Thoughts on Bipolar Overawareness Week: Part II

Here are some things that have occurred in my life:

  • racing thoughts
  • spending sprees when I have no money
  • cleaning at odd hours of the night
  • thinking that I’m the most amazing job interviewer ever
  • worrying that people are watching me through video cameras or the wall in public bathroom stalls
  • afraid that a video camera exists in our bedroom (I know it doesn’t. I think?)
  • talking to "friends" who don’t really exist
  • disobeyed parents
  • talked back to authority
  • suicide attempts
  • rage/anger/hostility/irritability
  • temper tantrums
  • violent outbursts
  • socially awkward
  • extreme mood swings (happy to sad or angry in the same day)
  • doing things and barely remembering them
  • memory loss/forgetfulness
  • chronic fatigue
  • indecisiveness
  • no interest in sleep
  • inability to focus on one thing for an extended period of time/lack of concentration
  • anxious about being around people I don’t know/don’t like
  • anxious to go out and spend time with friends and/or family
  • impulsiveness
  • overeating
  • persistent, negative thoughts

All right. So those are some things that have occurred over the course of my life. Let’s see what I diagnoses I can pigeonhole myself into.

Bipolar Disorder. Considering that some of the "symptoms" of bipolar disorder include racing thoughts, little sleep (or too much sleep – take your pick), spending sprees, pessimism, and suicide attempts, I am a classic case for this disorder. Why wasn’t I diagnosed until late 2006? Well…

  • One of the most famous direct-to-consumer television adverts for a drug begins with a vibrant woman dancing late into the night. A background voice says, “Your doctor probably never sees you when you feel like this.”
  • The advert cuts to a shrunken and glum figure, and the voiceover now says, “This is who your doctor usually sees.”
  • Cutting again to the woman, in active shopping mode, clutching bags with the latest brand names, we hear: “That’s why so many people with bipolar disorder are being treated for depression and not getting any better—because depression is only half the story.”
  • We see the woman again depressed, looking at bills that have arrived in the post before switching to seeing her again energetically painting her apartment. “That fast- talking, energetic, quick tempered, overdoing it, up-all-night you,” says the voiceover, “probably never shows up at the doctor’s office, right?”

No one bothered to ask whether I was "dancing late into the night," "in active shopping mode, clutching bags with the latest brand names," or being "that fast-talking, energetic, quick tempered, overdoing it, up-all-night" me. Not only that — most people who were quickly diagnosed with bipolar disorder about 10-15 years ago were more likely to have the overt symptoms: promiscuity, drug and alcohol abuse, or gambling issues among other things. The doctor usually saw me when I was depressed, suicidal — at the depressive end of the spectrum. But we’ll get back to my bp diagnosis.

Borderline Personality Disorder. I don’t fit neatly into the box on this one but here’s the criteria I do meet:

  • recurrent suicidal behavior
  • chronic feelings of emptiness/worthlessness
  • stress-related paranoid ideation or severe dissociative symptoms
  • identity disturbance
  • affective instability due to a marked reactivity of mood

I only need to meet 5 out of the 9 criteria to be diagnosed with BPD. There I go.

Major Depressive Disorder. I meet nearly every single criterion for this. And then some (hence, the bp add-on).

ADHD. Wikipedia has this explanation:

The most common symptoms of ADHD are distractibility, difficulty with concentration and focus, short term memory loss, procrastination, problems organizing ideas and belongings, tardiness, impulsivity, and weak planning and execution.

NAMI’s take:

Not everyone who is overly hyperactive, inattentive, or impulsive has ADHD. …how can specialists tell if the problem is ADHD?

Because everyone shows some of these behaviors at times, the diagnosis requires that such behavior be demonstrated to a degree that is inappropriate for the person’s age. The diagnostic guidelines also contain specific requirements for determining when the symptoms indicate ADHD. The behaviors must appear early in life, before age 7, and continue for at least 6 months. Above all, the behaviors must create a real handicap in at least two areas of a person’s life such as in the schoolroom, on the playground, at home, in the community, or in social settings. So someone who shows some symptoms but whose schoolwork or friendships are not impaired by these behaviors would not be diagnosed with ADHD. Nor would a child who seems overly active on the playground but functions well elsewhere receive an ADHD diagnosis.

Well, I was most always late to school and… I was easily distracted by toys and other tasks… um, I’ve always been a procrastinator. Do I fit into this category? And the criteria mostly apply to children. How do you slap adults with this label? How are kids able to "weakly plan and execute" things? Sheesh. I could still fall into this diagnosis though.

Then there are the fun ones: Generalized Anxiety Disorder, Oppositional Defiant Disorder (didn’t last long), Social Anxiety Disorder, Impulse Control Disorder, and a whole host of others I can’t think of because I don’t have the DSM-IV memorized. Can we declare the last week of May Psychiatric Overdiagnosis Week? Or how about Psychiatric Overmedicated Week? Then nearly the entire mental health community can participate. I can celebrate it by myself; it’s all part of my "identity disturbance."

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