things i have diagnosed myself with: part one

1. bipolar disorder without the highs and lows

I have come to the conclusion that I have a mild case of bipolar disorder. I have been in my “manic” phase for a couple of weeks and now am in my depressive phase. Bear in mind that my “mania” is another person’s depression. My highs are on the low side.  And my depression isn’t that impressive either. On really bad days, I skip the lipstick and consider driving my car into a tree, but who doesn’t? Seriously though, during my most recent “manic” phase I had this crazy amount of “creative” energy. Now when I say creative that sometimes means tearing my sewing room apart searching for the perfect fabric for another handbag-to add to my collection; or making fabulous labels, stickers and other not so useful things for my home based business; or making collages with pictures on my computer for no one in particular and wasting lots of expensive ink printing them out.   I call it a creative cluster fuck because mostly it means waking around my house in circles trying to figure out what to do with this energy and getting super frustrated that I can’t figure out how to channel it. It’s like me and anxiety. It’s not about anything. It’s free floating creativity, and it’s a bitch.

Now back to my depressed self.  I’m too tired to write an email. I wake up at 9:00 a.m. after getting eleven hours of sleep and I’m too tired to get out of bed.  A shower sounds like way too much work, but I insist on looking good at all times so I take the shower. When it comes time to squeegee the glass doors I start crying (it’s really hard to squeegee when you’re depressed) is that really how squeegee is spelled? I drink a pot of black tea and think about going out for a latte, but decide to take half a Provigil instead. Provigil is for narcolepsy or for people who lack the ambition required for a full fledged illness, and are just really tired like me.

My sister-in-law phones for our two hour catching up call. I’m lack luster but luckily she does most of the talking. Midway through the call I take the other half of the Provigil and about fifteen minutes later I realize that my personality has completely changed. I am now a very chatty, animated, peppy person. Unfortunately she has to go, so now I am all alone with my chatty self.  I decide to write an email. It wants to be a long, effusive email but I have this problem with my tailbone, coxodynia, or as my doctor calls it, a sore ass. So even though I want to keep writing because I have a lot to say, I have to stop due to the fact that I cannot sit for more than five minutes without my coxodynia acting up. So now I am depressed because I can’t do what I want to do, and the Provigil has worn off and my ass hurts.

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4 responses

  1. You are my hero.
    Sometimes I diagnose myself with bipolar disorder, too. That’s because I get depressed, but sometimes I’m not. The “not” part is the manic phase. The manic phae may involve getting out of bed without significant psychic pain, chatting happily with people I don’t know, and verbalizing strong enthusiasm. If I use hand gestures while expressing said enthusiasm then I know for sure I’m in a dangerously manic phase, and I’m embarassed afterwards.

    I thought I was depressed just now but your blog ismaking me laugh out loud so who knows what the hell is going on.

  2. Sorry for the length in advance :).

    I learned long ago, in what we affectionately termed in graduate school as “Insurance Appeasement” (the actual title of the class was “Mental Disorders” or something along those lines) that the DSM–where all these diagnoses are written down in a suspiciously Bible-looking tome–is not, in fact, a tool for diagnostics. Nor is it useful in any way except one: to give mental health professionals some tool with which to converse with one another regarding someone in treatment. It is written by a group of stodgy psychiatrists that are big wigs in the American Psychiatric Association, and they are just as vulnerable to in-fighting and micro-politics as anyone else. As a result, the things you can Google-agnose yourself with are mostly constructs of a combination of American culture, politics, medicine, money and mental health, probably in something close to that order.

    Absolutely there are mental disorders out there, and I have spent my adult life studying them and how to treat them. But the DSM does not distinguish between its contents that are written primarily from a place of mental health and healing (schizophrenia, Tourettes, Mental Retardation, Bipolar Disorder I etc) vs those written primarily from a place of politics, culture, fad or money that so color the written description of the actual issue that it is perverted to be unrecognizable (ADHD, Autism, Bipolar II). Most of these things exist–they are real. But to take the DSM too seriously and to use it to diagnose yourself is to lay yourself prone in front of a lot of factors that do not have your best interests at heart. There is so much written into the descriptions of these illnesses that is too broad or too specific, too off the mark, too arbitrary or simply there to pander to a group that has lobbied for it to really take many of the diagnoses seriously.

    Nevertheless, imperfect as it is, the DSM allows me to pick up a phone in say, Williston, North Dakota and call a psychiatrist in Washington DC and be able to outline to that doctor a patient they have never met in less than ten words. The full picture isn’t drawn but with a diagnosis you do not have to spend time hashing out the most basic of the details, and you have a general idea of what medications or other treatments might be available or have worked on other people with the same words attached to them. It is akin to building a house with 2x4s you get from Lowes, as opposed to going to the forest, cutting down the tree, cutting the boards, planing them, and THEN building. Saves a lot of time and effort. This shortcut at the very start of the process is the ONLY thing the DSM is good for.

    A lot of therapists don’t want to tell their clients what their diagnoses are–inevitably they go home and Google it and decide things about themselves and what their options are for getting better based on what they read, which was of course based on the DSM. But it was never intended that way, as a tool to judge oneself or put you into a box about what you must be like or what your prognosis must be. It was intended as a way for professionals to have a spot to START talking, a set of broad strokes that speaks to a huge group of people, not to individuals. When you start applying the DSM criteria to individuals too seriously, you miss things about the individual. That is, as we say in the biz, “bad practice.” 🙂 You diagnose, you send it to Medicaid for reimbursement of your work, and then you get down to the business of learning about the person in front of you.

    Anyway, remember what I was saying about how some diagnoses are more influenced by fads and politics and money than others? One of these diagnoses is Bipolar II. You are describing Bipolar II in your post; Bipolar I is the classical idea we all see from movies or in books–up for days at a time, 10 sex partners in one night, spending $50K in a day, writing a 300 page book in two days without sleeping… and then (most Bipolar people) crashing to the worst, most hopeless place imaginable, where you cannot even conceive of a world outside your bedroom. In actuality, you don’t need the depressions to be diagnosed as Bipolar… its rare not to have them but some people don’t. You just need the mania. Bipolar I is highly established as a diagnosis, it is easy to recognize, and is highly reliable in that if you give the person I described above to 10 different mental health professionals, at least 9 of them would come up with some flavor of the Bipolar I diagnosis.

    Bipolar II is NOT reliable in this way and those 10 professionals are quite unlikely indeed to agree to it based on a client in front of them. It is based on this highly dubious idea of “hypomania.” You describe something that would fir the criteria well in your post, I won’t try to do better–but, you’re not up for days, you’re not crazily spending money or compulsively acting out sexually or any other way–you’re just, basically, filled with restless energy. I am sure that if you look at the criteria for Bipolar II, you would meet it. So would I. So would a lot of people… the lion’s share of whom don’t have any problem at all, despite fitting in a diagnostic box (this is also true for ADHD, for example). The boxes are just too big.

    I think Bipolar II is an attempt to explain not a mood disorder but a general type of anxiety disorder mixed with some depression, or for some people, a really strong drive to succeed! The trouble is… Bipolar I is a highly (for mental disorders) genetically based disease. It’s real. It’s reliable. It’s cross-cultural (you’d be surprised how many disorders aren’t found on other cultures at all). Bipolar II… isn’t. So why are they lumped together? Because if you give people who are exhibiting these symptoms a Bipolar diagnosis, you can sell them more mood stabilizers. Mood stabilizers work, even on people without a mood disorder, so you think, “well it worked so that must have been the problem.” But an anti-anxiety med might have worked just as well, or some therapy. But… many of the new mood stabilizers are very, very expensive medicines–and many of the anti-anxieties aren’t. I don’t think this is a conspiracy theory, I think this diagnosis and many others are heavily influenced by people and organizations that have a vested interest in money… but not mental health.

    In other words, you can Google for the rest of your life and not find answers, because the diagnoses were never intended to give them, and even if they were, they can’t.

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