Mental Illness

“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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