When I met with my psychiatrist yesterday, we discussed my diagnosis. I learned that since I’ve been hospitalized for bipolar symptoms, my diagnosis is type 1, not type 2.
Since I’ve been ramping since July third, we agreed it was time to add low dose quetiapine (Seroquel), a sedating and mood stabilizing antipsychotic, to my medication mix. The medication enabled me to get a good night’s sleep last night, but it wiped me out today. Though I managed to take my son to two doctors’ appointments, I had to nap between the two.
Desperately wanting to think of myself as “high functioning” (a judgmental and stigmatizing concept), I’ve held onto the belief that I have bipolar type 2, rather than type 1.
Bipolar type 1 symptoms I’ve experienced include psychotic mania, rapid cycling, mixed episodes, two weeks psychiatric hospitalization, and months of partial psychiatric hospitalization.
The truth is, I struggle with hypomania whenever stressed or
overstimulated, then I cycle low as I must “recuperate” from the hypomania. I find simple tasks, like grocery shopping, difficult. I wish I could be the social butterfly I was many years ago, but today it comes at a steep cost — my mental health and stability.
Next week I’m going to my uncle’s funeral and memorial in Illinois. I met him only once, last year at my father’s memorial. My aunt, who’s my godmother, met him later in life. I’ll be seeing my extended family under tragic circumstances.
Social gatherings trigger me. Stress triggers me. Grief, as it echoes the loss of my father, triggers me. The trip will be difficult, but I look forward to seeing my family, even as we grieve.
I’m almost 56. At this age, I’m losing my parents, aunts, and uncles. I expect more losses to come.
Prayers welcome for my aunt’s loss of her beloved husband and soul mate.
Thank you, Lianne Sauvage, for inviting me to share my mental health journey at Belmont High School’s Mental Health Assembly!
For my speech, I adapted content from My Bipolar Thoughts, my memoir work-in-progress. The speech was scheduled for 25 minutes!
I plan to refine these speaking notes and use them again for future speaking engagements:
My Mental Health
When my parents introduced me as a child, they always said, “Kitt is going to go to Harvard medical school and become a doctor when she grows up.”
High school, I aspired to become a brain surgeon. Total overachiever. Medical Explorer Scout. Emergency Medical Technician training. Active on campus. Drama geek. School newspaper. High GPA.
Applied to colleges with the highest acceptance rates into medical school.
Didn’t get into any of those schools.
Receiving rejection letter after rejection letter hit me hard.
I had always been told I could go to school anywhere I wanted and could do anything I wanted. Wrong.
Instead of attending an East Coast Ivy League school, I started my freshman year at UCLA as a biochemistry major.
Letter from UCLA saying I had to take remedial summer courses since my SAT scores totaled under 700.
Back in the 80’s the math portion totaled 800, the verbal portion 800. My math score alone was 720 (yes, I was once a math geek).
Apparently, the Educational Testing Service (ETS) incorrectly reported my scores to UCLA.
When I showed UCLA my SAT scores, not only did I not have to do remedial work, but I was eligible for College Honors, in which I became active as a freshman.
As a freshman at UCLA I fell into a deep depression,
believing that my parents, my sister, the whole world would be better off without me alive.
When I told my friends of my suicidal thoughts, they made me promise to get professional help.
I saw a UCLA psychologist whose cognitive therapy, which works on rewriting your thoughts, helped me with my suicidal thoughts.
Still, my underlying mental illness remained.
Very active on campus, I volunteered in UCLA Medical Center’s emergency room, participated in College Honors’ Social Committee (glorified party planner), and trained as a peer health counselor.
For all but my closest friends, I hid behind a mask of competency, social skills, and overachievement.
But I was miserable and wanted to get quit.
The August before my sophomore year I came down with mononucleosis and used that as an excuse to quit UCLA.
For the next year and a half, I visited family and friends, worked part-time, and attended community college part-time.
Then, I transferred to UC Berkeley as a legal studies major, an interdisciplinary program I loved.
During my junior year at Berkeley, symptoms of depression returned.
My mother was diagnosed with non-Hodgkin’s lymphoma. I was devastated to learn of my mother’s diagnosis. At the time, studies indicated a five-year prognosis, that she would die in five years. She’s still alive thirty-five years later thanks to clinical trials at UC rival USC Keck School of Medicine.
That same academic year, my maternal grandfather died. My grandfather always held a special place in my heart. He was a kindred spirit as a gifted orator (I’ve always loved the stage) and storyteller (here I am telling you my story). When he died, it hit me particularly hard. My mother’s family asked me to give his eulogy, which was a huge honor. In speaking at his memorial mass, I was carrying on his legacy.
On my way home from the funeral, as I was driving over the San Francisco Bay Bridge, I fell into a trance state.
I felt a tingling all over my body, an energy pushing out, and a warm cleansing energy replacing it. The fact that I was driving over a bridge at the time disturbed me. At the time it seemed safer to continue off the bridge than stop on the bridge in the middle of traffic.
Now, I see that experience as a euphoric state of hypomania. At the time, given my history of depression, I knew if I went to a mental health professional and described the experience, they would diagnose me with a mental illness. But I found the experience meaningful, as somehow related to my grandfather’s death, and did not want the meaning dismissed.
Having graduated from Berkeley as a legal studies major, my first profession was as a legal assistant in Los Angeles and San Francisco. Working twelve-hour days six days a week, I crashed after a year on the job. What looked like over-achievement was a symptom of unrecognized, undiagnosed hypomania that came with a steep cost – my mental health and stability.
After working two years as a legal assistant, I quit, took time off, and applied for graduate school in psychology. While in graduate school, I worked as an administrator at a battered women’s shelter and completed my field placement doing play therapy with severely emotionally disturbed children in day treatment.
I got my master’s in psychology and became a licensed therapist. I worked with pregnant and parenting teens and severely emotionally disturbed adolescents in residential and day treatment.
Though my career as a psychotherapist was short-lived, only five years from ages twenty-five to thirty, it influenced how I think about mental health. My understanding is colored by both my experience living with depression and bipolar disorder and treating others living with mental health issues.
At thirty, my grandmother died, a dear friend from high school died, and a client threatened to rape me during session. I had a complete major depressive breakdown and found myself unable to get up out of bed and return to work. For the first time, I sought medical help for depression, seeing my regular doctor and then a psychiatrist for medication. Up until then, I had managed my depression with psychotherapy alone.
Rapid changes in prescribed antidepressant medications triggered mania. I ended up spending a week awake, thinking simultaneously at rapid speed in binary with ones and zeroes streaming through my head like I was a computer, about chaos theory, and about mystic saints. At the time, I wished that there had been a way to record my thoughts, so later I could decipher them and see if any made sense.
Though I clearly had a manic episode, I was not diagnosed bipolar at the time. Those who knew me then find this fact shocking. Since the episode was likely precipitated by antidepressants, I was not prescribed a mood stabilizer. My psychiatrist prescribed a three-day regime of antipsychotics which stopped the racing thoughts in their track and allowed me to sleep, which I needed.
After the manic episode, I was unable to function on my own. I would fall asleep driving to my temporary job. When at work, I couldn’t even read. The words were all jumbled. I appeared competent. No one could see that I, a highly educated and articulate former professional woman, COULD NOT EVEN READ A SENTENCE.
To my parents’ home and care I returned. They were supportive and encouraged my recovery. While living with my them, I received psychiatric treatment and psychotherapy. My new psychiatrist carefully administered an antidepressant, slowly increasing my dose. I remained stable on a low dose of antidepressant for almost a decade.
Once I was up for it, I returned to work, starting as a temporary file clerk for a commercial real estate firm. What followed was a decade long career in commercial real estate. It was a welcome change, not emotionally draining as helping severely emotionally disturbed youth, and it used my analytic and problem-solving skills.
Still, I continued my pattern of overdoing it, working long hours and neglecting myself, leading to repeated burn out and cyclical depression. As a result, my résumé lists numerous short stints at various jobs — shooting high, crashing hard — time and again.
Soon after moving back home and starting work as a temporary file clerk, I met my future husband. Three years after we met, we married and later had a son. I found being home with an infant difficult. At the same time, I found being at work, away from him, heart-breaking.
Depression during pregnancy and after pregnancy poses risks to both the infant and the mother. With my doctor’s blessing, I took an antidepressant when I was pregnant and nursed my son.
After my son was born, I returned to the workplace part-time. My job consumed more and more of my time. I went from working two days a week to four days a week until 7PM. At that point, I decided to quit work and stay home with him.
Staying home with my son full-time lasted a year and a half. Then symptoms of hypomania returned. I thought that God was calling to one church for spiritual direction and another church for bible study. Though going to church wasn’t “bad” for me, I recognized the feeling of religious euphoria as hypomania.
To be a good mother to my son, I sought treatment for symptoms of bipolar. Finally, at the age of thirty-nine, I was diagnosed with bipolar disorder type 2.
Fearing that I was now an unfit mother, I proceeded to put my son in daycare and reenter the workforce.
Once my diagnosis changed from depression to bipolar, my internalized stigma reared its head. As a clinician, I knew bipolar is considered a serious progressive mental illness. I believed that I could be a danger to my son and he’d be better off in the care of someone else.
I was wrong. I was the same person before and after the diagnosis. The only change was my treatment. Instead of only taking an antidepressant, now I was also taking a mood stabilizer.
Despite the challenges of bipolar disorder, and those challenges are real, I’m a good mother. I work hard to be a good mother.
Keeping with my history of hypomanic workaholism, I worked increasingly long hours until I once again fell apart. I broke down crying in the parking lot at the office and found myself unable to pull myself back together and return to work. To get myself stable, I had myself voluntarily hospitalized when my son was four and haven’t returned to work since.
For me, acceptance has been an ongoing process. I’ve overcome denial and internalized stigma about what it means to live with bipolar disorder. I’ve owning my diagnosis and allowing others in to help me.
I had been a high achiever, a perfectionist. Accepting that I have a mental illness involves accepting myself as broken, as imperfect, as fallible, as human.
That acceptance has allowed me to forgive myself for not living up to early life expectations. I never became a doctor or a lawyer.
But I did get my bachelors, a master’s in psychology, and much later even attended graduate school studying religion twice after my psychiatric hospitalization.
Given my history of mental illness, I’ve questioned my sense of calling, of having a higher purpose. My mental health journey has led to purposeful mental health advocacy.
I am not weak. I am vulnerable. There is strength is being vulnerable. I accept that I’m not perfect and flawless. I am loved, lovable, and loving the way I am. My life has meaning.
My life experience gives me purpose in helping others. I am grateful that I can speak and write to share my journey with others, hoping that it inspires others to accept themselves and others living with mental health issues and to get help if they need it.
People judge those of us with invisible disabilities. We even judge ourselves.
Someone once asked me if I questioned the ethics of receiving disability. I explained that my disability wasn’t visible. I ran down my history of hypomanic workaholism and subsequent crashing into depression, rapid cycling and mixed states which lead to my hospitalization.
Although I appear fine, traditional work and I do not mix well. My bipolar type II is well-controlled with medication and my careful avoidance of triggers to mood cycling.
Because my brain disorder is invisible and because my husband provides for our family, someone believe that I take advantage of a government program I do not need.
You see, I receive SSDI, which is based on my payment into Social Security taxes from past income combined with my current inability to work. I do not receive SSI, which is based on need (lack of resources).
Still, with this understanding, even I have felt guilty about being on disability (SSDI), about not being “productive.”
One of my psychologists (I’ve been in therapy since I was 18, so I’ve seen many psychotherapists over the decades) suggested I reframe being on disability (SSDI) as a long-term sabbatical. Reframing enabled me to accept my changed life circumstances.
Since then, I’ve further reframed my experience as God making me stay home to care for my high needs son (a migraineur who has struggled with co-occurring anxiety, depression, and health issues).
Of course, I don’t receive disability to be a stay-at-home mom. But, I didn’t want to be a stay-at-home mom. So, I’ve chosen to reframe my experience this way. I had to be broken to leave my ambitions behind, to accept a new lifestyle, to reprioritize my life.
Now, I do other work — I volunteer my writing, my time, and my knowledge and experience — while on my extended sabbatical from my former work.
What I can do, I do, and I do it well. No longer expect myself to work as I once did. It wasn’t good for me or for my family.
Thank you, Millie Jane, for this guest post. Millie shows compassion for her boyfriend who lives with a personality disorder. Too often those with personality disorders are vilified by family, friends, and even mental health professionals.
Millie is UK-based. I’m curious as to how the UK and the US differ in treating personality disorders.
Under US law, insurers don’t have to offer those with personality disorders parity (equal coverage) for their mental health care. California’s parity law covers these serious mental illnesses (SMI) and severe emotional disturbances (SED) of a child: schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorders, panic disorder, obsessive-compulsive disorder, pervasive developmental disorder or autism, anorexia nervosa, and bulimia nervosa. People living with personality disorders do not get parity treatment, which is an unjust travesty leading to unnecessary harm.
Living with Someone with a Personality Disorder
Author: Millie Jane
Does having a personality disorder ruin your chances of having a long, happy relationship? The answer is no, you just have to be in a relationship with the right person. I’m writing from the position of that other person. My boyfriend has both Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD), but that doesn’t mean I’m not the happiest I’ve ever been in a relationship. Sure, it has more challenges than perhaps the “ordinary” (note the quotation marks – there’s no such thing as an ordinary relationship), but I’ve always been the sort of person who can tough out a challenge, which means I get to reap the rewards. His personality disorders are a part of my boyfriend, but not all of him. And the good times definitely outweigh the difficult ones.
Disclosure: I am not a qualified mental health specialist by any means; I simply wish to share my own experiences and advice in the hope that I may be able to help someone in a similar position.
Manifestations of Personality Disorders
A fantastic thing to do when you’re in contact with somebody who has a personality disorder is to do your research. I’m sure if you’re reading this, you’re most likely already doing exactly that. There are many aspects to personality disorders and of course each case is unique, so for the purpose of this post I’ve chosen a select few features of BPD and ASPD that I feel are the big players when it comes to relationships, and some of my experiences with these.
Borderline Personality Disorder (BPD)
When someone is afraid that you’re going to leave them, it makes it difficult to have confidence in a relationship. I think it’s easy for people to get ‘put-off’ by this kind of insecure behaviour (especially early on), and the requirement of almost-constant reassurance can be tiring. This fear of abandonment can also surface in the form of the person suffering with the personality disorder threatening to leave you over what you perceive to be small things. How can you feel secure in a relationship if this keeps arising? The answer is just persistence and understanding. These ’threats’ are just a form of fear expression, to prevent you from leaving first – which is what BPD sufferers see as inevitable at some point down the line.
This is a touchy subject and the hardest to navigate. It’s incredibly difficult to see someone you love hurt themselves, and a lot of people can’t handle this. If you search online for what to do in this kind of situation, it’s most likely going to tell you to call an ambulance or the police so that the person can be detained in some way to prevent them causing further harm. People suffering from personality disorders find the intervention of strangers exceedingly stressful and, through experience, I’ve found that this isn’t always the best course of action. Don’t get me wrong, if you do not feel equipped to deal with these situations by yourself, you must seek outside help, especially if you feel in danger. There have been times when I’ve resorted to calling an ambulance, as I was unable to calm my boyfriend down and the cuts to his wrists were too severe for me to patch up and required medical attention.
The ability to foresee self-harm is key. If you see an episode arising, being able to hide dangerous objects and helping them take their emotions out another way can prevent self-harm. The most important thing is to remain calm. People with BPD take out emotions on themselves, and they will likely worsen if they have to deal with your emotions as well. Assess the situation. Is the item they are using to do damage going to hurt you if you intervene? If it’s an object such as a knife, do not put yourself in danger by attempting to take this off them. Try to resist from threatening to leave, as the abandonment issues will enhance an episode. Talking in a firm but caring voice, such as that of a parent, can help. Be understanding, don’t tell them what they’re feeling is wrong, highlight positive things and comfort them. I’ve had times when my boyfriend has broken down and ended up laying on the bathroom floor, and I’ve taken a pillow and blanket to him and laid down holding him until he was ready to get up and have me bandage his wounds. Every situation is different, but just knowing to remain calm and supportive is the most important thing. Every day I rub his scars with bio oil, and this kind of acknowledgement and acceptance really helps build trust so that he’s more likely to listen to me during an episode. After an episode, the person usually regrets it and feels ashamed, and so it’s important not to emphasise how it affected you and make them feel worse.
Antisocial Personality Disorder (ASPD)
You may have heard the saying that all anger stems from fear. I feel as though this is a good phrase to remember in heated situations with someone who has a personality disorder. Often, they may get angry over things you wouldn’t expect them to. Try to ask yourself what the anger could stem from, what are they afraid of? For example, fear of abandonment often surfaces in anger. If you remain calm, speak in a soothing voice, and do not mirror the anger, you can often dissect the issue together and overcome it.
Disregard toward Others
This is probably the biggest issue when it comes to being in a relationship with somebody who has a personality disorder. The important thing to remember is that disregard toward your feelings does not mean they don’t care about you, it’s just an intrinsic part of their disorder. When you’ve been awake all night because of an episode, and then have to work all day and get home to a filthy kitchen, it can be tough. When you try to talk about how you’re feeling, they may emphasise their own issues and value them above yours. This can often seem selfish and be frustrating, but it doesn’t mean they don’t want the best for you, their disorder is just causing them to overlook how you might be feeling. I’ve found the key to this is to step away and take a moment for yourself. Do yoga, have a bubble bath, read a book in a different room. When you feel the moment is right, you have to calmly and maturely talk through what is going on and help the other person see what you’re feeling. Communication is key, and letting the other person know that you understand and don’t blame them can help improve things between you.
Being aware of the manifestations of personality disorders can greatly improve your relationship, but the person suffering still needs to get the right medical help. Unfortunately, too many of us know the struggle of dealing with mental health services. The funding simply isn’t there, and people with mental health problems are largely overlooked as these issues aren’t visible. As if it weren’t difficult enough to seek help in the first place, not receiving the care you need can be incredibly discouraging and cause feelings of hopelessness. If you’re trying to help someone facing this, you need to encourage them to be persistent and not give up. Help is out there, it’s just not always easy to find.
Getting the right diagnosis is the first step, but the aftercare is also key. My boyfriend spent years of being passed back and forth between various mental health services, to no avail. None of the NHS services would prescribe him the medication he’s on now (anti-psychotics) as they felt they were too severe. After many different cycles of the wrong medication, he finally forked out to see a very expensive and distinguished psychiatrist, who after just one hour changed his medication, which has in turn changed his life. Not everyone can afford this, I understand, but there are many specialists out there with fair rates, and it’s worth the spending in exchange for a full life. Many psychiatrists will allow a free session if you’re looking around to find the ‘right fit’, as it’s important the person with the disorder has a doctor they feel comfortable with. Also, if you spend more for a psychiatrist to get that initial correct diagnosis and prescription, you can then change to a less expensive psychologist or counsellor for regular sessions.
Personality disorders are often misunderstood, and people (even some doctors) avoid them because they don’t want to take on the ‘hassle’ of it. The disorder does not define the person and with the right help, compassion and understanding, these people can live a full life with love and success.