I was diagnosed with bipolar disorder many years ago but I was sick for much longer. I have known that something was not quite right for most of my life; I just didn’t know what that was. I spent a great deal of my twenties and thirties wandering from doctor to doctor. When I felt depressed, I found a psychiatrist or general practitioner who would prescribe an antidepressant. When I began to climb out of the hole, I would convince myself that nothing was wrong, and I would stop taking my medication.
Even after two overdoses, two hospitalizations and extended periods of suicidal ideation, I somehow managed to avoid much follow-up care. The trick was that I rarely saw the same doctor twice. The problem was that I never saw a doctor about my manias, at all. In my mind, I couldn’t think of a reason why I should. When I was manic, I felt alert, quick, and seductive. My thoughts were clearer, people more interesting, new experiences were irresistible; things that had previously dragged across the surface of my life seemed to glide smoothly. I was a better version of myself. Or at least that’s what I thought.
It wasn’t true, of course. I can’t stress enough how truly terrible an actual manic episode can get, when left untreated. Still, anything that didn’t feel like soul crushing depression felt like an improvement. Eventually, each manic episode would lead to disaster. I would burn my life down around me. I would spend money I didn’t have, hurt people who cared for me, discard jobs, lovers and possessions. Often, I would lose touch with reality. I could be mean and quick tempered but I could also be sharp and exact. None of that mattered once I reached the pinnacle of my mania. Always, I would hurt myself and others. Then, I would begin to skydive without a parachute – straight towards the life I had just destroyed. Without explanation, I would find myself in the middle of a mess that I was responsible for creating. I didn’t intentionally treat myself or my illness this way. I didn’t even realize there was an illness; not one with a clear pattern, anyway. I simply couldn’t get enough distance from the eye of the storm to see with any clarity what was happening around me.
Thankfully, an astute doctor at a local free clinic began to ask the right questions. Why did you stop taking the antidepressants you were prescribed last year? Why did you hurt yourself? Why aren’t you working? Tell me about your divorce. All these seemingly unrelated questions led to a clearer picture of what was happening. This wonderful doctor gave me a name which would finally explain a life lived in peaks and valleys: Bipolar Disorder. While talking with him about this illness, I realized that I had experienced a lifetime of both manic and depressive episodes; though to be honest, the depression was more frequent and lasted longer.
Even after my initial diagnosis, I still found it rather difficult to maintain any semblance of balance. The reason my disorder was so hard to get under control was because each time I got depressed, I would romanticize my manic episodes. I’d want the first days, before things went wrong. I’d convince myself that this time would be different. This time, I knew better. I swore I’d start taking the mood stabilizer again; the minute things started getting bad. The mania felt like a drug and when I was most sad, I missed the high. I know it might seem strange to say but the only way I could begin this new journey was by allowing myself time to grieve the loss of my manias. That kind of madness can be intoxicating. I needed a minute to say good-bye. Then, as quickly as possible, I made tracks, putting as much distance as I could between myself and that part of my illness.
After a few awkward blind dates with random psychiatrists, true wellness began to find its way into my life under the care of my current doctor. This began the next stage of my journey: medical continuity. I’d never heard the term medical continuity until I began seeing Dr. K. From the beginning, he was very clear with me that although I didn’t have to continue seeing him, I needed to find one psychiatrist and stay put. I needed to be able to track my episodes of depression and mania. I needed a record of which medications worked and which didn’t. I needed my medical history and current treatment plan in one place. He was right. Since then, he’s been right about a so many things.
For me, being sick required very little effort; getting well was another animal altogether. Following a treatment plan is where the real work begins. Building a care team is just as important as finding a doctor: this means a therapist, a general practitioner and, when possible, a support system of friends and family. Bipolar disorder can be treated, but in my case, it is never very far away. Medical continuity is the only thing that keeps my illness at bay: show up for your appointments, take your meds, avoid your triggers and always, always be honest, with your care team and yourself. Ultimately, I began to accept that mania might seem enticing in hindsight but my memory bears little resemblance to the reality. Wellness began with a single step – understanding that I needed something fundamentally different- but it only worked when I was willing to reach out and embrace a new version of myself; and to be perfectly honest, even I can see that this version of me is better.