Last week I was diagnosed with Bipolar II, after years of being treated for depression. It’s not uncommon for people to get this diagnosis years later. It makes sense, when you think about it.
When it comes to diagnosing mental illness, doctors, whether GPs or psychiatrists, are largely reliant on what they see and hear from us. It’s not like there’s a blood test, or an MRI, that can confirm depression or bipolar.
And who goes around complaining about feeling full of optimism and self-confidence?
Or having bursts of creativity and productivity that don’t even need sleep to fuel them? Hell, those bursts laugh at sleep.
Or feeling unusually social and uninhibited; senses alive, with an extreme connection to music, texture, light?
Being on fire – the multi-tasking queen getting stuff done. Brilliant ideas and exquisite plans flying through my brain at the speed of light, so fast I can hardly capture them all. Thank god for sticky notes. (That is, until a few days or week later, when I look around at all the notes fluttering from my desk, monitor, notebooks, and, with a little more clarity, peel them off, crumple them up and wish I’d bought stock in 3M.)
No, we most often seek help when we have fallen so far down the rabbit hole we can hardly get back out on our own. When our brains are too dull and bogged down to process information. When we feel empty, numb and exhausted. When we don’t care about anything. When we are teetering on edge of the void of depression – that’s usually when we go to our doctors. That’s when they see us. And when they ask how we’ve been feeling, it’s the depression that’s top of mind, so that's what we tell them about.
So it’s not hard to fathom that after years of being treated for depression, but not responding, a person can find out they’ve been misdiagnosed. Especially when it comes to Bipolar II, in which depression is often the more noticeable state and the highs (known as hypomania), while disruptive, are not as destructive as the mania that accompanies Bipolar I.
Of course, there’s no guarantee that this is the right diagnosis either (cylcothymia is another option). However, given my history, both my psychiatrist and I feel quite confident we’ve got it right. But only time – and treatment – will tell.
As for treatment, he’s added Lamotrigine (mood stabilizer) to the Cymbalta (antidepressant) I am already taking. And he’s prescribed routine – for sleep, eating habits, exercise, chores and hobbies – as essential. Routines are stabilizing.
Sounds reasonable. Except I’ve spent my life eschewing, as much as possible, routines. Schedules and plans make me itchy. I’ve lived a lifetime of eating when I feel hungry, sleeping when I need it, creating when I feel moved to do so. I hate making plans, I avoid committing, because who knows how I’ll feel, what I’ll feel like doing, at any given time.
"Fly by the seat of her pants Cheryl" has some adjusting to do.