“I was on six different waitlists, hoping to get an appointment with somebody- anybody- who was a mental health professional.”

I didn’t really realize at the time what was happening, but now looking back I can see that I was experiencing symptoms of bipolar back when I was 11 years old. I didn’t really have any language or framework to talk about or understand how I was feeling until much later. I was experiencing serious depressive episodes, as well as what I now know was hypomania.

When I was a kid, I didn’t really have any frame of reference for mental illness, so I thought I was having a hard time and depressed solely because of having a rough time in school (being bullied, losing friends, etc). I think in reality, those social struggles in school are what triggered my predisposition for mental illness. I found out many years later that my maternal aunt is bipolar (and a lesbian too, we’ve got a surprising amount in common).  

I first started thinking that I was ‘crazy’ in college. It was a conservative Christian school, and I was struggling and bumping up against the rules, expectations, and assumptions about women and about gender roles. I was also discovering my queerness, as well as starting to deal with some past sexual trauma. A lot of major identity crises converged all at once. Coupled with the classically patchy college student sleep schedule, it was a perfect storm to set off some major bipolar episodes.

So, even though now looking back I realize I had been experiencing bipolar symptoms for many years, in college was the first time that I started questioning my mental health, my ‘sanity’. College was the first time that I went to therapy in pursuit of an answer.

My symptoms of bipolar type two prior to medication were major depressive episodes, often lasting weeks or months, which includes feeling numb, feeling lethargic and incredibly tired, weepy or teary, loss of interest and hopelessness, etc. I think of the difference between depression and sadness as when I am depressed, I don’t remember what it feels like to be happy.

I also experience hypomania, which includes racing thoughts, talking very quickly, talking a lot more than usual, needing very little sleep, eating very little food, feeling invincible, and feeling too happy in a way that feels nervous and unsafe. Before medication, hypomania could last anywhere from hours to weeks. I have never had a true manic episode typical for bipolar type one.

I also frequently experienced mixed states, where I would be very agitated, angry, unsettled and nervous. I would feel destructive, trapped, like things were closing in on me. There is the attitude of depression with the energy of hypomania. During college, and for the first couple of years out of college, this was probably my most common bipolar state. It could also last for hours to weeks.

I was living in New York at the time, and was in the middle of a deep depressive episode that had been going on for months. Trying to get psychiatric help in New York was an absolute nightmare. I was on six different waitlists, hoping to get an appointment with somebody- anybody- who was a mental health professional. At one point it was so bad, and I was so desperate and scared, I literally walked into a hospital emergency room and said, “I am having a psychiatric crisis and need help,” and they turned me away because they didn’t have a psychiatrist on duty.  

While I was waiting, I saw just a regular primary care physician, who put me on Lexapro. Once I started medication, obviously my symptoms changed. Lexapro definitely made it worse, I started rapid cycling, and having a lot more mixed state episodes. I was initially diagnosed with depression, which I understand is pretty common for folks with bipolar type two, because it is easy to not realize that hypomania is a manifestation of illness.

I moved back to San Diego, and when I got back I was able to see a psychiatrist relatively quickly, within two months. I truly was just very lucky and very fortunate that the man I ended up seeing, his specialty was actually bipolar 2. I would not have thought to talk about the things that I now know are hypomania, and past medical professionals had never asked me about them.

But when he heard that the Lexapro made me feel worse, made me feel crazy, he started asking things about how I behave when I feel “really good”, and I started talking about how oh, when I’m doing good, I really only need about two or three hours of sleep at night and I’m fine. When I’m doing good, I can do things really fast. I barely need to eat anything. And he was like hey, so, sleeping two hours a night and not needing lunch are actually not great either.

He started explaining about Type 2, that it’s often overlooked or misdiagnosed because of the lack of true mania, how folks with Bipolar Disorder tend not to have good reactions to antidepressants and how often folks with bipolar type two don’t realize that hypomania is not where their equilibrium is. He gave me a book to read (Why Am I Still Depressed? by Jim Phelps) which was very revelatory, and I definitely saw myself in the pages.

I was actually weirdly happy, and definitely very relieved, to get my diagnosis. Because I finally felt like something fit, something explained what I was going through, and something could be done about it. After years of thinking, “Something’s wrong with me, I’m crazy”, it was almost weirdly reassuring to have a name for it.

The constant emotional extremes had been really taking a toll on me, my relationships and my work, and I was actually very eager to start medication. He started me on Lamictal. Obviously, the very, very, very low dose because of the infamous Lamictal death rash. I didn’t have any sort of reaction to it at first, and he increased the dosage over time.

I definitely started seeing the results of the Lamictal when I got to about 200mg a day. It felt like someone was taking that constant up-and-down wave that I had been living on, and sort of squishing the highs and lows closer together. The peaks were definitely less high, and the valleys were definitely less deep. However, it also seemed like it was compressing the wave side to side as well, so even though the extremes were not as high or low, I was cycling really quickly.

He initially added Lithium to my medication. A classic of course, but it really had no impact on me at all. I did not notice any difference with the lithium. So I went off the lithium and he increased the dosage of the Lamictal. I am actually on the maximum dosage now. But, the maximum dosage really did the trick.  

I am under no illusions about medication being magic. I am very aware of the science behind it all, and the need for behavioural management, lifestyle management, environmental factors, etc. However, the effect of the Lamictal at the maximum dose certainly felt like magic.

Since I am on the maximum dosage of Lamictal, when I’ve needed adjustments, we’ve had to play around with other medications. Right now I take Lamictal and supplement it with BuSpar, which has been working well for me for about five years now.  It sometimes makes me very nervous about my future, knowing that I’m maxed out on the Lamictal, because I feel so grateful to it, and dependent on it for my sanity.

I worry about its effects fading away, and being stranded, and left to wade through the infinite combinations of other medications. That is one of my fears about growing old with Bipolar Disorder.  I know that bipolar never gets better, it is only well-managed, or not. I also know that it tends to get stronger. I am not at all the type of person that is ashamed of taking medication, trying to get off medication, under the impression that I can function without medication, or anything like that. I 100% owe my sanity, stability, and life I have today to Lamictal, and to the psychiatrist who diagnosed me in 2013.

When I got diagnosed, I did tell my family and my partner right away. I was actually so relieved to have an answer. They had all been watching me struggle for so long that I hoped they would be relieved as well. My wife at the time was really great, really understanding and supportive, and we did a lot of reading and researching together. My dad and sister were the same, very supportive, willing to learn.

My mother had, and still to this day has, a very difficult time dealing with it. She’s very uncomfortable with me talking about it at all, and I think that stems from her history and her relationship with her own bipolar sister.

With regards to New York, I still had not been called back off of any of the waitlists when I moved back to San Diego. Literally a year after I moved back, one of the offices called me to say, “Congratulations! We have an appointment available for you.” It is absolutely criminal that it is literally impossible to get any mental health care in some places of this country, and still very difficult everywhere else in this country. I am very fortunate that I made it through my crisis, and I was able to hold on until I got the help I needed. But not everyone is able to, and not everyone would still be alive after a year of waiting.

I have learned that one of my biggest triggers is inconsistent sleep or lack of sleep, so I do my best to maintain a really consistent sleep schedule. A couple nights in a row of going to bed too late, or sleeping at odd times, is a sure-fire way to throw off my balance.  

I also changed careers in order to be a better steward of my mental health. I used to make my living as an actor and a costumer for live theater.  The late nights, inconsistent schedules, not knowing when or where the next gig would be and the emotional requirements of the job were all things that were simply not good for me. Now I still work in theatre, but in an administrative and financial position, which allows me to still be a part of the industry that I love but is exponentially better for my mental health.

Social media is a double-edged sword. Sometimes it can send me into a spiral, so limiting my consumption of social media can be really helpful. At the same time, through social media I am able to connect with people like me, and create community outside of my specific geographic location. So I guess just being intentional about the content that I am viewing, and the people that I am interacting with on the internet. Making sure that I am actively seeking out things that edify me, that bolster me, that are beneficial to me.

A symptom of my bipolar that I hadn’t heard of people talk about is that I can get a real sensory overload. Especially if I am in a bit of a mixed state, but also just in general, I’m very sensitive to sounds in particular and I can find sound completely overwhelming and debilitating at times.

Noise canceling headphones are really great for helping me drown out or muffle the noise of my neighbors when I’m at home, or things like bass boost in music. I also have some loop earplugs that I absolutely love, and I always have with me. I will wear them in restaurants, on the train, walking down the street, really anywhere that I am finding the noises or voices around me to be agitating or paralyzing. I also just try to stay very aware of any sort of tipping in one direction or another and make changes to protect myself. I always have my eye on my equilibrium.

Julie Fast’s philosophy is, ‘Treat bipolar first’, and I fully subscribe to that (now – that’s been a hard lesson to learn).  Maintaining equilibrium is my top priority because it has to be. If I don’t treat my bipolar first, then I can’t be a good partner, I can’t succeed at work, I can’t nurture friendships, I can’t take care of my cat, I can’t pursue my passions, I can’t even do basic daily functions.

Something else that was a hard lesson to learn was that I do have limitations and I don’t have to feel bad or apologize for them. Maintenance is much easier now that I’m better about admitting limitations to myself and expressing my needs openly to others.

In terms of professionals I’ve worked with, as a classic millennial, I’ve had a long winding journey with healthcare, and so I got bumped around quite a lot when it came to the doctors I was seeing. As I mentioned when talking about my diagnosis journey, I initially saw therapists and PCPs that believed I had depression, which was not terribly helpful. But the first true psychiatrist I saw understood me and saw me right away, and I was very fortunate that his specialty was Bipolar Disorder.

I was unfortunately not able to see him very long, and I got passed along to another psychiatrist who was a little less knowledgeable, particularly when it came to bipolar medication. In my opinion, she did not properly prepare me for side effects, and did not warn me about other medications that could interfere with the Lamictal. She also put me on Prozac as a supplement to Lamictal, even after I told her that antidepressants had been pretty bad for me in the past.

After that, I lost my healthcare for a little bit and was on MediCal, and got assigned to this horrible man who is straight up did not believe me or my diagnosis. He really tried to get me off medication, and I was thankfully able to get refills prescribed through my old psychiatrist even though I was no longer seeing her, which helped tide me over until I could find a new doctor.

After that, all of my psychiatrists have been fine. They’ve listened, and been very willing to work with me on finding the right medication. They’ve supported me staying on Lamictal, and one of them was the one that helped me get on BuSpar as a supplement, which has worked really, really well for me. I have been frustrated that some don’t seem knowledgeable about medication interactions, particularly when it comes to birth control. I personally had to do a lot of research on the FDA website, and on bipolar forums, to learn about how various types of birth control could interact with and reduce the effects of Lamictal.

I am ‘out’ to some close friends, family and past co-workers, but I’m currently in a leadership position in my job and (maybe this is just internalized stigma) but I’ve generally kept it on the down-low at work because I don’t want my ability as a leader to be questioned or people to think that I am not stable enough to be in my position. I handle my illness very well, I am very ‘high functioning’ (she says facetiously, knowing that that is a pretty loaded and problematic term).

I think there’s definitely still a stigma, but I have been very fortunate to not run into outright prejudice very often. My experiences with stigma for the most part involve media-dash-film, television, and books that sensationalize or dehumanize the bipolar experience.  

I’m not particularly public about my diagnosis, but I also don’t hide it if it comes up naturally in conversation, and for the most part people take it pretty well.  It’s usually when folks don’t know, and say something stupid not knowing that there’s a bipolar person standing next to them.