Being Diagnosed & Treatment

Following the referral from the GP, I found myself once again in the Mental Health Resource centre waiting to meet with my new Psychiatrist.  I explained for years I knew my depression came in cycles, and I could almost feel the change coming when my mood was spiralling downwards.  I also explained the exuberant spending I would indulge in - with no worry about the consequences.  My constant want to move house (6 times inside the space of 5 years), and my impulsivity at changing cars.  I described my sleep patterns were either excessive or barely at all.  How I continued to feel suffocated by anxiety and my need for routine, structure and my ritual of cleaning.
He asked me what I thought was wrong and I said - "I have Bipolar Disorder, Type 2 because my depression is worse than my mania.  With that, I was given a mood diary and a mood scale which I was asked to complete over the course of the following month. 

The following month I was asked to repeat the mood diary as I had forgotten to fill in the back and my Doctor didn't want to make such a life-changing diagnosis too quickly.

After the second month of completing the diary I went back for my appointment and my new diagnosis, replacing depression was Type 2 Bipolar Disorder.  It was such a relief.  My mummy and others, myself included, had expected this was the case for a long time and the Doctor also commented this may also have played a role in why I had been switched to so many anti-depressants over the years because they weren't working.

I was shown a list of medications - mood stabilisers - shown their pros and cons and was told that Lithium is the most effective in treating Bipolar Disorder.  Upon choosing this I was also told that starting this medication would mean weekly blood tests as the therapeutic index is very narrow - meaning if the lithium level in my blood became too high the Lithium would become toxic and begin to poison me.  I was also, and still am, reminded that it is important not to get pregnant while taking this medication.  When I eventually started Lithium the initial dose was 200mg and as my weekly blood tests came back the dose was increased by 200mg each time. At 600mg of Lithium, I was weaned off my Venlafaxine, my Buspirone (for anxiety) was increased to 30mg per day, my Diazepam was increased to 15mg per day and I was prescribed 20mg Temazepam to help me sleep short term, during a particularly difficult time.

I had been referred to the home treatment team as my mood wasn't stabilising - I was stuck, and still am in this limbo - the clinical term is "Mixed Affective State" - some days I have a manic mind and a depressed body, others I have a depressed mind and manic body, some days I'm numb and feel like I'm just a ghost or a shell of a person and other days I hit every number on the mood scale.  I can't predict and I can't control.  I have been in this state of limbo for months - my medication has increased and changed I am now taking 800mg Lithium, 350mg Quetiapine, 40mg Propranolol, and I am being weaned off Diazepam now taking 12 mg per day.

As I type this I feel like a shadow of my old self - would I have been better to just carry on as I was or would that have ended badly? It's a question I ask myself sometimes. Because now I can't look after my old children on my own, the noise is too much a lot of the time and the being "normal" is exhausting, I can't drive, I have been off work sick since November, I can't manage my own money - which is hard when you have the impulse to spend, there are times I need to be reminded to wash and encouraged to eat. 

While I sit and think of the negatives I also know that this is early days.  Lithium treatment was a commitment I made - I knew it could be at least 1-2 years before I felt the benefit from it and I hope that psychological therapy that I have been referred to will work on my anxiety and OCD.

A new diagnosis can be scary and it did take a while for it to sink in with how much my life would actually change during treatment - but those feelings are normal (maybe slightly more intense when you are bipolar - you can either feel superhuman or like you are the world's biggest burden and better off dead) - but that's not the rational mind that's the extremes of the mood disorder, the mental illness that you have.  That's what I keep trying to remind myself anyway.  Every day is one step closer to less severe mood swings, to feeling less anxious and to being able to control my obsessions and compulsions. 

One day at a time.....