The topic of this post is not denial of a bipolar or major depressive disorder diagnosis, though that is extremely common, it is rather when you accept your diagnosis, but don’t want to accept that you’re in an episode.
Many of us who accept our diagnosis sometimes still lack insight into episodes. Maybe as a person with bipolar disorder, feeling extremely good for a change feels like you think you “should” feel. Meanwhile, others around you who know you well can easily spot the symptoms of hypomania or mania. They may even say so and recommend that you talk to your doctor. Or your doctor suggests that you take more of that sedating medication that you dislike. Maybe that angers and frustrates you. After all, who wants a pleasant hypomania or mania to stop? Perhaps in our past we felt that pleasant hypomanic state was even our “baseline” mood.
After 12 years, I will say that my insight into my elevated moods has improved. Don’t get me wrong, sometimes it takes a couple of days until the light finally goes on in my brain and I say “Hmm? I sure have been doing a lot of shopping and flirting with guys lately. Maybe, just maybe, I’m a little elevated in mood.” And I’ll confess that I’ve been known to ride that bit of a high until someone does notice. Usually my husband, therapist or psychiatrist finally says something and I do the good girl thing and take the “as needed” Seroquel, or whatever else my doctor prescribes. In the end, it is a very good thing. Retrospective realization and eventual present moment insight often led to quick action, keeping me out of the psychiatric hospital for about eight years.
As strange as this may sound, my insight into my depressive episodes is not as keen. What?!?! No, I’m serious! People may think “Well, you either feel bad/sad/down or not.” But what if you want so much to not feel bad/sad/down that you convince yourself that you’re not, even when you actually are? Let me give a couple of examples.
I have been on disability. During this period I clearly had episodes, and clearly had some times when I was mentally stable, but sometimes the depressive episodes drag on and on and I just want them to be over already. I try to convince myself that they are, if only for a brief moment. So I’m in bed (almost all day long), typing away on a blog post, and the topic of the blog post is generally pleasant. It is a story about the good ole’ days. I’m smiling when I type it. Then after I publish it the pleasure is gone. I’m binge eating. I’m not playing with my pet bird. I’m still in my pajamas. Listening to music or watching TV would feel too stressful. I don’t feel like cleaning the house. I dread running an errand. My mind will not dream about the future. It just settles on a kind of nothingness, except for maybe the moments when a “like” appears next to my post. My dad then calls and asks how I’m doing. I answer “I’m fine!” But am I really? Though I try to focus on the positives of the day as much as I can, I could still easily check off enough boxes in the depression category to qualify for the episode.
Then there are those days I make myself “stable”. I push myself to run a number of errands. I clean up the house. I play with my bird. I write in my blog. I chat with a friend. Maybe even I force myself to put the radio on during my driving. Everyone see me smile! Even if it is exercise to make that smile happen. I go to my therapist and she asks me how I am. I say “I feel just fine! I did all of these things. I’m heading forward.” She happily writes that down in her notes, and then I leave. I go to sleep that night and have a hard time waking up the next morning. I relive the day I wrote about in the previous paragraph. But that’s OK. Yesterday was a busy day.
Time goes on. If I’m lucky, the old “fake it till you make it” will actually seem to work. Or, one day I wake up and my stomach is upset and I can’t even get out of bed to make my husband’s lunch. I then wonder “Am I depressed? Was I depressed?” And the answers are “Yes” and “I don’t know.”
Issues like above have made it very difficult for me to use online or paper-based mood trackers. When I have, I later realized I made some dubious assumptions about my moods. I’ve found myself going back and changing moods for multiple days. Was my “upswing” really a hoax?