My Mental Illness Diagnosis Is Too Frightening To Face.
“This illness is about being trapped by your own mind and body…My mood may swing from one part of the day to another. I may wake up low at 10am, but be high and excitable by 3pm.” -NCBI article from The British Journal of General Practice: ‘On madness, a personal account of rapid cycling bipolar disorder’, written by J. General Practitioner.
Wednesday evening: my scalp tingles. I think to myself, “I’m so glad my depression only lasted one day. I can’t wait to cook dinner for my husband.” I play a mix on Spotify, singing along to the songs as I chop lettuce and boil water.
I joke around with him as we’re eating. His facial muscles relax as he must realize I am over the tempest of yesterday’s constant self-deprecation. My inability to mutter more than a couple of words at a time. My repeatedly telling him that I wish I could get a lethal injection.
I don’t know how he lives with me, being such a depressive. But tonight I’m thankful he’s rolling with my rapid switch from misery to contentedness. He must be used to this by now. Maybe he stays with me because he waits for these “up” moments.
I get into bed, turn on my electric blanket, and look forward to reading the memoir on heroin addiction I recently downloaded on my Kindle. “I love memoirs about drug addiction,” I think to myself. The author’s descriptions of hustling for money to buy his next fix fascinate me. And it’s comforting to know there’s someone out there whose life is more toilsome than mine.
Thursday morning: I’ve slept 12 hours but I still don’t want to get out of bed. I feel like waking will expose me to a world I cannot face. “Oh no,” I think to myself, “What is going on? Why did things change so quickly?”
I stumble upstairs to make coffee. “Good morning, Babe,” my husband cheerfully acknowledges me, as he does every morning. I don’t want to upset him, so I force out, “Morning. How you doing.” He’s deep into his stretching routine so he doesn’t notice that I can barely speak.
As the coffee percolates, I log on to my laptop to answer emails I’ve ignored for two days. I stare at the words on the screen, but I can’t bring myself to answer anything. The task of even writing a sentence to someone feels insurmountable.
“Why do I even live?” I ask myself. I look out the window, and even though it’s a sunny day, the trees and the sky look grey. They feel grey. There is no substance to them; they are like black and white cutouts from a newspaper.
I guzzle my coffee, hoping my low mood is the result of a caffeine deficiency.
It’s not. I text a friend, telling her how depressed I feel. She writes back, “I’m sorry you’re having a rough time of it. My husband and son are not talking to each other. I should have seen it coming. I love them so much and hate this.”
I think to myself, “Wow, she is suffering a lot more than I am.”
I text her back, telling her I want to help and offer to take her away, if even for a few hours, this weekend.
She responds with, “Thank you. I may want to do something. Can I get back to you?”
My mood switches from hopeless to cheerful because I love my friend and I am glad I can help her when she’s suffering.
I also offer her a reassuring piece of knowledge someone once told me: “Remember, everything is impermanent. Everything.”
I feel a sense of optimism as I set my phone on the counter and return to my morning stretching.
But that sense of well-being only lasts about 20 minutes.
I’m deflated and despondent by 1pm. I get into bed and write in my journal:
I feel tired and sick and depressed AF. I went for a short walk because it was sunny out but it made me feel suicidal. I walked home near the railroad tracks and thought about jumping in front of the train.
I can’t live this way anymore. I don’t know if I’m bipolar or what.
I want to kill myself. Yet yesterday I was content all day. I wanted to die last Thursday, also, then felt cheerful again by Thursday night. It lasted through the weekend, for the most part, except for one low hour Saturday morning, followed by a high all day, where I organized and cleaned like crazy. Good God. I AM some type of bipolar. If they wanted to hospitalize me right now, I think I’d allow it.
I slept so much yesterday and last night and I want to go back to sleep this afternoon. I haven’t even showered today. I am psycho. I hate it. I am so sick of fighting this battle.
I lie in bed most of the afternoon. After a few hours I start to feel restless, and impulsively sign up for a spin class on the studio’s app on my phone. Enthusiasm floods me again. I get to go ride a stationery bike outside with music blasting. It’s like a dance party!
But I drive to class reticently, thinking, “I am the oldest person who’ll be in this class. I wonder if the other riders laugh at me behind my back because I’m 20 years older than they are.”
But by the time the music blasts and my heart rate soars, my mood’s soaring, also. It’s 45 minutes of house and hip-hop music with an instructor yelling, “You are brave. You are strong. You can do hard things!”
If I said this mantra to myself all the time, I think, I’d never get depressed.
The remainder of the evening, I put away my laundry that’s been sitting around for days, I open Amazon packages, I recycle boxes that have also littered the house for days, I banter with my husband, laughing out loud at our repartee.
Friday morning: I’m dreaming of my dad, who passed away 11 months ago. In my dream, he is still alive and we’re having lunch together. Daybreak forces its way through my bedroom curtains.
“Fuck,” comes out of my mouth automatically. It’s a horrible way to greet a new day, but I utter profanity because my dream is interrupted and I realize that I will never have lunch with my dad again.
More, the inception of day possesses my mind with dread. Oh, God, I have to get up and face another day, I think to myself.
My psychiatrist has suggested lamotrigine, a mood stabilizer, multiple times during our sessions. I usually dismiss the idea of taking the drug. “But I’m not bipolar,” I tell her.
If I were bipolar, I think, taking Prozac would have driven me into mania. My dad took a similar drug, Paxil, and it caused him to have his first manic break when he was 62 years old. He’d never before been diagnosed with any type of mental illness.
Wouldn’t Prozac have triggered a manic episode if I were bipolar?
A study in BMJ Journal concluded that “In people with unipolar depression, antidepressant treatment is associated with an increased risk of subsequent mania/bipolar disorder.”
Perhaps, I start to consider, being on Prozac for decades has finally triggered the rapid and severe mood changes characterized by bipolar disorder.
I have also been in denial about the authority of genetics. The fact that my dad had his first hypomanic episode so late in life is significant.
I always thought, the majority of bipolar people start to show symptoms in their teens or twenties. Since I didn’t, I’m “just” depressed.
I assumed that I would already have experienced the risk-taking behaviors, excessive shopping, sleeplessness, delusions that typically characterize bipolar behavior. “I’m not like that at all,” I said to myself.
But in the past year, I have become more moody, sometimes my thoughts have raced so rapidly I have a difficult time communicating because my thoughts are racing faster than my voice, and, when I’m down, my preoccupation with suicide is frightening.
As I’m on a Zoom session with my psychiatrist, I ask again, “Wouldn’t I have developed mania from the Prozac?”
“Not necessarily,” she tells me. “Everyone is different and everyone reacts distinctly to medications.”
“So you’re saying I’m bipolar or cyclothymic or something like that?”
“No. I’m not diagnosing you as such. I’m saying you have bipolar genes, and people with these genes usually do well with lamotrigine.”
A 2017 NCBI article delves deeply into this illness:
“Cyclothymic persons react to positive events by quickly becoming extremely joyful, enthusiastic and active, in some cases they briefly appear excessively euphoric and impulsive.
They react to negative events (real or perceived) with disproportionally intense down-beating reactions. Even minor distress may precipitate a wide range of emotions and feelings, from unusual sadness to prostration, extreme fatigue, anguish, desperation, even to suicidal thoughts.”
That sounds so much like me.
I spend the entire day on line, researching bipolar disorder and cyclothymia.
It saddens me greatly that I may indeed have this illness, which, I have learned, I have little control over. A Harvard Health article concludes that “we are far from being able ot relieve all the symptoms or eliminate the worst consequences of bipolar behavior by drugs alone.”
Instead of treating “only” depression, as I’ve done most of my adult life, now I have to approach my affliction with a completely different mindset.
I started 25 mg. of Lamotrigine yesterday. I spent most of the day reading about bipolar illness and crying.
But today, I realize I have to accept that this may be my reality.
In J.K. Rowling’s Harry Potter and the Goblet of Fire, headmaster Dumbledore imparts his wisdom by saying, “Understanding is the first step to acceptance, and only with acceptance can there be recovery.”
I am now acknowledging my illness. It’s my only route to recovery.