The Minefield on the way to Diagnosis and Treatment of Bipolar Disorder

It's not always easy to get help, but for Bipolar Disorder, It's Necessary

minefield-to-mental-health-diagnosis.png

I know that when I see a train wreck or a bad car crash, I always thirst for the gorier details.  Human nature, as they say.  Let’s skip over the years and years of episodes, which I only see now in hindsight as bipolar episodes.  I nearly jumped off my balcony about a year and a half ago.  After that, I got started with a little bit of therapy, but it went wrong.  The therapist that I was assigned by my health insurance basically fired me when I told her that I was curious about other forms of therapy. This was two weeks after someone special to me committed suicide, so I was coping with my own suicidal problems as well as losing someone to suicide at the same time.  After that I ventured outside of my health insurance, trying to find another therapist or psychologist that would take me on.  Time after time I went to introductory consultations.

The challenge with introductory consultations is that you have to give the Reader’s Digest version of your story each time.  Each time, it is emotionally draining and painful.  Several times I thought I’d found someone good that I could work with, only to be told by them that they would not take me on as a patient.  I felt rejected, like I wasn’t even good enough to get help.  My depression started to lift as we moved into summer, and I started to feel that I was going to be okay.  If only I’d known what the next year had in store. 

There was an episode looming on the horizon.  It was unseen, and unfathomable.  I had started to come back to reality, come back to work, to rejoin life.  By that of course I now realize that I pushed everything back under the rug and trudged on, hiding my problems in over-working, over-pleasing, over-denying.  That lumpy damned rug didn’t do a very good job of holding things in though.  Little worn areas kept letting out little puffs of the problems, and then in one fell swoop, a whole cloud was released.

Let’s go to March of this year.  I go to March because that’s always a triggering time for me.  Coming into the Spring is when my body is most wracked with rheumatism, GI issues, and lupus symptoms.  Early March is also my birthday, and that brings it’s own set of triggers and difficulty.  Looking back now, I think I was severely depressed. This is usually the time of year that the doctor offers the suggestion of a new prescription.  Sure, why not? We’ve tried a whole pile of them, what’s one more?  I moved from Hydroxy Chloroquine to Quinacrine.  I don’t really know the difference, but they decided to give the Quinacrine a kick-start this time by starting it with Prednisone.  Prednisone is the old tried and true, so why not?

Prednisone has the effect of flipping a light switch for me.  When I start to leave my depressed state, especially when mixed with Prednisone, I begin to feel better physically, and it’s as though I have to make up for all of the non-productive time when I’ve been just getting the basics done.  I start to feel as though I can conquer the world.  It was not uncommon to find me in the Starbucks parking lot wondering why they don’t open earlier so I could get to work.

 By mid-March, mania was beginning to set in, though with faster cycles; depressed and back to manic.  It’s hard to explain, so I won’t (which is of course because I don’t understand it enough to tell you).   In April, I attended an intensive therapy retreat, which may not have been the best of timing.  I was forced to confront almost every difficult memory and bad thing that had ever happened to me, and in one of the more intense physical sessions, I felt my abdominal wall rip open. 

I had given myself a major hernia.  I came back into the real world feeling emotionally raw and in severe physical pain.  The rest of April was spent dealing with doctors and getting surgery.  The surgery was by far the worst physical experience of my life.  Shortly after that, I was having major GI issues, and my doctor decided I needed a colonoscopy to look for potential cancers.  I was in a tail spin.  

The Warning Signs of Bipolar Mania from PsychCentral.com

If you're not sure whether or not you're experiencing these symptoms, ask someone you trust. They may be able to help you identify behaviors that you cannot see.
  • Increased energy or a sense of restlessness

  • Decreased need for sleep

  • Rapid, pressured speech (can’t stop talking)

  • Inappropriate/impulsive speech or behaviors – like being overly honest and open

  • Overspending on shopping sprees, vacations, and so on

  • Taking on many new tasks and projects – thinking of and entering into lots of schemes and grand ideas

  • Increased sexuality, possibly including inappropriate sexual behavior or promiscuity

  • Impaired concentration

  • Racing thoughts, typically jumping from idea to idea (flight of ideas)

  • Excitability or irritability

  • Anger or hostility

  • Inflated self-esteem – feeling like one is special or better than others – having special powers or insights (commonly referred to as grandiosity)

In the course of a month and a half, I was under anesthesia twice, was having a very difficult time recuperating from surgery, and had more drugs running through my body than ever before.  I had been having bloody diarrhea for weeks.  I truly thought I was dying.   While all of this was going on, I was trying to maintain my job as well, and was quickly becoming aware that I was not able to do my job well, and the guilt of that weighed heavily on me.  I have always let my job define me, and allowed it to stress me out to unhealthy levels.

Take everything above and add it together, and what you have is the making for a complete disaster.  I broke.  My mind broke.  I went into a full scale bipolar manic episode the likes of which I could never imagine, and which I have only spotty memories of.  In the course of a week, I bought a new car, quit my job on bad terms, got 4 speeding tickets, one DUI, and landed myself on the other side of the country.  

Once I was on the other side of the country, I got myself involved in other people’s problems.  I had the grandiose idea that I could solve all of their problems, and in doing so, I spent my savings and my 401k, sold everything that I had taken with me on the trip, and over drafted my bank account so badly that I was virtually trapped with no way to get back home.  I had also bounced rent checks, so the home of almost 9 years that I was going home to was not going to be my home any longer. By the grace of strangers and Craigslist, I managed to find ride shares to pay for the gas for me to get back to Colorado.  I had run out of medication shortly before I left the east coast.  I was starting to crash physically, and I was beginning to cycle down from mania into severe depression and the reality of what I had done.  I sold virtually everything in my home and moved into my brother’s basement.  

Being unemployed and penniless has it’s advantages.  I was able to get onto Medicaid which allowed me to be treated at the Mental Health Center of Denver.  Finally, I found a therapist and doctor that not only understood what I was going through, but started treatment for Bipolar Disorder.

Today, I find myself as though I am a young child.  My life as I knew it was reduced to ashes.  Bridges were burned that may never be rebuilt.  I have no idea what direction to move in, and I feel powerless to affect any change in my life.  I seem to be in a state of Mixed Mood Bipolar right now, which is very scary.  One moment I feel like I can conquer the world, and the next moment I’m feeling suicidal.  I’m living from one panic attack to the next, unable to sleep, and unable to focus. 

I’ve started medications which seem to be helping somewhat.  I feel the need to rebuild my life, but I don’t know how to do that right now. 

If I’ve learned anything through this process, it’s that I cannot handle this on my own.  I need help in order to survive.  I’ve never been the person to ask for help, so that is hard.  I feel very fortunate to have gotten in to see professional care givers before it was too late.  My life very well may have ended by my own hand if I had not gotten help.

The road ahead looks rocky and steep, but right now I can't focus on that.  I’m trying to just survive each moment.