As some of you will be aware from my recent post about my discharge planning meeting, I found out that I had been given a diagnosis of Bipolar. This was not the ideal setting to find out about it but I did have the chance to ask a few questions at least. Apparently this has been my diagnosis for some time. I didn’t know that but suspected the label was going to be slapped on me at some point due to the pattern of my moods and that my consultant psychiatrist started discussing this possibility with me over a year ago. In addition, he had been referring to my happymental periods as episodes of hypomania. Even though I knew it was on the cards and I had even used it to explain to colleagues at voluntary work for ease, it kind of made me feel a bit off kilter. It sounds silly really but knowing that Bipolar is my official label was still a bit of a shock.
Receiving a diagnosis is an odd experience. It says that my experiences of life are somehow not quite right, different from the norm. For some people it can become their identity. I don’t want to become one of those people who take on a diagnosis and become it, even to the point of fitting everything to the diagnosis. I know it sounds like I am judging people but for me it’s a real worry. I see it happen on social media sites and it makes me sad to see an individual identify so fully and relate all life experiences to a mental illness. Just as I used to be Carrie with a diagnosis of Borderline Personality Disorder, I want to make sure that I am Carrie with a diagnosis of Bipolar Affective Disorder.
I’m not sure I even have Bipolar to be honest. I do have severe episodes of what is termed clinical depression and they last for months at a time. I’ve been having these since at least my late teens. I also have episodes of what definitely fit the criteria for hypomania and these usually last several weeks. Again, I’ve had episodes such as these for many years. The past year or so, I have had 3 episodes, which is really unusual for me – my psychiatrist reckons it is the stress and changes that has brought on more of these episodes. A couple of these episodes have nearly resulted in me making very damaging decisions, including the possibility of me losing my flat, and interventions were made by mental health professionals. So, in a way, I know in my head that I do meet the criteria for a diagnosis of Bipolar (that of Type II) but I don’t feel it. Maybe because I see Bipolar as something quite significant and I’ve seen people in full blown Bipolar I mania. Perhaps it’s because it seems trendy in the media and every other celebrity is coming out as having a diagnosis of Bipolar. I don’t actually know why.
In practical terms, it doesn’t change anything. I’m on a combination of medication that for the first time in my life I trust. My mood stabiliser has lessened the episodes of (and even severity of my last) depression. I know that the anti-depressant I’m on would work quickly if it needed to be increased. I’ve managed my recent episodes of hypomania quite well, without crashing into the pit of depression. These have been managed with benzodiazepines but my consultant thinks perhaps next time, short-term anti-psychotic might be more appropriate to control the high. I’ll continue to use the psychological methods I’ve learned in DBT to help with my Bipolar moods. Mindfulness, as ever, will be key to management.
However, I have decided to do some reading into Bipolar. I can’t deny that I have experiences of depression and hypomania, which are characteristic of a Bipolar diagnosis and my recent episodes of hypomania have escalated to more worrying levels. As you are aware I have recently started working again and key to this succeeding is me managing my mental health. So if I do have Bipolar and there are other means of self-management I am not aware of that can help me with this, it is important that I know of them. I need to be more aware of risks and triggers for moods but I also need to start to be more familiar with my moods – what is a normal emotional response and moods vs. what needs more support/intervention and is a product of having Bipolar. I’ve started off with ‘The Bipolar Disorder Survival Guide’ by David J. Miklowitz and I’m finding some of the information and approaches quite helpful. I’d be grateful though for any tips people have found helpful for self-management or any book recommendations. I do still have some reservations though as to the appropriateness of the label.