Wednesday, February 11, 2009

Am I the Only One?

**Addendum added: I just went for a walk and I realized that another reason I don't understand is because of my difficulty understanding, or accepting anything that is not black and white. I get completely confused when something is in a gray area. It makes absolutely no sense to me.

I often feel annoyed, frustrated, and maybe like I am being lied to when my pdoc and I discuss my diagnosis. I was talking to a friend about this and she asked me, "Why does it matter?"

That is a good question, and at first I really couldn't think of why it mattered to me. All I knew was that it did. It really did. It really, really did. It annoyed me, frustrated me, made me question my illness, made me worry about my illness, and made me not understand my illness.

Here is a "stream of consciousness" discussion with myself about WHY this bothers me so much. (***I have not edited it, because I was feeling a bit angry as I was writing...and if I edit I will remove some of the feelings):

First my pdoc says, I have major depressive disorder with cycling that takes me almost to hypomania, but not quite. Fine...I think that is close to accurate, although I can think of many times when my own feelings were that I was way to high for this to be "normal". Not that I want to 'be" a label, or be labelled, but it is kind of like when a person is diagnosed with something, they want it to be the right diagnosis...for example, if I have liver cancer, I don't want to be told I have kidney cancer, only to find out later I have liver cancer. I just want to know.

My confusion is compounded when my pdoc and I decide to use medications that work for BP disorder, when he expresses that I have a "bipolarlike": depression...(huh?) ...and when I find my mood increasing dramatically, my not sleeping more than a few hours a night and my mood ranging from super high, to wired, to happy, to high again and back. When I see myself doing more than I have done in years, all initiated within the time I have not been sleeping, and yet felt high and energetic.

But I still haven't figured out WHY it matters to me so much...partly sometimes I feel like the truth is withheld because of the stigma many attach to bipolar disorder, partly it seems my pdoc doesn't really put much emphasis on diagnosis, rather he looks at symptoms and how to address those (which makes sense)...but what happens if something happens to him and suddenly people who do base their treatments on diagnosis, see I am on a "bipolar" medications combo, yet I do not have bipolar. What if they decide I don't need the medications I am on? what if they don't recognize that I cycle despite not having bipolar?

I still don't understand why I feel frustrated that my mood disorder doesn't fit into a simple descriptive diagnosis. I can't be the only one. Some people have Major depression with no cycling, some have cyclothymia: "The highs of cyclothymia are called hypomania, a milder form of mania. The lows consist of mild or moderate depression"...Mayo clinic), some have BPII Mayor depression and hypomania, some have BPI, major depression and mania...where are the people who have major depression and a milder form of hypomania...sort of a reverse of cyclothymia? It doesn't make sense. And if people exist along some kind of spectrum, why don't they simply have some kind of, for example, 1-10 rating for mood cycling of all different kinds?

Also, how do you explain to your family what is going on? to your spouse? your friends? if there is officially no such thing as what you have? How do they find out information that might help you if what you have does not exist in any "official" context? How do they know you are just not making it all up?, or that you struggle both with the highs and lows?

I'm not sure if any of this makes sense, or if it even matters to anyone. Am I the only person confused by a psychiatric diagnosis? I guess the big reason I feel irritated is that I just want to know. I need to attach a name to how I feel. I want to know if my mood cycling is my fault, if I am in control of changing it, if I have done something wrong to create this type of mood hell. Or do I have an illness that causes me to feel this way? Is change my responsibility completely? Or are parts of my highs an illness which I need to control with medicine/therapy/lifestyle changes? Do I really go high...or do I imagine it? For some reason right, or wrong, I need to understand more than I do.


Life said...

Not entirely relevant but I am linking to you in my blog, I thought you may like to take a look... I got stage fright & tried to draw on the blogs I read and ended up not saying much at all!

Aqua said...

Hi Life,
Please feel welcome here. I understand stage fright, but the people who comment here are always respectful and caring. Thanks for the link. I tried to get to your blog, but it says your profile needs to be enabled...I love to read it if I can.

Anonymous said...

I regret pushing for my DX, it crushed my self esteem, and I'm not entirely sure that wasn't part of the purpose. That sounds paranoid, but clearly along the way I've p*ssed someone off. I can't wait to see my medical records, I doubt much of it bears resemblance to my dictation of events. The questions asked of me were leading, and my answers picked apart. From my recollection of any DSM interviews and what not, I felt like I was guest starring in Kafka's The Trial.

Besides it's all hoffle-poffle-waffle anyway. None of it is proveable by a test and therefore in my book it's likely to be biased by whoever does the ticky box sheet. Sounds to me like your Pdoc is trying to save you ending up with a bunch of spurious labels.

Lola x

cbtish said...

Everyone is confused by psychiatric diagnosis, except for good therapists, who just ignore it and treat the person, not the diagnosis.

The usual theory about diagnosis is that giving a name to a thing implies mastery of it. It is encompassed and tamed by our knowledge of its name — an old, old feeling of the magical power of words. By naming something, you no longer have to face the thing itself, only its name.

The mantra "hoffle-poffle-waffle" is an un-naming spell that lets you face the thing itself, even though the thing itself might be untamed and unknowable. Try saying it out loud the next time you are thinking about diagnosis, and see what happens.

She Sells Sanctuary said...

Hm. I get what you're saying & totally recognize myself in it as well, except i think i've "crossed over" to Not Needing The Definite Diagnosis/Definition as much as I used to. I have a couple of opinions & i hope you don't think they're like, "disposable", or not relevant... but here goes.
--i think the intense need to nail it down to something explainable to laypeople and/or to yourself is, of course, a reflection of your black & white thinking-- the absoluteness of it, the struggle to understand what it is. AND, it is entirely possible that you have a condition that wavers in and out of's almost like describing drunkenness, for lack of a better idea--sometimes you get buzzed, sometimes you get really really drunk. sometimes you just have a few sips & then stop. Does that make sense? Its like, sometimes your illness is so intense that your behaviors veer into "hypomania" w/out actually throwing you into that "category". . . if you know what i mean.

dont' know if i'm saying anything you don't already know--but here's another thing-- you HAVE a diagnosis, you ARE NOT the diagnosis. I know I used to get all pissed & frustrated when people would say that to me--I'd be like DUH, thanks!
but more and more since i've had a break from therapy, that really becomes more and more a real thing. When you're in therapy everything is RIGHT THERE, your stuff is just right on top of you, in your face, daring you to ignore it. And that kinda pushes the idea that you MUST "figure it OUT", Right Now! when really--not so much.

hope i didn't just make you throw up your hands in frustration.