i have not taken my bipolar diagnosis well, and that’s putting it lightly. emotions ranging from deep depression to unbridled anger fill the spaces in between absolute shock. one friend, in a noble attempt to positively reframe my perspective, pointed out that the diagnosis changes nothing. i am the same person i was before the diagnosis, except now i have a diagnosis to help me understand behavior that was already there.
strictly speaking, this is true. unfortunately it doesn’t really make me feel much better. and, i figure since my byline is “diagnosed bipolar and pissed about it” an explanation is in order.
this won’t be a comprehensive post because one of those entails doing more research than i’m in the mood for right now. i do have a few references in order and the general idea down, but i will likely write more about this in the future.
when i first went in for treatment last december, it was because i felt depressed. i had been essentially non-functioning for several months by then and i couldn’t pull myself out of it. none of my usual tricks worked. i got to a point where if i washed a single dish, that day was successful. by the time i was finished, i would be exhausted. i wouldn’t have even gone into psych services if one of my relatives hadn’t insisted i get help. i had a brief flash of motivation, and acted on it.
up until this point, i did not like the idea of taking anti-depressants. the situation had become so dire, however, that i wanted anything that would work. living that life was absolute misery. hopeless and empty don’t begin to describe it. so i was ready for anything. therapy, meds, you name it. i started medication as soon as i could and met with a counselor to see about processing through some of the depression. psych service counselors are short-term only though so i knew i wouldn’t be able to get much done. still, any progress would be good progress.
it turned out that i would get nothing done with that counselor. i told her my most memorable childhood memory, the one where my sister’s dad is on top of my mother in the living room. they have been fighting. i don’t remember the domestic violence in that particular scene but i am sure it had preceded what i was observing. i remember feeling scared. terrified. my mother is shouting to me, ‘call your grandma!’ and he is shouting, contradicting her, ‘no, don’t call her!’ i know my mother is trying to protect me, to get me out of there, and my sister’s dad is trying to make me feel like i have to choose a side, to confuse me. i don’t know what happened in the end. i just remember i am crying. it’s strange; i can even see myself crying, as if i’m watching myself from the outside. i was probably 3 or 4 years old. later i begin to suspect he was raping her. i don’t know this for sure and i don’t have the guts to ask.
the counselor stopped me cold and said i needed to go to trauma therapy. intensive trauma therapy, she said, probably for at least a year or two. i had already suspected PTSD, specifically complex PTSD, so this wasn’t particularly shocking. i stopped seeing the counselor and resolved to start intensive trauma therapy in a few months after moving back home. after all, i didn’t want to begin trauma therapy locally, move, and then have to start all over again.
the prozac worked like a charm. a little too well, perhaps. i was flying high and accomplishing things…lots and lots of things. boy, i thought, this stuff is great! what was my problem before? then i wanted to accomplish EVERYthing and i put quitting smoking cigarettes at the top of the list. wellbutrin had been my drug of choice for smoking cessation, so i requested it again once we had arrived at the appropriate dose of prozac. successfully quit smoking, but then was really over stimulated. i had muscle tension, anxiety and panic, jaw clenching even worse than normal, etc. so i asked the doc to switch me over to zoloft. that took away the stress alright…and just about everything else too! i didn’t care about anything and i was just happy to sit on my couch and hang out. apparently, this is called ‘complacency’ but i call it ‘what happens when modern medicine imitates mary jane’ (pot).
unfortunately being sober-stoned wasn’t going to fly either, so we did a couple more changes: changed wellbutrin to instant release 3x a day, and when that was done, switched back to prozac. this all occurred within a ~3 month period and i was a fucking wreck at the end of it. no day had been alike that whole time, and i was unable to predict my functioning from one day to the next. we probably would have kept going if that psychiatrist hadn’t left the office and i hadn’t been transferred to a new one.
my first visit with her was a day before my birthday and about a week after my sister had been hospitalized for suicide threats. i was, to say the least, a fucking shit show. i hadn’t slept the night before because i spent the weekend working on a manuscript, and i had taken nuvigil to help me with that. you could say i was a bit wired by the time i showed up.
after i gave her the medication recap, it took her all of about 5 minutes to ask if i had any family that had been diagnosed with bipolar.
time came to a complete stop. i remember thinking, wait, why are you asking about bipolar? i’m here for depression. i’m not bipolar. i mean my sister was just diagnosed with bipolar but that doesn’t mean anything.
i’m sure my facial expression said the same thing. i seemed to respond in slow motion, yyyyeeeeeeessssss, mmmyyyy sssiiiiiiiiisssttteeerr wwaaass jjuuusst ddiiiaaaggnnooosseedd. my heart was sinking. i wanted to throw up.
she asked about our parents’ behavior and i explained that we had different dads and, well, my mom hadn’t been diagnosed with bipolar so the thing with my sister being diagnosed doesn’t really matter, right? i think this is the only time in my entire life i tried to separate myself from my sister, to distinguish between us. to highlight our differences rather than reinforce our similarities. i felt like an asshole but i was in panic mode.
then this woman asked about our parents’ behavior. not diagnoses, but behavior. normally, i would have been proud of this behavioral assessment, but all it was doing was bringing me back to the conclusion that i may be bipolar. shock was setting in by the time she requested another appointment for a ‘full evaluation’.
i knew based on diagnostic criteria, i would fit on the bipolar spectrum. others told me to ‘wait until it’s official’ which i just found fucking annoying. by the time she completed the full evaluation the following week, i was given an unofficial bipolar 2 diagnosis, and an official ‘mood disorder, nos’. now i couldn’t avoid it. even today, i am still grasping at second and third opinions but my hopes are pretty low at this point.
here’s the thing. depression and PTSD are not necessarily chronic conditions. they both can be treated and can eventually go away at some point.
bipolar is a different animal entirely. here are some “highlights” of the bipolar beast:
- bipolar is with you your entire life (source: http://www.nimh.nih.gov/health/publications/bipolar-disorder/nimh-bipolar-adults.pdf)
- you can manage symptoms but they only go in remission, not away as in depression and PTSD (source: http://www.nimh.nih.gov/health/publications/bipolar-disorder/nimh-bipolar-adults.pdf)
- the primary form of treatment is medication and you should expect to be on medication for the rest of your life (source: http://www.nimh.nih.gov/health/publications/bipolar-disorder/how-is-bipolar-disorder-treated.shtml)
- you should also probably be in intensive psychotherapy for the rest of your life (source: http://www.nimh.nih.gov/science-news/2007/intensive-psychotherapy-more-effective-than-brief-therapy-for-treating-bipolar-depression.shtml)
- bipolar runs in families. with one bipolar parent, chances of a child having bipolar are 15-30%; with two bipolar parents, chances increase 50-75% (source: http://www.dbsalliance.org/site/PageServer?pagename=about_statistics_bipolar)
- as many as 1 in 5 bipolars complete suicide (source: http://www.dbsalliance.org/site/PageServer?pagename=about_statistics_bipolar)
- expected lifespan for bipolars is reduced by 9.2 years (source: http://www.dbsalliance.org/site/PageServer?pagename=about_statistics_bipolar)
each of these factors has been difficult to accept and a source of bitter anger. some are more traumatic for me than others. out of all of them, the one that really got me in a bad way was (is) #5. seriously, this part of bipolar fucks up everything.
having a family is a personal choice, along with all of the factors one considers when thinking about starting a family. to me, it was a deeply important goal because i had considered it an opportunity and privilege that would help me heal. let me explain. i have touched a bit on my early childhood here already but for simplicity’s sake let’s just say it was a goddamn freak show.
like many people, i wanted what i could not have. and i wanted it badly. as far back as i can remember, this started with a desire for a loving life partner. no one in my family seemed to have this one under their belt, and they still don’t. i admit i have spent an inordinate amount of time reading about, thinking about, observing, or practicing relationship skills. i have fostered characteristics and skills that would facilitate a loving relationship for as long as i can remember. i don’t tell many people this, but my career path and personal choices have all been made with a relationship and family in mind.
for many of my years, children were out of the question because i did NOT want to repeat history. the possibility made me sick and there was no way i could allow that to happen. you know that saying, like mother like daughter? no phrase has scared the pants off of me more than this very one. when unknowing people suggest my boyfriends look at my mother to see how i will end up, i shiver and hold back tears.
one thing was for sure, any and all children would NOT be had until i had a steady career and a steady marriage. under no other circumstances was i willing to bring a child into this world.
i used to feel sorry for myself a lot. i’d see other people who clearly admired their parents. their mothers were actually…mothers and cared for them. those children were not seen as a burden or an inconvenience. importantly, their mothers wanted to be mothers, to nurture and raise, to help and support. mother’s day is and was especially hard because the universe of possible awesome mom behaviors is advertised everywhere.
i remember the day i broke. i was shopping with an ex boyfriend from two years ago. we stopped in a williams & sonoma so he could take a look at gifts for his own mother, since it was right around mothers day. i hadn’t spoken to my mother in 6 months and that period would stretch to 2 years, so i was there and trying not to dwell on the periodic feeling that i was gipped.
this store, however, had a big display in the front advertising the wonderful behavior of mom and oh don’t you remember when she was awesome and, you know, a MOM? bitter feelings flooded me and i was one big pity party, feeling sorry for myself because i would never have that.
then i had a beautiful epiphany. wait a tick, i thought, i may never get to have that mother…but i could certainly be that mother. and with this thought my entire life changed.
seriously, it was that transformative. i no longer felt sorry for myself. i was able to let the past stay in the past. my focus shifted from what i don’t have to what i do have, and from my past to my future. it was a realization that shook me to my very core. a key part of it was the knowledge that i could create my own concept of motherhood, i could build it from the ground up. i could take all the very best parts i had seen from other people and try to synthesize them into a coherent person.
this practice wasn’t new to me; often i had to construct things completely from scratch because i didn’t have a model to work from. it has its benefits and costs. but it would work, and it would be lovely.
so now, bipolar disorder is throwing a wrench in my plans. remember the statistics: with one bipolar parent, chances of a child having bipolar are 15-30%; with two bipolar parents, chances increase 50-75%. the idea of producing a child who will spend most of his or her life depressed, with a reduced life expectancy, a 1 in 5 chance of completed suicide is NOT what i had in mind when i was thinking about having kids. i can’t bear the idea.
so now, kids are likely out of the question. in that case, why get married at all? i mean, the marriage institution is (imo) really only so my children have security.
and if kids and marriage are out, then what the fuck have i been doing all these years? what am i doing in a phd program? had i known i was going to be diagnosed bipolar, i would have stuck to the more artsy stuff that i was passionate about instead of going and trying to be responsible. dance. painting. sculpture. performing arts.
now i’m going to be paying off a fucking degree for years that i may not even get to use fully. the thing is, I JUST DONT KNOW. after all my careful thought and planning, bipolar has thrown me back into the void, where i don’t know what’s going to happen. i can’t make predictions and so i’m just stuck like a pig in mud.
and that, ladies and gentleman, pisses me off.