HAWMC Day 2 -What You Should Know

April 2, 2013

Today I am asked to introduce my condition to people and to share five things that I want people to know.  After all the different diagnoses I have had even in the last few years, I figure this is a good thing to do.  Unfortunately, I do not have just one condition, but am in recovery from anxiety, bipolar II disorder, ED-NOS (eating disorder not otherwise specified), borderline personality disorder, and fibromyalgia.  I am going to briefly define each condition and then write the top things I want you to know. Not every condition will have five facts, as that would take too long to write!

Anxiety, for me, is to constantly be in a state of panic. I feel intensely overwhelmed and like I cannot handle life on life's terms.  I have racing negative thoughts that may become very loud, almost like hearing voices, and I become so desperate for them to stop that I want to kill myself.

1.  Saying "take a chill pill" or "relax" to someone who is very anxious is incredibly condescending and does not help at all.

2.  Many people who deal with anxiety take a PRN-a medicine that you take as needed-to help reduce the anxiety symptoms.  Unfortunately, there is a stigma attached to taking them, but it is important to know that needing to take a PRN is not a weakness.  Occasionally I take Vistaril to help calm me down when my anxiety level is too high for my other coping skills to work.  Taking a PRN is always better than letting the anxiety get out of control.

3.  Dialectical Behavior Therapy can be very effective in helping people deal with anxiety.  DBT is a type of therapy that teaches concrete coping skills.  Personally, I find it way more helpful than Cognitive Behavior Therapy.  It was first developed for people who have borderline personality disorder, but it is now used to treat many different disorders.  Even though I also have borderline, the main reason why my therapist wanted me to take her DBT class was because of my anxiety and it has helped me a lot.

4.  Sometimes anxiety can be hard to identify.  It may start out as irritability, an inability to make decisions, muscles pains, trouble sleeping or eating, needing to do something obsessively such as counting calories or rearranging items in order to feel like things are "okay." These are all things that have happened to me and it took me a while to realize that I was anxious.

5.  Anxiety is often more dangerous than depression is.  People often associate suicide with depression, but oftentimes people with depression are too unmotivated to act out on their suicidal ideations.  It is the intense panic, desperation, and increased energy that come with anxiety that more often leads a person to kill themselves.

Bipolar II is where a person switches between periods of depression (low mood, energy, motivation, suicidal thoughts) and periods of mania (higher energy, impulsivity).

1.  Not every person who has bipolar disorder is going to experience extreme mania.  The type of bipolar that is most often described in the news is bipolar I, which is the type where a person has a mania where they  spend all their money or think they're Jesus Christ or fly to another country for seemingly no reason.  I have bipolar II, which is where a person has periods of depression followed by periods of increased energy, impulsiveness, racing thoughts, and perhaps irritability or anger.  The periods of increased energy in bipolar II are not nearly as extreme as those with bipolar II.  When the new DSM comes out there will actually be five different classifications of bipolar disorder.

2.  Bipolar disorder can be difficult to diagnose, as most people first seek help when they are depressed, so they get diagnosed as depressed.  This can be very frustrating for the consumer, as often antidepressants without a mood stabilizer will make the person jump from their depression to mania.  This has happened to me.  In fact, it happened just a few months ago!

3.  Good, regular sleep is incredibly important for people with bipolar disorder.  I once had a therapist who said for bipolar disorder, getting enough sleep is more important than taking one's medication!

4.  Although racing thoughts and irritability are no fun, the motivation and increased energy that comes with mania can be very appealing.  Many people do not want to give their hypomanic states up (hypomania is the type of mania that people with bipolar II experience) and so will not want to take their meds.  Hypomania is so appealing, in fact, that many psychiatrists try to keep their patient in a state of slight hypomania, so that they will be productive, motivated, and not terribly depressed.

5.  Many famous creative people have bipolar disorder including Robin Williams and Carrie Fisher.

Eating Disorder Not Otherwise Specified

1.  ED-NOS includes binge eating disorder; those who restrict, but have not lost enough weight to be anorexic; those who purge, but don't binge, so do not classify as bulimic.  Basically it's for those who fall between the cracks of anorexia and bulimia.

2.  Therefore, it is almost impossible to tell if someone has an eating disorder by the way they look.  Not everyone who is fat has binge eating disorder and not everyone who is very thin is anorexic.  Likewise, many people with eating disorders look like they don't have an eating disorder at all (on the surface, anyway).

3.  ED-NOS is the most common type of eating disorder.

4.  Eating disorders are the mental illness with the highest mortality rate.

5.  Fortunately, it is absolutely possible to achieve full recovery from an eating disorder.  I know, because I have.  I'm going to write another post about that soon.

Borderline Personality Disorder - One has to have five out of nine characteristics to be diagnosed, but one usually has an intense fear of abandonment, mood swings that are shorter than those with bipolar, extreme sensitivity, impulsiveness, and frequent suicidal thoughts and gestures.

1.  There is a huge stigma against people with borderline, but people with borderline are not monsters or terrible people.  In fact, one of the most positive things about this diagnosis is that it is proven that people with borderline can change.

2.  Medications can treat some of the symptoms for BPD, but there is no medical cure.

3. Fortunately, with much talk therapy and Dialectical Behavioral Therapy, people with borderline can learn the skills necessary to cope with their personality and can even eventually become well enough that their diagnosis is no longer applicable.  That doesn't happen with bipolar-bipolar has to be treated with medication for life!

4.  Having borderline has nothing to do with stalking.  I only feel the need to say that, because a friend of mine once exclaimed when I told her my new diagnosis, "but you don't stalk people!"  I was very confused and didn't really know how to reply.

Fibromyalgia - It's like arthritis, only joints AND muscles are sore and achy.  Fibro usually is also followed with Chronic Fatigue Syndrome.

1.  Fibro pain varies widely from day to day, so just because I can do something one day doesn't mean that I'll be able to do it tomorrow.

2.  Some people seem to go through remission and some people don't.  Sometimes symptoms get worse and sometimes they get better.  Mine seem to have gotten a bit better than when I was first diagnosed.

3.  Many people with fibro also have depression.  This still does not mean that it is okay to say, "If you would just learn how to manage your depression, then your pain would go away."  That is incredibly invalidating and condescending.

4.  People with fibro sometimes experience what is called "fibro fog," which is where they become confused and have trouble concentrating or remembering things.  This is probably because of the pain or exhaustion.  It can be very frustrating.

Whew!  I wrote more than I thought I would!  I hope that this post was helpful to you and that you learned a lot.

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