I don’t even know how many times I’ve been misdiagnosed at this point. But the hits just keep on coming…
If you’ve been following along recently, you’ve probably noticed that my Crazy Lady diagnostic status is up in the air. Well, not exactly – everyone still thinks I’m crazy, but after more than two years, the docs still haven’t figured out what’s going on. Sad but true.
When I started this blog, my diagnoses were Bipolar Disorder II and Attention Deficit Disorder. Earlier diagnoses included Major Depressive Disorder (Recurrent), and Anxiety Disorder NOS (not otherwise specified). More recently, I was handed Premenstrual Dysphoric Disorder (aka Depressive Disorder NOS). Mood Disorder NOS shows up on my test orders, but Bipolar II is still on my therapy slips. NOS fits nicely, I think, since it basically means “something’s definitely screwy but we don’t know what.”
The lack of diagnostic certainty around the mood disorder used to bother me, but I basically don’t care anymore so long as I get what I need (as if). However, unlike the mood-related brain cooties, the ADD Dx has 100% agreement from every single clinician. Not once or twice, but five times, and verified by computer-based testing. So that diagnosis is sticking. I wish the rest were as clear.
The bottom line is that with so much uncertainty, I’m really not comfortable with my blog tagline anymore – “Bipolar bird tells all” hardly seems to capture the crazy properly and I’m a stickler for truth in advertising. Plus it was never really that good of a tagline.
Which leads me to announce my first-ever blog contest: help me craft a new tagline! Your very own clever/snarky/witty words could grace the header on my successful, well written, attractive (smartypants crazy) blog!
- Submit as many taglines as you like via comments on this post.
- If you put more than one tagline in a comment, they must be numbered. Sequentially. With integers.
- Reader support for submissions will be taken into account, so reply with your +1 (or whatever) on taglines you like. Vote early and often!
- Taglines must be three to six (or so) words long, in English, with no line wrapping.
- Spelling and grammar matter. Incorrect use of apostrophes is unacceptable under any circumstances. Punctuation should be avoided unless necessary for cleverness or clarity.
- Submissions are open through Friday, July 25; finalists will be announced on Monday, July 29 (probably with a poll for voting).
- The winner/s will be announced on Friday, August 2.
- In the event of temporary insanity (ha!) decisions will be delayed until I’m able to make sound judgments and rational comments.
- The winning tagline author will be credited and linked on my “About” page, if so desired.
- If y’all are incredibly clever, there could be more than one winner.
- I have the right to censor anything I feel is inappropriate.
- I will make the winner a prize.
- I have the final word.
- Play nice, OK?
Let the games begin!
When I read this story about premenstrual dysphoric disorder, “All the Rage”, it was like when I first read books about bipolar – here, yet again, is my story…a few details aside. It’s pretty convincing as a mirror of my own experience, in which what appears to be bipolar disorder is in fact premenstrual dysphoric disorder. Except the data aren’t quite as clear for me. That would be too convenient.
It’s much more likely I have a hormonal imbalance on top of a mood disorder. Plus the ADHD, of course. A recent blog post by Natasha Tracy on how a person with bipolar disorder thinks also really rang true – she describes the general tenor of my mental patterns very accurately. I have been a catastrophizer extraordinaire since I was at least 4 – I can remember episodes acute anxiety about improbable disasters for over 30 years! I never thought it all that odd, but how would I know? Anyway, those thinking patterns alone do not bipolar disorder indicate, either.
In fact, there are a lot of really confusing, conflicting details, and it has been an uphill battle to get anyone to take a look at the bigger picture before diagnosing through the lens of their own specialty. I find that after pinning so much on a diagnosis that could give some some kind of answers, after a few years what matters the most to me now is that I get the most effective treatment possible. The label that goes with it is less and less meaningful, at least until I try to talk to anyone about it.
Perhaps I’m just jaded, or in a bad spot with respect to acceptance right now. Maybe I’m right about everything, or maybe I’m wrong about everything – either conclusion sounds completely logical to me, depending on which day you ask. More likely I’m right about some of it, in whatever fashion is most ultimately ironic.
Regardless, I hereby relinquish my bipolar disorder diagnostic status out of respect for those whose symptoms better match the clinical specification. I’m OK with “mood disorder not otherwise specified” for the time being.
I sat down to write a post and drew a blank. The last couple of weeks have been relatively peaceful, stable, uneventful, and more or less productive. Nothing exciting to relate, and nothing much to complain about in the here and now.
The longer days and spring weather are a tonic; I just plain feel better when the sun comes out a little more often, when I’m not waking up in the dark, and when it’s warm enough to spend time outdoors (but not so warm that I have to retreat back indoors).
I said things in therapy today that felt amazing. Like, “I can’t do it all.” And then we both smiled (really big genuine smiles) because it has taken so long for me to say that, and not just say it, but also believe and accept it. After commenting that I seemed almost perky, Hippie Dude remarked,
I wish I could bottle you like this for when you’re just dragging.
I know exactly what he means. He asked if I was fixating on waiting for the other shoe to drop, as I usually do. I said, “What other shoe? I’m ignoring it. It’s not going away, but I don’t have to pay attention to it right now.” He seemed mighty pleased.
My moods have been fairly stable for the last month (a whole month!) aside from some irritability. The hormonal horrors have been muffled or muted or entirely absent. My system still needs a couple months to “settle in” but if this improvement sticks around, I’m going to declare it a miracle. I’m actually letting myself get my hopes up.
The Yaz seems to be stabilizing the hormonal layer of my mood issues, so we’re further reducing lamotrigine to 100mg. Three months ago I would have laughed and then cried (all day) if you’d said that I’d be titrating off Lamictal this spring. It’s terrifying, in a really complicated way, to let go of a drug that has served me well. But the idea of being free of it – well, that’s quite a carrot.
It’ll probably take the rest of the year to perfect my morning cocktail, but it suddenly seems possible. I can’t begin to express what an enormous relief that is. Seriously. It’s sort of mind-boggling.
At least for today, I’m feeling optimistic about getting my brain cooties under control. Not every detail has been accounted for as yet, and basically only time will tell, but it seems increasingly likely that the bipolar Dx could be rescinded. Although, ironically, one can argue that PMDD is a bipolar spectrum disorder – the affective symptoms sure can match – even though the cause is clearly hormonal. The DSM doesn’t rule that out, last I checked.
The title really says it all.
It’s been uneventful as winter lingers and springtime teases. It’s not a particularly cheery season for me. The time change screwed up me, as usual, and I think I had bronchitis for the last 2.5 weeks. But it’s much better now.
I got a major work project wrapped up, but it actually makes my worry a bit more vague since it’s no longer attached to that project. The truth is that my work is suffering due to time lost to illness and treatment, which makes me even more anxious. Far too much of my time goes to doctor’s appointments, therapy, and being sick. I’m also finding that I can’t really make the time up on weekends and evenings. It just doesn’t work – I simply have to spend time on things like groceries, DBT and yoga classes, and household management. These are necessary things. Plus let’s face it: my brain shuts down after about 7 PM, so working late only happens under the strictest deadlines anymore. So I’m actually putting in less than 40 hours, which is part of why I feel so damn guilty about it.
Meantime, there’s just a lot of uncertainty and worrying. I’m trying really hard to manage that as proactively as possible. I recently read a fantastic book, Self-Compassion, by Kristine Neff, and I’m trying to figure out how to put that wisdom into practice.
Diagnostically, I don’t know where things are anymore, which is frustrating. There’s the PMDD thing, a theory which seems to hold water, so let’s take that as a given. As I discussed with my PNP, and she agrees, the ADHD Dx is likely to stick around. It’s not just the horrendous inattention associated with parts of the menstrual cycle but the overall everyday inattentiveness, and the evidence going back to childhood – way before puberty.
So now we’re up to PMDD and ADHD. The generic labels on my charts from my primary care providers have included Anxiety Disorder and Mood Disorder – both NOS – but that’s not based on recent evaluation.
The PNP doesn’t think bipolar fits – apparently I don’t exhibit the level of irritability usually seen in others with Bipolar II. I don’t know what to believe myself, which is an uncomfortable place to be with respect to acceptance, and yes, identity. Maybe I’ve convinced myself that I experience hypomania when I really don’t. The Mood Disorder Questionnaire resoundingly indicates otherwise, but I just don’t know anymore.
Anyway, it all goes in circles, like a neurotic dog chasing its tail. I feel like there’s no resolution, no end in sight, and only the small hope that the next oral contraceptive will help better regulate my system. I’ve had lower back cramps with ongoing spotting for over a month now, and that can stop anytime.
We’re reducing my dosage on lamotrigine from 200mg to 150mg, starting today, so we’ll see how that goes. It would be great if I could eliminate a drug from the mix, so I’m willing to try. At this point, I don’t feel particularly optimistic, but nothing ventured, nothing gained, right?
Julie Fast and John Preston, Loving Someone with Bipolar Disorder. Oakland: New Harbinger, 2004.
DeeDee was crazy when I met her. She knew it, and I knew it, even if no one really knew it. It was part of the attraction–a feature, not a bug. She was simply more interesting, more challenging, and more fun than other girls. Her mood swings made me work to keep up with what she was thinking and to know how to respond. Then we discovered why: she isn’t just crazy, she’s bipolar. I’d been doing well for years with her mood swings, but this was serious.
Treat bipolar first. This refrain echoes through Loving Someone, because unless the disorder is treated, there is eventually no one to love, only bipolar disorder where someone ought to be. Fortunately, this book is intended to provide a comprehensive, holistic program (in conjunction with medication) for doing just that.
The first step is to make note of all of the states the bipolar loved one exhibits: (hypo)mania, depression, anxiety, paranoia, hallucinations… then the various symptoms of each state, so both partners can identify when a bipolar attack is in progress. Next, compile a list of what works to address the symptoms, then begin examining the various triggers that set off an attack–so in future, noticing and treating a trigger might stave off further symptoms and escalation into a bipolar episode.
This is going to take a while. The authors provide examples to help get started, but also make clear that there are many lists to compile, discuss, and revise throughout the relationship. All of these are also part of the medical bipolar treatment process, so they should be familiar to someone who has already been diagnosed with the disorder, but Loving Someone is for the partner, who may not get this information from a doctor directly, or may even be exploring a potential problem before seeking diagnosis.
The rest of the book provides an example of one couple developing a treatment plan, then addresses other questions someone with a bipolar partner might have: the discussion about getting treatment, sex, work and money, and the “well” partner’s needs. It mostly seems like common sense to me, but it is a nice introduction to the disorder which makes the illness, and what maintaining a healthy relationship in spite of it requires, understandable for someone who is just starting to grapple with a partner’s disorder.