Saturday, August 22

Not so manic now...

Had a bit of a lightbulb moment this week, it's still sinking in and I'm not really sure how I feel about it. I had an appointment with a psychiatrist at St Ann's hospital in Tottenham to discuss some of the side-effects of the medication I have been taking and to review my 'condition'.

Since I was a child I've had some instability with mood, my mother picked that up in the first five years of my life. I once refused to speak for a week because a girl at school had died of cancer, and had to be sent out of the room when the news came on because it would send me into a depression. At school I was lively and misbehaved to the point of being accused of suffering from hyperactivity. When I was good I was very, very good, and when I was bad I was horrid. I could be funny and withdrawn within the space of a few hours. I became used to people claiming jocularly "Oh Gem, you're mad!" And reader, I think I started to believe them. At 19 I was nearly institutionalised for a breakdown during the uni summer hols. At 22 it happened again. And so on and so on to the present day...

It's been five years since I was diagnosed by a stony-faced Victorian psychiatrist as suffering from a 'mood disorder' which, I was later told by my GP who had my notes, was type II bipolar disorder. Okay, I thought, fine, at least it has a name now. I took the pills they prescribed me. I got on with it. But increasingly recently when I sat back and took stock of my life since that diagnosis I realised that I have: learned to drive, held down a job for over 3 years, moved to London, passed a post-graduate teaching course and worked as a teacher in a London secondary school. So, as you can imagine, doubts had begun creeping into my mind as to the legitimacy of this diagnosis. This is not meant in any way to disrespect people who suffer from bipolar disorder and have successful and fulfilling lives, I am sure it IS possible, but since the diagnosis I have not had any episodes of depression or heightened mood that were severe or debilitating enough to affect my career or relationships. I have felt down, and I have felt a bit manic, but I have managed to get a grip on my mood and get myself back out there within a few days. I'm not so sure that if I was suffering with bipolar disorder this would be so easy, or even possible. And I think that sufferers of BPD would agree.

So it was this week that I found myself spending an hour in consultation with the psychiatrist, discussing my adventures with my good friends excitement and depression right back from as early as I can remember. Together we read all the notes from reported counselling and psychiatric diagnostic sessions. And at last I heard somebody utter the words I have been thinking over and over for the last three years: "I don't think you have bipolar disorder at all. A mood disorder, yes. Slight instability, yes. But not bipolar."

I will still need to use antidepressants in the near future, but at a reduced dose to help with the side-effect problem. I have been referred for cognitive behavioural therapy to help me cope with the mood swings. In the future there is a distant possibility that I might be able to come off medication completely. I don't know how I feel about that yet.

The only times I have been off antidepressants in the last ten years is when the b.a.d. things have happened. What if they happen again? What if the life that I have spent so long getting back is pulled away from underneath my feet, thrusting me back, head-first into the seemingly endless pit of misery and despair? I need to move forwards. I can't stay as I am. But I am very, very afraid of going backwards.

I've been off and on about 6 different types of anti-depressants since I was 16, but have been taking 150mg of Effexor (Venlafaxine) for the last five or so years. The side-effects are varied and unpleasant and the drug gets a very bad press on the internet with sites like this. I tend not to diss it too much because I've been relatively happy and sane whilst on it. Tomorrow I will take my first reduced-dose tablet at 75mg. I'd be lying if I said I wasn't nervous. I'm HOPING that it just makes me feel a bit sick, or fluey. I don't know how I'll cope if it makes me confused or depressed.

Should I be happy? I guess so. I wept for joy on the way home, but that quickly gave way to fear and trepidation at the road ahead. I don't feel funny and I don't feel brave. I feel shit scared and isolated. It's a bit lonely out here, in the non-bipolar world.

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