Hey guys, guess what I found out recently? I'm not just depressed... I'm bipolar!
Depending on how well you know me, I imagine you might have one of the two following reactions:
1. What... really? No way! Ok well... that's sucks.
2. Oh... oh?? Oh! Well that actually explains a lot...
At least, these are the most common responses I've heard when telling my friends one-on-one. Most of them had witnessed me in a depressed state before, but most couldn't remember ever seeing me in a manic state. This is not surprising, considering that I didn't even recognize my own hypo-manic episodes when they were happening!
There is also a vast spectrum of knowledge about bipolar disorder even within my well-educated, intellectual friend groups. Some people have heard of it but don't know what it means. Others have lots of personal or family experience with bipolar or a similar mood disorder. Even those that are familiar with the disease seem to have a lot misconceptions about it. Since my own diagnosis, I've already felt the weight of the social stigma associated with mood disorders and mental illness in general. As a result I am considering getting involved in mental health advocacy, and this blog post is my first step.
Eventually I would like to tell "my story" in full, but since I am still piecing it together for myself through a new perspective, I'm not sure where to start. So instead I will answer some questions that I anticipate from my community:
Why are you telling us this?
I've always been a very public person. Back in my livejournal days, I would publish even my most emotional posts publicly for the whole Internet to see. Now I tend to use a little more discretion, but the principle is the same: I like to wear my heart on my sleeve.
Even during periods of depression, I had no problem admitting to my friends or coworkers that I was depressed. Those around me were usually compassionate and gave me the slack I needed to get through it, because they could tell that underneath this weight of depression was a bright and dedicated person who was trying her best not to let anyone down.
But this! Bipolar disorder?? The moment I heard my new diagnosis, my own stigma kicked in and suddenly I was scared to open up about it. And that is precisely why I need to do it.
I took some time to digest this new information and process it with my close friends, but now it's time for me to take a note from the LGBT community and come out. My reasoning is: the only way we can dissolve this social stigma is by showing the world how many of us capable adults are out there recovering from mental illness.
How did you "find out" you were bipolar?
There is a very long version of this answer that I will not go into in this post, but for now I will try to summarize.
I've been on various antidepressants over the years, but the last one I was prescribed was Effexor. I started taking it in June 2014, and it was extremely effective at pulling me out of one of the worst depressive episodes in my life. What I didn't know at the time was that this type of antidepressant (SNRI) is known to preclude manic episodes in patients with bipolar disorder.
In January 2015, I had my first major manic episode that was clearly identifiable by any mental health professional. It probably began shortly after New Year's Eve, but only spiraled out of control a couple of weeks later. On Tuesday Jan 13th, my therapist made a note that I was behaving strangely and to monitor this in our next session the following week. She had no way of knowing that by Saturday morning I would be in the midst of a full blown delusional manic episode.
I can tell you what that was like another time, but suffice it to say that I was making no sense and behaving so out of character that my boyfriend had no choice but to call 911 and have me taken to Psychiatric Emergency Services. In the emergency room they gave me a shot of Haldol to bring me down, and I spent the next 72 hours under observation in a facility that seemed halfway between a hospital and a prison. I was released Tuesday, January 19th once they were sure that I was lucid, functioning, had a good support system at home and a follow-up appointment with my psychiatrist scheduled the next morning.
Wow... Are you okay?
Actually, yes, thanks for asking! I feel better than okay. The first week or so was really rough, because they took me off of all my existing medications at PES so I was still going through some withdrawal. Also it took a few days for my new medication (only one! A mood stabilizer called Depakote) to kick in.
But now that my meds are getting stable and I've mostly come to terms with my illness, I feel a sense of balance that I don't remember ever having before.
It will take time for me to settle in to this feeling. I suppose that in the past, I've assumed that life would always be such a roller-coaster of ups and downs. Because everyone has those, right? I knew my downs were more pronounced than usual (hence the depression diagnosis) but what I didn't realize was that my ups were not normal either.
I knew how to be depressed without being overly sad, because I knew that depression wasn't really about sadness even if it felt that way. Now, I am learning to be happy without being so intensely excited, because I have realized that ambition and motivation don't have to feel like being on the edge of your seat all the time. Furthermore, when I do get excited about something new, I now recognize that slipping back into depression is not inevitable once the initial excitement wears off.
What are you going to do now?
The short answer is: Recovery. But that's an incredibly ambiguous term that wasn't even widely used in the mental health profession until recently.
From what I understand so far, there has been a shift over the last decade or two amongst some mental health professionals who have decided take a new approach to mental illness. This recovery approach is more akin to recovery from substance abuse and addiction problems than to medical treatment of an illness. Although medication is still an important factor, the focus is to gain self-acceptance and -awareness so that one can identify symptoms early, and to learn coping methods to deal with those symptoms as they occur.
On an individual level, recovery means different things to different people. So far I've identified a few things that I think will work for me:
- Focus on my personal relationships and maintain them in a mutually supportive way. My close friends and family have been invaluable in helping me through my roughest patches and I am so grateful!
- Better define my personal goals and career ambitions. Many of my frustrations in life, and the precursors to both my depressive and hypo-manic episodes have been career-oriented. Upon reflection, I think many of these frustrations were a result of allowing my schooling and most obvious career path to make my decisions for me rather than to pave my own way in the world.
- Help others and give back to my community. While I was still in the psychiatric facility myself, I found myself connecting with the other patients. There was one guy in particular that was very agitated, so I would talk him down and tried to help him remain calm and balanced. I think this says a lot about me, but I will not pretend that this trait is purely altruistic. I'm an extrovert and I rely on other people for support -- both those that are sicker than me at the moment, and those further along in recovery -- but it is much more gratifying to me if I can see that the benefit is mutual.
Sounds good. Anything else we should know?
If there's one thing I've learned recently about mental illness that I would like the world to know, it's this:
It is just so. damn. common.
Wikipedia tells me that "about 3% of people in the United States have bipolar disorder at some point in their life." That doesn't actually sound like much, but consider that bipolar is on a spectrum of mood disorders that includes everything from mild seasonal affective disorder (SAD) to schizophrenia. Some of these disorders differ from each other only in terms of the level of psychosis observed in the patient.
I feel like most people (my past self included) think of SAD, other depressive disorders, and even bipolar II as one thing, whereas psychosis and schizophrenia are something completely different. It's an us/them mentality, where anyone who has displayed psychosis is immediately part of "them" aka "the real crazies."
Well, I have crossed over that line. If you know me at all, you know that I'm normally very reasonable and rational, and you probably can't imagine me going off the deep end. But I did. I saw the other side and I came back, and now I'm mostly back to my old self. But I was a good case, an easy case, with the right support system in place and access to the right services. Not everyone has that, and it is not their fault.
There is no Us vs. Them when it comes to mental illness. We are all somewhat broken and maybe we can't be "fixed," but with the right care and support we can all recover and live happy, meaningful lives.
