okay, and that I don’t need anyone’s help, but I do not want anyone to think that I am going to play the “victim” card and expect a free pass on bad behavior, even if it is sometimes illness-induced.  Being “called” on a spate of irrational behavior is what got me into treatment in the first place.  (And a huge thank you to my dear friend, who knows who she is.  I am so grateful!  Another huge thank you to a physician friend who helped me to navigate my health care system and find a psychiatrist when I was in crisis.)  I admit that I am afraid of scaring some of you away, but that is an issue for another post.

Hmmm…  I’m finding there is really no good way to wrap up this post, so for now I’ll just say “until next time…”

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