There’s Nothing “Hypo” About It

Four or five weeks ago a wave of hypomania hit me so abruptly I felt like I was suddenly caught in the midst of a hurricane. It was in fact the beginning of a mixed episode more intense than any I had ever experienced before. I had read and heard that bipolar disorder has a tendency to get worse with age, that for some people each episode implies that each concurrent episode may be more severe than the last. And so, I had experienced with bipolar depression, but never with the flip side.

I was feeling so angry, irritable, and upset. There were some situational things going on in my life that would explain being upset, but that couldn’t explain my desire to put my hand through the wall. After a few days of feeling progressively worse, I realized that it was more than situational. I was furious all the time and the only thing getting me through the day was a particular fantasy. When I started to feel my anger spiraling out of control to the point of feeling violent, I would imagine myself holding a sledgehammer, walking through various buildings, and breaking everything in site. It was a very therapeutic fantasy and it got me through the most difficult periods.

My nurse psychiatrist put me on trileptal at first, but that almost immediately may be significantly worse. Within twenty-four hours I felt maniacal and didn’t take more than two doses. During the several days without medication while I was struggling with this furious anger and maniacal energy, one day I got up, put on my sneakers and went for a run. If you know me, you know that this is completely out of character. I think the last time I was able to run more than ten feet was at the age of sixteen. So this in and of itself gives you some idea of what it’s been like. At the end of that first run, I finally felt normal again for the first time since the whole thing began. I’ve been running a few times a week since then. It’s the only thing that pretty reliably makes me feel normal.

The sledgehammer fantasy led to the idea to go the batting cages, which is something else that my husband and I have been doing about once a week since this whole thing started too. It’s been very therapeutic to just get all my energy and aggression out. It’s also been a way for my husband to help and support me through this process.

Incidentally, hypomania is an eminently misleading name for this phenomena. Mania is a much more fitting term, though I appreciate that there is a big difference between mania and hypomania. The prefix “hypo-” makes hypomania seem so much quieter, calmer, less disruptive than it is in reality. I wish there was a better name for it. I really like the descriptor maniacal, although that really makes me sound crazy, doesn’t it? I mean, it feels pretty crazy in the moment.

My nurse psychiatrist switched me to lithium now, which I’m not thrilled about. It makes me really tired and I think it turning the hypomania into depression, which I don’t think I prefer. Honestly, I’d rather not be on any medication and just run off the energy. But the reason I went on the medication in the first place was because of the violent anger, because of feeling like I wanted to put my hand through the wall all of the time. That was not a good feeling at all. So, it’s an evolving situation. I’ll let you know how it goes.

I hope you are well.

Surviving Suicide and Finding a Diagnosis

This post originally appeared on ConquerWorry.org.

Sadness, depression, anger, feeling out of place, knowing something was wrong with me; these are among my first memories.

I saw my first therapist at the age of seven, shortly after my parents split up for the first time. I was experiencing shortness of breath and coughing fits so extreme I would vomit. The inhaler didn’t help me breathe and the doctors wanted to put me on tranquilizers. Eventually, I recovered from the physical ailments, but the emotional ailments stuck with me.

It wasn’t until my teenage years that I started seeing a therapist regularly. I hated her. She didn’t listen to me. She asked me questions she thought would give her the information she needed. There was no silence inside those sessions, no room for me to find my words. I used to write letters to my therapist that I never gave her. They were full of words I couldn’t bring myself to say.

No one knew I had tried to kill myself.

When I was fifteen, I started hurting myself and attempted suicide for the first time. My therapist suggested to my parents that I see a psychiatrist. But the psychiatrist only asked me questions in front of my mother. When she left the room, he asked me if there was anything I wanted to say, but I still couldn’t find the words to tell the truth. No one knew I had tried to kill myself. It was a dirty secret that I was terrified to admit. I thought my parents would be angry.

At sixteen, my diagnosis was depression. At seventeen, it was depression and anxiety. At eighteen, I went off to college and attempted suicide for the second time. The university psychiatrist got me into regular counseling. I was diagnosed with major depression and given my first anti-depressant, which had no effect.

I thought I was just a lazy, weak, and useless person.

At nineteen, I moved across the country for a geographic cure and finally found a counselor that listened to me, but still didn’t get the right diagnosis. I was given anti-depressant after anti-depressant, each of which gave me new side effects, but no symptom relief. A part of me thought that the anti-depressant’s not working meant that there wasn’t actually anything wrong with me, that I was just a lazy, weak, and useless person.

After graduating from college at the age of 23, I finally found a psychiatrist who put the pieces together. He asked detailed questions and got a thorough history. He drew a physical timeline of my moods that made the bipolar pattern emerge. He was the first doctor to give me a useful diagnosis that made sense. Rapid Cycling Depressive Bipolar Disorder II.

Sixty-nine percent of people with bipolar disorder are misdiagnosed, and one-third of these don’t get the correct diagnosis for more than ten years. Anti-depressants can be incredibly dangerous to people suffering from bipolar disorder, exacerbating symptoms and generally making people feel worse or having no effect at all.

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Photo by kropekk_pl via Pixabay

But because we don’t talk about mental illness, it is impossible for people to know if they are getting correct diagnoses or medications. From my first diagnosis, to the correct diagnosis it was almost ten years. And once I received that diagnosis, it took another five years to find a medication that actually made a difference. Three hospital stays, two more suicide attempts, and fifteen years of avoidable suffering.

The moment I was properly diagnosed changed my life.

The moment I was properly diagnosed changed my life. It was the moment that I realized I wasn’t a lost cause. There was a reason anti-depressants didn’t work for me. I wasn’t just a lazy, useless person. There was an illness that explained my suicide attempts, self-harming behavior, depression, and anxiety.

Getting the proper diagnosis made a world of difference. I am not a failure. I have a chronic illness that can be treated.

Steps to take if you need help:

  1. Make an appointment with a counselor.
  2. If you can’t get in to see a counselor or psychiatrist right away, make an appointment with a primary care doctor.
  3. While you are waiting for your appointment(s) research your symptoms. Knowledge is power. And while I don’t suggest that you self-diagnose, or self-medicate, educating yourself about what you’re experiencing can help you decide if what your doctor or therapist tells you makes sense.
  4. If you don’t feel heard by your provider, go see someone else and keep going to new people until you feel comfortable. If you don’t like your therapist or psychiatrist, they won’t be able to help you.
  5. If you can’t afford to see a doctor, most places have low-cost options. There are therapists and psychiatrists who offer sliding-scale fees and there are state-sponsored programs for low-income people.
  6. If medications don’t help or if they make you feel worse, tell your doctor. Make sure they’re addressing all of your symptoms and don’t give up on medications, because new ones are being created all the time. Even treatment-resistant mental illness can be treated.
  7. If you feel overwhelmed, ask a friend or family member for help. Reach out and don’t stop looking until you get the help you need.
Mental illness does not have to be a death sentence. You are not a failure. You are a strong, resilient person and if you have a mental illness, you have a chronic illness that can be treated.

Where Credit is Due

I don’t complain much and almost always only to my husband/mother/sister/best friend. Sometimes I worry that this blog is self-indulgent whining. My goal has always been to speak out about mental illness, to break the silence and the stigma, and help anyone who might read it that is suffering and feels utterly alone.

But sometimes, what I have to say about this day in my life feels small, petty, downright stupid, and like complaining. I end up sensoring myself. But this defeats my purpose. It is the thoughts that feel small/petty/stupid/self-indulgent/complaining that most need to be shared. Because feeling that way about what you are thinking/feeling is what stops people from talking about their illness/pain/suffering.

Mental Illness is essentially a first world problem. Most of us have our food/housing/health/safety needs basically met. And this leaves room for a host of other challenges that wouldn’t be quite as significant if we were only worried about not getting blown up. Although, of course, there are a great number of people who are homeless, food insecure, or living in dangerous situations who also struggle with mental illness. It is good to remember from time to time that there are a great many people in the world that are struggling to secure their physical well-being. And it is poor form to compare anything to the difficulties of people in Syria for example.

However, the blessings that you or I may have do not diminish the challenge/struggle/danger/pain of mentall illness. And so this, recognizing that I am seriously blessed with general physical health, financial wealth, safe and secure housing, etc., is the place from which I share my experience with mental health.

Today, I am sitting on the back patio of my large, comfortable house, watching my silly dog run around in the grass, listening to music from Pandora, and typing this post on a relatively new and expensive laptop that is almost exclusively mine to use after sleeping until I felt like getting up. I am worried about what the dog is eating, which of the many things in my fridge we will have for dinner, the weeds growing in the rocks, the flies going in the open back door, the impending changes in our life, and the mass of laundry that needs to be washed and folded.

I don’t know what to do with my life. Every day I feel more and more that I am wasting my precious time. I don’t want to feel this way when I get to the end of it and look back. I am not passionate about much of anything. I started this blog up again so I would have something to show for the passing of time. I know all of the things I *should*/*could* do: keep an orderly house, volunteer for anything, get a full time job, go back to school, etc. None of those things appeal to me (especially the orderly house part). I am in the unique and (extremely) self-indulgent position of not having to work outside the house. I run our business in a small number of hours a week and spend the rest of my time rumbling around the house (lately knitting and watching way too much TV).

I feel the largess of my lifestyle and I hate it. I regularly get the urge to sell all my stuff and go live in a tiny house (although that’s pretty self-indulgent too…but at least it leaves a small footprint on the planet).

When I was in college, I took the maximum load of classes and worked one or two jobs at the same time to support myself. At the end of a day where I had gone to work, gone to class, gone to a different work, gone to class, and done homework, it was incredibly satsifying to sit down over a meal with friends or watch TV in my pajamas in my teeny studio apartment. I had earned that rest.

Now, I don’t feel like I have earned any of the incredibly blessed life that I have. I am grateful and restless (I’m not sure that’s the right word) at the same time.

I am depressed, lacking energy and motivation, and anxious every day. My amazingly supportive husband gets up (at an ungodly hour) every day and goes to work to support us financially. And I wake up every morning struggling with the meaning and value of my life. This, I remind myself, is why my life is structured the way it is. I don’t work outside the house because doing so seriously exacerbates my anxiety, which is the same reason I don’t get involved in any other organizations. I don’t schedule meetings or appointments for first thing in the morning because I frequently have sleep disruptions that make mornings challenging. I purposely limit the demands on my time, because I don’t respond well to stress and requirements. I go where the wind takes me most days and these days, the wind only ever takes me to my couch.

But I am alive. I work for a (small) living. I do enough laundry to keep E and I in clean clothes and towels. The dishes don’t usually overflow the sink before getting done. The dogs are well cared for. And I bathe (almost) regularly. All in all, for me, that’s not so bad.

What can you give yourself credit for? Remind yourself of what you have accomplished today. If staying alive is all you can manage, then try to be grateful for that.