Since I was ten years old, I had been tentatively diagnosed with a whole handful of different disorders and seen a variety of therapists and doctors, none of whom ever seemed to get it quite right. Some called what I experienced Generalized Anxiety Disorder, some PMDD (Premenstrual Dysphoric Disorder), and later others prescribed me birth control, considering whatever this was to be hormone-related for the way it ebbed and flowed, disappeared and came back with a vengeance. I took the antidepressants, tried the fish oil pills, the Midol, a whole host of special diets, exercise regimens, and hormone tests, but nothing ever made the dark cloud that seemed to follow me everywhere for weeks at a time dissipate except time itself. One day I’d wake up, write off the sadness or nervousness I had experienced to a ‘funk’ I must have been in, and carry on my happy way, unscathed and jubilant.
Now in hindsight, the signs were glaring. My parents called my room ‘The Lion’s Den’ for at least one week out of every month, not because I was particularly angry, but because I was fiercely sad and constantly spiraling, and there was never any talking me through or out of it. Even at such a young age, I always caught myself thinking that maybe the world just wasn’t made for people like me, who feel as deeply as I feel and think as hard as I think. I knew that I was different, I just wasn’t quite sure what exactly it was that made me that way. And no matter how sincerely my parents expressed their love and support for me, or tried to talk me through the spinning thoughts that were taking up so much space in my mind, I could never seem to find peace in those moments where it was so far from within reach. The only thing I could ever do was wait for the storm to pass.
Never once did Bipolar Disorder cross our minds, though. That was for crazy people. We thought that people with Bipolar Disorder were undeniably angry, and that they lash out against the people they love without any remorse. The idea that Bipolar people could flip their emotions like a dime was the only narrative that could describe our knowledge of the illness at the time. We thought that being Bipolar meant exactly what people who used it as an insult meant: that the person could act like two completely different people within the same small time frame; that they could be peaceful one moment and completely flipping out in the next.
From the minimal amount we had read on it and from what we had seen in the movies, Bipolar Disorder couldn’t possibly be what was causing me anguish for so many years because I was mostly stable, I almost never took what I was feeling inside out on others, and my mood swings into what I now know was depression and anxiety were so gradual it was hard to tell where they had their beginning or end. Most everything I suffered from manifested internally, and only the people closest to me could even tell something was wrong when it was happening, usually because I was twirling my hair or fiddling with my nails faster or more furiously than usual. I didn’t act like two different people in a short amount of time, I just went through long-ish periods feeling one way, and even longer periods feeling what I thought was my normal, my homeostasis. It wasn’t until God, the Universe, Allah, or whichever higher power you subscribe to made sure there was absolutely no way I was going to be able to ignore this thing that was holding me back from my truest, most healthy self any longer that we opened up our minds to what this could really be. And the time I believe the divine force decided to reveal to me what I suffered from was what seemed to be the least opportune moment, right after graduating from college, when ‘adulting’ began and just about everything in my life changed.
By some stroke of luck and, admittedly, a lot of grueling effort, I graduated from Stanford University in the Spring of 2018 after four of some of the most difficult and transformative years I’d lived to date. I had a job lined up that made sense with what I majored in, I was dating someone I thought for certain I would eventually marry, and was in the process of finding the most charming apartment for me and two of my best friends to live in in the Marina District of San Francisco. Life was unfolding just the way I had always hoped it would and no part of me anticipated anything going wrong.
I spent the summer before joining the workforce enjoying life at home in sunny San Diego, traveling with my mom, and reveling in cherished time with my family that I rarely got in the preceding four years. It was a summer I’ll never forget as it contained some of the most purely joyful days of my life and served as a limbo between the hard work that was behind me and the type of hard work I knew, or thought I knew, was ahead of me in the “real” world.
The first few months of official adulthood went just about as well as they possibly could. Everything in my life seemed to have an enchanted quality about it and I woke up every day absolutely thrilled for what was to come. I was exuberant. I flew through the preliminary training at my healthcare consulting job, made a handful of kind, caring, similarly-humored friends at the office, and was performing above expectation for the first time in what felt like years, coming from Stanford where I was accustomed to performing averagely at best.
I vividly remember sitting at what I thought was my big, fancy desk (I was entry-level; this desk was not special) near the window on the thirteenth floor of our office building, gazing out at the skyline of the Financial District, feeling as light as a feather and almost frighteningly happy, thinking at what felt like the speed of light, “I can’t believe I get to live this life! There are so many people out there yet to meet! So many things I can accomplish! And see! And travel to! And feel and touch and do!”
My senses grew increasingly heightened by the day. The smell of the office coffee floating from the kitchenette down the hallway to my desk was as fragrant to me as my mom’s freshly baked-from-scratch cinnamon rolls on Christmas morning. The ability to inhale and exhale bewildered me as I became acutely aware of the fact that my circulatory and respiratory systems were working in conjunction to keep me alive, second by second, minute by minute. My joy was so specific. I was fascinated by the miracle of living in a way that I had never before experienced to this capacity or anything even close to it, and I was fully aware and constantly frustrated by the fact that no one around me was feeling it with me. Everything was so achingly beautiful and so divine and so overwhelming, and every interaction I had felt momentous, like fate, like the stars had aligned for that exact moment when my coworker asked me to grab coffee before work or join them for a Corepower class. Nothing was insignificant.
One day after a Monday morning meeting when I returned to my desk, I found myself staring down at my arms, the way Amy Schumer does in the movie I Feel Pretty after she concusses herself in Soul Cycle and believes she has acquired a brand new model-esque physique, and thought, “Wow. I have this body and it belongs to me. This body encases my soul! What a miracle to have a vessel through which to experience everything!”
Bear in mind I was supposed to be focusing on running reports for our client hospitals, not taking a moment for existential bliss to course through my veins, but I couldn’t help it. It was like I had taken eight shots of espresso and microdosed on acid at the same time (I’ve never tried LSD but I felt like I was mildly tripping from how friends had described it to me). I was edging on uncomfortable. But never once did it cross my mind that I could be experiencing a medical phenomenon. I wanted to get used to this feeling and live the rest of my life this way.
This was hypomania. The good kind.
From my experience and through conversations with other people who have been diagnosed with Bipolar II Disorder, I have come to understand that hypomania looks slightly different for everyone who experiences it. However, hypomania is typically characterized by the following presentations: inflated self-esteem or grandiosity, decreased need for sleep, increased talkativeness, racing thoughts or ideas, marked distractibility, agitation or increased activity, and excessive participation in activities that are pleasurable but invite personal or fiscal harm. The symptoms are the same for mania, the upswing experienced by people with Bipolar I, except they lead to hospitalization or include a psychotic break (a complete break with reality ie. hallucinations).
I don’t remember when exactly my hypomanic episode, the one that I thought at the time was a mere series of really good days, went from good to bad and bad to worse because, again, these things happen gradually for me. But when it did get bad, it seemed like it got worse exponentially faster. Sometime a few months after the euphoric feelings started, my thoughts picked up speed. I began to ruminate on philosophical questions about the meaning of existence, and I quickly became absolutely obsessed with answering them. It became increasingly difficult to turn my attention away from my incessant need to understand why humans were placed on Earth and whether we were actually placed here, created here, or evolved to be the way we are. I needed to know the point of it all. And I wasn’t just curious. I was desperate to come to terms with the metaphysical, so much so that I could hardly concentrate on anything, let alone my job or relationships, anymore. This presentation is medically known as an existential obsession, which is also a common symptom of Obsessive Compulsive Disorder. I had this BAD.
More and more, I would find myself needing to excuse myself from my desk at the office to “use the restroom,” just to spend the following ten to fifteen minutes hyperventilating in the handicapped stall farthest from the bathroom door. I actively avoided engaging with my coworkers and friends I had made in the office, afraid that if they saw how I’d changed they’d freak out, or worse – tell someone. I had no clue what was going on with me, but it wasn’t a completely unfamiliar feeling. These feelings felt awfully familiar actually, just on steroids.
I figured it would be the same as it always would and if I just stuck it out; that “this too would pass” as my mom would always tell me. So I trudged on in my adulthood, white knuckling like I always had through each and every day of the week, being left without a single ounce of energy at the end of each day yet still capable of hyperventilation and entertaining my intrusive trains of thought throughout the following sleepless night.
My thoughts would move too quickly to pause them for long enough to interject and give any real attention to the people I came into conversation with, and I was rather quickly losing my grasp on reality. It became nearly impossible to gather or keep track of my thoughts because there were simply too many. Anyone paying close attention could have caught me scrolling through an extra open tab on my computer open to reddit, entertaining my existential crises and trying to find anyone out there who felt equally obsessed with solving all the world’s most unintelligible questions. At one point I had even created a Google document that I named “Ashley’s Thought Organizer” in an attempt to manage and sort through all of my thoughts by getting them down on virtual paper.
That didn’t work.
My friends noticed me losing weight, and that I had retracted inward in almost every way possible. My boss kindly let me know that she noticed that I appeared distracted on most days. Many of those closest to me would later admit they thought they were losing me and couldn’t figure out why. I lost thirty unintentional pounds in the matter of three months, and my hair started falling out in generous chunks. There were an increasing number of nights where I would wake up around 3 am with my heart pounding out of my chest because intrusive thoughts were flooding my mind at an uncontrollable velocity and I was completely defenseless against them. Not even the highest (safe) doses of tylenol PM could win this fight.
I was beginning to realize that something was going physically and mentally wrong with me, but I wasn’t quite ready to ask for professional help. I was convinced that whatever was going on was something I could get under control on my own if I just tried hard enough, or made enough google docs.
I thought that maybe there were tangible steps I could take to get a hold of this thing that was taking over me, and I thought that if I took those steps I could prove that I was “strong”, that I wasn’t a “quitter,” that I had my shit together and could handle life on my own. In another attempt to do this, I sent a mass group text to all of my closest friends saying that in order to gain control of my frequent panic attacks, I would have to be less responsive to my phone, thinking that maybe it was the constant beeping and buzzing that was sending me into an almost constant frenzy of irritability and sensitivity to stimuli. That worked just about as well as my google docs.
Thank God for my mother. She talked me off of the proverbial edge more times than I could count; on my commute in the morning, on my lunch breaks, my “I need air” breaks, when I’d get home to my apartment and my mind would still be reeling, even in complete and utter exhaustion. She would be on the other end of the phone, reminding me to breathe, that I was okay, that none of these grand thoughts I was having needed to be solved today or tomorrow even. Even still and regardless of the beautiful support and advice my mom gave me, it was like my mind’s volume was all the way up, but I hadn’t yet blown out the speakers.
I eventually chalked all of these psychological symptoms up to the IUD that I had gotten placed just before they started occurring, one that I thought would merely serve as a more reliable form of birth control. Once I found out that psychological and emotional side effects were a common complaint of other women with IUDs and other forms of hormonal birth control (I even joined a Facebook support group with thousands of other women with similar experiences), my thoughts about God and the origins of the universe promptly turned into compulsive research about hormonal contraception methods and whether they can elicit these kinds of obsessions and feelings of loss of control.
“Can the Mirena IUD make you feel crazy?” and similar iterations were literally my most frequent Google searches in 2019.
I found answers ranging from “hormonal contraception can trigger pre-existing mental health conditions” to “there is no possible way that an IUD is making you feel this way,” and read countless articles and stories about women who felt like a completely different person a few months into their trial period with a hormonal IUD. But no matter what I found that would either support or deny what I was experiencing, I could not be satiated. There was no scientifically substantiated evidence that the IUD was the direct cause of my symptoms, but I was at the point I could no longer deny that something was going seriously wrong with me, something that I couldn’t fix alone. My mom sensed this too, and she drove the long nine hours from San Diego to San Francisco the minute I texted her what every mother fears to read:
“Mom, I don’t know how much longer I can do this. I would never want to do it to you and our family, and I know that many people would consider it selfish, but all I can think about is how jumping off this building would put me out of my misery. I don’t want to die but I also cannot keep living like this. I need help.”
I called in sick from work. My mom went into full hero mode. She completely ignored her fear of bridges and drove right over the Bay into San Francisco, clutching the steering wheel and likely driving way over the speed limit, to come stay with me in a hotel for a few days to assess whether my condition was as bad as it sounded. It was. I remember, at this point, not even being able to function in the lobby of this hotel on my own and navigate the task of getting a key to our room. I was absolutely fragile and my incapability to accomplish simple tasks was enough to send me into a crying spell. Once I had my mom with me, I didn’t ever want her to leave me alone. For the first time in my adulthood, I needed her. She had my sister at home researching all of the best mental health facilities in California and calling them to schedule a consultation at the very least. My mother was tenacious, brave, and completely transcendent. She placed her fear of losing her baby as she knew her beside her and did everything she knew she had to do to get me the help she could so clearly see I needed. We were both terrified. She of losing me. Me of losing everything.
After about a full week of my mom and older sister dropping everything in their work and personal lives to find Southern California mental healthcare facilities and comparing their program offerings, we all landed on an outpatient wellness center in Newport Beach. My mom helped me communicate with the HR department at my job and thankfully they were completely understanding and compassionate, willing to provide anything they could to support me while I got back on my feet.
My mom and my godmother promptly moved me out of my San Francisco apartment and I was homebound for San Diego to live at home for the second time already since graduating college six months prior, as if my self esteem wasn’t at ground zero already.
The therapist we met upon our consultation at the wellness center, who is still my therapist today, instantly convinced us all that I was in good hands, consoled my mom who had at this point been to hell and back, and set me up with a treatment plan. In our helplessness we found a sliver of hope in this place and for the first time in months I got the sense that, eventually, everything might actually be okay again. We knew this place would be my very best shot at getting better. I was to join their Intensive Outpatient Program for the next two months, or for as long as it would take to get a handle of what I was experiencing and recover any semblance of who I was a few months before.
At first, and for a good couple of weeks, I was utterly humiliated by the fact that I had been admitted to an intensive outpatient program for mental health, so much so that I used every white lie in the book to cover up where I had gone to my friends back in San Francisco and at the office I was taking medical leave from. I knew on an intellectual level that struggling with mental health was nothing to be ashamed of and that I was incredibly privileged to have access to this type of care, but when it came to actually experiencing the need to accept professional help for myself, the very real, ever-present stigma most often won the game. I felt ostracized by my own understanding of what it meant to be a person who needed to take time off of work to get their mind right at a mental health facility. The word “weak” echoed through my head on a daily basis, even though I knew that asking for help was a true sign of strength.
All of the movies and books and sources of media that referred to these types of places as the “loony bin” or “nut house” rang through my mind and shame enveloped me. Although I was not spending my days limping slowly down a cold, dimly-lit, sterile hallway like a zombie in a hospital gown and long, white socks, the way that the movies made psychiatric facilities and patients appear, I struggled immensely with the fact that I had technically been “admitted” to one. I tried my best to make light of my situation by calling the wellness center my “happy camp,” so that the friends I confided in would know that I still knew it was funny that I was there, so that they would be convinced that I was somehow still above it. But regardless of how I felt about it then, I was at the right place. I committed to showing up every single day because I truly had no other option.
It took a total of two appointments with the center’s psychiatrist, Jonathon, whom I call my own personal alchemist, to properly diagnose me with Bipolar II, and explain to me that the symptoms I was experiencing were the textbook definition of this disorder from the DSM-V. I remember sitting in his nicely decorated, contemporary office space gazing out the window at the wealthy folks of Newport Beach who were clad in designer clothing and carrying bags worth the price of these past two appointments, wondering if any of them would ever find themselves in a mental health facility or if they were as shiny and perfect inside as they looked on the outside.
As Jonathan cleared his throat and prepared himself to tell me something I could tell right away would be something that could change my life forever, I examined his desk and his fancy watch and wondered if maybe I should have gone to school to be a psychiatrist. Although my mind was still racing with all kinds of stressful thoughts and questions that I couldn’t possibly answer, I felt a particular sense of calm in Jonathan’s presence. I don’t know whether it was because he looked like a young Saint Nick or because he told me that I reminded him of his daughter, but I felt deep down that I could trust this man with whatever he was about to say.
I felt the texture of the twill fabric of the chair below me and grasped the metal sides to brace myself for what was to come. After taking a deep inhale, Jonathan proceeded to explain to me that I was living through my first debilitating hypomanic episode, typical of people with Bipolar Disorder to experience in their early twenties (my twenty-third birthday was one month ago at this point).
This was the first time I had ever heard the term “hypomania,” and it sounded too intense for me. But in truth, I was mostly unphased by the name that Jonathan was attributing to what I was feeling. I didn’t believe he was completely right just yet, but I was so desperate to feel better and so fully aware of my state of minimal functionality that I was willing and ready to try anything he would suggest. Despite my doubts, my alchemist knew what he had on his hands as clear as day. He had a name for the turbulence I couldn’t help for the past twenty-three years, and he was already concocting a formula to help
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