“Maybe you’re just feeling better,” my psychiatrist said, “because something good has happened in your life.” He was the only psychiatrist who was open on a Saturday and covered by my insurance plan, provided by a job I couldn’t stand.
I pondered this as I stared out the window on a dull, gray February afternoon in Queens. The monotony of my desk job hadn’t changed in the nearly two years I’d been there, except that I was barely making deadlines because I couldn’t focus. My personal life was the same—still solid with my long-term boyfriend, but nothing particularly life-changing going on. I saw my friends regularly, and my family was good.
Which is to say: Things were fine, but nothing that great was happening—at least, nothing to elicit days’ worth of feeling euphoric, barely sleeping, being hyper-creative, and starting a million projects I knew in the back of my mind were never going to get done. I would later find out that this was a form of mania. My psychiatrist at the time, however, didn’t believe me when I explained the symptoms.
“Why don’t I keep you on the same dosage of Wellbutrin, and you come back in a month to see how you feel?” I took the paper prescription and headed out of the office, knowing the “crazy-sexy-skinny pill” wasn’t going to be the answer to my problems. I would eventually be diagnosed with bipolar II—a milder yet more confusing form of bipolar disorder. But it would take some frustrating trial-and-error to get there.
“Bipolar I is anyone who’s had a full-blown mania, and you only need one [manic phase] to meet those criteria. Bipolar II is the people who’ve never had a full mania, but have had mild manias called hypomanias,” psychiatrist Michael Gitlin, professor of clinical psychiatry at the UCLA School of Medicine, explains. People with full-blown mania experience what he calls significant functional impairment. “They’ve done damage to their life because of the mania: getting arrested, getting fired, ruining a long-term relationship, pissing away life savings, getting hospitalized, being psychotic. Any one of those will make you manic, not hypomanic.” Hypomania, on the other hand, isn’t as life destructive, but is still accompanied by racing thoughts, an increase in energy, and feelings of grandiosity.
While the manic phases in bipolar I and bipolar II are different, the depression is equally severe. People with bipolar disorder are depressed most of the time. Some people have manic phases frequently, while others only have a few in a lifetime and may not experience mania until later in life. This is why it’s so often overlooked and misdiagnosed.
I was first diagnosed with depression during my freshman year of high school. I went from being a straight-A honor student to barely pulling in Cs and Ds. When I wasn’t in school, I was in my room sleeping, ignoring my homework. I would pack my lunch, only to toss it in the trash once I got to the cafeteria. I lost 20 pounds. There was nothing to be depressed about, which was the most frustrating part: I had the typical privileged white upper-middle class upbringing, with a loving family and vacations and a nice home on a golf course. The more I reflected on this, the worse I felt; it would have been easier to pin my depression on childhood trauma. People who say things like “happiness is a choice” have never known what it’s like to be trapped in the prison of your own mind, ashamed of simply existing and believing you don’t deserve to live to see another day.
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