Ayelet Waldman (who I really haven’t liked every time she’s written a column for the Times, just my gut, I have felt like she’s often written herself so she comes off as selfish and there’s a projective worry I’ll deal with later…) wrote recently about her initial diagnosis as bipolar II and her experience with topamax and her later discovery that she wasn’t bipolar at all– “just” premenstrual dysmorphic. I’d missed the article, but my therapist brought it up at yesterday’s session as a way to work back to a frequent topic– her perception of my overreliance on my organic disease versus more situational causes for my depression and my consequent feelings of powerlessness over my future, and the fact that Topamax hasn’t been effective for me in the long run even as it seemed to really work at the start.
I can concede the last point, even as I argued with her (again) about how I know and understand that there’s an intersection between genetic predisposition and my situational triggers and how I cope/choose to respond– but that sometimes I do better than others.
What Waldman says in the article, though, about the intense feelings of relief that the bipolar diagnosis gave her because it explained some of her more intense behaviors– her rages, her hypomanias, all of those things– those are things I’ve had too, even as it’s been true that no mood stabilizer has worked for me for more than a bit and unpacking the question– am I medication refractive?– or is it just that coming off one med and onto another works an equilibrium/placebo effect in me for a while before I hit another major depression, and I’m “simply” subject to major anxiety and depression, as she suggests?
I don’t know what to think. I’m going to be working with a new psychiatrist starting next month because the one I’ve worked with since I was first diagnosed is changing to a different type of practice and won’t be able to continue to see me– and I’m certainly beyond the efficacy plateau on the Topamax at the 2-ish year mark (suicidal ideation will kind of make you see that light), just like the rest of the mood stabilizers, just as I’m feeling better now that I’m on SSRIs and reducing the mood stabilizer in my system– but there are things left to explain.
It makes me sick to my stomach to think I have to start from scratch in trying to understand the whys of my crazy again. Shellshocked, even.