Welcome to the Jungle, Revised Edition. Hilary T. Smith

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СКАЧАТЬ might be causing your symptoms? Are you on crack? Pregnant? On the autism spectrum? Have a brain tumor? Or are you just hungry? Many medical conditions share symptoms with bipolar. You want to rule these out as possible causes before deciding the diagnosis is bipolar.

      Of course, it can be difficult to rule out other conditions if those conditions are undiagnosed (maybe nobody's realized you're autistic, or pregnant, or anorexic, or have some obscure vitamin deficiency that is either causing or exacerbating your “bipolar” symptoms) or if those conditions are not recognized by your culture as being valid (like having a spiritual awakening or emergency.)

      Unless you're on a really cushy medical plan, it's unlikely your doctor will run the dozens of tests necessary to exhaustively rule out other possible causes for your distress. It is therefore important to take as thorough an inventory as possible of your own health before you go to your doctor's office. Write down a year-by-year health inventory, as far back as you can remember. Include anything that seems significant, whether or not it seems relevant to “mental” health (after all, physical health and mental health are closely entwined). Have you ever had seizures? Insomnia? Childhood anxiety or depression? Self-mutilation? Stress-related conditions like eczema? Had a traumatic injury that still causes you pain? Other chronic illnesses? Frequent fevers or flus?

      This might all seem a little over-the-top, but the more of an expert you can become on the working of your own mind and body, the happier you will be in the long run. Even if the doctor looks over the list and decides your symptoms are still mostly due to bipolar (even though you do have anemia and PTSD and a few other things with bipolar-esque symptoms), the inventory can help you see the bigger picture and help you come up with a plan to improve your overall health, not just the “bipolar” part of you. Mind and body are related—a fact which gets overlooked too easily in the drama of a mental illness diagnosis.

      CONDITIONS THAT SHARE SYMPTOMS WITH BIPOLAR

      Believe it or not, bipolar disorder doesn't have the market cornered on things like insomnia, grandiosity, and suicidality. Here are just a handful of conditions that share these symptoms:

      Condition: Aspergers/Autism Spectrum Disorder

      Bipolar-esque features: Depression, anxiety, obsessions, socially inappropriate behavior, periods of intensely focused activity, social burnout and withdrawal, loneliness, hypersensitivity, suicide attempts, seeming “grandiosity.”

      Condition: Temporal Lobe Epilepsy

      Bipolar-esque features: Bouts of paranoia and confusion, overwhelming ecstatic/spiritual experiences, depression, hallucinations.

      Condition: Anxiety Disorders

      Bipolar-esque features: Paranoia, panic, restlessness, obsessions, fear, worry, insomnia, depression, strange behaviors, self-medicating with alcohol/drugs.

      Condition: Primary Insomnia

      Bipolar-esque features: Inability to sleep with seemingly no cause; can lead to hallucinations, agitation, depression, suicidality, self-medicating with drugs/alcohol.

      Condition: Chronic pain

      Bipolar-esque features: Depression, suicidality, insomnia, anxiety, self-medicating with drugs/alcohol.

      Condition: Seasonal Affective Disorder

      Bipolar-esque features: Marked changes in mood and energy levels, insomnia, anxiety, hypersensitivity.

      Condition: Spiritual Experience

      Bipolar-esque features: Intense energy, feeling like God or talking to God, seeing lights and colors, “grandiosity,” desire to talk to strangers or make big gestures. Other times: depression, suicidality, guilt, agitation, dissociation. (People on meditation retreats experience this stuff all the time.)

      “OH MY GOD, I THINK I HAVE ALL OF THESE! I'M AN ASPIEBIPOEPIANXIOUSPAINSOMNIAC—AND I'M ALLERGIC TO KIWIS, CAT HAIR, AND RAIN!”

      OK, OK, easy, Tiger. You might be an AspieBipoEpiAnxiousPainSomniac . . . or you might just be a human being who's working with a particularly challenging mind and body, the same way your cousin Angie is a human being who's been working on an unusually challenging muscle car for the past six years (she got it running ages ago, but now she's obsessed with getting it to make a particularly . . . muscular . . . kind of roar when it drifts around corners . . .).

      On the other hand, AspieBipoEpiAnxiousWhatever might not be that far off the mark. With the rise of genetic testing, scientists are finding possible links between conditions like bipolar, autism, and schizophrenia—hinting that they might not be as separate and distinct as we've assumed. Other researchers have found a strong connection between bipolar disorder and chronic pain, bipolar and anxiety, bipolar and trauma, bipolar and Kundalini syndrome (it's a thing!). . . the list goes on. So where does one condition end and the next one begin? It's hard, if not impossible, to pinpoint. That's why it's important to take steps that improve your whole life, not just “bipolar”—because “bipolar” is almost never the whole story.

      3. FAMILY HISTORY

      It's taken as a given that your uncle Bernie is off his rocker, but has anyone else in your family been diagnosed with a mental illness? Have any of your relatives been hospitalized for depression, mania, or psychosis? Anyone receiving counseling or taking meds for a psychiatric disorder? Or does anyone have a condition that can look similar to bipolar, such as Aspergers, temporal lobe epilepsy, schizophrenia, or straight-up depression? Bipolar appears to have a strong genetic component, and bipolar in the family can predict bipolar in you. Don't be afraid to contact family members and relatives to get as complete a picture as possible. Maybe your mom/uncle/grandpa has a condition you didn't even know about.

      4. PSYCHIATRIC HISTORY

      Did you get diagnosed with unipolar depression three months ago, and now you have so much energy you can't sleep? Have you ever been diagnosed with another psychiatric disorder? The doctor will want to rule out unipolar depression, schizophrenia, and other possible psychiatric causes for your symptoms. The doctor might ask you to draw a “mood chart” of the past twelve months or several years. This might seem obvious, but if you've been through a recent trauma such as rape, a violent relationship, or even a scary car accident, you should definitely speak up. Trauma can shake you up in a way that resembles mental illness. And if you have both a mental illness and trauma, there's no reason you should address only one of the two and ignore the other.

      “BIPOLAR” IS A WORD FOR A PATTERN

      You didn't get diagnosed with bipolar because you're ugly or because the doctor doesn't like you. Let's face it—he's uglier, and his personality needs improving. You got diagnosed bipolar because your symptoms more or less fall into a common, distinct pattern, observed in millions of people. We're currently calling that pattern “bipolar” and treating it with pharmaceuticals and talk therapy. In the past, the same pattern has been called by a different name (hello, “hysteria”) and treated by different means (like lots of cold showers). In the future, it will undoubtedly be called something else entirely and treated with mind melding and cosmic nanoprobes. In other cultures, what we call “bipolar” has other names and other symptoms СКАЧАТЬ