Diagnosis

In December of 2014, I sat in my psychiatrist’s office as she asked me questions like, “Does it feel like your thoughts are racing?”, “Do you have a hard time focusing?” and “Are you sleeping?”   Were my thoughts racing?  OF COURSE THEY WERE!  Doesn’t everybody’s?  Did I have a hard time focusing on one task at a time?  Obviously!  I am a very busy person!  Was I sleeping?  I slept until 4 am every day, when I spontaneously woke up and starting thinking about my to-do list.  In addition, my senses were heightened.  Colors were brighter, sounds were louder and smells were stronger.  It felt like my brain was on fire.

My doctor’s next words were, “This concerns me.  I think we might be dealing with bipolar disorder”.  I burst into tears.  (Side note:  It’s never good news when your psychiatrist says, “This concerns me.”)  She clarified that she thought I had Bipolar Disorder Type Two, a diagnosis later confirmed by my current psychiatrist.    Bipolar Disorder Two is characterized by periods of depressed mood alternating with periods of hypomania (less than full mania), often with long periods of normal mood in between.  (Footnote 1.)

I’ve always experienced periods of intense productivity and energy, when I feel connected to the universe, can work tirelessly, am excited about life and feel full of hope, creativity and plans for the future.  I’ve also experienced periods of real depression, instability and extreme agitation.

My life story was unusual, though, so it seemed natural that my moods would be extreme.  I was born into an established, upper middle class family in Tulsa, Oklahoma.  We enjoyed a beautiful home, a country club membership, nice cars, trips to Vail and the Bahamas and an extended network of family all within a few miles.  We were happy.  Through bad luck, a downturn in the economy, and most likely an undiagnosed mood disorder on my dad’s part, though, my dad lost his business and we lost everything.  When I was eight, we sold our possessions and moved to California with nothing: no money, no family and no connections.

The next several years were a struggle and weren’t happy ones for my family.  My mom kept a roof over our heads with her teaching job, and my sister and I worked hard to get scholarships to college.  I loved school and was highly motivated to succeed.  Some caring adults took my under their wing, and I got lucky.  I got into Stanford and received enough financial aid to attend.

As a result of these circumstances, I viewed my life in terms of survival.  I was born into wealth, a large extended family, and a happy life.  Then we lost everything and it all fell apart.  My family fell apart.  Through hard work and determination, though, I had fought my way back to the top.  My life had been bipolar.  Who wouldn’t have had some extreme moods in these circumstances?  I had fucking made it.    

By the time I sat in my psychiatrist’s office at age 35, though, I suspected that I was different, and not just in terms of life circumstances.  My life was very stable by that point, but my moods were not.  I was happily married, we were financially stable, I had great family and friends, and my life was generally pretty great.  Despite this stability of circumstances, though, I still had “on” days and “off” days.  During the “on” days I could care for my kids, eat healthy food, exercise, do errands, engage with others socially, get all sorts of things done, and felt excited about life.  On the “off” days, though, I felt no joy about anything and just wanted to sleep.  I wasn’t able to care for my kids without hiring help, and this caused me endless shame.  I couldn’t reconcile my “on” self with my “off” self.  How was it that I had run a fucking marathon, but couldn’t function?

It was obvious to my psychiatrist on that fateful day in 2014 that I was in the middle of a full-blown hypomanic episode, triggered by being on an antidepressant.  This is a very common fact pattern:  person with latent bipolar disorder gets depressed, seeks help, is incorrectly diagnosed with simple depression, is put on an antidepressant, gets hypomanic (or manic) as a result of the antidepressant, and is correctly diagnosed with bipolar disorder.  (Footnote 2.)

I knew my brain felt out of control, and started to wrap my mind around the idea that it had a label.  For the first time, I considered the possibility that my extreme moods weren’t normal.  My doctor immediately started weaning me off the antidepressant, and started the process of putting me on the correct medication.  Recovery began and it was official.  I was bipolar.

Footnote 1.  www.webmd.com/bipolar-disorder/guide/bipolar-2-disorder#1

Footnote 2.  www.psychiatrictimes.com/bipolar-disorder/switching-mood-depression-mania-antidepressants

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