Thursday, October 8, 2009

Minds on the Edge


Anonymous said...

Well, I am one: a consumer, and a disillusioned one, at that. After decades of mental-health treatment, and to my (initial) shock and horror, I was recently diagnosed with bipolar disorder, at age 54. I am just now ramping up on Lamictal.

So why did I not get diagnosed properly, and earlier? Is it because I look so good, and I don’t live in poverty? There is stereotyping about who is, who can be, mentally ill. I think this stereotyping is patently unfair. Even my (new) psychiatrist--when he suggested I attend a local support group--said I would meet some “really weird” people there but, in the same breath, said that going to these meetings might make me feel “less alone.” (Wait, please run that by me again…)

He was “impressed” by the fact I have carried on all these years, completed a graduate degree (I have no memory of how THAT happened), owned homes, etc. and stayed out of debt, the hospital and big-time trouble. Surprisingly, he said if I were male I probably would have destroyed myself; “impulse control and pain tolerance” being superior in females. I’m not sure what to think about his remark. It seems double-edged and-- as a female--I vaguely resent it. Perhaps having such good impulse control and pain tolerance, I should be doing an even better job of things. The term “high functioning” also came up and that is double-edged sword, too. So, am I basically severely ill and fucked up, but managing things well and I look great. (Wait, please run that by me again…) How much do I need to suffer, do I need to fuck up and act out, how many times hospitalized (I never have been), to prove my case?

Over the years, this is one way I have characterized my illness to friends and co-workers: “My operating system requires so many resources that I can’t open and run a lot of applications.” So I keep my life small, and simple. In other words, I may look swell, but I am disabled, I have major limitations and folks had better keep their distance.

I am sometimes plagued by semi-voluntary, rapid-fire “free association” during conversation. (Rather like that television series, “Connections.”) On and on I go. My statements amuse or startle, or both. Because of my lack of inhibition, I say what others will not say, and approach taboo subjects with cold objectivity (I think) or remote humor. This I call my “stream of consciousness” mode. It is nerve-wracking and guilt-inducing. (It is the hypomanic phase of bipolar, according to theory. And it is rather a relief to learn this.) Another way I describe this phenomenon is,” I have a gymnast in my head. She cannot stop; she can never rest.”

A textboo case, I spend weeks in bed (except for going to work, the last bastion of my respectability) as the house becomes a chaotic mess. Bills go unpaid (for lack of energy, not money). I subsist on cereal and peanut butter. Many people have described depression--
—so I will not spend time on it here.

My (new) psychiatrist said making the bipolar (II) diagnosis was, in my case, “Not that hard.” Finally, a hit? In psychiatry, a miss is as good as a mile.

Your blog is increasingly academic and erudite, but I am living on a more personal level: with sorrow I understand (now) that I did not get proper mental-heath care… for decades. I have dumped tens of thousands of dollars into an industry—the mental-health machinery-- that failed me. But it was mostly my fault! As a consumer, I didn’t feel entitled to beg for mercy, to beg for more meaningful assistance. One reason I am now getting aggressive treatment is this: I made it clear that I am tired; I am at the end of my rope, perhaps at the end of my lifespan-- which would be okay. True statements. (Hey, THAT got his attention!)

Perhaps, in my case, this time,”they” (so lazy of me to use that term) are onto something. I hope so! In the meantime, as I wait for the Lamictal, etc to kick in, I suppose I will continue to appear just fine--from a decent distance, and remain high functioning. A marathon runner, with heart disease.

Mark Grimsley said...

Thanks so much for taking time to write this. By and large I've been fortunate in the psychiatrists and therapists with whom I work. It's good to be reminded that this is not the case for everyone. I hope in the future you get the support you deserve.

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