Trauma

So my therapist disagrees with my psychiatrist about my diagnosis. She thinks I have Major Depressive Disorder with PTSD instead of Bipolar Disorder. That’s the assessment she made in our intake session, and her diagnosis has remained the same as she’s continued to see me. I don’t really doubt the bipolar diagnosis my psychiatrist has given me, and just assume my therapist has her doubts because she hasn’t yet seen me in a manic state (I’ve only been seeing her since July). I also think she’s especially attuned to look for symptoms of PTSD because she deals primarily with patients with trauma.

When I mentioned the diagnosis to my mom, she said she agreed — she never thought I was bipolar — but took issue with the PTSD part. “What trauma have you experienced in your life?” she asked me. “Rape? That’s about it.”

I just laughed it off, but the comment totally invalidated what I’ve gone through. In fact, I think I’ve experienced an especially high number of traumas in my life compared to most. Abortion, being ridiculed by my peers for eight years, domestic violence, being arrested, being involuntarily committed, being homeless…just to name a few. Some traumas were easier to process than others. It doesn’t mean it’s been easy for me. I’ve had a lot of healing to do.

I deal with trauma in a very dissociative way. It took me about a year to fully process that I had been raped, for example. Until then I had just exhibited a lot of suicidal tendencies without knowing exactly why I wanted to die. I remember listening to “The Great Gig In The Sky” from Pink Floyd’s Dark Side Of The Moon on repeat and calling my sister crying, telling her I didn’t want to live anymore. I would break down in a heap on the hardwood floor of my apartment and just sob. That was before I was medicated. I had actual feelings then. I don’t cry much anymore.

It was during the domestic violence episode that I exhibited real signs of PTSD. I had to get a restraining order but still feared his family, who I couldn’t specifically protect against with a protective order. Hypervigilance is a feeling I know well. I feared for my life during the assault, and I continued to fear for my life after he was gone. I would walk the mile home from work looking over my shoulder constantly to make sure nobody was following me. I would keep the blinds drawn, ensuring no eyes could peer in. I avoided the stairwell we used to take home from work together. No matter where I was, I didn’t feel safe. I continued to live in the apartment he and I once shared, so the threat of him showing up at any minute was very real. Luckily he wasn’t stupid enough to violate the restraining order.

I’m not sure I’ve experienced a full flashback, but my obsessive mind definitely tortures me with distressing thoughts. It was impossible to focus in the weeks and months following the assault. Part of that had to do with the head injury and resulting nerve damage I suffered, and being in a lot of physical pain. I couldn’t do something as simple as read a script to do my job at work.

So, yes. I’ve had my traumas, thankyouverymuch. I didn’t grow up in abject poverty — I didn’t have it rough in that way — but my life has been colored by the effects of the various traumas I’ve endured. Some people are better equipped to handle traumas than I am. I feel weak sometimes, like I’m too sensitive for the world. I tend to become overwhelmed by my emotions and let the trauma take over my entire world for awhile. I’ve been criticized for that before, actually. That I let my emotions take me over. I don’t know if I’ll ever be able to exercise better self-restraint in this sense.

I’ve never been terribly interested in getting an exhaustive list of diagnoses from a doctor, but in my estimation the bipolar diagnosis is the one that fits best. I had a therapist who put “Borderline Personality Disorder?” in my medical records, but I don’t think that’s accurate, either. (I don’t like abandonment, but no self-harm is a big way in which I don’t fit the diagnostic criteria.) And while I have experienced symptoms of PTSD in my life, the traumas don’t continue to haunt me to this day or have an effect on my ability to function in life, so I hesitate to add that to my list of diagnoses too.

I’m less focused on diagnostic labels and more interested in identifying the symptoms that plague me so that I can work through them. Depression, mania, and anxiety all come up in my life. I think those are best explained by bipolar, and I respond to bipolar medications, so that says a lot about the accuracy of the diagnosis, I think. The rest is just details to work through in therapy, and it doesn’t really matter what you call your disorder if you’re working through your problems effectively. So I don’t spend too much time concerned about my diagnosis.

This question popped up on my Facebook feed and made me think. It feels like for some of the folks in that group, bipolar is their very identity. Especially the folks on disability. I try not to define myself by an illness. I am so much more than that. I am not my limitations. I like to think of myself as being fairly normal so that I don’t get caught up in thinking of myself as uniquely disadvantaged. It may be a bit of a lie that I tell myself, since bipolar can’t really be considered “normal,” but I hate owning the disorder, because if I do I feel like I can let it own me.

I’m the one that’s in control. Not bipolar.