About three years ago, I authored an essay entitled: MentalHealthError: an exception occurred. In this essay, I "came out of the closet", so to speak, to my community about being diagnosed with bipolar disorder. In the post, I detail the dramatic unfolding of how I came to be diagnosed, and my (fairly psychedelic) experiences and perspectives held while under the care of the behavioral health services unit of the local hospital.
Over 150,000 people read that essay the weekend it was published, and I was overwhelmed with the outpouring of love and support that the community expressed towards me.
I haven't written much about my struggles since, so this post can serve as a follow-up.
At the end of the post, I left things off on a fairly positive note, saying:
I am doing very well.
It's been about six months since this incident occurred, and I'm happy to say that I've made a full recovery. Bipolar Disorder is something I've had for a while (unknowingly), and will have for the rest of my life. I now know how to manage it, with the proper blend of awareness, medication, and sleep. It will always require extra special attention, though. It demands respect :)
Before, I was completely undiagnosed and had no idea there was even a problem. Going so long without a diagnosis also caused some very serious delusions to build, over time. That is unlikely to happen again, but I now know how to recognize any odd thought patterns and avoid psychological sinkholes if it does come up.
I also learned to rely on my family and friends to keep me in check and generally support my health as much as possible. I was a bit too self-sufficient before.
Now that I have a diagnosis, I have a much deeper understanding into the way my mind works, and know how to prevent another episode from occurring in the future.
I'm completely back to normal, before all the woo-woo entered my life, and I'm much happier and whole because of it. I'm completely grounded in material/physical/scientific reality, and it puzzles me that I could have ever not been this way. I still struggle with sleep occasionally, but I'm learning how to adapt to that.
This, as it turned out, was a fairly optimistic perspective, and with how things have played out, thus far, things have not been quite as positive as I had hoped for.
Relapse in Reality Perception
Since I wrote that post, I have been hospitalized about once per year for psychosis. I wrote about one of these "relapses", on my journal. Unfortunately, I continue to have problems occasionally, and when that happens, it becomes quite evident that this is something far beyond exercising high levels of self-awareness.
Self-awareness is key, to functioning well, of course, and is mandatory. But, it is not enough.
Schizoaffective Disorder & Borderline PTSD
My diagnosis has changed from Bipolar Disorder (Type 1) to a potentially more stigmatized Schizoaffective Disorder (Bipolar subtype). The key differentiator between these diagnoses is that a schizoaffective patient can experience delusions/hallucinations all the time, not only during periods of mania.
Luckily, my psyche is relatively well-controlled (most of the time), and I am able to recognize immediately when something that I perceive isn't based on real sensory data. Sometimes, hallucinations can be trans-sensory, which is harder to detect, and causes a sort of self-induced synesthesia to present itself.
My doctor informed me that most people that have my diagnosis are homeless.
I have also been diagnosed with “borderline” Post-Traumatic Stress Disorder. I take gabapentin
(scheduled) for that.
I have also switched medications from Lithium to Abilify Maintaina (a $2,000/mo injection, without insurance). It seems to work rather well for me, most of the time, with few side effects. Lithium was a horrible experience of side-effects, and the pros didn't outweigh the cons.
Lessons Learned (the hard way)
Find a doctor (psychiatrist) that you trust
I can't stress this enough.
If the person that is in charge of the chemical component of your well-being isn't trusted, there won't be a positive feedback loop built between the two of you, and your care could be sub-par, because of your lack of true participation.
Support network (can be a double-edged sword)
I'll reiterate this lesson-learned from my first post: you need a support network. I can't stress this enough. People who's judgement you can trust and who can step aside and "say something" to you when you're acting unusually (or, given enough time, at "that point of the cycle again").
I will also note that there's a subtle art to learning to balance the opinion of your support network against your own opinion of your well being. This is something you need to exercise yourself, but I think it eventually happens to everyone, so I'll share about it here: one day, you may have to "stand up" to your support network and say "I am well". However, this may not be true. Just remember not to throw the baby out with the bath water.
Take life one day at a time
Some days are really though to get through, just being alive. On those days, I remind myself that tomorrow is a new day, you can't have sunshine without shadow, and that darkness reminds you to appreciate the light.