The Bipolar Express

This blog is difficult for me to write. I could lose potential clients or future employment over this admission. Most people know about my depression because I grieve the loss of my sister every day. The sadness makes sense to them. I have impressed people in many job interviews with my ability to cope and with the creation of my nonprofit Blue Faery. I cannot imagine, however, gaining that same respect and sympathy, if I said, “Oh, by the way, I’m bipolar.”

Depression Diagnosis

During the fall of 2002, one year after my sister Adrienne’s death, I was no longer able to handle my emotions by myself. Since I didn’t have health insurance, I entered a clinical trial at Cedars-Sinai for depression. It seemed like an easy way to get support and medication. Being paid for my time was a bonus. However, depression and grief are different. Very different. No one discussed those differences with me. In fact, no one asked about my prior mental health history. They only asked about my current mental health.

If I had to map the result of the initial intake conversation, it would look like this: Your sister/child died > you are grieving > you are depressed > you are severely depressed > you qualify for our clinical trial. I was labeled as severely depressed. Desperate to get help, I accepted the diagnosis even though I knew it fit at that moment but didn’t fit my history.

After the clinical trial ended, I obtained health insurance. I found my first psychiatrist, who said, “I’m just a pill pusher. You need a therapist.” I had already been to grief support groups; they did not comfort me. So I ignored his advice but took his prescription. I took a combination of antidepressants and went on with my life knowing I was functional but still faking it more than half the time.

However, while I was writing the first draft of my book, I saw a therapist (MFT) from 2006 to 2009. While she helped me work through my emotions, especially my issues with my mother, we didn't talk about my medication. By this time, my primary care physician administered the only antidepressant I took. I don’t know how much she and my doctor communicated with each other though I gave them permission to do so. In my view, they seemed to have an agreement: you take care of her meds and you take care of her mind. Neither one of them ever questioned my diagnosis.

Bipolar Diagnosis

When my world came crashing down in 2010, I found a new psychiatrist. He was old school. He wrote his notes in pen on a legal pad. He asked insightful questions. He asked about my life before Adrienne died, while I was raising her, before I was raising her (i.e., college), and my teenage years. While he never dismissed anything my previous doctors had said or done, he suggested perhaps my diagnosis had not been accurate.

I think it was my second or third visit when he said, “I believe you may have bipolar disorder. But not the one you hear about all the time. A more subtle one.

”My first thought was: great, I’m crazy. My second thought was: bipolar … highs and lows … yeah, that could be me. The diagnosis still seemed strange, but it made sense when I reviewed my health history, considered my DNA, and examined my life — in detail.

About Manic Depression

Today, doctors understand more about bipolar disorder (also known as manic depression). There are five types of bipolar disorders: Bipolar I disorder, Bipolar II disorder, Cyclothymic disorder, ‘Mixed Features’, and Rapid-Cycling. Nearly 6 million people, which is about 2.5% of the U.S. population, suffer from some form of bipolar disorder. Most people are in their teens or early 20s when they develop symptoms of bipolar disorder. Nearly everyone with bipolar II disorder develops it before age 50.

In 2010, I earned my seat on The Bipolar Express with a diagnosis of Bipolar II. I was 38 years old.

Major symptoms include

  • more depressive episodes

  • more hypo as opposed to hypermania

  • incredibly functional most of the time (which is why bipolar II is often misdiagnosed)

My Health History

Studies have linked creativity to bipolar disorders as well as thyroid disease. I had Grave’s Disease (e.g., hyperthyroidism) in my 20s, received radiation to remove most of my thyroid, and will remain on thyroid replacement medication for the rest of my life.

Other symptoms, especially during a hypomanic episode, include racing thoughts/speech, insomnia, anxiety, irritability, emotional intensity, binge behavior (e.g., food, drugs, alcohol, sex, money), and taking on too many projects at one time.

While I don’t do drugs and do drink socially, I am guilty of saying YES to too many things. (Read The power of NO.) Also, I have suffered from insomnia my entire life and have experienced intense dreams since childhood. Even when I feel sad, I have bursts of creativity where there are so many thoughts in my head, I can’t get them out fast enough. To solve this problem, I write fast and I type fast. This year, I began dictating the first drafts of my writing because I can speak faster than I can type. #winwin

My DNA

Though almost anyone can develop bipolar II disorder, people with an immediate family member who has it are at higher risk. On my mother’s side of the family, there is a history of depression, schizophrenia, Alzheimer’s, and other mental health issues including (you guessed it) bipolar disorder.

During my freshman year of college, my psychology course had four professors throughout the semester. After a lecture by the neuroscience expert, I approached her. I explained my family’s medical history and then I asked, “What are my chances of developing a mental illness?”

She frowned and shook her head. “It’s not good,” she replied.

“Not good?” I asked though I knew what she meant. Her body language spoke volumes.

“It’s highly possible given what you’ve told me,” she patted me on the shoulder, which I took as a dismissal. I lowered my head and walked away.

My Life

Not content with my psychiatrist’s diagnosis, I read all about bipolar disorder. I researched doctors, medications, and alternative treatments. I attended support groups, and I felt the diagnosis was accurate. I even googled “bipolar + female authors” and Virginia Woolf and Sylvia Plath were in the top results. Really!?! Both women committed suicide. One of my writing peers had compared my poetry to Sylvia Plath on multiple occasions. That's when I became worried.

After taking numerous online diagnostic tests and getting the same results, I created a visual life map on foam board. I started with my childhood up to 2008. What I saw both did and did not surprise me.

There was a clear pattern of mood swings and productivity levels. I almost chuckled when I saw the fall of 1993, my final semester of college. Determined to graduate one semester early because it was going to save me over $10,000, I enrolled in seven classes that equaled 20 credits. I worked part-time as a waitress four nights per week. Since two of my classes were at night, I had one night off: Mondays. It was the only night I slept. I hated that semester. I went on one date in four months.

When I took my last exam on Friday, December 17, 1993, I wasn’t excited or proud though I wanted to be. I had finished my bachelor’s degree in 3.5 years, maintained a 3.67 GPA, graduated cum laude, and worked the whole time I was in school. I remember walking on campus that afternoon. The usual sunny Southern California weather had disappeared. The sky appeared gray; the air contained a chill. It was the last day of exams and the last time slot for exams. No one was around. I yelled, “I’m finished. I’m fucking done.” I jumped up and down. No one heard me. No one saw me.

Exhilarated but exhausted, I wanted to sleep for a week. Instead, I partied for the next 20 hours before collapsing in bed around noon the next day. A hypomanic episode or just another 21-year-old girl celebrating a major milestone? Maybe a little of both considering one day later, I drove across the country with my best friend. Though I love sleep, I can get by without it if necessary.

Family/Friend Reactions

I dreaded telling people I was bipolar even though it doesn’t change who I am. It does, however, explain so much about me: lifelong insomnia, constant activity, intense creativity, mood sensitivity, intense passion, hyper-sexuality, and a searing sadness that follows when the walls come tumbling down. I never understood how I could go from the top of Mount Everest to the bottom of the ocean. The funny thing is … the closest people in my life were not shocked.

After my diagnosis, I remembered things people had said to me in my late teens – early 20s.

A close friend in college used to call me crazy. He was half-teasing, but there was always a note of sincerity in his voice. He said it the same way Matiaz says to Ponette in the French film Ponette (5:30). “You’re nutty but nice.”

During that same period, my stepmother expressed her belief that I was manic-depressive. She didn’t make that statement during an argument either. She said it in the same tone you would say pass the salt, please.

When I asked her about it after my diagnosis, she replied, “I remember you having severe mood swings. You’re fine. You just feel things more deeply than most people.”

My dad — like my stepmother — always suspected it. “Well, you had to get some of your genetic material from your mother.”

One of my oldest friends said, “Yeah, I knew.” When I asked him why he never said anything to me, he replied, “I couldn’t tell you I think you’re bipolar.” Point taken.

Another friend of mine said, “It’s okay. It’s not that surprising. Look at how creative you are.” His response blew me away.

A few years later, I met several yogis who had also been diagnosed as bipolar. I remember one woman who said, “Yeah, heard it before. So what. Doesn’t define me.”

Her words stuck with me. She was right. Being bipolar doesn’t define me. Not one bit.

My Reaction and Actions

Choosing the Right Drugs

Initially, I accepted my psychiatrist’s suggestion to add another medication to the mix: Abilify. After experimenting with doses and not feeling any difference, he agreed with my assertion: less is better. He knew about my mother’s history with drug addiction and my reluctance to take any medication whatsoever. Also, when you take thyroid medication daily because you no longer have a thyroid, your thyroid medication(s) is top dog. Thyroid meds don’t always play well with others so it’s a balancing act. Today, I take Wellbutrin, the one antidepressant with which I have experienced no side effects. It doesn’t interfere with my thyroid meds either.

I still don’t sleep well even though I maintain ‘good sleep hygiene.’ My psychiatrist was conservative about prescribing sleep drugs such as Ambien, and I appreciate his approach. The last thing I want is to become addicted to sleeping pills. The one time I was given Ambien after surgery, the drug stopped working after two days. My thoughts and dreams overrode the drug's ability to work. Not even Ambien can compete with the bipolar part of my brain.

The only drug that has ever eliminated my dreams and helped me sleep hours at a time was Xyrem. My former neurologist prescribed it two separate times, and it worked but the side effects were devastating. The first time I experienced so much nausea, my weight dropped to 99 pounds. (I’m 5’3″ and normally weigh around 115 pounds.) The second time, I felt like I was constantly on the verge of peeing in bed. Incontinence caused by a drug I don’t need? No thank you!

Creating the Right Mindset and Lifestyle

Mindset

I don’t think of myself as bipolar. Until I found my handwritten notes for this blog post, I had forgotten about my diagnosis. Seriously — 100% forgotten! My boyfriend and I have been together for over a year, and I never mentioned it to him until I decided to write this post. When I think of who I am, I don’t think about being bipolar. I don’t label myself that way. I believe it’s an unconscious choice I made a long time ago.

After I recovered from my 20-month depression (2010 – 2011), I vowed I would never allow myself to sink that low again. Every day, I choose happiness. No question, some days are tougher than others, but happiness is a conscious choice. Every. Single. Day.

As for hypomanic episodes, I rarely overindulge though I went on a major shopping spree this week on Amazon. Books are one of my vices, and I bought three books on my wishlist because they were on sale. I spent $16.53 on two paperbacks and one digital book. Anytime I can buy three books for under $20, I’m in because I’m still on budget. I don’t enjoy counting every dollar, but when I put my mind to it, I can and I do manage my money well. Budgets give me structure, which I need for both my personal and professional monetary expenses.

Lifestyle

After completing a 300-hour yoga teacher training in 2012, I realized I could stabilize my emotions by making better lifestyle choices. I needed more consistency and structure in my daily life in many areas.

The first one was acknowledging I am a night owl who prefers showers/baths before bedtime. Easy, right? Not really. Depending on where my job was located, I had to wake before 6 a.m. to get there due to 60+ minutes in Los Angeles traffic. If I wanted to take a morning shower, which I thought was what you were supposed to do, I would wake up even earlier. It sucked. By establishing a bedtime routine (even if I had to get up early), I found it easier to fall asleep and stay asleep. Though any change (e.g., traveling, illness) can disrupt my routine, I always return to it.

BEDTIME RITUAL

I will admit I go nuts over lotions and oil, but my skin is dry and sensitive so it needs a lot of TLC. When I stick to my routine, my skin is soft. Very soft.

The bedtime ritual did not happen overnight. Like any good habit, it developed slowly. I started by taking my showers/baths at night. I was already washing my face and brushing my teeth. Then I added things. I rearranged the order as well until I found the ideal step-by-step process that works for me. Some nights, I’ll skip steps and that’s okay. However, I feel better when I stick to my routine. For example, I haven’t been applying my hand lotion before falling asleep and my cuticles are a disaster.

After getting comfortable with my bedtime ritual, I decided it was time to create a morning ritual. While there are fewer steps, I’m not a morning person so I found this task to be more difficult. Since I work from home most of the time, I knew beginning my day the right way was crucial for my success.

MORNING RITUAL

  • Wake up, drink water, get dressed, and wash my face

  • Eat a light breakfast with hot tea or coffee

  • Read The Week (the actual magazine) or listen to a podcast while I eat

  • Meditate silently for 2 – 5 minutes

  • Do mindset practice which includes saying specific affirmations aloud and visualizing results

When I complete all the steps in my morning ritual, I am set for the day. I am prepared to write, to create, to conquer the world. I’m still terrible at maintaining my morning ritual when I travel, but I’m working on it.

Another daily ritual is my online gratitude journal. (Read Three ways to master an attitude of gratitude.) Unfortunately, a year’s worth of gratitude was erased when I switched phones. However, after 365 consecutive days, the habit has become part of my lifestyle.

One of my habits that has disappeared but is making a comeback is maintaining a consistent yoga practice. I don’t say daily because I know that’s not realistic for me. Yet. I would be happy if I exercised (e.g., yoga, strength training, walking outside) at least four days per week.

Exercise is a hard habit for me to maintain because it’s not goal-oriented. As a former ballet dancer and marathon walker, I knew what the end goal was. Another performance. Another marathon. Because I’m so competitive, I do well when there is a final goal such as getting in shape for my 20-year high school reunion. (Read Exercising My Ass Off.)

Even though I feel better when I exercise, especially doing yoga, the end goal is not enough for me. One of the things I’m working on this year is changing my mindset around exercise. I believe if I exercised as little as 30 minutes per day, my sleep and productivity would improve.

The Bipolar Express

Despite the doctors and medications, I feel as though I had to go on this journey by myself.

If you’ve ever read Harry Potter, you know the children must walk alone in the train station toward the barrier between platforms 9 and 10 in order to reach the Muggle-invisible Platform 9 3/4  where the Hogwarts Express awaits them. Not only are they doing it alone but there’s a level of trust that the platform will appear. That’s what a diagnosis of bipolar disorder feels like to me.

I had to get to the platform by myself. I had to trust once it appeared everything would be okay. That I would be okay.

Writing this blog and (finally) publishing it signifies that I found the platform. I bought my ticket. I entered the train called The Bipolar Express. Though the ride may never be over, I discovered in every station, I had family and friends waiting for me. They accept me for who I am. Sure, they may have been worried, but I bet they were also wondering Geez, what took her so long to get here?

Recommended Reading/Resources

P.S. One of the most stabilizing people in my life was my sister Adrienne. At the age of 22, I was thrust in the position of raising her. I had little money and no job stability so I had to get my shit together. Adrienne had become an eight-year-old wild child used to doing whatever she wanted whenever she wanted. By giving her structure and boundaries, I created a more consistent, secure lifestyle for both of us. She saved me from myself.

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