Bipolar Disorder Versus Depression

At my meeting with Dr A, Consultant Psychiatrist, nineteen days ago, I was asked why I thought I had bipolar disorder. Well, the truth is, at the time of being asked - I didn’t. All I knew was that despite various courses of well reputed antidepressants, therapy and a great deal of effort and learning on the part of me and my family, I was still experiencing a roller coaster ride of depressive episodes. It wasn’t that I thought I had bipolar disorder, but given that the treatment regime I was under was not working, in the sense that I could not maintain good mental health for more than a few months at a time, it felt like somebody needed to questions either the treatment or the diagnosis of straight depression. That somebody turned out to be me.

This blog post may well lack continuity. It’s nearly 8pm and every few minutes Xavier brings me the Lego plane he is playing with - in three or four pieces, for me to put it all back together again. Bless him. I know 8pm might seem a little late for a four year old but that is another story. We abandoned bed times after a five day trial period. Before that bedtimes were a bit of a battle ground and the only way Xavier could win was to do his utmost to keep himself awake in bed long after his story had ended and the lights had gone out. This just made him grumpy in the mornings. Now he gets ready for bed around 8pm, including a bedtime story, but after that he does what he likes, so long as it isn’t watching a DVD or playing on my phone (far too stimulating). He falls asleep really peacefully in our company and gets carried up to bed whilst he sleeps, with an ego the size of a five year old!

During the conversation with Dr A it emerged that a diagnosis of bipolar disorder would not be clear cut. Other factors, like my perfectionist tendencies and low self esteem could also account for some of the symptoms making it difficult to give a definitive diagnosis. It was a frustrating discussion for me because the whole conversation was based on my appalling ability to recall facts from my life. I’ve met people who can reel off their life as though reading from a CV and I am not one of them.

After the meeting, away from the stress of it, I was asked to complete The Mood Disorder Questionnaire. I had never seen it before; it claims to accurately identify 7 out of 10 people who have bipolar disorder and screen out 9 out of 10 people that do not. In the quiet of the waiting room and without the social interaction, these questions were now much easier to focus on. I want to reflect on those questions again here because, as I found in my first meeting with Dr A, so much depends on the ability of the patient to communicate key information.

There are most certainly times in my life when I feel very, very good; sort of invincible. During these times I’ll be more prone to do things such as strike up conversation with strangers; be a bit reckless for fun like stealing something from a shop or an exhibition; and be a bit loud even without the alcohol – talking over others. I feel like I become very in tune with the world, as though I can see how it is operating beneath the surface. Experiences become vivid: painted marks on a canvass, a musical movement, light penetrating a tree canopy, a plastic bag caught on the wind; they all become intensely beautiful and moving. My creativity at these times explodes and I get an inexhaustible thirst for new information, usually fed by days of research on the Internet. If I talk it through, conversation jumps around unpredictably as thoughts quickly fire in and out of my mind and the exciting connections form. I become driven – working on projects harder and longer. Our very own modest Victorian terrace house is a good example of that: The completely renewed wiring and plumbing; the newly installed central heating system; the bathroom and kitchen remodel: the new loft insulation and boarding, the solid wood flooring installation; and so much more in this house was done with these two hands whilst I worked a full time job in a secondary school. And as for whether I’ve done things considered excessive or foolish, remember I have seriously attempted gambling as an occupation in the past, out run the police when pursued and live now with unserviceable debts, not related to the gambling I might add.

Something that is perhaps a bit more 'out there' is a feeling that I have some sort of power over the world, like an ability the think consequences into being. Totally awkward admission right there. I feel somewhat superior to others, as though I understand truths in a way they can't. Other people can irritate me with little aggravation because their thinking can seem so clumsy and their methods backwards.

I’m not proud of any of this. Actually I am quite embarrassed about some of it, and even a little ashamed, but I’ve always said I’ll be honest here - even if that means I have to admit I can be a thoroughly detestable person at times. This is a picture of life, as me, that I’ve never discussed before because nobody has every really asked about it. It is, in a quite perverse kind of way, now that I read these paragraphs back, something that has been absorbed into the image I have of myself when I am well. It doesn't sound at all well though, does it.

When I am asked, as I was, if I have ever been in trouble with the police then the answer is indeed ‘no’. I have never been in trouble like that but for a speeding infringement. When asked if any of my blood relatives have been diagnosed with bipolar disorder the answer is again ‘no’. But that isn’t to say they don’t exhibit all these traits too. My parents are first generation emigrants who keep themselves to themselves. What you and I might consider symptomatic of a mental health issue would never be spoken about in these terms.

So I am a little frustrated at both the questions I was asked by Dr A and the way I answered them, because I think we could have had a much more productive hour together. I have another follow up appointment at the start of May. The evening’s dose of Quetiapine has started to make me feel very drowsy again, so its time to go to bed.