Cyclothymia
A persistent instability of mood, involving numerous periods of mild depression and mild elation. This instability usually develops early in adult life and pursues a chronic course, although at times the mood may be normal and stable for months at a time. The mood swings are usually perceived by the individual as being unrelated to life events. The diagnosis is difficult to establish without a prolonged period of observation or an unusually good account of the individual's past behaviour. Because the mood swings are relatively mild and the periods of mood elevation may be enjoyable, cyclothymia frequently fails to come to medical attention. In some cases this may be because the mood change, although present, is less prominent than cyclical changes in activity, self-confidence, sociability, or appetitive behaviour. If required, age of onset may be specified as early (in late teenage or the twenties) or late.
The essential feature is a persistent instability of mood, involving numerous periods of mild depression and mild elation, none of which has been sufficiently severe or prolonged to fulfill the criteria for bipolar affective disorder or recurrent depressive disorder. This implies that individual episodes of mood swings do not fulfill the criteria for any of the categories described under manic episode or depressive episode.
I was diagnosed with Cyclothymia in 1998. I accepted treatment, which meant that I began a short course of a combination of drugs; Depakote, an anti-seizure medication, and Wellbutrin, an antidepressant.
Some bad things ensued. Things that were unrelated to the medication, but probably very related to the diagnosis. I refused to continue the course after finishing it, in the form of refusing to revisit the physician who had originally diagnosed my illness/prescribed medication.
Somewhere during early 2000, I realized I needed to return to the idea of medication, although I stubbornly denied inside my head that I was truly cyclothymic.
In November of 2000, the day Al Gore Dubya became president, I began a round of medication for the cyclothymia; Lamictal (lamotrigine). I took the medication for over two years. When I reached the end point, almost two and a half years later, I decided I no longer wished to be dependendent on the drug. I felt that I was capable of handling life without it, that I had equipped myself with the emotional/mental tools necessary for survival, and I stopped. Just like that.
Then I began to relearn how to be a normal person, sans the enbabling/stabilizing assistance provided by the medication, and I began to learn how to think of myself as normal. I taught myself to stop thinking of my existence as seen through the lens of someone with an illness. To stop giving myself excuses as to why I was incapable of finishing projects, of speaking coherently, of balancing a checkbook, of living frugally, or rationally, on a regular basis, of not having hypomanic thoughts or episodes. Of not acting out extremely self- or other-damaging behavior.
It mostly worked. I led a fairly balanced life.
Post-pregnancy, one year ago - the nurse tried to tell me that I might have some post-partum depression. I scoffed at her, because I know from depressed, and I figured it wouldn't touch me, because I'm a pro at this shit. I can handle depressed. I was more terrified of what might happen as a result of the regular loss of sleep, due to my awareness of how it makes me cycle like a fucking hamster in a wheel (and the subsequent bouts of mania and depression that are part and parcel of the cycling), but I didn't mention that. I kept mute about my secret concerns, i.e. paranoia, instead insisting that I would be able to manage, and almost convinced myself, I was so confident in my explanation. I can hear it, my telling her that I had a firm grip on my head, and I would be fine. Fine. Yes. Of course.
Months later, as my son nears his thirteen-month birthday, I step back. I take stock. Open my hands. I look at my patterns. I think about the debt. My lack of control with money.
My mood swings. The tyrannical anger. The uncontrollable rage I somehow control, but with the minutest breath pressed between messy revelation and orderly maintenance. The ever-so-slightly-blurred line.
The insane need to speak, that I can not contain at times, the sheer volume of thoughts that tumble headlong into the void while my mouth acts as a ventriloquist's dummy, mawkishly slapping open and closed so fast that it should break, it should not be capable of such rapid movement. My brain compressed, as it speeds, low and sleek, racing at an impossible rate. The words coming, coming, coming, and the off-switch I so desperately long to press - it is broken. It is non-existent.
My body dances like an awkward clown, freakishly quick, horribly nervous. I am unstoppable, a machine on fast-forward, as I fly from task to task, banging limbs and toes and fingers into objects that cannot slow me, even as I sustain damage that I will later regret; jammed fingers, broken nails, bloody scratches, deep, black-and-green bruises that linger for weeks, a tangible reminder of my embarrassing manic moments (which are, it turns out, nothing like a Bangles song, much as I'd like them to be).
The depression that keeps my mouth sealed in a line for hours at a time, some days, despite being aware that my son does not understand, as his awareness of the quiet sadness I hide grows as he grows.
The knowledge that my child may someday develop bipolar disorder in some form, because my brother is affected, and I believe my father is, and my uncle, too. And possibly -- hell, probably -- my cousins. The genetic predisposition is there, actually, in staggering proportion.
I pretend. I ignore. I shun. I excuse. I disbelieve. I fake. I act. I lie. I refuse. to. acknowledge.
I ache. I bury my head in my arms. I shake my head slightly, warding off the tears easily. I no longer cry over this. It is too real for an empty, watery display.
Maybe it's time to reconsider medication.
