Bipolar or Not, that is the question.

There are two strains of thought in the mental health profession.  As with many other conditions as well, some doctors are quick to diagnose bipolar, some are hesitant.  My psychologist is one who is hesitant to make that diagnosis.  Or to put it differently, he has to personally witness a significant manic or hypo-manic state to confirm the diagnosis.  He has no problem with the depression side of my diagnosis, as he has seen that a plenty.  One of the reasons he has not seen the manic side of my personality is that the last time I was in one, I backed away from counseling because I was doing so 'well'.  That was the time I resigned my call, established my business, cashed in a significant portion of my pensions, bought a CNC router, enlisted my son to join me in the business, and in doing so exhibited by my own count, 5 of the 7 defining symptoms of a manic phase of bipolar disorder.

Both my current, and previous psychiatrist fall into the camp of being willing to make the bipolar diagnosis more freely.  One of the signs that they use is the degree to which depression responds to anti-depressants.  Turns out that normal depressions most often respond well to anti-depressant therapy, while bipolar depressions do not.  Bipolar depression, on the other hand, responds to mood stabilizers, not anti-depressants.

The psychologist that is reviewing my case for disability falls into the camp of being very hesitant to offer the bipolar diagnosis.  That may affect the outcome of my appeal, only time will tell.

I have a backwards attitude toward the diagnosis.  Rather than confirming the diagnosis, and then prescribing treatment, we tried a different approach.  Treating the depression 'as depression' wasn't working, and so I asked my doctor if my recurring bouts with depression could actually be bipolar.  She agreed that was possible.  I was currently taking Lamictal to control the seizures I was having.  It is an anti-seizure medication that is also a mood stabilizer used to treat bipolar disorder.  What was decided was to increase the dosage to a therapeutic level for bipolar disorder and see what happened.  Turns out that was the one thing that improved my situation.  In essence, we prescribed the treatment, and then, based on its success determined that the diagnosis was correct.

In contrast to some of the opinions to the contrary, I am personally convinced of the correctness of my diagnosis.  One of my reasons for being even more convinced than any of my medical team is that I am deeply aware of my inner thought patterns.  These go way beyond what is actually manifested in specific behaviors.

So, for example, when I set out to develop Luther Park and the Beacon at Southridge, there were the actual behaviors, and also the underlying scheme and grandiose thinking that went far beyond.  I was successful in the first case, Luther Park is an 87 unit senior housing ministry that is doing fine.  I failed to pull off developing the Beacon (a 225 unit senior housing community) in part because of the economy, but also in part because it proved to be beyond the scope of what was possible.  What was lost in the process was that in my vision, these two projects were just the first two steps of a major plan that would totally transform the church, not only in this country, but also with an international impact as well.  The vision that I had was so ambitious, that I didn't share it with others.  It would be better, to reveal it one step at a time.  No one would buy in, if they saw the whole deal. . .

The bottom line is that left untreated my  mood swings are way beyond the norm, and have been getting progressively worse.  With treatment, they have  moderated and would be, by most observers, be seen as within the parameters of what is normal.

One of my great-uncle's favorite jokes was about a man who was out in his yard spreading salt on his lawn.  His neighbor sees what he is doing, and asks him why in the world he would do that as it will kill the lawn.  "To keep the elephants away."  was the response.  "There aren't any elephants here!" his neighbor replied.  And the man said simply --  "It figures."

I'm being treated with Lamictal to keep the bipolar symptoms away.  "But you don't have any symptoms of mania!"  "It figures."