“But You Don’t Seem Bipolar” and Other Things You (and My Gynecologist) Shouldn’t Say

Soon after my revelatory meeting with my psychiatrist, I embarked on that most delightful of all womanly privileges, my annual pelvic exam. This time I also had a specific mission – to discuss the potential side effects my being on the pill was having on my mental health and what alternative solutions there might be.

Along with meditation and other anxiety-reducing techniques, one of the first courses of action my psychiatrist recommended was to stop taking oral contraceptives to see if and how these seemed to influence my mental health. Since I have always found myself to be very sensitive to the pill and experienced many side effects for years, it made perfect sense to me that altering my natural hormones might have an affect on my mental health.

As is traditional, the doctor was “running late in surgery,” which gave me lots of time to build anticipation over both the exam and talking about the “b” word with someone outside of my inner circle of family and friends. My anxiety built so much that by the time the nurse took my vitals my blood pressure was high.

(Side Note: When I texted my husband to tell him about the blood pressure spike, he very thought (ful?less?)ly asked, “Why do you think you’re feeling anxious?” To which I sweetly replied, “I think it’s because a strange man is going to stick a metal object with a sharp blade on it inside of me and scrape my cervix.”)

Before the blessed event, I sat across the desk from my doctor (who, for reasons I believe are entirely self-explanatory, my friends and I refer to as “Poor Man’s Matt Damon” (PMDD)) and explained to him, “I was recently diagnosed with bipolar depression and…”

“Really?” he cut in skeptically. “But you don’t seem bipolar!”

I stared at him blankly for a minute, too stunned to think of a response. To be honest, the first thing that popped into my head was “And you don’t seem like a moron…” but thankfully I waited a beat. Finally I said, “Well, I’m pretty sure it’s accurate.”

“Huh,” he said, still not fully convinced.

I continued on, explaining my doctor’s suggestion of getting off the hormonal birth control to see if it made any difference.

“Why would that make a difference?” he pushed.

“Well…I guess…because…your hormones affect your moods. And it’s a mood disorder?” I ventured.

“Well,” he finally said, “I’m not a psychiatrist so I won’t argue with her, but I don’t know about that.”

Initial awkward conversation aside, we moved on to the most glamorous part of the ordeal, in which I put on a sexy gown essentially made of paper towels and attempted to make light, casual conversation with PMMD while he poked and prodded.

“So, I remember that you’re a writer, ” he began, no doubt having read over my chart while I was changing. “So…do you write more when you’re manic?”

I lay there looking up at the ceiling in this most vulnerable of positions, trying to ignore the cold pressure of the speculum and the heat rising to my face. I responded like I always do when I feel uncomfortable and don’t know how to show it. I laughed. I laughed like it was all a big joke. “Yes,” I said. “But of course, I do everything more when I’m manic.”

*******

While my doctor’s response was especially surprising given his career as a medical professional, the general sentiment is one I have encountered many times. Even before bipolar was part of the mix, I would mention my social anxiety to people and they would say, “But you always seem so confident. I would never guess.” When used to assure me that I can pass as normal in social situations, I honestly do appreciate this sentiment, but I have a harder time when it comes across as skepticism.

When I was first diagnosed, I felt relief and denial in equal measures. I was relieved to hear that this decade-long struggle had a name and that the regular return of depression was not a sign of weakness. In some ways it was empowering to reframe what I had thought of as recurring failure as remarkable resilience.

But as I wrote in my last post, I also had a hard time coming to terms with this word which brought with it stigma, shame, and fear. My awareness of bipolar disorder was limited to the extreme cases portrayed in movies or cited in news stories. While I now know that this disorder is a wide-ranging spectrum with many sub-types and that the experiences of people who fit under the larger mantle of “bipolar disorder” can vary tremendously, my initial understanding of it was embarrassingly narrow.

One of the things that compelled me to start writing about this was the desire to educate other people and to challenge the stigmatization of mental illness in general, and of this one in particular. To share your experience openly and honestly with someone and have them respond with doubt is incredibly invalidating, and it puts you in the strange position of actually trying to build an argument to convince someone of your suffering.

Dear Dr. PMMD, I’m glad I don’t seem bipolar. But that’s kind of the entire point.

How many people around us seem completely fine and are dying inside? How many people paste a smile on their faces while their bellies grow heavy with dread? How many people seem to keep a thousand plates spinning without every dropping one, but wake up in the night with their hearts racing, unable to breathe. How many people have a hundred friends, but no one who really knows them?

It is noble and right to reach out and to ask. But it is our high and holy calling to listen and to believe.

 

 

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12 comments

  1. Closest I have come to that is being told that he (Dr.) had no idea what my problem was, and then gave me a prescription. We had an interesting conversation about about the prescribed meds would perhaps resolve the unknown problem. I found myself a new family doctor after that. 🙂

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    1. I have a lot of friends who are doctors or who have doctors in their family, so I hate to generalize, but…this is exactly the kind of thing doctors get a bad rap for. As entertaining as the stories are, I will also be looking for a new doctor when the time comes. 🙂

      Liked by 1 person

  2. Thank you so much for sharing. I, too, have only a narrow view of bipolar and have a friend who’s been diagnosed who doesn’t fit the tv depiction of it. Thank you for helping me understand, at least a little, what may be going on.

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    1. Thanks for reading! I think the most important thing for you to do to support your friend is to ask about their experience and then just listen to how they describe it. Remember that they are exactly the same person they have always been. It’s very unlikely that this is something that suddenly developed, so knowing this doesn’t have to change anything about your relationship with them. Much love to you and to your friend.

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      1. Thanks, Lily, I’ll do that. I would also encourage you to get a different gynecologist if you are able to. The pill definitely affects more than just the reproductive system. Everything is intertwined way more than we think.

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      2. I am absolutely going to get a different doctor! And I did end up getting off the pill anyway, about 8 months ago. I agree with you, it affects everything. It hasn’t fixed all of my issues, but it’s definitely made me feel more in control of my own body. Also, I know there are resources out there for those supporting friends and family members with bipolar disorder and other mental health issues. I do not know if you or your friend are people of faith, but if so, you may find this resource helpful. http://mindsrenewed.project.show/

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  3. um so i really love this post. thank you for sharing your experience. it had me chuckling even though i am sure you were cringing inside. i was a bit shocked at his reaction as much as you probably were. it seemed a bit off. anyway…….your last paragraph is so perfect. love

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  4. I liked your post by the third sentence. I just had my annual too! Twinsies! Anyway, I learned that my former doctor did not prescribe the lowest dose of birth control to me even though I frequently complained that my periods were irregular and extremely lengthy, and worse he TOLD me that I was on the lowest dose.

    After years on birth control coming off it also screwed around with my moods. The first few months I cried at everything. Every. Thing. Just bawling all over the place – at work, in the car, at home.

    My new Gyno Doc isn’t bad. I do have to fight for what I want at times – let’s test my hormones AND my thyroid to see if anything there is causing the mood swings (because they came back). She tried to say no but I wouldn’t hear of it, in the most polite way.

    I usually get the exact opposite of you when I go to any doctor. Oh, you’re on anti-anxiety and anti-depressants…this pain in your arm, this migraine, this bloody nose with chunks of brain in it is all in your head. *pat on the head* you’ll be fine if you lose some weight.

    Thank you, Dr. A. Hole, for your unhelpful advice. Now I go in with notes. I track everything. My moods, my pain, and then I guard myself for a calm conversation about my health. It’ll cost a bit more? That’s fine, I’ll skip lunch for a week, run the damn tests.

    When I did switch doctors a couple of years ago we did find that some of my issues were directly related to being extremely deficient (not just low, oh no, deficient as in not on the scale because I just didn’t have any) in Vitamin D and ferritin. But that former doc just kept telling me that my restless legs, my moods, my chronic pain was just all in my wacky mixed up brain.

    If you can, because sometimes it’s just not possible, but if you can, find a new doctor. Go onto Facebook page for your town and ask people there who they recommend for a doctor. That’s how I got my previous Gyno Doc. He was the first one to support my decision to not have children and what we could do about it.

    PS my husband always asks me why I’m feeling anxious about something. I’m the first to tell anyone that I can’t always trust my brain and my feelings. It’s usually the most helpful thing to have him ask me why I’m anxious so I can refocus my attention. Just my experience.

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  5. you are literally my hero. and the ob story was the funniest thing i’ve read in a while. have i ever told you what a great writer you are???? 🙂

    lorienowensphotography.com |||We are living our adventure.|||

    On Mon, Nov 6, 2017 at 10:34 PM, Such Small Hands wrote:

    > lilyellyn posted: “Soon after my revelatory meeting with my psychiatrist, > I embarked on that most delightful of all womanly privileges, my annual > pelvic exam. This time I also had a specific mission – to discuss the > potential side effects my being on the pill was having on ” >

    Like

  6. Your article was remarkable and thank you! Before I had a neurologist diagnose me as having severe panic attacks (for absolutely no reason) I too went to my GYN thinking it was hormonal. When his “have a hot bath” solution didn’t work, he accused me of either being a bored housewife, or an alcoholic or drug user. None were even the realm of my personal life. After seeing a neurologist and clear evidence in my EEGs, I’m now on the right track and have been for 23 years. My beloved neuro also sent a scathing letter to my ex-GYN. Best of luck to you! (BTW chronic attacks run quite high in my family (genetics!) and can cause depression and mood swings…something I always watch for.

    Like

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