Medications
Type
Reflection

Writing, medication and me

I have Bipolar II, at least that is what my psychiatrist tells me. It took her less than two hundred minutes of knowing me to diagnose me. Sixty of those minutes were spent getting a detailed history of my drug and alcohol intake: how old was I when I first consumed the drug? How often have I consumed said drug since? How did it make me feel? No paranoia? Etc.

Another thirty minutes were spent discussing my rather dramatic upbringing and my father, who suffers from Borderline Personality Disorder. About five–eight minutes were spent on my sexual abuse (to be clear, it was not my father). Approximately fifteen minutes on my romantic relationship history, ten on niceties (she was very apologetic for drinking tea during my session), and the rest on asking the standard questions related to what the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, the fifth and most recent addition) lists as the standard criteria for the classification of mental disorders, to determine whether or not I have bipolar tendencies.

So that’s:

DSM-5 questions = 80 minutes

Drug and alcohol history = 60 minutes

Family/formative years = 22–25 minutes

Boyfriends = 15 minutes

Niceties = 10 minutes

Two counts of childhood sexual abuse = 5–8 minutes

Time to medicate

Now, before this diagnosis, I was under the impression that I was a little left of centre but generally a happy person who, sometimes, but rarely, got very sad. And in light of my actual life lemons – I’ve had some terrible boyfriends – I think I can say, all things considering, I make pretty damned good lemonade. Which apparently is my problem. My over-happiness is called hypomania and, according to my doctor, that’s not good.

Before discussing my treatment options to ‘get well’ (fuuuuuck youuuu) she told me to do some research on my disease.

This is what the Black Dog Institute – ‘a world leader in the diagnosis, treatment and prevention of mood disorders such as depression and bipolar disorder’ – says about it:

Bipolar II disorder is defined as being present if the person experiences episodes of both hypomania and depression but no manic episodes.

Firstly, I’d like to say that I have very rarely experienced any depressive symptoms, and when I did it was after molestation, my father attempting suicide, reading about my possible STDs in a text message on my boyfriend’s phone where he discussed it with the person he was cheating on me with, etc.

Understandably, I was a little curious. If bi means two and, one of the two bis is missing (the negative one, I might add), aren’t I unipolar? Which is just polar? But hey, tomayto tomarto right?

Moving on, I wanted to understand more about this dominant polar, this hypomania. Research at the Black Dog Institute had identified ‘six principle features’ of hypomania and mania. First up, ‘High Energy Levels’, individuals felt ‘wired and ‘hyper’, their thoughts ‘race’. Which was the reason I went to a psychiatrist in the first place. Other signs included ‘feeling extremely energetic and making decisions in a flash; talking more and talking over people; racing from plan to plan and being constantly on the go; and describing the need for less sleep without feeling tired’. Okay, so I recognised a lot of that.

Next, ‘Positive Moods’ (God forbid, I thought):

The positive or hedonistic mood is reflected in descriptions such as feeling confident and capable; being extremely optimistic; feeling that one can succeed in everything; being more creative; and perhaps feeling ‘high as a kite’. Any general anxiety disappears.

This was somewhat me. Though feeling I can succeed in everything certainly wasn’t true, particularly if it was 9–5 routines or involved hand–eye coordination.

‘Irritability’, which was ‘reflected in irritable, impatient and angry behaviours’. Rarely, I thought, and almost always justifiably. I mean, my mother is wonderful but my God can the woman badger.

‘Inappropriate Behaviour’ was ‘becoming over-involved in other people’s activities’ – which I didn’t‘increased risk taking (including increased consumption of alcohol and drugs, getting a tattoo impulsively, and gambling excessively)’ – well, I didn’t gamble or get random tattoos. Inappropriateness could also includesaying and doing somewhat outrageous things’ – come on, define outrageous! – ‘having increased libido and getting into relationships that are later regretted’ – okay, that sounded familiar, but who hadn’t done that?

‘Creativity’ was another symptom, apparently. ‘Seeing things in a new light’ or with ‘crystal clarity’, which was, ironically, the opposite of how I felt, hence my psychiatric appointment. It also included ‘feeling quite capable of writing the “great Australian novel”.’ I never claimed it was going to be ‘the great Australian novel’, but I was writing a book – and hey, fuck you, if I ever finish it, it will be good!

Lastly, ‘Mystical Experiences’.
That is, believing ‘that there are special connections between events’, coincidences, feeling one with nature, etc. Seriously?! Doesn’t every religious person fit this category, so around 85 per cent of Earth’s population, plus hippies, yogis, witches, etc.

While I had doubts about some of the above, I agreed with my shrink’s assessment: I was hypomanic. Which was awesome – how fun does the person above sound!

I’d been told to write down any questions I might have following my research. Mine were: if I didn’t have the depression but only the hypomania, did I have to medicate? And if I did medicate, would the above attributes of my personality – those I used to think of as special parts of who I was, but now knew were just chemical imbalances – be taken away?

The answer to both was yes.

The problem I have is that I am full to the brim of awesome stories and memories and thoughts and feelings that I really want to put into words, but I can’t because I am totally overwhelmed by them. The downside to being hypomanic is that the inside of my head looks like a unicorn overdosed on rainbows and vomited them into my skull, which is exploding with multi-coloured slush rather than crisp, clean colours. And I am drowning in that slush.

Maybe if I didn’t want to be a writer that wouldn’t matter. Maybe if I wanted to sit all day at a desk and have guidelines to focus my thoughts, it would be easier.

But I have a distinct feeling that if that were the case, my other polar would rear its ugly head and maybe my ‘illness’ would present itself in much sadder ways.

My psychiatrist listed a plethora of other reasons my hypomania was an issue, writer or not. She said that it was like I was a little drunk all the time, and while I may be a happy drunk, I can’t make good decisions in that state. She asked if I thought it was a coincidence that four out of five of my serious loves have been screwed up fuckwits with probable personality disorders themselves. Was my prefrontal cortex misfiring, causing me to make bad decisions and seek such men out? When I suggested that this could be attributed to the fact that, at a young age, I came to the conclusion that I would essentially play the role my mother did – the fixer-upper-er and saviour, and marry someone like my father, fucked up and in need of saving – she dismissed it. No, that was not the reason. The reason was chemical.

I wondered if I could get a refund for all the therapy I’ve paid for over the years.

She also told me that people see me as weird. Not as weird as a manic person she said, but (using her arms as if the hands of a clock) ‘about 30 per cent left of centre’. She said I talked fast, got flustered when I spoke and overshared. But how was I supposed to act when answering questions that would determine whether or not I had a personality disorder?

She said my odd personality intimidated people and that I found it hard to build new relationships because of this. She had never once asked me about my friendships, new or old, though I have plenty of both. She has never seen me interact with anyone other than her receptionist when paying my bill (between $350–$450 depending on length of appointment). She had no idea about my interactions with others outside her office, yet claimed this was what I did.

When, more pleadingly than defensively, I explained that I regularly made friends and great ones at that, she said that friendships were one thing, but that I didn’t meet men who respected me. She said men did not see me as marriage material or take me seriously. They saw me as odd, a bit of fun. I didn’t tell her I had men in my life that treated me with the utmost respect and that they wanted a future with me, but that I didn’t find them attractive because they were not weird enough. I couldn’t access that information at the time because my confidence had been shattered, rearranged into the shape of a big fuck you, and then shattered again.

What she was trying to get through to me – and maybe the harshness of her approach was a tool rather than completely out of line – was that in order for me to live a normal and functioning life, medication was the answer. That I needed mood stabilisers. And the pieces of me left over, after I’d swept the broken hypomanic me to the side, the pieces of me that made me seek help in the first place, agreed to try.

So now I am taking medication. The day after my first night of medication, I was extremely tired. I napped about six hours during that day. When I upped the dose on Tuesday, I had a similar reaction the following day, though not as bad.

I am doing a month of no drinking but since starting the medication I wake up feeling like I am a little hungover each morning. Not enough though to dissuade me from getting up, going to yoga or a morning swim in the ocean.

But when I open my eyes under the water, for instance, and feel elated that I am alive and lucky to live by the beach and to start every morning this way, I realise that this feeling might soon be gone, because I have Bipolar II. At least, that is what my psychiatrist tells me.

Samantha Stroop is a young writer who has studied in both New York and Sydney. She is currently writing a contemporary woman's fiction novel, but her true passion lies in personal essay writing.

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Comments

  1. I love everything you said here. There’s way too much pressure overmedicate. Everyone’s mileage is different. I don’t have kids, maybe if I did, I’d be much more inclined to medicate my depression (again) but I used to envy the BPD people. I wanted that mania. I still do. It sounds fucking great as long as no one is hurt. It sounds like what normal is — you know, loving life, loving people, not wanting to die. I don’t think doctors necessarily get that part. Good luck.

  2. I find it really weird that one of the six principal features of hypomania and mania is creativity per se and the ambition to write the great Australian novel in particular. Really weird.

  3. I get the ambition to write the great Australian novel bit – simply entertaining such an impossibility in such a bourgeois form deserves a clinically insane certification given Australia’s deeply flawed white history.

  4. who defines sanity anyway? I think we tend to over-analyse ourselves. Everyone is different and we react to things differently. I have depression and I’m medicated but to me it’s a characteristic that medication helps put in perspective. More or less it’s just another label like the words bubbly and cute or moody and rude. I’m not my depression but it’s one thing ABOUT me that my friends and family need to understand. You’ve inspired me, I feel like writing. :) Great essay! Touche I say.

  5. Yes, it’s easy to denounce the whole psychiatric profession as an affront to creativity, but actually, medication is really essential in some cases and the whole ‘fuuuuck yooooou’ to treatment attitude is one of the things that holds people who need it back from accepting it.

    I refused medication for depression for fifteen shitty years because I was afraid I’d lose the writing. It was a fluke that I finally went on it when I was prescribed a low-dose antidepressant to treat a weird case of insomnia (I was dreaming constantly through every night for a whole month, waking thirty times a night) and discovered it actually improved my mood and helped me think more clearly. Suddenly I didn’t have to work freakishly hard to haul ass out of bed every day and that meant I was more productive.

    I’m still super sensitive, I still feel things deeply and see the world the same way as I ever did. The difference is that now I’m just about 75% less encumbered by a depression that was once debilitating at times and which not one of the 5 therapists I tried over 15 years could even begin to help me with.

    Meds ain’t for everyone and psychiatric practices are obviously imperfect, but it’s worthwhile putting the middle finger away for long enough to find out what’s right for you. Hope it all goes swimmingly, etc.

  6. First of all, Samantha, congratulations on dealing so well with a situation with all kinds of complicated threads.

    The DSM was never meant to be anything more than a collaborative approximating guide for the various phenomena psychs came across in their practice and research. It was never eant to be the bible. I have a therapist friend in NYC who says the DSM exists today for the solepurpose of justifying the practices of Big Pharma.

    Many people still believe that extreme experiences and aberrent thoughts are indications of mal-adjustment or “mental illness”. But often we’re talking about mal-adjustment to a mythical norm. But the norm, when any kind of real thought is pu into it, is often frighteningly irrational and repressive to individuality. As R. D. Laing wrote a long time ago in The Divided Self, and I’m paraphrasing, ‘an abnormal reaction to an abnormal society is normal’. Most people also believe that psychologists are there to serve troubled individuals, when most often they are there as adjusters, to get you back into your assigned mold. Psychiatrists seem to care only about you talking long enough for them to determine which medication you’ll be prescribed by sessions’s end; they don’t give a shit about you at all (generally speaking) and could probable be replaced with software packages.

    She said my odd personality intimidated people and that I found it hard to build new relationships because of this. She had never once asked me about my friendships, new or old, though I have plenty of both. She has never seen me interact with anyone other than her receptionist when paying my bill (between $350–$450 depending on length of appointment). She had no idea about my interactions with others outside her office, yet claimed this was what I did.

    Exactly.What profound arrogance and ignorance couched in the authority of an advanced diploma. Pfllllit!

    I really like what you write here, Samantha. As someone who has been diagnosed with paranoid schizophrenia (but who knows what diagnosis they came up with behind my back), I can relate to the interactivity and chutzpah you describe. I don’t know what your feelings are toward standing before a group of strangers, but what you describe here would probably inspire all kinds of people struggling to cope with the recovery process and you might consider becoming a speaker for this.

    Good luck with your novel and your life!

  7. Writing is medication, I find. And here’s a discontinuous analagousness formula over which a lot of emotion has been shed:

    Writing : Medication :: Rejection : Depression

  8. Those pills look like exciting & poisonous lollies. Such an individual relationship, that each of us have to mental health, mental illness, ease and dis-ease. I’ve seen friends suffering so terribly I think ‘just take your freakin’ meds’ because they’re better than the utter anguish and despair of a bad episode — and there’s always the fear of suicide in the more terrible moments. In a world that is increasingly ill-minded and of questionable ethics and morals, let alone daily life-style madnesses of a consumer drone-world, it’s hard to know what’s depression/manic behaviour and what’s a natural response to a depressing and over-stimulating environment. Diagnosis probably comes down to the relationship built between a patient and doctor, and that takes time, and consistency, which aren’t really valued in our medical system because of financial impulses … and the ‘professionalism’ of not making real relationships. All the best, Clare.

  9. Firstly, mentioning marriage material sounds sexist as shit.

    Secondly, the drug of choice for bipolar type two is lamtrogine. It is generally side effect less and leaves hypomania untouched. Black dog recommended it for me and if that’s what they recommended for you you have little to worry about.

    My depression is stabilised and my normality is more productive and creative.

    And I get hypomania.

    Its pretty great.

    Other drugs don’t let you off as easy, so there are some combos that work fine, they just take a while to find.

    Ultimately if you think they’re medicating you for a non-problem based more on sexist thinking about marriage material I reckon you could just tell them to fuck off.

    Just be wary as time goes. The disorder often gets more intense with age or stress and even if your hypomania gets worse I end up not eating, pushing through on little sleep, having to actively reign in aggression and narcicism and being a bit of a dick.

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