And there are no blood tests for this, I take it...
March 1, 2011 5:41 PM   Subscribe

My therapist now thinks I've got ADHD. Everyone agrees I'm bipolar. I'm self-diagnosed with medical students' disease. How do I sort this out now that I know she's biased?

(My apologies for the length. The crazy does the editing around here. I am an American female in her late 20s, if it matters.)

In addition to my research-induced hypochondria (I regularly convince myself I have syphilis, rickets, the flu, skin cancer, schizophrenia, borderline personality disorder, Asperger's...) I am genuinely diagnosed Bipolar II, with (they're debating this one) social anxiety/avoidant personality disorder/OCD. For the last three months my therapist has been trying to get me through Self Esteem, but I kept getting jammed up on this mantra of "I don't have unrealistic expectations, I just want to be normal - the kind of person who opens her mail and takes out the trash and has filed anything at all in the last three years and can go more than a day without losing her keys, her work ID, or her prescriptions!!!! I don't have poor self-esteem, I'm just a loser!!"

The last time I said that (about a week ago,) she whipped out a list photocopied from Delivered from Distraction (from the chapter "The Feel of ADD") and read it to me. I admit, most of the stuff on the list ranges from a few "isn't everyone like that"s to "well, yeah, sometimes," to a "I can't believe that was on the actual list and not something you said based on the 29 sessions we've had together" or two. She gave me homework in the form of reading Women with Attention Deficit Disorder. When I got it, two days later, I read the first ~50 pages and had to stop because it was upsetting me so much. I finally reached the, I think, fourth chapter, last night, and started finding stuff that doesn't completely sound like me.

But I have no idea if I can trust myself, because it takes horrific exposure to the photos on this page to get myself to stop thinking I have syphilis, and I'm a virgin (this happens about three times a year - I convince and unconvince myself about BPD about once a month; Asperger's once every two or three months; it's a collection of favorite diseases I go back to again and again and I never notice I'm in the whirlwind again till I'm totally freaked out.) And now I kind of feel like I can't trust her to be super objective. She was also pushing the self esteem thing really hard, though, and it wasn't till I did the exercise where you stop and write down everything your inner critic tells you, and I couldn't stop doing it long enough to catch my breath (29 entries in 45 minutes, stopped because I was in tears) that I started buying in.

I'm also deeply unhappy with the idea of having, potentially, three diagnoses and yet another pill to keep track of (I've missed three doses out of fourteen in the last two weeks, because I set my pill box down in the wrong place and kept forgetting to move it back till I was on my way to work and realized it was still on the stairs, halfway to its goal.) I also have pretty serious problems with change - when they switched my diagnosis from unipolar depression to Bipolar I I was in denial for probably five years. The switch from Bipolar I to II was easier - I believed that one after a year or so. I didn't believe the depression diagnosis for over a year after they first told me, which was six years after the first time I slept for two days straight and fantasized about killing myself and almost doubled my body weight in four months' time. I understand that's officially "atypical" depression these days. I'm kind of still bitter about all these name changes.

And, perhaps worst of all, I am reading all this ADHD stuff and thinking it sounds exactly like me but also thinking "and it's all a great big code word for "complete loser""/"it's all a cop-out"/etc. A big part of me doesn't believe this diagnosis is real, or even that I'm having difficulties that I couldn't overcome if I'd just apply myself for once. I am having trouble resolving the reality of taking 45-minute showers because I've forgotten that I'm taking a shower or that you have to do stuff in the shower or whether or not I've washed my hair or that it's even a week day with my belief that the reason I have such a hard time getting both a) myself to work on time and b) breakfast inside of myself, on the same day, is simply a matter of really poor decision-making. If I were a better person, I think, my kitchen floors would be clean and I'd have time to swing by McDonald's, ever. I dream about going back to 2nd grade and forcing myself to finish my freaking homework/bring my homework home in the first place, because if I'd had good habits forced on me then this wouldn't be a problem now, right?

So! It's a muddle. I have three weeks before my next psychiatric appointment, which will mostly be focused on how my Bipolar II is poorly controlled at the present time (e.g., staying up till 2am totally focused on stupid romance stories and contemplating my loserness, getting up three and a half hours later, ready for work, having had no caffeine the day prior.) I have a week before my next therapy appointment, where I will have to be something other than a a) blubbery mess, b) worshipful convert, or c) defiant nonbeliever.

For what it's worth, my ADHD-type symptoms seem to fall heavily on the inattentive side, and I'm intimately acquainted with the DSM-IV criteria (my family would block my access to the medical side of Wikipedia if they could, I think.) I have strong hoarding tendencies and the therapist has been trying to persuade me to hire a professional organizer since our third session, but she never said one word about ADD/ADHD till our most recent appointment, and of all the self-diagnoses I have bestowed upon myself, I have never, not once, thought of this one (this is a hallmark of all of my "true"/doctor-driven diagnoses; I never accurately guess what I have unless a medical professional thinks of it first.) ADD/ADHD has always been a joke diagnosis in the back of my head, though - or rather, a fancy acronym for "little boys who aren't good at pretending to be little girls in the classroom." I was pretty much stunned (finally, a chance to use "gobsmacked" in context!) at the suggestion at first, and was openly skeptical during the remainder of the session. I have always seen myself as being like the absent-minded professor and his compatriots in the Disney pantheon, and until I read this "Women with ADD" book I had never once noticed that they're always men.


I applaud those who read the whole thing, ye mighty, ye stalwart few. By "how do I sort this out," I mean specifically:

- Does this sound like ADHD to you? (I like to start with the obvious.)

- Am I right in thinking there are no objective tests for this? Blood tests? Scans? Really hard-to-game questionnaires? If there are objective tests, how best to arrange them? Do they cost lots of money? Please don't link to test questions; I'm very (compulsively) good at gaming tests if I know what I'm going to be asked in advance.

- How can I be open to this possibility without convincing myself 110% that it's true? (Links to mantras I can recite in the ten minutes before my appointment = very helpful.)

- Is there anyone out there who's had a stable diagnosis for a really long time, that they're comfortable with, after doing something like my ten-year dance of the "this is what's really wrong with you, no wait, I've changed my mind, oh wait, don't forget about this, crud, never mind that second one, but trust me now because I've got it straight for reals?"

- Is it rational to not trust my therapist to be objective? My only other issue with her is that she's really, really into EMDR, and is I think still a little upset I have no interest in pursuing it (it creeps me out, sounds like hooey, and makes me uncomfortable for reasons I can't quite articulate.) She also took a few weeks to accept that I don't think I have PTSD and don't want to call the (admittedly difficult/numerous/life-shaping) hardships of my childhood "trauma." We get along great other than the PTSD/EMDR thing, and she very rarely brings either up.

- What are the odds that I can have a normal(ish) life? I know this is hard to answer, but I always feel like I'm two steps away from a residential facility of some kind (to the point that I have investigated which ones I'd like best, ensured I would be eligible for Medicaid if necessary, etc.) I have only had a few boyfriends, and behaved like a lunatic in each relationship (that whole "can't make eye contact," "I'm positive you'll notice I'm horrible soon enough," "I must flee before you realize I'm crazy, also my life is falling apart and you're better off without me" thing is unhelpful.) I want kids and a house and to feel like I'm a normal flawed person and not a total basket case, and it seems like these diagnoses are on the "permanent basket case, do not pass go, do not collect $200" side of things.

- At the very least I would really love to be the kind of person who takes out her trash and doesn't lose her prescriptions and can have people over and does her filing. That's a reasonable objective, right?
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! to Health & Fitness (22 answers total) 10 users marked this as a favorite
 
Just reading this question makes me think you should give this ADHD diagnosis a shot.
posted by crankylex at 5:51 PM on March 1, 2011 [8 favorites]


whoah. I don't know much on this subject, but I'm pretty sure that an armchair diagnosis from people on the internet is probably not what you need.
posted by bitdamaged at 5:54 PM on March 1, 2011 [17 favorites]


Neuropsychological assessment is usually how people call the differences between OCD/ anxiety/ bipolar II/ Asperger's/ all that other fun stuff... but having a thorough assessment won't help you if you are compelled to game it. Perhaps you could discuss the usefulness of diagnosis vs. the usefulness of just having strategies and getting your symptoms under control with your therapist; it doesn't seem like another label is going to make you any more content.
posted by fairytale of los angeles at 6:01 PM on March 1, 2011


The symptoms of Clinical Depression closely resemble the symptoms of ADHD - just throwing that out there to be considered. My PCP diagnosed me with ADHD (female, early 30s) and I was on Adderall for 4 months with absolutely no improvement. Then I started therapy and my shrink said the ADHD diagnosis was incorrect (owing to the age that ADHD is typically diagnosed and the typical age onset of clinical depression amongst other things), had me start an anti-depressant, and within 4 days I was a different person. YMMV and there are obviously differences in our situations, but it's something to consider.
posted by mewithoutyou at 6:22 PM on March 1, 2011 [2 favorites]


I would merely point out the following:

1) A diagnosis changes nothing. If you were crazy yesterday, you're still crazy today, just crazy with a title.

2) If getting diagnosed with ADHD means you take Ritalin and taking Ritalin means you remember to take your bipolar meds, we're looking at a big net win here, whether you have ADHD or not. It has all kinds of off-label uses.

Worry less about the diagnosis and more about what it potentially buys you.
posted by DarlingBri at 6:24 PM on March 1, 2011 [22 favorites]


From what I understand about ADHD, medication usually has an almost instantaneous and undeniable effect. So the idea is, if you try ADHD medication, you WILL know whether the diagnosis is correct or not.

My friend who has ADHD and was only diagnosed recently was resistant to the idea at first, but within 20 mins of taking a pill, she said her brain fog cleared entirely, and it was as startling as it is when you are short-sighted and try glasses for the first time.
posted by lollusc at 6:26 PM on March 1, 2011 [5 favorites]


set my pill box down in the wrong place and kept forgetting to move it back till I was on my way to work and realized it was still on the stairs, halfway to its goal

IANAP, but I would seriously investigate the ADHD diagnosis based on this one line.
posted by KathrynT at 6:31 PM on March 1, 2011 [4 favorites]


I think you're too hung up on the diagnostic end of this. Frankly, you're diagnosis is irrelevant. It's only there as a descriptive tool to help the clinician decide on a general course of treatment that has been proven to be effective in treating a certain set of symptoms. For some people, it can be helpful and comforting to put a name to what they've been going through. Based on what you've written, though, I think it's keeping you from benefitting from treatment. You're obsessing over it (and no, I'm not suggesting you have OCD). Try leaving the diagnosis to the clinician. Ask questions, communicate and clarify but leave the diagnosis to the clinician. Focus on your treatment.
posted by smokingmonkey at 6:33 PM on March 1, 2011 [6 favorites]


Adult male 35, diagnosed with ADHD a few years ago. Things I've learned:

- When "normal" people read those lists of ADHD symptoms, they either say "that's not me" or "yeah, sometimes that happens, but then I kick myself in the ass and it is OK." They are a little too specific and targeted at the [spectrum of] the disorder to be able to be gamed.

- People with ADHD can certainly be normal without treatment. They either marry an organizer who points them in the right direction all the time, or have super-human drive and just do all their work three times until it is finally done. But most of the time, undiagnosed ADHD creates excess drama in people's lives. Always running late, messy house, stressed out from lack of finishing anything, etc. It often is comorbid with depression and bipolar disorders.

(Especially because the manic side of bipolar is, essentially, a temporary treatment for the ADHD. You feel awesome, you can finish things, you wonder why life can't be like this all the time. And then the mania wears off and you are faced with all the stuff you weren't able to accomplish and depression sets in. Treating the ADHD may not eliminate the bipolar, but it can take the edge off of it. When a manic period sets in, you don't have to "make use of it" to get a bunch of stuff done, because a lot of it is already done. And then a low period looms, it doesn't spiral quite so much because there isn't quite so much shit piled up.

We may not be able to control some of the biological ups and downs, but we can control our reaction to them, and the mindset they happen in. When your mental and physical enviromnment isn't quite so chaotic and perilous, the highs and lows are a little easier to recognize and ride out.)

However, treatment for ADHD isn't just medication. It involves retraining yourself and re-learning how to be organized, and un-learning a lot of the bad habits.

Is it rational to not trust your therapist? It *can* be, but I'm not sure it is in this case. You know your feelings and behaviors, they know psychology. So if they told you something completely off the wall that doesn't mesh with anything you are feeling, maybe they are wrong. But to have such an instant connection to the ADHD behaviors, I think she may be onto something.

ADHD is insidious, especially adult ADHD, because these cases usually aren't the obvious, slam-dunk cases. Some people can't make it through 1st grade before the symptoms become obvious. Others take longer. That doesn't mean the disorder isn't there, it just means it is a bit more subtle. As we get older, it is harder and harder to run our lives on pure adrenalin.

Regarding this: (that whole "can't make eye contact," "I'm positive you'll notice I'm horrible soon enough," "I must flee before you realize I'm crazy, also my life is falling apart and you're better off without me" thing is unhelpful.)

Try looking at it through this lens: Don't give people reasons why they shouldn't (or should) like you. They will like or dislike you for their own reasons. And you will like and dislike them for your own reasons. Easier said than done, of course. And it might be helpful to think about it from the other person's perspective- they probably see you as a delightful person.

Also, it is possible you aren't actually sabotaging these relationships. It's possible they just weren't really working out, and the easiest way for you to end them was to fall into that self-deprecating pattern.
posted by gjc at 6:40 PM on March 1, 2011 [18 favorites]


I too don't want to let you get hung up on diagnoses - but I will say that I had anxiety so severe that I didn't believe I had taken a pill when I had it IN MY MOUTH -- I didn't believe I had an address right -- when I had just written it down, etc, etc. The first step is having a therapist you believe in and genuinely feel is there for you. I thought maybe I had ADD but once the meds and therapy took hold the distractions relaxed themselves -- once I couldn't get out of the house because I needed to look something up on the computer, noticed I had cheese left out, decided to look up the history of the monks who made the cheese, forgot why I was in that room...it was ALL anxiety. I am not ADD at all and after lots of cycles of meds and therapy things are getting on track.

Good luck, please don't let the people who are all "whoa" distract you from getting the right help.
You're showing your wound, people are always going to say, "wow," or "ew, gross" when you show your wound, whatever kind it is.

If you're not happy with your therapist find another one, it doesn't matter why. They're not your parent, they're not supposed to just tell you what to do/what you are and you do it in some authoritarian way. It's a process and a collaboration.
posted by sweetkid at 6:42 PM on March 1, 2011 [4 favorites]


Posters saying "Just give the meds a shot!" should be aware that ADD/ADHD meds (at least the ones like Adderall and Ritalin) are a terrible, terrible idea for those suffering from bipolar disorder or anxiety. They can set of hypomanic episodes in the former and anxiety attacks in the latter.

It's my understanding that depression and anxiety can create symptoms similar to those with ADD/ADHD. I would continue to search for a medication regimen that works for you and can follow before following another diagnosis.
posted by schroedinger at 6:48 PM on March 1, 2011 [3 favorites]


What does it matter if you "have ADHD" or not? What matters is, will your life be more functional and happier you take Ritalin or Adderal or try any of the non-drug coping methods suggested for people with ADHD. If you are offered the opportunity to try any of those things, what's the harm in trying? If it doesn't help you, just stop.
posted by Ashley801 at 6:51 PM on March 1, 2011


It's my understanding that depression and anxiety can create symptoms similar to those with ADD/ADHD

Yes, this exactly is my experience and understanding.
posted by sweetkid at 6:51 PM on March 1, 2011


(Is it at all possible that there's a teeny tiny part of you that thrives in your current chaos and is resisting treatment because there's a tiny part of you that doesn't really want to get better?)

Also, why not try EMDR? If it's hooey, there's no harm done.

Also, in terms of tests: is anything in the DSM testable? Much of it isn't, and yet you wouldn't write off other diagnoses of mental disorders.

Also, what would you tell a patient who presented this story to you? Would you say, "Trust the therapist, who is a professional who you trust"?
posted by bluedaisy at 7:09 PM on March 1, 2011 [1 favorite]


My own experience, limited to depression, is that once you find the right meds, you won't be in doubt about your diagnoses any more. I've had recurring bouts of major depression for pretty much my entire adult life. I started therapy somewhere during the second major episode, got better, had a few good years, had another bout, repeat, until finally two years ago I tried medication. It helped. I felt better. But, I thought, my life was also getting better at that point (found a job after a long search, etc.), so it was probably that and the continuing talk therapy that was making me feel better at that point, right? I went off the meds, moved, started my new job, had an objectively pretty great life going. Except I was coming home from work, crawling directly into bed, and playing a constant loop of thoughts about how much I sucked over and over in my head.

"Self," I thought. "Your inner mental landscape seems very at variance with what's going on in your life. The meds helped the last time you were depressed. Maybe you should give those a go again?" I did, and within a month those spiralling, recursive thoughts are gone. I was able to have a normal social life that didn't involve feeling like it was a massive effort not to just crawl into bed. My house is clean. Well, clean-ish. I feel right. (As in, centered and grounded, not Charlie Sheen-style "I'm a winner.")

Here's the thing. Without my years of trying to beat my depression without meds, and the invaluable skills I learned in talk therapy, I wouldn't trust that the meds are working. That there's really something in my brain chemistry that requires them the way I'd require insulin if I was diabetic. It was an iterative process, in which I tried out various hypotheses for what made my brain work the way it did. Was it because I was a loser? Well, talk therapy and CBT convinced me it wasn't that. It still felt like that inside my head, but I'd worked through the thoughts and observed enough other people with the same beliefs about themselves to know that it empirically just wasn't true. So if I wasn't a loser, why did my brain keep telling me that I was. Hmmm, maybe there's some chemical connection that's just not being made? Let's try medication. Well, that worked, but it was probably coincidence. Man, I suck. Heyyyyyy, wait a minute. Let's try that medicine again...

So don't think of your evolving diagnoses as lost time, or wasted. You've been learning something incredibly valuable about your inner landscape the entire time. You're getting better at knowing what is going on with you. (For what it's worth, your insight that helpful diagnoses have turned out NOT to be the things you convince yourself that you have, but things that others notice about you seems like a real, and valuable insight.)

It seems like your therapist may be on to something here. I'd talk to him or her about it. Bring up your concerns that ADD meds might exacerbate your condition in a dangerous way if the bipolar diagnosis is right and the ADD diagnosis is wrong. Make sure your doctor is taking that seriously, and that you would be more closely supervised than usual if you decide to try the medication. And then, if you feel like they're taking your health concerns seriously, and it's not putting you in any danger, try it. This diagnosis too might be wrong, but it'll give you a little more of the puzzle. Help fill things in a little bit more. And, in the best case scenario, maybe you will wake up one morning and say "I feel better. I know enough to know that this is working."
posted by MsMolly at 7:51 PM on March 1, 2011 [10 favorites]


I kinda think that if you don't trust your therapist and she's pushing you toward treatments you don't want to try you should find a new therapist.
posted by NoraReed at 8:14 PM on March 1, 2011 [2 favorites]


I couldn't even read all of that.

As pointed out, meds for ADHD are contraindicated for someone who has bipolar, so it's important to get this right.

None of us can tell you a thing about what your diagnosis is. A valid diagnosis has to come from a psychiatrist, neurologist, or psychologist, who must specialize in ADHD. You do need a valid diagnosis to orient you and put your mind at rest.

Good luck.
posted by tel3path at 4:11 AM on March 2, 2011


The symptoms of Clinical Depression closely resemble the symptoms of ADHD - just throwing that out there to be considered.

No they don't. You don't know what you're talking about. Your personal experience here does not mean that the two diagnoses are similar. Indeed, there is no diagnosis called "Clinical Depression" in the DSM. At best some symptoms appear similar when taken out of context. The poster is already being evaluated for a mood disorder.

Am I right in thinking there are no objective tests for this? Blood tests? Scans? Really hard-to-game questionnaires?

There are no objective tests for any of the psychological issues you've talked about. Further, not only will people on the internet not be able to diagnose you, but given your admitted issues with diagnosis and hypochondria, you should make a real effort to not engage in this kind of question asking.

It sounds like you've got not only a complex diagnostic case, but also a conscientious treatment team. Your therapist took 29 sessions to suggest to you that you might have ADHD, which indicates that a lot of thought probably went into her assessment. The questions you have here are questions you should ask your therapist and the rest of the people on your treatment team. The short answer, however, is that you can live a fulfilled and fulfilling life with the diagnoses you've listed here.

As pointed out, meds for ADHD are contraindicated for someone who has bipolar, so it's important to get this right

This is not always true, and I wish people would not second guess the not-even-started treatment for a disorder they don't even know if the poster has. Competent and careful psychiatrists and therapists have been treating ADHD and Bipolar Disorder together for a long time. Furthermore, Bipolar II is a very different disorder from Bipolar I (not that the details should stop unqualified folks from weighing in.)
posted by OmieWise at 5:38 AM on March 2, 2011 [9 favorites]


I apologize for my misstatement about ADHD meds and bipolar.

It is a distraction from my main point, which is that the OP should be talking to professionals about this, not to us.
posted by tel3path at 5:55 AM on March 2, 2011 [1 favorite]


First off, I'm not going to get into the diagnosis debate very much. I do want to say that I have ADHD and depression and they still haven't officially diagnosed the ADHD because of the depression due to some symptom overlap and the fact that doctors generally prefer to treat the "worst" problems first. (In other words, if patient is despondent and depressed, and also can't get anything done, treat the despondency first so patient doesn't off themselves while you treat the "can't get anything done.")

However, this is a call only a qualified psychiatrist can make.

- Does this sound like ADHD to you? (I like to start with the obvious.)

Yes, absolutely it does, but I am not a psychiatrist or a therapist. You may need to trust your therapist on this.

- Am I right in thinking there are no objective tests for this?

There are some objective tests, which can be done by a psychiatrist, but honestly the best test is for someone who knows you well, like your therapist, to suggest the diagnosis.

- How can I be open to this possibility without convincing myself 110% that it's true?

Mantras: if I were you, I'd repeat to myself something like "I am more than my diagnoses. I am a human being who isn't perfect and who may have problems, like other human beings, but I am more than my diagnoses."

- Is there anyone out there who's had a stable diagnosis for a really long time, that they're comfortable with...?

I spent 9 years trying to get my fairly classic atypical depression diagnosed and medicated properly. Trust me, I know what you're going through. I finally ended up with about twelve diagnoses (MeMail me if you want to know them all) and while I still struggle with some of them*, I feel much better now that I'm at peace with the problems I have.

* (Borderline Personality Disorder traits? That seems like they're just trying to placate me by not giving me the actual diagnosis!)

- Is it rational to not trust my therapist to be objective?

I don't think it's rational not to trust your therapist to be objective. If you really don't think you can trust her, then please, get another therapist. Find one you can trust.

- What are the odds that I can have a normal(ish) life?

Let me tell you a little story.

In 2004, a girl's house burnt down. She thought she'd somehow caused it, even though three fire investigators said she hadn't. In 2004/2005, she tried to kill herself upwards of 6 times and was hospitalized, both voluntarily and involuntarily, 3 times. She left her job after slightly less than a year due to repeated panic attacks. Then she did not leave her house except for doctor's visits and therapy for 3 years. In 2008, she tried to kill herself again, but was not hospitalized. She went to partial hospitalization after the last suicide attempt but left after only a few days. She had no long term romantic relationships and she was desperately unhappy whenever she was single.

In 2011, she's taking full time classes, volunteering at a local radio station, and happily single.

As you have probably guessed by now, that girl is me.
posted by saveyoursanity at 7:43 AM on March 2, 2011 [4 favorites]


ADHD doesn't make you a loser. Coping with ADHD has given you tremendous adaptability, and you should be proud of that. In nature, ADHD confers some advantages. We live in cities and towns and work at computers, so ADHD is less advantageous. If medication might help, it's probably worth trying.

You can think of yourself as defective because you have bipolar disorder and maybe ADHD, or you can think of yourself as a person who is trying hard to live a good life while carrying a large burden. As handicaps go, it's significant, but I count myself slightly lucky because modern meds exist. The change in your diagnosis is frustrating, but it only matters because your care providers must try to categorize this and find appropriate medication. The DSM is woefully inadequate, but it's the tool they have to use. Focus on your good traits, your successes, and not on the labels. The labels exist so that appropriate medication can be prescribed.

I'm not sure you'd trust any therapist, but think about what you want to get from therapy, and if this provider can help you. I've had a bad therapist, and it's hard to find good ones, so assess carefully. And, really, good luck.
posted by theora55 at 12:57 PM on March 2, 2011 [2 favorites]


I made myself wait a whole entire day before coming back to say anything. Hugs for everyone!

Lots and lots of thanks to everyone who answered my questions; I feel much less crazy after reading this thread. ^_^

For the questions/comments I can't resist replying to specifically:

- I've been on antidepressants off and on for 15 years, plus some antipsychotics, mood stabilizers, and so forth. I've used Paxil, Wellbutrin, Tegretol, Lamictal, Abilify and at least ten other things I can't remember. I promise you, the mood disorder thing is on the radar and has been (without my knowledge at first) for a very, very long time. The me on mood stabilizers and antidepressants is the one who is frustrated about how she still can't get any filing done - the me off of them is a sobbing mess who would have deleted this question halfway through on the grounds that she's a worthless waste of space, assuming she could get out of bed or come up with the idea of posting to begin with. Alternatively, she would have done all the filing in a giant bathroom-skipping burst of insane energy by now. And yeah, I do miss the hypomania; if I wasn't prone rapid-cycling I'd be a lot more likely to deliberately try to induce it.

- I like my therapist, as evidenced by the fact that I can actually call her when I need her (my current psychiatrist's staff scares me; it took 9 days for me to work up the courage to call them and set an appointment last week.) In an average month I spend about 3 hours talking about non-work stuff deeper than "plastic, please," and 2 of those hours are with her. If we didn't get along, I wouldn't have made it last two sessions. I pretty much don't trust anyone, which I think is what theora55 was alluding to.

- EMDR just bugs me, and I don't want to do it. I have to give myself permission to set these kinds of boundaries when it's possible, because I frankly live in a universe where I'm not altogether certain anything's the way I see it, and I'm almost always screwing something up. The therapist gave me permission to set this boundary (even though it obviously bugs her,) so that's that. Mostly I mention it because she really pushed it hard for some time; this informs the "she's biased" issue.

- I am way cozier in depression/chaos than in an orderly environment. I don't really know what normal is. I definitely don't work as hard as I should to achieve it. Hence the low self-esteem; this is where I refrain from enumerating all the ways in which I'm a worthless backsliding slacker. I don't thrive, I just know what's happening and the unhappiness is familiar. Therapy twice a month = still probably not enough, but we do what we can.

- The label thing bugs me because of the lack of control, I suspect. Also, I feel like I have to keep redefining who I am, and to a certain extent like I've been living a lie up till that point. Did I mention I have issues? Anyway, I know it's nothing I should be worried about and irrational and so forth.

- I don't want MetaFilter to diagnose me. I (and my insurance company) pay some experts to spend loads of time with me and do that. But I have no generically smart, disinterested observers at my disposal - you know, the kind who I can give a summary of my situation to and get a nice outside opinion on things (very important when your own opinion is unreliable by definition,) without causing long-term damage to my few standing interpersonal relationships. Ooh, ooh, except for everyone on Ask MetaFilter! Hey! Check you guys out! My plan, behold, it worked! Go me! Go us!


Oh, and I can't stand being stingy with best answers, especially since this is my "not connected to the real me" account and so I can't effectively demonstrate my affection with excess favorites on later posts. But I wanted DarlingBri and saveyoursanity to know that I've copied portions of their responses down in my journal and would give them super extra best answer marks if I could.

(anyone else want to chime in, I am so not done looking at these answers!)
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 4:28 PM on March 2, 2011


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