Mental Illness

I’m Kind of a Superhero and Other Things I’ve Learned From Bipolar Depression

Last week one of my students called me out. “Mrs. Dunn. Why you in such good mood today? Last week, you seem tired. Today you are hyper. Why you so happy?” (I teach students who speak English as a second or third language).

“I’m in a good mood because it’s Friday,” I told him. “I’m excited for the weekend. Believe it or not, teachers love the weekend.” I was surprised by how perceptive my student was. The truth was that I was in a good mood because finally (finally!) the heavy fog of depression had lifted for longer than a few hours or even one good day, and I felt hope and energy and excitement that I had not felt in nearly three months.

In truth, I was in a short burst of hypomania that often comes just after a depression for me. I am Type II Bipolar which means I never experience full-blown mania with psychosis or delusional beliefs and reckless behavior, but sometimes experience a milder form of elevated mood called hypomania. My bipolar disorder is marked by very regular periods of moderate to severe depression and occasional bursts of high energy/activity accompanied by high adrenaline and impulsivity. For me, hypomania is subtle enough that it can easily be taken for just a very good mood, though it’s often accompanied by spending sprees, new tattoos, sleeping less, trying to do ALL tHE THINGS, and being increasingly social or chatty. Hypomania isn’t necessarily a bad thing for me (it ‘s sort of like what I imagine being on speed would be like) as long as I can be aware that I am experiencing an elevated mood and can keep my impulsivity in check.

Over the last nine months I’ve spent a lot of time trying to make sense of the last 12-15 years of my life. There is still so much I do not know, but here are a few things I’ve learned.

• I might never be “healed” and that is OK. Along with the “You don’t seem bipolar” comments, another common response I receive from well-meaning friends and family members is something along the lines of hoping that I will get better or believing that God can heal me. These are beautiful thoughts, and I don’t want to make light of them. I also believe in a powerful God. But it is not helpful for me to think of my illness as a condition I might suddenly be healed from. The nature of bipolar depression is that I go through seasons of depression and seasons of stability, with occasional bouts of hypomania in between. Learning that I am bipolar and that I am likely to experience bouts of depression chronically for the rest of my life has actually given me an incredible sense of hope. The best way I can describe this is that it is like having seasonal allergies. People who suffer with allergies can treat them, but there is rarely a permanent cure, so they are also not surprised when they flare up. Before I knew I was bipolar, I still experienced depression. Every time depression lifted I believed it was gone forever, and every time it came back, I believed I had failed in some cosmic way. Knowing that depression is likely to recur makes me feel intense gratitude for the stable times. It keeps me from believing that the depression is somehow my fault, and it also gives me hope when I am in those seasons because I know that they will end. In the past calendar year I had two long bouts of depression lasting a total of about 5 months. During the first depression, before I knew about being bipolar, I truly thought it might never end, and but during this most recent season, which lasted nearly three months, I knew that one day I would feel better.

• Having bipolar depression has taught me to show greater compassion, to others and to myself. I try to live believing that everyone around me is doing the best that they can. Because 98% of the time I am doing the best I can. Often it is not the right thing and it is not good enough, but I really am giving everything I’ve got. It’s not up to me to judge how hard someone else is trying based on their performance. I have no idea what’s going on inside their minds or in their personal lives, so I choose to believe that they are doing their best, just as I am doing my best. As part of self-compassion, I am learning to celebrate small victories in times when small things are taking all of my energy. I have a few encouraging pep talks for this.

o For example, “You are so awesome! You got out of bed and then you put on a shirt AND PANTS! PANTS! You could have just given up and stayed in bed all day, but instead, you are doing the thing. You even brushed your teeth. You should write that on your To-Do List and then cross it off. Cause you did that. Cause you can do things. You overachiever, you.”

• Some of the things I like most about myself are directly related to bipolar disorder. I am deeply empathetic. While I don’t get my own feelings hurt easily, I cry easily and often when I sense someone else hurting, even if that person is an actor in a commercial. It is this intense empathy that makes me good at my job and (I think?) is one of the things that my friends appreciate about me. It is also one of the things that is likely to spark depression. Often, depression begins when I have reached a level of empathy saturation I can no longer sustain. I am constantly absorbing the feelings of people around me, especially of those suffering all over the world. While that isn’t necessarily a good thing, I firmly believe that the empathy is a gift. Basically, I like to think of it as a superpower—like Dr. Charles Xavier’s except less useful.

• “I have a condition!”is a magical phrase for explaining to your husband why you have gone completely limp and are requiring him to physically drag you into the bedroom and put you to bed because you are “too tired to go to sleep.”

• I am not alone. This, mostly thanks to many of you who have told me so.

There is so much that I am still learning about myself and about how to live the fullest, richest life I can. I am not defined by my illness, and yet, it is as much a part of me as my terrible dancing and my freakishly small hands. Today I find that with all of the things that are hard about living with bipolar disorder and (perhaps even more so) wearing that label, I am profoundly grateful. I am grateful that there is an explanation for the things I feel and that it’s no longer a mystery. I am grateful for treatments and for coping strategies. I am grateful that I pushed through the fear and the shame and started talking about this, and I am grateful for all the love and understanding waiting for me here. Most of all, I am grateful for a family that is immensely supportive and for a faith that, though feeble, is still somehow enough.

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“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.