DX: Bipolar Disorder NOS

Not being a psychiatrist, I can only imagine how difficult it must be to diagnose a condition that’s as much of a chameleon as bipolar disorder. In fact, I was surprised when mine gave me a provisional BP diagnosis at our first appointment back in March of 2012. He’s pretty conservative in this area, as well as with medications—a position I appreciate as a clinician myself. I don’t want a shrink who passes GO and collects $200 before the couch is warm underneath my butt.

However, he wasn’t even sure I had bipolar at that time; I think the diagnosis was given mainly as a reference point, and he added “question of depression”, thinking he might change it back to MDD if I followed the pattern he saw in the office that first day. (He did start me on a bit of Lamictal though, which helped that end of things considerably.) The idea was that if this turned out to be the case, we’d have a couple more visits to do some therapy and then I’d go back to my regular doctor, since the average case of depression usually doesn’t require the care of a psychiatrist.

Well, we all know how THAT turned out. A couple of months into treatment, I waltzed into the office for an appointment on a nice, warm, sunny spring day, higher than a kite and dressed in bright, almost garish clothing; he took one look at me and asked, “Are we manic today?”

Of course I denied it, and of course he pretended to believe me, but that’s when the ‘question of depression’ diagnosis went away. Bipolar Disorder Not Otherwise Specified (NOS, for short) stayed put, and since then there have been no doubts whatsoever that the bipolar designation is 100% spot on.

Where we can’t seem to resolve matters is which actual flavor I have. My symptoms are all over the map; but as severe as they can be, they don’t always rise to the level specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is essentially the Bible for diagnosticians. For example, I’ll meet three of the criteria for a manic episode, but the fourth is dicey so it’s technically considered hypomania. Or I’ll have a depression that lasts for a week-and-a-half, but not the two full weeks required to qualify for such an episode.

There are times, however, when I meet every single criterion for a major mood episode, and that’s where the NOS diagnosis gets even fuzzier. Technically, if you’ve ever had a mixed episode (symptoms of both mania and depression at the same time) or full-blown mania, your diagnosis is Bipolar 1. I’ve had two mixed episodes just in the 15 months I’ve been in treatment, as well as several incidents of mania, two of which were very serious and nearly required hospitalization.

A few words about mixed episodes: In short, they are a brass-plated bitch. I just came through one about a month ago, and the scars still remain. If you’ve never experienced the feeling of being totally out of control, just try sitting on your bathroom floor at 2 AM, scrubbing the tiles with an ancient toothbrush and bawling like a toddler deprived of her favorite blankie.

But almost all the other symptoms I have are more consistent with Bipolar 2: severe ‘atypical’ depressions in which I sleep 10-16 hours a day, eat everything that isn’t red hot or nailed down, and feel like 300 lbs. of lead. I also experience periods of HYPOmania during which I have both great energy and enough of my wits about me to put out prodigious quantities of work, and to enjoy life con brio.

Recently I asked my pdoc about updating my diagnosis, as it was still in the NOS (translated: wastebasket) category and I really want to pin this thing down so that I don’t have to explain it to people, like the job counselor at Voc. Rehab, when they want to know if I’m Bipolar 1 or 2. Actually, I’d like even more to be able to explain it to myself; and BEING bipolar, I lack the ability to deal consistently well with life’s grey areas.

Now, my pdoc will be the first to tell you he isn’t the world’s greatest diagnostician when it comes to determining the “grade” of bipolar in a given patient, unless of course he or she is floridly psychotic and needs hospitalization at the time of diagnosis. (I’ve come close to going inpatient, but it hasn’t happened yet……and I hope it never does.) He works with a well-known bipolar specialist and consults with him on some particularly gnarly cases, but mine apparently isn’t gnarly enough, and that’s a GOOD thing!

So he hemmed and hawed around, making a case for both varieties, though he figured if I MUST pin him down on it, he’d probably call my version a 2……but he couldn’t rule out 1 either. (Confused? So was I.) In the end, he said he still had to label it NOS because he just couldn’t make that determination as yet. (This was before my latest mixed episode, in which he treated me for mania when I thought I was depressed; turned out he was correct and I settled down within a few days. That’s why HE gets the big bucks and I don’t. DUH.)

Perhaps one day he’ll figure it out and come up with a firm diagnosis so I can quit doing my little OCD-ish thing and worrying about specifics. Or not…..I’ve heard that it sometimes takes months to determine whether a person is bipolar at all, and several years more to flesh out the picture of bipolarity with which he or she presents. So as cautious as my doctor is, the fact that he saw enough on the very first visit to diagnose me as BP is rather telling. And as many different meds as I need to control it, NOS can be pretty serious, even if the books tend to dismiss it as “a mild form of the disorder”.

I just want it wrapped up all neat and tidy with a bow. Is that too much to ask? LOL

Oh, Happy Day!

After six weeks of job-hunting, sweating over applications and resumes, and not getting even a nibble, the miracle of networking came through: this afternoon, one of my best friends in nursing (who happens to be the director of nurses at the long-term care home where I worked years ago) discovered that she needed a part-time RN. Guess who happened to be in the right place at the right time? Yep—as of the moment I turn in the job application, I will be once again gainfully employed.

This is the place where I was most content as a floor nurse. I had awesome co-workers and a great crew of nurses’ aides, and we worked together as a team in the best sense of the word. They had my back. I had theirs. Three years later, we’re all still Facebook friends, and when my sister broke her hip and had to go to a nursing home for rehab, this was the one I chose. Three weeks ago they had no job openings (and believe me, I asked), but the staff has been talking the whole time about how much they wanted me to come back.

Today, their wish—and mine—came true.

This is why one should never, EVER burn bridges when leaving a job. At the time I left (cutbacks in hours due to low census made it impossible for me to stay on), I was still in excellent standing, and I’ve maintained good relationships with the other nurses and staff all this time. So when the possibility of a part-time opening came up, my name was at the very top of the list….and since I’m available, the job is mine to turn down.

Not that THAT’S an issue. I’ve wanted to go back to work there ever since I was kicked to the curb at my executive-level position. At 54, I have no real ambition anymore; I’ve done everything I wanted to do as a nurse, and then some. All I want now is to give an honest day’s work for an honest day’s pay, leave the job at the door when I go home, and not have to worry about it again till my next scheduled shift.

And best of all, these people know me. They know I’m bipolar, they know I have to be medicated and to see a psychiatrist regularly….and they like me anyway. I won’t have to explain my little ‘nonconformity’, or worry that it will be discovered when the inevitable happens and a mood episode sneaks through my protective shield. I don’t even have to ask for accommodations, because my soon-to-be boss already knows my limitations and has promised me that there won’t be any nights or back-to-back evening/day shifts.

Sometimes things really do work out for the best, even though we can’t see it while we’re going through the agony it takes to get to ‘better’.

Doing happy dance now….YAAAAAAAAAY!!

Stupid People Tricks: The Bipolar Edition

Here’s how kook BPNurse shows everyone she’s a kook: She goes to an appointment in a big building, gets turned around in there but doesn’t realize it, goes out to her car and can’t find it…..then panics and calls the police to report it stolen.

It was hilarious when my mother did the same thing way back when she was in HER mid-50s. Today, not so much. I’m a tad sensitive about my cognitive deficits anyway, and this was a blunder of the highest magnitude. I mean, what fool loses her own car in a parking lot? Somehow, a nondescript medium-blue Ford Taurus of early 2000’s vintage doesn’t seem like a car anyone with half a brain would want to steal….but the only other alternative was that it had been towed, quite possibly because I was parked between two disabled-parking stalls.

My first call was to my husband: “I don’t know where the ^%#*@&! car is,” I told him, the first faint stirrings of anxiety beginning to bubble up beneath the protective layer of medications. “I’m calling the police. I think the people here thought I parked it in a handicapped space and towed it by mistake.” Well, it seemed plausible; I really couldn’t imagine what anybody would want with my elderly vehicle.

It never occurred to me that my directional dyslexia might have been to blame for the car’s mysterious disappearance. I later recalled having gotten lost inside the three-story brick facility, but thought I’d made the proper course correction to find my way back out to the parking lot where my car awaited.

Guess what? I was WRONG. And when I’m wrong, stupid shit like this happens.

So I had the dispatcher checking to see if the car was in the impound yard, the building employees asking other employees if anyone had called for a tow, and while I was at it, I was taking pictures of the parking spot between the stalls that were clearly marked with the blue and white little-dude-in-the-wheelchair symbol. I’m not sure what that would’ve proved since there was obviously no car in the space, but it gave me something to do until the cops got there.

Fortunately, the two who arrived on the scene were VERY nice and quite willing to assist me without making me feel like some dumb hysterical female. I showed them my pictures and went through another lengthy description of the aforementioned Ford, then one officer went one direction while the other stayed with me. A third unit arrived to assist and promptly found the car, which was parked around the corner….right where I’d left it.

Have you ever felt about 17 kinds of ridiculous? Yeah, me too, and never more than I did at that moment, even as I was thanking the Lord above that my car hadn’t been stolen OR towed. I was mortified. All I could think about was the time my mother had done this same thing and how embarrassed SHE’D been—that, and the fact that I felt like I really must be losing all my marbles now. What was my next move, I wondered—the Alzheimer’s care home?

I apologized over and over; I felt terrible that I’d taken three city police officers off the streets to deal with a scared ol’ biddy and a missing car that wasn’t missing after all. But they all told me not to worry, it happened all the time; they even told me some funny stories of similar incidents committed by other folks who made me look like a Rhodes scholar by comparison. These included a tale about a woman who denied that she’d parked her car elsewhere and insisted that “somebody else must have moved it”, even though she had the keys and there were no signs of forced entry into the vehicle.

That made me feel a bit better, and since this little drama made good fodder for the day’s blog post, I figured I ought to use it. Considering the fact that between the brain damage caused by my illness and the medications I take to treat it, I can be QUITE the ditz at times, so we might as well get a few laughs out of it, yes?

Quo Vadis?

What do you mean, “what’s that mean?” OK, fine—I thought the Latin sounded more elegant than “where are you going, and why are you in that handbasket?” As the saying goes: an ounce of pretension is worth a pound of manure. Deal with it.

Anyway, that is the question I am having to ask myself now that I’ve been excommunicated from the working world, at least temporarily. I’ve been sending out resumes and online applications for every nursing job that even remotely sounds promising (and doable), and I haven’t gotten so much as a phone interview. I’m already on my fifth week of unemployment benefits, which last a maximum of 26 weeks, so essentially if I don’t find a job by early November, my dearly beloved and I will be out on the street before Christmas.

This has, of course, induced some mild anxiety and convinced me that I need extra help in finding suitable work…….or at least some kind of direction. As it is, I’m chasing my tail and becoming frustrated, knowing that the economy hasn’t yet recovered in my part of the country and feeling every single DAY of my almost fifty-five years on this rock we call Earth.

Thus, tomorrow morning I get to go down to the state Vocational Rehabilitation office and talk to a job counselor about my bipolar disorder and how it affects my ability to hold down a job. I am NOT looking forward to it. But, as with some therapy sessions where my pdoc brings up a really touchy subject (and the man is an absolute bulldog when he spots a weak area in my armor), it’s crucial to my personal growth, and in this case, my financial survival. I really don’t relish the idea of spending the winter begging like a refugee from an old Charles Dickens story: “Please, sir, may I have some more?” Sheesh.

Yep, it’s going to be a fun time…..said no government-services applicant, ever.

It’s not like I haven’t talked about my illness, ad nauseam with people in a position of authority before. It’s just that the last time I did it, the discussion didn’t end well for me. Memories of that terrible, final hour in my director’s office keep coming back to me whenever I put in yet another application or write yet another cover letter. I’ll never forget how it felt to have my entire tenure at that facility condensed into a single, six-word sentence: “It’s not your fault; it’s chemical.”

So, is biology destiny? Am I doomed to forever wander from job to job, dogged by the specter of an illness that can yank the rug out from under me at any time it so chooses? Or can I learn to stop worrying and love the damned thing for the energy, the imagination, and the wild creativity it lends to my life….and by extension, my work?

We shall see. In the meantime, let’s hope my counselor is a nice fellow who doesn’t think I’m a wuss for letting my disorder slap a “disabled” sticker on me. I’m NOT disabled….I merely have a disability. There’s a big difference. And never has it been more important than right now.

Where am I going? I haven’t the foggiest idea. But it’s gotta be better than where I’ve been these past few months.

Silver Linings Playbook

Why is it that you always have to see a movie more than once to catch its more subtle nuances and flesh out the characters?

I loved Silver Linings Playbook the first time I saw it. There were a few cringe-worthy scenes in which the bipolar lead would go off on a loud, profane, and often tangential rant, during which my husband glanced at me with a half-smile as if to say “See what I get to live with?” And I LOVED the scene in which Pat and Tiffany got to chatting about the different meds they’d taken in the past: I’ve had similarly animated discussions with my son’s mother-in-law (also BP) over the baked beans at family dinners while everyone sat back and watched us, like cats at a tennis match.

This time, however, I viewed the film with a more critical view of the relationship between Pat and his family, all of whom are rather rough around the edges, but Dad is by far the most challenging. In fact, he has many of the same issues as his son, but cannot seem to understand for the life of him where Pat’s coming from. Well, I don’t know about Pat, but I’d have issues with a family member who craps all over me and then gets offended when I complain about the stench.

In fact, I’m dealing with such an individual as we speak. Tonight, I found out that my closest relative, who’s headed for assisted living (courtesy of a fall and subsequent hip fracture), has her late husband’s snub-nosed .38 revolver hidden somewhere in her room at our house. She’s never even taken it out of its holster; its only value to her is that it DID belong to him, and thus holds some sentimental value.

Only one problem: assisted living facilities don’t allow firearms on the premises; she really has no other option than to give it up. None of her kids wants it, and they all live too far away to come and get it even if they did.

Now, I’ve wanted a gun since I took police firearms training awhile back—I once had a concealed-carry permit and was a pretty decent shot—but never got around to buying one. Not that I’d have gotten all butt-hurt if my relative had preferred to sell it, but it seemed to me that a good solution would be for me to keep the weapon. However, when I said as much, she declared loudly that she’d throw it in the river before she’d let me have it.

The reason? She didn’t like the fact that I wanted it…..so she hinted dramatically at her suspicion that if I were to go “mental” again, I might use the gun on myself.

I should mention that this relative is one of the only three people who know I briefly considered suicide a couple of years ago…..and now she was using this knowledge against me to announce in front of God, her roommate, and anyone who happened to be walking by that she thinks I can’t be trusted with a firearm. It’s apparently never occurred to her that there are enough pills in my medicine cabinet to kill me five times over, or that I would never in a million years leave a bloody mess for someone else to clean up. All that matters to her is some long-ago speculation about what it might be like if I weren’t here.

And as the story of Pat Solitano shows, it’s hard to focus on the silver linings in your future when your family insists on dragging you back to your past.

Driving While Bipolar

I got pulled over awhile back for driving under the influence of Zyprexa.

Actually, what the Oregon State Trooper noticed was my huge gaping yawn and erratic weaving within my own lane as I was passing him on the freeway about half a mile from where I worked. I was still yawning uncontrollably, with both hands on the steering wheel in plain view as I’d been taught many moons ago by my brother-in-law (himself a veteran of countless traffic stops), when the officer came up to my car window and asked for the usual documents.

“Get enough sleep last night, Ma’am?” was the initial query as he looked over the information, then peered into my eyes over his sunglasses. “You look pretty tired this morning. Did you know you were having trouble staying in your lane?”

I didn’t—at least, not until that moment—but then it occurred to me that I had absolutely no recall of the drive, and I lived 25 miles away from the job. “I guess I am a bit tired,” I conceded, then promptly stumbled into an episode of verbal incontinence that could have gotten me arrested. “I’m taking this new medication, and it makes me a little drowsy in the early mornings.”

The trooper was instantly interested. “What medication, Ma’am?” he wanted to know. I could’ve bitten my tongue off at that moment, because not only had I essentially just admitted to DUI, but now I had to explain what I was taking, and even worse, why I was taking it.

With all of the intelligence and grace of the college graduate that I am, I replied “Umm…..it’s well, um, Zyprexa.”

He was diplomatic, but firm in his pursuit of the truth. “And what kind of medication is that?”

“It’s something to calm me down a little,” I answered, realizing in the same moment how this second blunder must have sounded to the officer, but I was still reluctant to tell him that it was an antipsychotic. “It’s not a narcotic, though. Look, here’s the medicine.” Luckily I was carrying it with me for PRN (as-needed) use, so after fussing in my purse for a moment I produced the little green bottle and held it up for inspection. I was hoping he’d see that there was no red “C” for “controlled substance” on it and let me go without further ado.

“And you’re taking this because……..?” he persisted.

My humiliation was almost complete, and I blushed to my hairline. “It’s for my bipolar disorder.”

The expression on the trooper’s face changed the instant my confession was out. “I’m sorry,” was the surprising response. “My wife’s sister has that. Brutal disease—she had to stop working because of it. Wouldn’t wish it on anybody.” Then he handed me back my license and registration and continued, “You know it’s a crime to drive under the influence of ANY intoxicant—even prescribed meds. Right?”

My mouth went dry instantly and I could barely croak out the words “Yes, sir.” But instead of ordering me out of the car and reaching for the cuffs, he leaned in closer toward my window and said, “Look, Ma’am, since you’re close to your work I’m going to let you go, but only THIS time. I don’t want to see you on this freeway again when you’re too sleepy to drive safely. Good luck and have a nice day.”

To say that this was better than a Christmas gift would be an understatement. Not only had I barely escaped an embarrassing and potentially damaging criminal charge, but by the grace of God I hadn’t injured or killed anyone……including myself. So whenever I talk to people about bipolar medications, I often throw in this little story as a public-service announcement that even non-narcotic drugs can make us unsafe behind the wheel.

Bottom line: NEVER operate a motor vehicle until/unless you know how a medication affects you. (That includes dosage increases; something that was OK at 20 mg may knock you on your keister at 40 mg.) Thank you for not driving while bipolar, and like my friend the trooper said….have a nice day!

Normal? What Is This “Normal” You Speak Of?

Actually, it looks an awful lot like……..me. At least for the time being.

It seems a bit odd to be discussing bipolar disorder when I’ve never felt less bipolar in my life. But I think I love this newfound serenity even more than I do my hypomanias. This is what it must be like to live without a mental illness. I’m not bouncing off the walls, I’m not sweating bullets, I’m not itching to claw anyone’s eyeballs out, and I’m not the least bit depressed.

I’m feeling—dare I say it?—downright normal.

It’s not that I don’t have a lot of stress in my life. I have a close relative whose health has been in free-fall for over a year, and then wound up in a nursing home after breaking her hip in a catastrophic fall. Suddenly, I’m thrust back into a caregiving role without the title (OR the pay), and while I don’t mind helping her face the transition from independence to assisted living, I am greatly disappointed in this relative due to her mean-spirited and incessant sniping, almost all of which is directed at me.

I understand that she’s upset and angry. I understand that she’s scared of leaving her comfort zone and going to live in a place where they’re going to insist that she get out of that damn bed of hers and take a shower once in a while. But it’s not my fault that she chose to overdo it on the narcotics—AGAIN—lost her balance, and fell….or that she’s no longer safe to manage her life alone, at home or anywhere else. I wasn’t the one who did it, and I don’t have to own it. What a concept!

And I’m handling it. It pisses me off, but I’m dealing with it competently and with a degree of equanimity that I wouldn’t have thought possible even a few weeks ago. At long last, my meds are working in perfect harmony and all’s right with the world, even though what’s going on in MY world really sucks right now.

It doesn’t hurt that the weather has been bright, warm, and sunny for the past week; that’s when I’m at my best no matter what the surrounding circumstances may be. But there’s a maturity in the way I see this situation that wasn’t there before, and I’m almost afraid to trust it for I know how my illness works, and I’m already waiting for the proverbial other shoe to drop. In fact, it’s such a foreign concept that I can’t help thinking that it’s all a dream, and that I’ll wake up in the morning in my default mode….which is to say, a bipolar hot mess.

But for today—and maybe even tomorrow—I’ll take pride in knowing that I’m taking care of business like a real, live normal person. And for now, that is enough.

Strange Brew

Looking down at my handful of sanity tonight, I am once again amazed by the different colors and shapes of the various medications in my palm, and I wonder at the technology and the brilliant minds that brought them into existence.

Here is a dark blue capsule; it’s the antipsychotic, which for some reason costs less for 40 mg caps than it did for the 20 mg. About $50 less, which is a significant savings. I don’t think I’ll ever figure out what pharmacies are thinking when they set drug prices…..all I know is I appreciate spending less money and getting more bang for my 100+ bucks.

Here, too, are the two giant fish oil capsules which help keep my blood fats within acceptable levels; they’re a clear amber and really quite pretty, if a bit hard to swallow. The major side effect is the seal burp—a nasty phenomenon that accompanies the ingestion of said fish oil, which is rather unpleasant and causes my cats to circle around me and sniff my breath for half the night.

The round yellow pill is Klonopin, which I take only on the nights when I want to sleep and not be anxious the next day. Then come the five little white ones; the diamond-shaped one is metformin, which is the only thing I take for diabetes. There are also round ones of varying sizes; the largest and second-largest are blood-pressure meds, and then come the 1 1/2 tablets of my mood stabilizer and a 3 mg melatonin to seal the deal on sleep.

My daytime regimen is much simpler: another dose of mood stabilizer, a Vitamin D gelcap (is there anyone who lives in the Pacific Northwest who’s NOT Vit. D deficient??), still another blood-pressure pill, and the oval, salmon-colored antidepressant. Make that one-half tab: I’m on a sub-therapeutic dose because my p-doc (psychiatrist) won’t let me increase it. Unfortunately, a therapeutic dose tends to throw me right into mania and he knows it, so I’m forced to cut these itty-bitty pills into two pieces.

I cursed him for almost a year over this. Every Sunday when I filled my med minder, I’d have to haul out the pill-splitter and try to get this slick, odd-shaped, elusive little sucker to fit into the mechanism. Every week, I’d chase them round and round the bathroom, split ’em into thirds instead of halves, crush a couple inadvertently, and swear horribly when I did it because he kept me on a VERY short leash with those; and if I tried to refill even a day too soon, I couldn’t get them until I was completely out.

And then, about a month ago, I accidentally discovered that they split beautifully when you hold them between your thumbs and index fingers and merely snap them in half. Who knew??

Stuff about Nothing

OK, so I talk a lot about bipolar disorder and what it’s like to live with it, but I don’t ALWAYS talk about bipolar. Sometimes I will hold forth on politics or religion (you know, the topics our parents taught us never to discuss in public), and other times I just yammer about anything that comes to mind. Today, I’ll tell you a little about who I am.

As mentioned elsewhere on this blog, I’m a registered nurse who’s been more or less happily married for almost 33 years. My husband should be high on the candidate list for sainthood after putting up with me for so long, although he does have his own less adorable moments (like when he buys yet another model airplane when there are 75 others downstairs in the man-cave). We have 4 beautiful grown children; we also had a daughter who died shortly after birth, which was easily the worst time of our lives. To say the least.

Three of these beautiful children have produced a total of six even more beautiful grandchildren, with one more on the way this October. My ‘baby’, the 22-year-old, is gay, and while I’m pretty much your average conservative Catholic girl, to see this young man and his partner together is one of the joys of my life and I will defy ANYONE to claim I should be ashamed of him.

When I’m not working—like now—I enjoy blogging (surprise, surprise), gardening, writing articles for the world’s largest online nursing community, NFL football (my team is the perennial also-ran Chargers from San Diego), church activities, and good times with my hubby and our ever-growing family. Life is never better than on a summer’s day with the grandsons playing on our big front lawn, the barbecue grill cooking up a delicious meal, the sounds of birds in the tall pines, and a glass of iced sweet tea in my hand.

Still, if I didn’t have this weird, warped sense of humor that enables me to laugh uproariously at almost anything, I’d never have made it through life. While I don’t find physical comedy particularly enjoyable (think the Three Stooges and most Jim Carrey movies), I delight in life and break up at some of the damnedest things…….like body noises. I’m the eternal 10-year-old; though I love sophisticated humor, there’s nothing funnier than a perfectly timed butt-trumpet during a sober moment or the middle of a tense movie scene.

So, that’s a bit about me. How about you?

How I Got Here

You know, no child wakes up in the morning thinking, “Gee, I wanna be a psych patient when I grow up.” For one thing, they don’t understand it, no should they be expected to; mental illness is hard enough to explain to adults (especially those who don’t have it). For another, kids with issues don’t usually know that ‘normal’ kids interpret the world differently, and wouldn’t believe you even if you told them so. All they know is that somehow, in some way, they’re always wrong.

That’s how it was for me, anyway. It didn’t help that I was the daughter of hypercritical, social-climbing parents who never admitted to having skeletons in the family closet. To hear them tell it, we didn’t have mental illness in the family. We didn’t have alcohol or drug problems. We were too good to possess such low-class character flaws……even though both sides of the family were loaded with alcoholics and depressives, and I’d bet the house payment that my mother was every bit as bipolar as I am.

That attitude was a good portion of the reason why I was never diagnosed until late in middle age. Even though my folks are long dead, it’s hard to overcome thirty years of conditioning and another couple decades of trying to undo the damage it did. Looking back now, I know I’ve had this illness for most, if not all of my life; the signs were all there even as far back as kindergarten. I was the kid who was always about 15 degrees off ‘cool’, the grade-schooler who was picked last for the softball team and perpetually stuck in the outfield.

I was the 13-year-old who fell into a months-long depression after my grandmother died and was put on about a half-dozen different meds in the search for what ailed me. I was the high-schooler who dreamed of escaping my so-called life full of dateless Friday nights, and making my parents sorry for treating me like crap by dying in some dramatic fashion.

I was also the young wife and mom who would’ve committed suicide the night after my second child was born and then died, if only I’d been able to pry open the seventh-floor window in my hospital room. And, I was the adult who drank like a fish and still have no recall of entire six-month periods of my life, courtesy of what I now know to have been mania and alcoholic blackouts.

But since we supposedly didn’t have these problems in our family, they went mostly unnoticed—and untreated—until the defining mixed-manic episode in the winter of 2011-12 that led to my first visit to a psychiatrist. I’d secretly suspected bipolar disorder was at the root of my issues for years after taking a couple of online quizzes that pointed strongly in that direction, but when I waltzed into my new doctor’s office with this announcement, he asked, “What in the world makes you think you’re bipolar?”

It wasn’t to be the last time he would challenge my thought processes…..not by a long shot. Although he wound up agreeing with me about the initial diagnosis, we’re still wrangling about the type of bipolar I have, and just about the time I think it’s time for him to pin it down once and for all, the damn thing does its chameleon act and changes again. My provisional diagnosis was Bipolar Disorder Not Otherwise Specified, which in essence is a wastebasket diagnosis that means “It looks like bipolar, smells like bipolar, and walks like bipolar…..we just don’t know which flavor.”

Then he reluctantly changed it to a squishy Bipolar II because I had a couple of hypomanias which may or may not have crossed into manic territory; he just couldn’t put a finger on the way my illness was acting. Now that I’ve had a full-on mixed manic/depressive episode, however, he can’t rule out a determination of Bipolar I, even though I’ve never had frank psychosis (except, of course, for the hot mess I found myself in during my brief time on Wellbutrin).

I don’t know how I feel about this. While there’s absolutely NO reason to get hung up on a number, it bothers me that after 15 months and several near-disastrous mood swings, I still don’t have a definitive diagnosis….other than the fact that I’m bipolar as hell. Meh.