Who the Frag Am I?

May 4, 2010

On Phase Shifts

Filed under: Bipolar Disorder — wtfmi @ 11:30 pm

I haven’t posted in over a month. This isn’t because I don’t have things to say … okay, maybe it was because I didn’t have anything to say. *grin* But more to the point, my attention was focused elsewhere.

My husband has ADD. I don’t, so far as I can tell, but I have the same on-again off-again excitement levels. For the past month, give or take, I’ve been excited about re-theming and adding new features to one of my wesbites. I worked hard on that and it took all my time, energy, and enthusiasm. No, that’s not quite right … I gave it all my time and energy, quite willingly.

After I finished that work last week, I slowly came down. I puttered about mindlessly, reading a bit, playing a bit, but mostly feeling like I was missing something. Nothing seemed quite engaging enough …

Then I crashed hard two days ago. I spent all of Sunday in bed, staring at the wall when I couldn’t force myself to sleep or read. Yesterday I woke up angry — at myself, primarily, because I was wasting my time lying about being depressed — and stayed angry all day. I couldn’t talk to anyone without being nasty so I locked myself in my room and forced myself to sleep or stare at the wall.

Today I feel much better! I have a new project in mind that should keep my busy for a week or two and I’m very excited to get to work on it! I’m not angry!  (Well maybe a little at the stupid things I have to pay attention to which are not my project …)

I wish I knew what the hell is the matter with me.

February 19, 2010

On Borderline Personality Disorder

Filed under: Autism, Bipolar Disorder — wtfmi @ 8:02 pm

Yesterday I mentioned that I don’t always agree with my psychiatrist that I have (sub-clinical) bipolar disorder. The criteria don’t quite fit right. There is another disorder with criteria that fit me much better … Truth is, I am afraid that I have borderline personality disorder (BPD).

And I do mean afraid. I’ve been terrified of a BPD diagnosis since I was an adolescent. Being labeled with BPD can be the equivalent of being labeled as a difficult, lying, manipulative bitch. Get branded with BPD and your chances of anyone in the mental health professions believing you ever again go way down. And as it happens, being disbelieved or dismissed is a major sore point for me, perhaps because it happens so often.

(Be aware that I am not saying anything about people with BPD here, only about the attitude of many mental health professionals.)

So yesterday, after posting, I decided to learn more about the underlying intricacies of BPD. I mean, I’d read the DSM-IV criteria before, but I know that the DSM is rather far off when it comes to autism and I assume the same is true for BPD as well.

I spent the next 8 hours reading up on everything I could find online. (The internet contains a lot of iffy information, but by starting with sources you already trust (if available), keeping an eye on your source’s sources, and cross-referencing the information you find, you can at least distinguish patterns in the available information. I also find the net to be a valuable source for the personal experiences of affected people.)

When my husband eventually pried me away from my computer and forced me to eat something, I was awash with new information and new thoughts about patterns of behavior — and I wanted to share it with him. Poor man. I basically brain-dumped everything I’d read on him in a fast-paced thirty-minute lecture, in no particular order, frequently punctuated with the exclamation, “Isn’t this fascinating?!”

But one thing that stood out to me while I was researching — besides the fact that the criteria for BPD are so broad as to be useless, that the shorthand concepts that we often use to describe BPD are not the incontrovertible outcome of those criteria, and that there is precious little actual research on BPD — what struck me was how many of the criteria could just as easily be the outward signs of undiagnosed autism, especially for women on the end of the autism spectrum that appears less challenged with social interaction … well, once you stripped away the whole “difficult, lying, manipulative bitch” thing.

So after dinner I went looking for research on that notion. I didn’t find any (suggestions welcome) but I found a decent number of opinions on it flying around the autism-sphere.

One of the common opinions is that autism and BPD are two entirely separate things that cannot possibly be related, largely because BPD is all about being too sensitive to feelings, too lonely, and too socially manipulative, while autism is all about being insensible to feelings, unable or unwilling to be with other people, and unable to lie or manipulate. Of course, both of these are simplistic to the point of being untrue.

Another opinion I found is that BPD probably contains a number of disorders which are currently all mashed together because we haven’t done enough research to separate out the threads. One of those may be ‘classical’ BPD (although I think we should still take a careful look at the sexist aspects of that definition), while another may be co-morbid with autism or even an outward manifestation of undiagnosed autism.

But the most valuable of the opinions I read was this one: it doesn’t matter. Diagnostic labels are only useful insomuch as they are … well … useful. The BPD label isn’t useful to me while bipolar label is — primarily because it comes with medications which I have personally found to be useful in smoothing out some of my nastier moods.

And the most useful label of all — for me, from my own strictly limited point of view — is the autism label. Because autism has helped me understand myself and my life enormously.

So I’m going to calm down about BPD and stop treating my bipolar disorder as a separate and terrible disease. These are just labels for patterns of behaviors I display, and my behaviors ultimately come from who I am. Sometimes I need help with those behaviors, and sometimes I am happy with them, but in either case what you call them is only useful if it helps me.

February 18, 2010

On Writer’s Block (this is a lie)

Filed under: Bipolar Disorder — wtfmi @ 6:13 pm

I do not have writer’s block.

What I am having right now is a mixed episode of bipolar disorder. (Doesn’t that make it sound like a tasty side dish in a restaurant?)

According to Wikipedia, font of all knowledge, this may also be known as ‘agitated depression’ — which is an excellent description of what I am feeling. Wikipedia goes on to say that this:

[…] is a condition during which symptoms of mania and depression occur simultaneously (e.g., agitation, anxiety, fatigue, guilt, impulsiveness, irritability, morbid or suicidal ideation, panic, paranoia, pressured speech and rage). Typical examples include tearfulness during a manic episode or racing thoughts during a depressive episode.

Racing thoughts during a depressive episode … that’s me. In particular, I am simultaneously so angry I could spit, and too depressed to get out of bed on my own.

Every night I lay in bed thinking about things I want to post. I write entire posts in my head — deeply personal, very analytical, full of rich language and profound insight. Then I fall asleep. I write them in the shower, also, and in the car, or any other time I’m bored. (I’m doing it right now, for a different post than this one!)

I go over the language again and again, make mental notes for post after post. And because thought connects to thought, because all the concepts interlock, because patterns are so important to me … the damned things never end. And so the act of sitting down to type is beyond me.

No, that’s not true … the act of deciding what to type is beyond me. It’s all crap anyway.

And yet here I am, typing. I have a brief window of not-as-badness in the morning. And I feel a responsibility to my imaginary readers to post, even if it is crap.

I haven’t said much about my bipolar disorder yet. For one thing, I do not have an official diagnosis of bipolar disorder. (Mind you, that doesn’t stop me with regards to autism. But in this case I don’t always agree with the unofficial diagnosis anyway. Depends on my mood.)

I started seeing a psychiatrist when my family doctor suggested that my chronic depression was something more, was bipolar. I freaked out about that: seems like everyone I know deals with depression and even anxiety, but bipolar disorder sounds so much more serious. You know, like a real mental disorder. My therapist also doubted the idea since I never seemed particularly manic to her. She suggested that a psychiatrist, someone with experience with mood disorders, could shed some more light on the matter.

The psychiatrist talked to me for almost two hours. Then he said that I seem to have sub-clinical bipolar disorder, with manic and mixed states that have been intensified by my antidepressants — which is apparently not uncommon. Nothing to get upset about. He would probably diagnose it as bipolar disorder not otherwise specified (BD-NOS) or even a mood disorder NOS.

I noticed, though, that my chart continues to bear the codes for depression and anxiety, and nothing else. I wonder if this is to spare my feelings — although I have ceased to be freaked out by a diagnosis of bipolar disorder — or for some other reason. Perhaps to avoid future stigma should someone be looking at my history? I suppose I could ask.

He’s also been slowly reducing my antidepressant — Effexor — and put me on a mood leveler — Lamictal. And it’s been helping. The duration and severity of my fluctuations have been waning.

But they aren’t gone.

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