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Bipolar Delusions, Diagnoses and True Mental Health

by Laura on January 25th, 2013

During my escape from reality in late 2001, I had … hallucinations, paranoid delusions, suicidal ideations. I believed I was a bionic robot. I believed I was a terrorist spy responsible for 9/11.

Ohhhhh yeah, it was a crazy time.

Finding wholeness in integrating our various selves

I haven’t spent much time writing on this blow about my visit to psychosis and back; bionic robots and conspiracy theories freak people out. I try to be more positive now. I don’t feel comfortable with this becoming a “bipolar blog,” either; I don’t take mediation, I haven’t done so for ten+ years.**

So, what is it, are you bipolar, or not? We need answers, dammit.

I need(ed) answers, too. It’s not that easy.

As I recovered, I was very lucky to have psychologists and psychiatrists who were reluctant to label me one way or another. Of course, diagnoses are necessary for professionals to use research delineating symptoms to fit a patient’s characteristics into the medical body-of-knowledge. That’s how treatment plans are developed.

Nevertheless, all of this What If-ing from earlier this week got me thinking, What if I were to stop telling myself I might be bipolar, and instead I say, “I might not be bipolar.” Perhaps I should stop defining myself in these ways, period, and just say, “I am a person with issues. Sometimes I’m high-maintenance; sometimes I’m sad. Most times I overthink all this shit.”

DSM-IV and diagnosis is imperative for treatment, yes. But when I “pretend” to steal my son’s bite of lasagna so he will eat his dinner within a reasonable time frame, I don’t reveal to him that I’m using a layman’s reverse psychology, and that I’m making it a game. No. I may pretend to know what I’m doing, but I don’t reveal my methods.

I’ll give the doctors credit: it was always, “You might be bipolar. We just don’t know. If you have another episode, then you are definitely bipolar.”

The idea that patients cling to, and define themselves according to, their diagnosis is so true. I set out my goal first-and-foremost: do. not. have. another. episode. No more trips to crazy town. No more insomnia-inspired meaning-of-life revelations.

Specifically, I focused on not to get myself in that not-sleeping, not-eating, too-many-emotional-life-events-happening at one time situation.

Intregrating identity; becoming whole

Recently, a couple of people who’ve read Adopted Reality have said they never really thought of me as bipolar.

Perhaps my mental breakdown was instead an artistic person experiencing a very creative response to overwhelming circumstances. (Which took an entire book to attempt to describe.)

What If … I don’t have to define, or un-define myself in psychological terminology? What If … At this point in my long-term recovery I can begin to integrate this ‘very creative self’ with my normal, not-hospitalized self? What would happen then?

*  *  *  *  *

Check out writer Grace Peterson’s review of Adopted Reality on her blog. Here’s a snippet

There is no disputing that society still has a problem with mental illness. Regardless of where the stigma originates, it’s fueled by ignorance and intolerance. Better information is the way to change that. When the events of a person’s life are laid out as succinctly and dramatically as they are in Adopted Reality, it becomes understandable how an otherwise normal person could succumb to a mental breakdown. This is the take-home message of this absorbing memoir.

 Thanks, Grace!

*  *  *  *  *

** Let me be perfectly clear: I am not a doctor, and I am not dispensing medical advice. For people who have bipolar diagnosis, it is often imperative that they remain in therapy and on medications. In these cases, treatment is a matter of life and death.

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  1. I appreciate this post. Sometimes it takes a WHOLE BOOK to describe the nuance of one's experience; a simple label (like bi-polar) comes sometimes too quick and easy. We as a society in general want black-and-white perspectives, and life is not so clean.

    • Laura permalink

      I know, right? A whole book, and I feel like I really left a lot of stuff out. There were entire themes (sexuality, relationships, religion, spirituality) that I dealt with only superficially … because I had a story to move forward! I actually really like how you handled this in your memoir, The Percussionist's Wife: you narrowed your scope. We don't get too deep a glimpse of your childhood, your parents, your "other issues." We mostly see you dealing with a very tragic and specific time period in your life, and we see you trying to handle it, understand it, and get yourself in a healthier place.

      This is, I think, truly the beauty and challenge of memoir: people DO want neat, clean explanations, and life just doesn't seem to want to comply.

  2. I so understand your dilemma, Laura. I was sort of diagnosed with: Borderline Personality Disorder, Postpartum Psychosis, PTSD, Anxiety Disorder, Depression (But the doctor used a different word that I can't recall right now). Plus another lay-counselor diagnosed me with Multiple Personality/DID. … On the one hand, I really appreciated the definitive labels but I also didn't feel that some were applicable. And were the "memories" I was remembering REALLY memories or just fabrications of a delusional, brainwashed mind?

    It gets very precarious. It's true what Monica says. We want those black and white perspectives but the human psyche isn't so cut and dried.

    Great post!

    • Laura permalink

      I agree. I mean, on the one hand, I really can't blame professionals for trying to make a diagnosis. That's their job; it's what they are trained to do. Sometimes, in order to get your patient access to certain help and medication, you need to have that "label" — which was certainly true in my case with the bipolar. That does not mean that professionals need to share every-single-in-and-out of their diagnostic process in order to help their patient. By staying that you perhaps have, PTSD, then well, a psychiatrist can help you identify and understand: trauma. She can use the tools for treating PTSD and try to see if they "work" on you, and by that I mean: help you.
      The other problem is that therapists can sometimes be easily tricked by ill patients, especially if the patient is smart and/or manipulative. I'm not saying this is you, but I'm saying that therapists sometimes see what they want to see, and fit us into roles that don't work for us.

  3. It is a difficult subject. My dad is, apparently, a bipolar and has to take medication. That said, I sometimes wonder whether he is schizophrenic. In fact, I am not sure that we know a lot about mental illnesses. I pray for the medication to keep working (as it does) in order to prevent another crisis…

    • Laura permalink

      I know, right? I'm so sorry about your dad; but for those who respond to the medications, it can be the difference between broken relationships and hospitalizations … and somethine resembling a 'normal' life–whatever that is. A lot of this feels like an art; a willingness on the part of the patient and the therapist to combine talk therapy with the medications (and constantly tweak dosages and combos, too.). And it is so hard …

  4. Laura, mental illness of any type causes both patient and family and friends, as well as clinicians, to walk a fine line between all the "what is it really" questions that abound. My stepdaughter (in her 30's) is bipolar/ADHD and I have watched her life rollercoaster through highs, lows, depression, anxiety, suspicion, and on and on. Watching her catapult out of control is difficult and leaves us feeling so helpless. I'm so glad that you and others, like Juanima Hiatt, are sharing your stories and your truth. Thank you!

    • Laura permalink

      Thanks so much for commenting. Yes, and I remember your family story well. I am so sorry about your stepdaughter. Not to put undue onus on the patient in these situations, but the patient does need to take responsibility for his/her mental health and well-being. That's not to say they are alone, they can have therapists and medication to help. But yes, sharing our stories can help us realize how important family and friends are to the mental wellbeing of the community.

  5. Very good post, informative and thorough.

  6. Very interesting. I look forward to reading your book! I am going to add it to my "list". :-)

    Without knowing a lot about your story yet, it sounds like your psychosis was pretty clear-cut but I like that even so they weren't quick to label you with a firm diagnosis.

    The problem I have with the whole thing is that the same patient can be given multiple diagnoses for the same symptoms depending on which psychiatrist is seen and what particular bent and medication preferences that psychiatrist has. It almost seems like both psychology and psychiatry are more subjective "art" than objective science, although the scientific side, as they learn more and more about the brain and the nature of human behavior, is no doubt gaining momentum.

    I tend to side with the person who attempts to not define themselves by diagnoses subjective or otherwise, even though I imagine this is easier said than done.

    Anyway, I can't wait to read more!


    Rachel :-)

    • Laura permalink

      Thanks for commenting. Yes, I agree–psychology and psychiatry are definitely an art. You're right, it is so important to recovery not to let the disease define the patient. I find, especially with bipolar, there's this sense of romanticizing the disease. Enjoying the highs–being productive, creative, and even enjoying the lows, because people feel it makes them more empathetic to their fellow humans. I don't know, I think that's a dangerous path to take.
      P.S. Thanks for your interest in Adopted Reality!

  7. What a journey! I must say I'm thirsty to read more and have to get my hands on your book.

    • Laura permalink

      It's so great to see you over here! Thanks for checking out my blog :)

  8. A DSM IV diagnosis is nothing more than a label, you are right, and I have seen diagnoses change over and over again on the same client. It does allow some standardization of treatment Laura, and medication to be prescribed if necessary. (I believe the less medication the better, personally.) People are all unique though, and complex creatures we are at that. I love your insight, and wisdom. Bravo to you!

    • Laura permalink

      I get the standardization of treatment and prescription, thanks for commenting. Yes! All people are unique and it's just I think professionals can 1. talk all they want about diagnosis among their peers, but 2. don't necessarily have to show the patient the ins-and-outs of their diagnosis. Or, they can explain that the patient fits with this module for now, and so we're going to try treatment based on that. But, the diagnosis may change. It's like, either be completely open about how difficult it is to assign someone with a label, or shield the patient from all of the internal medical thought-processes.
      It's great to hear your perspective as a professional, thanks again!

  9. I can so relate to this, Laura! A close family member of mine was diagnosed with Asperger's and I know that it continually permeates our language and the way we act with each other, and most importantly, how he acts and thinks. There's a lot of consciousness about it and a lot of, "I wonder if my brain works like this and I'm acting like this because I have Asperger's." Anything can be attributed to that umbrella as if it's an excuse. Thanks for bringing up this super important discussion!

    • Laura permalink

      You are so right–I think that the diagnosis can be used as just one lens through which to view one's life, behaviors, words and thoughts. But just as "not everything" is attributable to one's upbringing, one's biology, etc., "not everything" connects to a psychological diagnosis. It can be such a hard thing to figure out, and especially with something like Asperger's where there are a wide range of behaviors that can connect to the disorder. Some are more affected than others. It is really tough …
      So glad to see you here!

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