296.89 [F31.81]: Bipolar II Disorder With Dysphoric Hypomania, Rapid Cycling, Most Recent Episode: Severe.

There it was. Finally I had a name for it. As well as a mixed feeling of panic and relief. Knowing that something is wrong with you and not knowing what it is is more dreadful than the illness itself. Illness –  that word. I have an illness. A terminal illness. It has no cure, no fully effective treatment, and it will impair for all time my “social, interpersonal and occupational functioning.” There it was – a selfie in words, grabbing me by the throat.

Dysphoric Hypomania.” That’s when the hypomanic phase is high activity but with negative mood – anger, irritibility, fear;  and self-destructive, self-punitive behaviors – Often involving drugs and alcohol; also hypersexual behavor, compulsive shopping, fighting, firing off angry emails (that you will soon be very ashamed of), blowing up at your spouse for not closing the toothpaste tube, driving nowhere, watching Nickelodeon at three in the morning, and so on.  Why couldn’t I at least have been lucky enough to get the “Euphoric Hypomania?” Great mood, positive activity, heightened creativity, increased (even if over-inflated) self esteem, and that “Everything is really ok” kind of feeling (even when it really isn’t). At least then I would feel happy about half the time.

But I am who I am and I got what I got, and I need to keep learning, day by day, how to live with it. The worst thing I can do is fight it. Resistance is futile. That is not to be confused with resignation, or weakness. This is an illness, and as such it is not subject to the force of will – not any more than diabetes or cancer is. It is about constructively accomodating it into my life and into my very being. Even to befriend it. It’s about adapting to it – using it to your advantage when you can and mitigating the damage when you can’t.   No, the struggle isn’t about killing it off. It’s about managing it.

And I have been given by some very kind people several tools with which to do that: Therapy, medication, meditation, exercise, writing, dancing, and most important of all not to stay alone for very long. My mind is not always my best friend, and at those times I shouldn’t be left alone with it. I don’t have to discuss my disorder with everyone or anyone. In fact I don’t have to discuss anything at all – Just being around people – sitting on a park bench – helps, no matter which phase I am in at the time.  And then there’s the ultimate medicine – helping someone else. No matter how miserable you feel, no matter how bleak things seem, or maybe really are – Your life is always somebody else’s dream. Find that person. It isn’t hard – they are all around you. Give them your hand and feel your insides change. It’s miraculous.

Of course all of these things sound very pretty, don’t they?  And they really do help. But sometimes – too many times – I just can’t bring myself to do any of them. Sometimes the compulsion to self-destruct is just too overwhelming, and sometimes I’m just too depressed to do those things that I know will relieve it. Those are the times that I look at that selfie, pour it a cup of coffee, and invite him to just sit down and make himself at home.

Copyright December, 2017, Dr. Bill