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Getting Any Psychiatric Diagnosis

Charlotte Walker

Getting any psychiatric diagnosis inevitably leads to a lot of questions. Once someone has been given a clinical label, it’s not surprising that they begin to wonder: why do I have this disorder? What’s the prognosis? What are the treatment options? What will my family and friends think? What does this mean for my work like? But getting diagnosed, when it’s the right diagnosis, can also answer questions people have been asking themselves all their lives. I was reminded of this last month when watching a fantastic video by International Bipolar Foundation blog colleague Christi. Christi also does a lot of work with http://www.askabipolar.com/ and had decided to use the site to share the story of how diagnosis solved the mystery of what had had been going on in her life.

I related to Christi’s video post a lot, because over the 9 months since (re)diagnosis as bipolar, I have done a huge amount of slotting the puzzle pieces of my life into the bigger bipolar picture. The first time I was diagnosed with bipolar (at age 21) I didn’t want to accept the diagnosis and therefore refused to invest in the process of learning about the condition and seeing how the information I gleaned measured up against my life. This time around, a little older and wiser, I have been reading books and websites on the topic, as well as chatting with many other bipolar people on Twitter. Consequently, this time around I have had a large number of “light bulb moments”. There have even been times when reading about other people’s experiences, I have laughed out loud because their behaviour is so familiar to me. A moment of, oh yeah, that’s me, right there – and it’s been a bipolar trait all along! Finally, some things that have always puzzled me are making sense.

Take, for example, my sense of self-esteem. As a teenager (and bear in mind my symptoms began at age 12) I could never understand how my feelings about my appearance and attractiveness could fluctuate so wildly. Of course, all teenagers have some sort of self-esteem issues, but even at the time I felt that my feelings were beyond the norm. I vividly remember looking at myself in the mirror at about age 14 and then running from the bathroom, crying to my mother that I was “so ugly!” And yet I remember another time, no more than a few months later, when I looked into that same mirror and thought how beautiful I was. I remember thinking that I could probably do whatever I wanted in life, because I was so intelligent and so good-looking (grandiose, much?). At the time I was so caught up in feeling hideous/gorgeous that I never stopped to consider that both feelings might be wrong, and that the truth was likely to be somewhere in the middle.

Later in adolescence, I had my first serious boyfriend. From the outset, I could not understand how at some points all I wanted was to be with him – in fact, I was terrified he might leave me – and at others I struggled hugely to control my attraction to other people. I would end up flirting with strangers and kissing people I shouldn’t, and hating myself for it. These bad behaviours were totally bound up with my mood swings, occurring when I felt invincibly sexy and beautiful. When my mood dropped again, I would become convinced that no-one would ever find me attractive apart from my boyfriend.

Then there were all the bursts of enthusiasm and energy. Why, oh why, did I have to have go through periods of sticking my hand up in the air for everything, only to become terrified a few weeks later by finding myself in too many roles of responsibility on too many projects and committees. Overwhelmed, my anxiety levels would rise to level where I would drop out, hiding away at home and refusing to answer anyone’s calls. In a problematic workplace, I was always the one who took the grumbling to the next level, speaking out publicly to the boss (at which point my colleagues quickly often melted away, denying that they had ever had any problems.) Possessed by a righteous desire that everything be fixed, and a belief that I was the only one to do it, I would alienate both managers and work buddies in one fell swoop.

Spending is another one. Sometimes I have been able to live within an extremely tight budget with relative ease. I have frequently saved money, and generally been pretty risk averse when taking out financial products such as mortgages. Yet at other times I have blown unnecessary amounts of money on clothes, jewellery and books. I spent up a bank loan I’d been given without even starting the essential work on the house it had been granted for. Over and over, my prudent, “be careful, you never know what’s round the corner” approach to money becomes an attitude of, “Ah, whatever, I deserve this, and I deserve it right now. I’ll worry about paying for it when the credit card statement comes in.” I don’t spend as excessively as many bipolar people I know, but I’ve certainly made life uncomfortable for myself by blowing cash when I’m already in debt or taking money I needed for essentials to spend on frivolous things to make me feel good.

Repeating these same mistakes – same problem, different job/relationship/decade – I used to wonder what was wrong with me. How could a seemingly smart cookie make such stupid mistakes? And then make them again, and again? It’s taken me a long time to understand that my behaviour has been different in different periods of my life because behaviour comes from thinking, and from time to time my thinking has been dominated by my mood state. Of course when I was well I was able to look back at periods of uncontrolled behaviour and resolve never to be like that again. And of course when my mood state shifted, I forget about every promise I ever made to myself.

I’ve been undergoing a course of CBT with a National Health Service clinical psychologist. We’ve been working on recognising the thoughts and feelings that go with my bipolar mood states and devising strategies for managing my behaviour. Finally I am getting to the point when I can say to myself, “uh-oh, that’s not Charlotte thinking – that’s hypomania in the driving seat!” Hypomania has been a particularly state for me to get to grips with because until last year although I recognised my depressions only too well, I had no idea that many of the behaviours I felt the most ashamed of were due to hypomania or bipolar irritability. I’m starting to be able to challenge my own thinking, and am just beginning to take steps to curb the worst of my problem behaviours, but it’s going to be a long, slow road.

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