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Jessica McNeill Azar Headshot

When the Doctor Says 'You're Bipolar'

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"I know what's wrong with you," the doctor said, as she folded her hands behind her head. "You're Bipolar. You have Bipolar Disorder, Type II. That's why the antidepressants you've been taking work great for awhile, then just STOP working. Your body chemistry must have a mood stabilizer to temper the antidepressant, or you'll have too much serotonin. This shoots you up, and then you crash."

I sat there in silence, then pasted a well-practiced smile on my face, the mask that's helped me coast publicly through long periods of misery. And said, "Well it's good to know why the meds quit working... what's the difference in Bipolar and Bipolar II?"

She answered me with a somewhat condescending tone. "As a Bipolar II patient, you won't experience the wild manias that are associated with Bipolar Disorder. Manias are where one goes on alcohol binges, spending sprees or engages in other risky behaviors. You instead have Hypomania, which includes severe irritability, insomnia, pressured speech and other milder but still invasive symptoms. As a Bipolar II, you also have more severe depressive episodes than someone with classic Bipolar Disorder." She paused a second and looked at me meaningfully, then said "That's why a higher suicide rate is associated with Bipolar II. The depressions are more frequent and can be harder to emerge from."

Higher suicide rates?! More severe depressions?! I don't even experience the WOO HOO of classic manias? I can't even have the more enjoyable variety of this mess, I thought to myself. I now know that Manias can be destructive to a person's life, but at that point I was in shock and feeling cheated in a myriad of ways.

"Now what do I do? Where do I go from here?" I said with a forced, yet believable cheerfulness.

I was somewhat relieved to hear that there was a name for the endless rollercoaster of moods and emotions that had ruled my life for so long, but it fueled my anxiety at the same time. I could practically hear the CLANK of the prison bars coming down around me, because being imprisoned is what it felt like. From voracious prior research, I knew that Bipolar is "incurable." It's a life sentence. I also knew that there are ways to manage symptoms, but that there was no "one size fits all" treatment for Bipolar Disorder, and tons of variables to consider. My shoulders struggled against the weight of the news. The knowledge that managing my symptoms could be like a part-time job depending on my needs was overwhelming.

"It's a good thing that you already have children, because having more isn't a wise choice for you, now that you know what you're up against. Pregnancy and Bipolar don't go together... You know how horribly you felt after both of your sons' deliveries? That can actually get worse with subsequent births," the doctor said, very matter-of-factly.

My mind jolted with the realization that I did, in fact, have kids (my sons were barely 2 and 10-months-old at this point in time) and that my diagnosis would affect them. What if I couldn't hold it all together?! What if I crumbled beneath the demands of being a mother and trying to keep my illness in check? And I was HORRIFIED at the thought of not being able to safely (in terms of my sanity) have more children... I always dreamed of having four kids. While I was grateful for my sons, her statement felt like a slap in the face and a kick in the heart. "So I can't have any more children?" I asked evenly, hiding my horror.

As she removed her glasses, she said, "As we discussed, your Postpartum Depression was severe after your oldest son's birth, and also bad following your younger son's birth. You would have to go off of all of your mental health medicines that I'm about to prescribe at the first sign of pregnancy and that within itself can be catastrophic. Why would you want to put yourself and everyone else through that hell?"

I was stunned. Really. Stunned. She was rebuking me for even entertaining the thought of additional children. I felt like I was being treated like a child or someone who couldn't control any aspect of her behavior. My life plans were being laid out before me in relation to my new "limitations" and it felt as if my control over my own destiny was being repossessed. Inside my head a tiny voice screamed through the Brain Fog of depression. "This cannot be right! You know yourself. Your life is not over. You are still in control of yourself."

She wrote out prescriptions for a higher dosage of my current antidepressant, an anxiety medication and a mood stabilizer. Part of me was excited about the prospect of feeling better -- emerging from the isolating mental fog that had surrounded me for so long, and actually enjoying my kids again. Another part of me was scared that these medicines would make things worse. The doctor had warned me of that possibility, and also cautioned me that I would probably never feel GREAT, but that we were going for "good enough." Good enough to function sanely, good enough to make it from one day to the next, good enough to not burden the lives of my family with my symptoms. This didn't set well with me, because I'm not the type of person that accepts "good enough" anything out of myself. I'm a highly driven, goal-oriented individual, that is, when I'm not in the pits of hell depression. I knew that I would need to explore accompanying treatment options to enable myself to surpass the "good enough" range of functioning... I had dreams to pursue and a life to live.

At that moment, I began to realize that while managing Bipolar II was not going to be easy, doing my best to do so was the key to living out an amazingly fulfilling life. I had what I needed to truly survive inside of me -- my determination, faith in God, and a thirst for knowledge. Making use of those has taken me far, and six years after being diagnosed (and having two more children) life isn't always easy, but I wouldn't trade it. Using those internal resources has shown me that changes in diet, medications and exercise, as well as a good support system are key. In some ways, the feeling of being told I have Bipolar Disorder has fueled my drive to do things I might not have attempted otherwise, like running a marathon (I discovered that running helps my symptoms). It also inspires me to be an even better mother than I ever dreamed I could. I have Bipolar, and I'm learning that it's not such a horrible thing after all.

jessica azar

Jessica is a happily married, SAHM to four young children. She writes at Herd-Management.com about their misadventures and life as a mom with Bipolar Disorder. And Scotch Whisky.

Previously Published at www.stigmafighters.com and herd-management.com