So, I Guess I'm Bipolar.

Reflections on a year on anti-psychotic medication after a decade of unofficial depression.

Photo by Ehimetalor Akhere Unuabona on Unsplash

Trigger warning: This post mentions suicidality and drug use.

Depression can be considered treatment resistant when the affected person doesn’t respond adequately to at least two antidepressant medications. After showing an inadequate response to nine such medications and many combinations thereof, I still hadn’t received any diagnosis of depression nor any treatment resistant variation thereof. And in fact, depression alone may be the wrong diagnosis altogether. But I’m getting ahead of myself again.

I first attended counselling for what I didn’t yet know to call depression and anxiety more or less a decade ago. After a few years of processing and working through trauma, my counsellor and I agreed it was time to give medication a try for my worsening symptoms and mood. I filled my first prescription in 2018, and in the seven years since have been prescribed the aforementioned nine different antidepressants and various combinations thereof. Some medications would help for a short time until within six months they wouldn’t, others would help for a shorter time until the side effects became unbearable, and a few did nothing whatsoever or worsened the situation. Some medications provoked nightmares so vivid and disturbing I dreaded going to sleep at night, and would often delay or avoid doing so. One medication in particular, escitalopram if I’m not mistaken, left me feeling so calm and emotionless I felt as though I could take my own life as casually as I could tie my shoelaces.

Not once through the seven years, nine medications, three doctors, four counsellors, and one psychiatrist, was there so much as a suggestion that there may be more than depression at play. Never was the possibility of treatment resistant depression so much as mentioned. Frustrated, I swore off meds on a few occasions, opting instead to address my depression with psychedelic drugs. I really do believe in the power of psychedelics to help treat mental illness in the right context and under the supervision of trained professionals. With no legal framework for such therapies, though, the world of psychedelic medicine is a Wild West as filled with fraudsters as with helpful healers. With no real guidance I took my chances on my own, and any positive results were seldom sustained.

My breaking point came just over a year ago when I embarked on my last of many misguided magic mushroom trips. My trip was poorly timed; I wasn’t at all in the right headspace for it, having recently sunk to a low in my depressive cycle. Mushrooms often bring up what’s buried deep inside, and my suicidality showed. The TL;DR is that I spent the entirety of my last mushroom trip crying and begging my trusted friend and babysitter to please let me die. Gold star to my friend, by the way, who stuck around with me until she was sure I was safe then immediately contacted my family doctor. Thank you! My doctor promised, but ultimately failed to follow up on my suicidality: No check in call, not even a mention of it on my next mental health follow up. I felt hopeless, and in terms of the healthcare system, I likely was. I was also very lucky.

Value community, friends, mine saved my life. Not long before my lowest, a then acquaintance, later friend, and coincidentally a doctor, suggested what several years’ worth of follow ups failed to address. The doctor friend, having spoken with me no more than a handful of minutes, suggested I may be suffering from bipolar II disorder and may benefit from antipsychotic medication. The antipsychotics would serve as a mood stabilizer, levelling out the hypomanias and subsequent prolonged dips that characterized much of my adult life and are indeed indicative of bipolar II disorder. From there it would likely be a whole lot easier for an antidepressant to do its job. I had nothing to lose by the time I hit my breaking point, so I advocated for the new medication from my walking prescription pad of a family doctor. One year ago to the day I took my first foray into antipsychotics. It’s been a year almost free of suicidal thoughts. Nothing is perfect, and side effects abound, but they’re manageable compared to the crippling depression they help balance out.

Adding to my luck, my change in medication coincided with a significant change in circumstance. Though quite late, my official major depressive disorder diagnosis made me eligible for Canada’s Disability Tax Credit. While the tax credit is nowhere near enough to live from, the supplement to my meagre income put me in a position to better my circumstances so that I could better address my depression and newly discovered bipolar II disorder. I also benefited from below market rent during my recovery thanks to the kind folks who took me in when I lost my housing. I’ll forever be in their debt, and they’ll forever be family to me. It’s amazing how much time you can devote to feeling better when you don’t have to spend every waking second struggling to pay outrageous rent in a city like Vancouver. I also must acknowledge my own work through consistent counselling over the past decade. I wish these circumstances could have coincided years ago.

Though life on the whole has drastically improved, I’ve noticed some other, less desirable changes too. My motivation to write has significantly decreased, as has my motivation to engage in any of my many crafts and creative outlets, leaving me to wonder if my depression and my creativity are somehow inversely correlated. These days when I try to write I find myself staring at the screen for hours with no real ability or desire to focus. I’ll often distract myself with mindless tasks like sorting through and deleting thousands of emails to free up space in my Google drive. I’m reminded of an episode of Depresh Mode featuring an interview with Zac Carper of FIDLAR. Carper, recently diagnosed with bipolar II disorder, spoke openly about his reluctance to take antipsychotic medications for fear of dampening his creativity. I can’t help but understand and to wonder, was my depression or bipolar II disorder in large part responsible for my own creativity?

It’s hard to reconcile how I’ve felt over the past decade, and indeed much of my life. It’s hard to pinpoint or attribute certain phases to depression, bipolar II disorder, or just shitty life circumstances. That said, a year in, I have no doubts I’m finally on the right medication. Though I have no official diagnosis of bipolar II and doubt I ever will, this is by far the longest a medication has worked for me with manageable side effects, and I haven’t so much as increased the minimum dose. And though this story has a happy ending, I can’t help but be at best disappointed and at worst disgusted by the medical system that let me down time and time again. I’ll try not to think of it, to live in the now, and to acknowledge the incredible privilege of the boredom I now experience from time to time. With any luck, I’ll hopefully find the motivation to write about it too.

Thank you for reading my Adventures in Antidepressants. If you’re enjoying these posts and would like to read more, please share this or any other post, like and comment to help game the algorithm, and please subscribe (it’s free unless you feel like kicking a few bucks my way.) Every interaction makes me feel seen, validated, and encouraged, and hopefully helps break the stigma surrounding mental illness. I don’t know how long it’ll take me to write the next post, I’m quite busy enjoying life, but there are many more stories I’d like to share. Thank you for all your support and encouragement so far.