Monday, December 15, 2014

To Accept or Reject Mental Health Labels, That is the Question

What's in a mental health label? Schizophrenia. Bipolar. Anxiety. Depression. OCD. And so on.

Does a mental health label define you?

I've had numerous conversations with my therapist about the bipolar label. I've been diagnosed for seven years now. I went six years in between my first and second hospitalizations for mania. And in those six years I did not really claim the label. My therapist showed me the bipolar entry in the DSM (Diagnostic and Statistical Manual of Mental Disorders). There is an entry for single-episode mania. Mania is what determines a bipolar diagnosis; otherwise, one would just have unipolar depression. I thought I had that, the single-episode diagnosis, not the full-fledged diagnosis. I thought my one episode of depression and one episode of mania were one-time flukes. I didn't think I really had bipolar disorder. However, my psychiatrist disagreed. He told me "once a Heisman trophy winner, always a Heisman trophy winner." I hated this analogy.

The two medicines I was on for those six years in between hospitalizations kept me stable. Having a bipolar diagnosis didn't impact much for me except sleep. I had to be in bed by 11pm in order to avoid next-day grogginess. But that was the only inconvenience. I had a few side effects within the first few months of being hospitalized, but after I changed to a new medicine I was fine.

Until 2013.

Elevated liver enzymes were detected in my routine blood work. Elevated liver enzymes might mean liver damage. I was told to stop taking this medicine immediately. My psychiatrist didn't replace this medicine, leaving me only on one medicine to maintain my bipolar disorder. Within two months I was manic and hospitalized. This hospitalization removed all doubt that I was really bipolar. I was hospitalized for ten days as the doctors tried to find me a new medicine cocktail to control my mania. I had to also go on short-term disability for two months.

Needless to say my therapist and I renewed our conversations about my label. I could no longer act like I didn't have a mental health diagnosis. I didn't have any friends with mental health diagnoses, so I wanted to talk to other diagnosed folks. In search of a space to discuss my disorder, I sought out and attended a DBSA (Depression and Bipolar Support Alliance) meeting.

My therapist was concerned. He didn't want me to identify with a mental illness. He didn't want it to define me. But I disagreed with him. Just as I am black and a woman and an American, I too, also have bipolar disorder. It does have an impact on my life: my choices, my thoughts, my actions. To deny the label would be like denying a part of me. Now, I don't subscribe to the belief that to have a mental illness means I have to be consumed by instability. I am a highly-functioning professional.

For me, having a bipolar diagnosis does not signal dysfunction or disability.  I've learned to use the diagnosis to my advantage. I think it makes me special: I am creative, intelligent, and empathetic. When I look at my bipolar lineage (all the famous writers, artists, actors, and doctors), I feel proud.

And when I read the DSM entry for bipolar disorder, I see that I have had nearly every symptom of mania and depression. The diagnosis and label made my actions and thoughts make sense. I've actually found comfort in the label. But I do realize not everyone wants to be labelled.

What say you? If you are diagnosed, how do you interpret your label?

11 comments:

  1. I accept my diagnosis. It has enabled me to forgive myself for not being perfect.

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    1. I feel the same way! Not that my diagnosis is an excuse, but it explains a lot for me. And for my actions that I'm not proud of, I know what part of the root cause is. So it takes a little of the blame off me. And I just want to say thank you for following/reading and commenting on my blog! I can always count on you to engage with me :) I hope you are doing well.

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  2. Hi Monique. I want to say thank you for having this blog. Its a warm feeling to know I am not alone in this cold world. I embrace my diagnosis. And you are right, its not an excuse but my personality has a lot to do with this diagnosis. Through the highs and lows I have been able to explain to others how it is to live with this. I can say that I have helped so many others understand what their family and loved ones may go through. Thank you for your awesome blogging!

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    1. Hi Princess. You are welcome :) Thank you for reading! I agree with you that I also feel that my personality is shaped by the diagnosis. Sometimes I wonder what the "real" me is really like. And yay for you helping others understand.

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  3. On another note, going off that medication immediately after being on it for years would certainly have produced a toxic withdrawal syndrome and rebound effect that would explain your sudden, extreme breakdown. Your doctor should have warned you about it. Most psychiatric medications require extremely careful tapering, usually about 1 to 8, i.e. if you've been on them a year, take a least a couple months to come off. If five years, take six months at least to taper off. Otherwise, it's extremely dangerous psychologically, and often traumatic physically. If that's what 'convinced' you that you're 'bipolar', you may want to research the withdrawal syndrome issues of that particular drug before reaching your conclusion. Withdrawal syndromes for nearly all psych meds are now widely acknowledged and studied in the scientific literature.

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    1. Thank you for the information about withdrawal symptoms. I just read a few articles about the specific withdrawal symptoms for the two medicines I abruptly stopped. Both mention mania relapse as a withdrawal possibility. My psychiatrist did not talk to me about the possibility of a relapse. I actually changed doctors because I wasn't completely happy with his care. Thanks again for the info!

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  4. Thanks for this inspirational post, Monique. It can be really upsetting when you’re being defined based on your condition. While it’s hard to accept it after being diagnosed, people shouldn't be discouraged by it. As long as they have people who support them and stay by their side, they should continue holding on and stay strong.

    Jason Hayes @ DECORM

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    1. Thank you for reading Jason! It is much easier to cope when you have a good support system.

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  5. Hi!
    I just discovered your writing through the Huffington Post and I love your work so, so much(!) I actually edit an art and literature print journal on mental health and am currently working on the second issue (as it happens Dior Vargas, who I saw you wrote about here is being interviewed for it also!) I would seriously love to include this blog post in our second issue if that is something you'd be interested in of course? If that's something you'd be interested in or you'd simply like to find out more you can email me at: bethanyroselamont@yahoo.co.uk
    Thanks so much and excited to hear from you :)
    All the best,
    Beth

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    1. Hi Beth, Thank you for following my work! I've just emailed you.

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