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Posts Tagged ‘diagnosis’

Part of the reason I write this blog is to document my particular struggles with mental health. Having to deal with some kind of challenge that’s within the range of mental health is just as common as dealing with some kind of difficulty with any kind of physical health. In other words, either category is EXTREMELY broad. Physical challenges can range from diabetes or thyroid issues to cancer or gallstones. Any disruption in mental health can lie anywhere in a big range, too. Physical illnesses can sometimes prove tough to pin down, but it seems figuring out a diagnosis of a mental illness can prove consistently more difficult. Even if a diagnosis seems mostly straightforward, finding a treatment that will help the person going through it to get to a fairly “normal” state is far more difficult.

I’m in my mid-40s, and I’ve been diagnosed with depression, bipolar, or atypical bipolar disorder variously over the past 25 years or so. I’ve gone through a number of antidepressants and some medicines that are usually prescribed to treat bipolar disorder. Some have helped for a short time, some haven’t helped at all, some have made me feel worse. Some have helped enough for me to live my life pretty normally. I’ve been seeing a very capable nurse practitioner for the past five or six years, I think, and I’ve been on an antidepressant that’s pretty much kept me mostly in “normal” mode. But I’ve still had bouts (or very, very long, standard stretches) of what I’d just call irritability. And I know that just isn’t ME. I’ve known instinctively that it’s more a quirk in my brain chemistry or something, rather than a defining characteristic of who I am. And my extremely busy life managing a household, taking care of four daughters (now one of whom is married and out of the house, so the dynamics and responsibilities have somewhat changed, but not at all taken her “off the register,” so to say), working from home part-time and volunteering and managing fairly big church responsibilities, just for a short summation, keeps me running at a high level. It’s easy to say it’s “understandable” I’m irritable. But recently I thought it was time to check in with my practitioner and address the irritability again. I’m exhausted from “managing” it. Surely there’s something out there to help me with my underlying mental health so I’m not working so hard to manage and can just live, expending a bit less energy on coping?

pill-bottle_21_G6So we visited a few weeks ago, and talked for a while. She is fantastic because she’s very thoughtful and discusses the issues with me, asks probing questions, revisits assumptions, etc. We’re partners in my care, and I really feel she’s very knowledgeable, and she’s sensitive as well. That’s a biggie. She said to me that perhaps I’m not really on the bipolar spectrum at all. All she could say was that I’m just my own thing. So there might not be either a diagnosis for whatever I present as yet, or because mental health really is so varied and unique to each of us, maybe there isn’t or won’t be, if that makes sense. All we know is there have to be some kinds of ways to help me with some kind of existing medication so I can function better. So she said she’d try something, a medication that psychiatrists sometimes use to help with that part of mood. It’s a seizure medication used off-label in this way. She tried me on a very small dose, and I actually do feel it’s helping. My life is still CRAZY BUSY!, but I feel a little less like I have to work hard to manage my mood even while I’m managing my life. So I’m feeling hopeful and a little happier, just to have an extra tool in my arsenal, and to know that my practitioner is really awesome at her job.

This just leads me to a few conclusions yet again: we still don’t know a lot about mental health and illness. We’re doing better than 30, 50, 70 years ago, but we have far to go. And we need far, far more practitioners who have the training, experience and skills to deal with this complex issue. So many people are suffering and there simply aren’t enough practitioners around to help them. I’m blessed to have found someone who can do what she does. Even that’s not perfect, but it’s really about the best I think there is. Meanwhile, I just wish, wish, wish we had more incentives for people to go into the profession and stay there, that the specialists were available in every small and underserved area.

I write this because I just want to put my voice out there. I’m mostly a “success story,” and that’s just because I’m not crippled by my lapses in mental health, and pretty well functioning, and I’m a very resilient, determined personality. I have at least enough income and resources that I have been able to find someone to really help, but that’s still taken a great deal of time and work on my part. It’s been a long and tough journey. It shouldn’t be this hard.

As we work to try to improve outreach, availability and quality of care, and genuine help for those of us with mental health challenges (again, not at all just a small portion of our population), let’s continue to just be kind, patient and understanding to those around us who struggle and need our help. It still does mean the world.

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It’s going to take a whole lot of posts to cover my life and experiences in this department. So I started at the beginning, but I’ve been jumping around since that first post. I’m going to try to explain a bit where I am now.

We moved to California in late summer of 2008 from Alabama, where we had lived in one town for 10 years. We were pretty well settled there, even though we hadn’t expected to stay there for so long. But our children’s needs, primarily, induced us to move cross-country. Though I had some time to plan and prepare for the move, the whole thing didn’t go nearly as smoothly as I would have liked. It took ages to get into a house of our own, during which time we lived with family and had all of our possessions in a storage unit. Then we waited and waited for our house in Alabama to sell, and after a year of waiting and one very low offer that fell through, we decided to rent it out. The stress of all those things, combined with the financial stress of paying two mortgages for a year, made life very difficult. I just felt depressed and frustrated and irritable pretty much all the time.

I had been seeing a psychiatrist in Alabama for a year or two, during which time he’d put me on an antidepressant that seemed to help fairly well. But with the move, it just wasn’t doing enough. So I started surfing the Web one morning and found a site that turned out to be very useful. It’s just a very simple-looking site by a psychiatrist who has shared many of his insights online. He also wrote a book called Why Am I Still Depressed? I pored over the site and then ordered the book. I decided that it was time to see a psychiatrist in my new town, rather than having my general doctor keep writing scripts for the old antidepressant.

The site had really struck a chord with me; its information led me to believe I was experiencing what this doctor (James Phelps) describes as bipolar II. Armed with this bit of information, I found one of the two psychiatrists in town that my health insurance covered and made an appointment. My new doctor and I talked, I shared my opinions, and he prescribed a new medication; he called my condition “atypical bipolar disorder,” but it’s just a slightly different name for what Dr. Phelps called bipolar II. The new medication seemed to work fine, and just knowing I had new information and a new medication gave me hope.

Three years later, this is still the diagnosis I’m working with. I’ve tried some different meds and a different doctor (I’ll write other posts on those topics), but we’re still going with that. Honestly, though, I still wonder how many other factors are at play. Dr. Phelps’ website talks about how thyroid disorders are sometimes tied in with bipolar II, and since I’ve been hypothyroid for about 12 years now (well, that’s when my doctor and I discovered it), I can’t help but think it may play a part in what I experience, even though I have been on thyroid replacement medication for all that time and it’s supposedly controlled (according to blood tests that my current doctor administers every year: and THAT, again, is a whole other topic). I also have noticed that I feel particular sensitivity to hormonal fluctuations, during pregnancy and postpartum and my monthly cycles, and those must be factors as well. I’m fascinated by how things work, and the complex interplay of hormones in the body is so interesting to me (I even wrote a paper about hormones for a research project in English in high school before I knew how personal it was). So I would love to figure out exactly how all these things work together to create my particular issues. Doctors, however, basically don’t seem to care about this (How could they not? Do they not have any curiosity?), at least when it comes to treating me. They just want to know that they’re finding a good medicine to treat me, and that’s all that matters. They have a point, I suppose, but I’d just love to know how all this works inside me. As far as we’ve come in being able to treat mood disorders, it still feels like we’re kind of living in the 19th century treatment-wise compared to all the other feats of medicine that exist.

So I could say now, “Well, this is it. I’m almost 42, and I’ve finally figured out what’s going on with me.” But even though I feel fairly confident that I’m on the right path — and it’s a big relief, I must say — I still wonder if in 10 years my diagnosis might change and I’ll look back and say, “Gee, we were close but not quite there.” At any rate, this is the best we have right now, and we’re going with it. It’s something, and something is better than nothing. I suppose, when it comes down to it, this is really just an extension of my previous post, “What’s in a name?”, because we have a name but that name could very well change. It’s just nice to have a name; it helps me to wrap my mind around what I experience, it helps me on occasion to explain to others if I feel so inclined, and now it might help you.

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