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Are You Bipolar?

Life was going well before, for the most part. “On paper, I’m perfect: went to a nice private school, graduated from Wharton with two degrees, on a fast track to private equity or a hedge fund. Look, I was in tech in 2000—it wasn’t an easy thing to be doing. I was going to be the first one of my friends to make a million.” Somewhere along the line, though, she got confused. “I was hypersexual—I needed to have sex every day, and if I was drunk, you could get me to do anything. My boyfriend liked it, too, by the way. I went to Vegas and I was in a boutique at the Hard Rock, and this guy said he’d buy a thong for me if I’d model it for him, so I did. Now I look at that thong and I think I’m a slut. But at the time it seemed like a fun thing to do.”

The last month or so had been particularly rough: She felt angry and sad all the time. “I’m sorry to say I like the idea that there’s something wrong with me that’s not my fault,” she said. “I’m allowed to wallow in pity. I didn’t ask for this—this BP Express came to me. Now I see everything as a product of being bipolar, the result of an uncontrollable disease. My anorexia, my drinking, my OCD things like counting steps, were masking the bipolarity—all attempts to control the mania. I thought I had a bunch of different problems, but it turns out that the root cause is one.” She took a sip of her water—she ordered only water. “Right now, I don’t want to be black or white, zero or 100. I want to be gray. If that’s a numbed-out version of a fun person, that’s what I’ll be.”

The Indian-American banker was certain about who she was, and who she wanted to be. But I was much less so. And others had their own questions about the new diagnosis. “There are certain fads that take off, and the current one is bipolar II,” says Howard Smith, director of operations for the Mood Disorders Support Group. “A few years ago it was schizoaffective disorder. Then it was borderline personality disorder. Next year it will be something else. It’s not that doctors don’t know what they’re doing: They’re responding to patients. Patients press doctors for labels. And doctors want to keep you on your meds, so they’re okay with it.”

Doctors, and meds, play some role, though. “The fact is that if you have a lot of treatment options for something, you’re more inclined to want to diagnose it,” says Joseph Goldberg. “By analogy, if I have many treatments for depression but very few for dementia, and the two diagnoses are often hard to differentiate, I would sure prefer that my patient had depression. And I might even treat him as though he had depression, because it’s easier to treat than dementia. But that’s not a scientific way of deciding whether a diagnosis exists. So there’s some thinking here of, ‘Might this fall in the bipolar spectrum, and because there are so many medicines now to treat that thing, should we try one out?’ ”

Andrew Solomon, for one, has looked at life through many different medications. “You get to a point where you’ve been through so many changes or chemical selves that you think, Okay, we’ll try another bunch of chemistry and see who I turn into,” says Solomon. “What I really hoped was that if I got a new diagnosis, I’d get some new treatments, and maybe I would feel wonderful all the time. But that didn’t happen. So the clarity I hoped would come with that diagnosis of bipolar II has not been forthcoming—my experience has been maybe it’s bipolar II, maybe it’s depressive.” Over the Christmas holidays, in fact, Solomon relapsed into a major depression. “At this point, I would be happy to take mood stabilizers if they seemed appropriate to my doctor; I’m taking an antipsychotic, even though I’ve never been psychotic,” he says. “Unfortunately, the way you deal with these things is you take 27 medications, and if they don’t work, you try another 27. In some curious way, you disavow your authentic engagement with the idea that there is such a thing as a proper, stable, immutable self.”

As for myself, I spent months resisting the diagnosis, staring at my little shelf of pills. The medical Establishment had spoken, which is always a daunting thing. Still—was this, too, a symptom?—I kept wanting some hard evidence of my condition. “I wish there was a test,” I said at one support group. “There is no test,” said the girl in black pigtails, peering at me through her square designer glasses, “and if there was, I don’t think you’d take it.”

It took a period of plummet for me to begin the course of medications I had been prescribed. I worked the Lamictal into my system slowly, and I didn’t think much about the potentially life-threatening rash until I woke up one morning with a spray of pink bumps across my arms and neck. I didn’t have to wait long at the emergency room, and it didn’t take the doctor long to decide what to do: no more Lamictal.

I’d love to say that I did the responsible thing, heading back to the psychopharmacologist for a new batch of prescriptions. Instead, I called time-out. I began to see a new therapist, who saw drugs as a last resort and had no faith in my diagnosis. A long period of relative peace and happiness followed this renegotiation of myself, and the depression scared into corners by antidepressants seemed to lift in a more organic fashion, bit by bit. And now, I tend to believe that my interlude as a bipolar patient was the result of the perfect storm produced by a period of maturation colliding with an expanding diagnosis. Because afterward, without meds, there was no madness—there were only other relationships, other challenges, and other ways of growing, and with them, new risks, new experiences, new summits.

But maybe that’s the hypomania talking.

Related Website
Depression and Bipolar Support Alliance
Support message boards and chats, quizzes to help you determine whether you may have the disorder, recommending reading, lists of local support groups, and other resources.