Congratulations, you're bipolar!

bipolar bear

Nobody ever says that. They didn't actually say that to me at first. That's the thing about diagnoses: sometimes the doctors can't agree on one. Or, as a smart doctor wrote in a recent editorial in the International Journal of Bipolar Disorders,  "It is still the case today that psychiatric diagnoses seem to be more consensus-based than validity-based ...." In other words, psychiatric diagnoses are not like diagnosing the measles: it's just not as clear-cut as all that. 

So I've been diagnosed with: major depressive disorder, adjustment disorder, borderline personality disorder, manic-depressive disorder, and bipolar disorder II. Not all at the same time, or from the same doctor (note: if you have more than one diagnosis, be cautious handing a list over to, say, a judge. Just sayin'.)

I go with bipolar II. There are a couple of things that I understand about this diagnosis. 1) It's not bipolar I -- which is "classic" manic-depression, and 2) It's not depression. Simple, see?

Ok, really, it means to me that I rarely have manic episodes -- so rarely, in fact, that I have generally been classified as depressed (or atypically depressed) by most pdocs (pdoc is just an abbreviation for psychiatrist). The manic episodes are generally milder than bipolar I, don't include delusions, and don't require hospitalization. In fact, I can only recall one episode of real "mania" in my life, and that was after starting on Prozac the first time. Another factor in bipolar II is that the depressive episodes are far more frequent than the manic episodes. According to a study cited in The Bipolar Disorder Survival Guide, people with bipolar II have an average of 40 weeks of depression to 1 week of mania.

That explained a lot to me when I read it. It's a good book.

So I have a shitload of days when I am living in depression. Then I have days when I feel okay, just not that motivated. There are also days when I actually feel functional. The manic episodes are pretty rare.

I want to stress that while I am living with an illness, I am struggling not to be defined or confined by that illness. Sometimes I lose the struggle, but I keep trying. I hope I can share with you the stuff I have learned that works, that doesn't work, as well as my personal struggle.

More on defining bipolar disorder: NIMH publication "Bipolar Disorder"