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Up, Down, Sideways: Coming to Terms with Bipolar II

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I was first diagnosed with major depression when I was sixteen. At the time, it made sense: I didn’t want to eat, I could hardly roll out of bed in the morning, and I couldn’t find any reason to smile. Counselors couldn’t find anything unusual about my thought patterns or my life. Under a doctor’s supervision, I took antidepressants for a while, then moved on. I thought that was the end of it.

In college, the depression returned in fits and starts. It didn’t feel like that high school numbness. Some days, sure, I criticized myself too much, didn’t bother to get up in the morning, and couldn’t think of anything that might make me happy. But this only lasted two or three days. Then my abusive inner monologue would speed up and I would find myself filled with nervous energy. In some ways that was worse. Where before my nights had been gray, now they were full of violently powerful emotion—I had to fidget or cry or scream into my pillow or do something, anything. The pain of sitting still was unbearable.

And in a few days that, too, would pass, and I would be free for half a month or more before the slow depression came back. No one phase ever lasted more than the two weeks doctors always quote, so I lessened my extracurricular load, rescheduled meetings and assignments to wait until after an incipient episode, and kept going. I figured this was something I should be able to get over, so I studied cognitive-behavioral techniques and positive thinking. When that didn’t work I studied spirituality and prayer and meditation. When that didn’t work I moved on to the next hopeful topic, thinking that surely there would be some solution I was smart enough to grasp.

It was early in senior year when I had my first panic attack. I was just sitting in this new class listening to the teacher’s introduction. And then my thoughts raced to blinding speed and my heart started thumping and I felt like my chest was collapsing. I sat still, not knowing what to do. Sure, I was halfway through an agitated episode, but I had never felt this awful in public. The minute class ended I rushed back home and called Campus Health.

One counselor said it was depression. One psychiatrist said it was depression. So I resumed antidepressants. Immediately the mood cycle—normal, sad, bewildered—sped up, with the agitated bewilderment taking up more and more of my time.

When I got a job and moved away, I found a new doctor. After two visits she directed me to a book, Why Am I Still Depressed?

That’s when it clicked into place. It turns out that in between depression and classic manic-depressive bipolar, there is a Bipolar Type II. In it, euphoric mania is replaced with hypomania, an energetic but often deeply unhappy state of mind. Sometimes it cycles about as slowly as classic Bipolar I. Sometimes it speeds up, switching between states in a matter of weeks, days, or even hours. Like it did with me.

Mood stabilizers were a revelation. Under my doctor’s supervision, I started a fast-acting stabilizer to go with my antidepressant. And the agitated episodes began to ease up. When a panic attack started, the deep breathing and positive thinking techniques I had studied for so long actually seemed to make a difference. I even started thinking that maybe I could work for a full month at a time without taking days off to stay at home crying.

That was over a year ago. I have a steady job now and a steady boyfriend. And, yes, a steady psychiatrist. When I go to sleep, I’m confident that I’ll be okay tomorrow. And if I have a bad day and spend a few minutes crying, I can pick myself back up without the disastrous emotional crash of my college days.

For years I thought my life would always be scheduled around tides of invisible pain. But now—I would never have dreamed!—I have hope that it’s going to be smooth sailing.

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