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There is a recognition among many of us crazies, as well as the professionals that treat us, that most of us do not simple fall into one camp – we’re bipolar with a hint of ADD; we have a borderline personality disorder with depressive and psychotic features; we suffer from schizoaffective disorder with post-traumatic stress disorder (PTSD) and addiction mixed in. Humans are complex, and their brains even more so.
And what’s more, my depression isn’t like your depression. In fact, so much so, that using the same word is almost nonsensical. I sleep 15 hours a day, but you only sleep 3. I have a successful job, but no family or friends. You have neither but participate in online support groups 10 hours a day. I think about killing myself every day but you actually plan for it once a week. You never cry but I cry all the time. Are we the same? Am I more depressed than you, or less?
And things get more complicated when you compare personality disorders and bipolar and ADD and PTSD combined with comorbid conditions like addiction. And yet somehow we’re supposed to suss this all out, find a label, and a treatment that goes with it. That’s pretty tough.
So some doctors would like not to put people in boxes, but to place them on continuums. You would become a multi-dimensional person, probably with severity ratings attached. So, I might be 80% bipolar, with a severity of 7/10, 10% anxiety, severity 3/10, and 10% PTSD, severity 2/10. (The scales used here are coming out of my head, not from any published source.)
And if you know mentally ill people, and you’re educated about disorders, you can see that continuums really do fit more people than boxes do. Boxes are, naturally, self-limiting.
But there are some problems here. Well, too many to count, really. First off, how would you measure how depressed a person is? Or how schizophrenic? Or how bipolar? There are many scales that have been developed for this but there is no standard as none have been proven to be wholly accurate. The scales we do have are more effective at measuring change over time, to tell if you’re getting better or worse, than objectively coming up with a score indicating how much you are of something.
And severity. Severity is a personal thing. If I can’t work because of a disorder, then naturally that is severe, but it can be just as severe to have nothing in your life but work. Doctors feel that planning your suicide is worse than thinking about suicide but if all you do is think about your death all day long, is that not severe? What if you cut yourself but never really suffer any grave injury, is that severe or not?
It’s personal. Severe to me probably isn’t the same as it is to you. And it probably isn’t the same from doctor to doctor either, so coming up with a measurement is rather difficult.
But even if we could measure how much of an illness you had, and how severe it was, and we could assign you a magic number that represented all of that, what good would it do? It doesn’t change the treatments we have available. It still doesn’t change the drugs, or the therapies, or the electroconvulsive therapy (ECT), or the vagus nerve stimulator (VNS). All that remains. And as it stands now a doctor might prescribe any medication for any disorder anyway so what’s the point in being so numerically specific? Whether you’re 100% bipolar or 75% with some PTSD doctors are going to try lithium, mood-stabilizers and antipsychotics anyway. It really doesn’t matter.
I applaud a system working to recognize that we’re all different and that through standard diagnoses we almost always get it a little bit wrong, but at this point I just don’t see a way around it. Mental illness isn’t like a burn where you can measure the percentage of skin affected and burn depth. It just isn’t that simple. And maybe one day we’ll know more and we’ll be able to attach numbers to the illness of a brain but unfortunately we’re just not there yet. I suspect until we really have a biological way of identifying issues: 25% excess serotonin, not enough dopamine and so on, we’ll be stuck with the muddy mess of trying to categorize seemingly infinite variations on the human brain. Broad strokes are really the best we can do until not just something better, but something more useful, comes along.
Natasha Tracy is an award-winning writer, speaker, advocate, and consultant from the Pacific Northwest. She has been living with bipolar disorder for 26 years and has written more than 2000 articles on the subject.
Find more of Natasha’s work in her acclaimed book: "Lost Marbles: Insights into My Life with Depression & Bipolar" on Amazon.
Connect with Natasha at the social media links below.
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I’m never going to call bipolar pain a “gift.” Most days, I just want it to stop. But emotional and even physical pain aren’t always random torture—they’re often trying to tell us something. This piece digs into what your pain might be saying, how to listen, and how that can make living with it just a little easier.
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most mental illness is caused by injury to the back causing incordination between autonomic and central nervous systems. Please find an osteopath that is familiar with the original methods of adjustments founded by Andrew T. Still. Gentle stimulation of nerves and releases made by a qualified doctor help the body to heal itself. injuries of the spine cause nerve impulses that produce the neurotransmitters to become sometimes clogged or over excited. Over time physical damage of the brain can occur. Remember most osteopaths won’t even know that what they do can help with mental disorders. Doesn’t mean they can’t help. Just ask: hey doc could you feel for subluxations and adjust? Time should be spent by the doctor on your back and believe me you will fell much better afterwards.
Hi Jack,
I see no reference to literature on this subject.
In Still’s page on Wikipedia it doesn’t mention mental health at all: http://en.wikipedia.org/wiki/Andrew_Taylor_Still
I’ve actually had subluxation treatment many, many times and find it has nothing to do with mental illness, but please pass along some literature if you’re aware of the contrary.
– Natasha
Natasha,
do some research on Still-Hildreth Osteopathic Sanatorium. Finding the right osteopath is the key. Most of the tecniques developed by Still have been lost or replaced by chiropractic adjusments that are too rough not giving the body a chance to heal between adjustments.
There is a mind, spirit and mental conection in all of us. Sometimes that can get messed up due to an injury, toxins and even the way we think.
My son has had extreme bipolar disorder for the last six years. Medications have done nothing but put him out if they did anything. I’ve realized the holistic way of looking at mental illness may be the key. There are many more things to do besides back adjustments that need to be done. Since we’ve started the holistic aproach my son is doing better than he has in years with out any medication.
Tiedye-
Well, I can't channel thoughts, but I will say that writing is worth it when I see you say that I can express how you feel.
Thanks for your words. They touch me too.
thank you for this post… i swear sometimes you hit exactly what i think about at the right time…
good luck with everything.. stay strong, and no matter what happens in your life, you've touched mine through this.
Hi COMH,
Join the club. Antipsychotics are the medication of the moment. Well, the last few moments, and probably the next few to come.
Yeah, I get that our heads are scary, but in honesty, most everyone's is, just not so often. When the average person flies into a rage no one seems to find it all that odd, although I would never do it and would find it scary. It's just a lot more societally acceptable. And all those people who commit acts of violence. I would say their heads are pretty scary too.
If any of that makes you feel better.
We, the crazies, definitely feel your frustration.
Hi,
I can really relate to this post. I agree that doctors will try the same drugs for everything – my psychiatrist just loves atypical antipsychotics (I hate them). He won't even bother to diagnose me because he's going to prescribe the same drugs anyway!
I think the fact that everyone's depression and mania looks different makes diagnosis hard.
I had a week-long episode where I wrote constantly, didn't need sleep, had so many ideas and thought they were all so important and people needed to read them, and really thought that I could make money on the internet with my writing. I just had to keep writing. I also felt great, and didn't even think it was weird at the time. But it was so unlike me.
It's incredibly frustrating to not know what's going on in my head!
bibi – I'm glad you found me too :)
Yes, good doctors do tend to mix cocktails. It is the case that most people with a severe mental illness can't be fully stabilized on one medication alone. Understand though, a doctor might start out only prescribing one medication to see what happens and then only after seeing some improvement, add others. Scientifically, it makes sense only to add one medication at a time.
I'm sorry to say that crying non-stop is pretty common. And alternating with headless chicken running, well, that's bipolar alright.
damn I am so glad i found your site as a newly diagnosed person who is not fitting in one specific box. Tell me if I am wrong but it seems the most effective doctors are the ones who will and are willing to try out various combos and cocktails and what not to get us at least remotely stable. What struck me the most about this post though is that you hit it on the nail everyone's depression is different. One person might sleep all the time, others like me run around like a chicken with it's head cut off or then the next week i cry non stop.