Bipolar Disorder: Misdiagnosis and Moving Forward.

When I started writing these pieces, I was in a battle with crippling depression. In fact, it was around 5 years ago when I initially started journaling about my mental health conflict. I hoped that releasing my thoughts into the physical world through penmanship would result in the battles becoming more manageable. While it was successful, it wasn’t until later that I realized my experiences could be of benefit to others. I have tried multiple therapeutic avenues throughout the years. Prozac (fluoxetine) and Cipramil (citalopram) – antidepressants pharmacologically referred to as selective serotonin reuptake inhibitors – provided nothing but unwanted weight gain, fatigue, and self-loathing. Therapy sessions were no better. I was pushed to see a psychologist when I was fourteen. Rather frustratingly, the sessions were littered with patronizing questions and unrelatable approaches. Seven years later, I decided to voluntarily see the university counselor. I was hoping for something different. While she was nice enough, my feelings towards therapy remained the same. I walked out of every session feeling worse than before I walked in. The medical approaches I was informed of to regulate my suicidal thoughts and defeatist attitude completely failed me. For the next seven years, I avoided medication and therapy like the plague. While that could have been the end of it, my internal conflict was finally greeted with some essential external support.

Even when finishing up my undergraduate biomedical science degree, I wasn’t familiar with behavioral psychology. After all, I never studied it. If I did, perhaps I would have considered the potentiality of being misdiagnosed. After my withdrawal from psychological support in my early twenties, I accepted my fate. I always considered myself as a train wreck waiting to happen, often withdrawing myself from social situations as a result. For years I didn’t consider myself worthy of anything. Bad week at work? Yup, I’m not good enough to do my job. Had an argument? It must have been my fault. Drinking was sometimes a great way to release myself from this, but not always. Certain social scenarios made me irrationally angry. I had – and occasionally still have – a ferocious temper. During my time as a graduate student in London, most of my socializing came in the form of a pub rather than a restaurant. I just put two-and-two together, concluding – incorrectly – that alcohol was the likely cause.

If it wasn’t for my girlfriend, I would have likely spent the rest of my life without knowing any better. What if I spent the next fifty years believing that I was a total catastrophe? What if I continually propagated false notions of insufficiency with regards to my colleagues, friends, and family? Until recently, these were considerably common thoughts. Alcohol also had the ability to amplify this irrational toxicity. Several drinks were sufficient to elicit an internal fury. While it often didn’t present itself externally to those around me, it had the ability to destroy me psychologically. Self-harm was a common thought that would swirl around my head during these periods of berserker-like rage. I would eventually calm down, but only when I was left to my own devices. As such, I often fled social situations to quench and pacify the emotions. Unfortunately, this was usually after smoking and drinking in excessive quantities. Music helped, but it was always in tandem with unhealthier habits.

At the start of this year, my girlfriend stressed that the shifts in my mood were significant. They also appeared to be semi-regular. As a scientist, I should have materialized a hypothesis many years earlier; a pattern was evident. Extreme irritability and irrational anger would usually be present over a week, but not necessarily every day. This was often accompanied by several weeks of lethargy, apathy, and depression. While exercise could help stabilize these emotional disparities, it was always a temporary solution.

I think she was aware of that fact. Despite the positives of exercise, it wasn’t sufficient to fix the problem. What was the alternative? In her mind, therapy appeared an attractive option. Regrettably, I never truly relayed my experience to her with regards to therapists. I was apprehensive and lingered against the idea, but it was her persistence and determination that eventually persuaded me to give it a shot. Woohoo! A return to therapy. The reemergence of a condescending dick was imminent.

As you may have expected, I hated it. The best part was that it was over a virtual conference call. See, even the coronavirus didn’t want me to see a therapist. Almost identical to my experience as a teenager, I felt like I was being repeatedly patronized. However, the therapist was nice enough and easy to talk to. The experience provided an avenue for me to project my concerns to someone who was analyzing me through an objective lens. While I will always hate it, therapy can be brilliant for that. The key is to find the right therapist. This was something I accepted in my early twenties, but it is an approach that has never suited me. I always feel worse after a ‘therapy’ session, with those negative emotions often lasting for several weeks. This was only further confirmed following these new sessions. I would argue that they made things worse for me. Despite this, they did change my life forever.

My therapist identified something that many before had missed. ‘You are describing many symptoms commonly associated with bipolar disorder.’ While aware of what bipolar was, I had never really familiarized myself with the key symptoms associated with it. How would you initially describe bipolar disorder? What would you associate it with? For me, I immediately think of intense mania. Manic episodes often result in reckless decisions. During periods of mania, you never really care about the consequences of your actions. As such, dangerous driving, excessive gambling, and unprotected sex with multiple partners are commonalities for people who suffer with bipolar. What I didn’t know however, was that bipolar disorder is separated into two distinct classifications. The first is Bipolar I disorder, which is defined by episodes of depression and at least one episode of mania. In some cases, mania can trigger psychosis. As such, hospitalization is common for Bipolar I patients experiencing a manic episode. In contrast, Bipolar II patients commonly experience hypomanic episodes rather than full-blown mania. Common symptoms associated with hypomania include hyperactivity, agitation, a decreased need for sleep, and increased distractibility. Though, this is not an exhaustive list. Individuals with Bipolar II rarely require hospitalization due to a hypomanic episode. As such, clear differences between the disorders exist. But despite these differences, depression is evident in both conditions. As such, medical intervention is often required for patients irrespective of their disorder classification.

A few months after seeing a therapist, I was diagnosed with Bipolar II by specialized psychiatrist. I have always preferred conversing with a psychiatrist, as they are more likely to use their medical knowledge to treat patients, rather than using psychotherapy techniques to address abnormal behaviors. We also often share common interests in neuroscience. I do not regularly get the opportunity to discuss my career in depth outside of the working environment, so this was a welcome change. It took him two sessions to confirm the diagnosis.

I felt psychological relief for the first time in almost ten years. It became incredibly obvious why antidepressants didn’t work for me – they are not particularly effective for those who have bipolar. In fact, antidepressants can make bipolar worse, and even triggering a manic episode. Instead, I was prescribed a medication called Lamotrigine (Lamictal). Lamotrigine is an anti-epileptic drug often used to help prevent and control seizures. However, it is also a mood-stabilizer commonly used for bipolar II, delaying bouts of depression and hypomania in patients. Strikingly, I noticed a difference within about four weeks.

Before my diagnosis and new medication regimen, I was extremely defeatist. If something went wrong, I would often hit an extreme low point. This doesn’t gel with a scientific career, wherein failure is incredibly common. If you are unable to develop a thick skin during grad school, it can be difficult to stay motivated. In contrast, since taking my bipolar medication, I have developed a startlingly rational mindset. Now, if something in my life goes wrong, instead of accepting the worst-case scenario as an inevitability, I can conceptualize alternative pathways and learn from potential mistakes. Now, I feel like I can approach any challenge. I feel refreshed and revitalized. But the most amazing thing? – I want to learn about my psychological trauma. I want to learn how to regulate it. For the first time in my adult life, I feel like I could control my mental health, rather than allowing it to control me.

This process hasn’t just miraculously cured me, though. My irritability remains debilitating. Depression can also still take hold, with suicidal thoughts flooding my mind at least once every six weeks. They’re quite dangerous, as I welcome them due to pure fascination; I am terrified of death, so I want to understand and rationalize this paradox.

Nevertheless, I feel empowered to move forward, and I hope that I can help others through the sharing of my own experiences. We all face challenges in our lives, but that doesn’t mean we should let them rule over us. So, are we going to let them, or are we brave enough to challenge them? We are all strong enough to challenge our inner demons. We are all strong enough to not only survive, but to thrive. Trust me when I say this: If I can do it, you can do it too.

“Though nobody can go back and make a new beginning, anyone can start over and make a new ending.” – Maria Robinson

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