People who cut themselves are taken to the hospital and stitched up. Those who need wisdom teeth removed go to a dentist for surgery. Even terrible diseases like cancer, if not curable, are at least able to be identified by doctors so that the best treatments can be given. Mental illnesses, however, have no visible symptoms. Despite what they say in person, doctors are often dismissive of mental illness and are inexperienced in dealing with it. Here, I describe how four months elapsed between the first appearance of symptoms and my eventual diagnosis of bipolar disorder, and what I learned from repeated misdiagnoses by the medical establishment.
On August 5, 2006, I read on the Internet about Sam-E, a nutritional supplement that is advertised to increase concentration and reduce anxiety and depression. After buying a package from the local drugstore, I read all the side effects carefully. The pills supposedly had a half-life of three hours. Two were recommended, so I took one in the morning and one in the evening.
While I did not notice any increase in mood, I immediately encountered an increase in concentration. Rather than frequently losing focus and having to retrain my thoughts with great effort, I could work for hours that day without a break. I went to bed thinking that while my mood had not improved, at least I would be able to concentrate better if I continued to take the supplement.
In the morning, the increased concentration had given way to a complete inability to keep anything in my mind for more than a second at a time. It was difficult to speak in full sentences because I would easily forget what I was saying while I was talking. Believing that the condition was a side effect of the medication, I waited for it to subside for four additional days, but the problem didn't get any better - only worse.
By August 10, despite stopping the Sam-E, a new problem had reared its head - I lost the ability to feel emotions, and therefore was unable to determine when it was appropriate to talk to people. Most people, I imagine, decide what to say next by how they feel according to the previous thing that was said. But since I couldn't feel anything and whatever I did feel disappeared from my head a second later, I could only say the first thing that came to my mind - and as a result, I said nothing. I withdrew, saying little and avoiding other people because I had lost the ability to determine the correct actions in response to what they were doing.
A month later, I had been reduced to simply going to work and coming home, staring blankly at the TV. While "staring blankly" is an overused term when it comes to television, in this case I actually was staring blankly, because I couldn't get anything that was happening on the TV to actually stick in my mind. It all disappeared from my mind a second later, and I was unable to follow TV shows.
I decided to take action by calling a counseling service, hoping that they would be able to get to the bottom of the situation. I called the number and waited on hold for half an hour, after which a nurse asked some questions such as whether I was going to commit suicide and whether I was going to hurt myself. When I said no, she asked me other questions that I had difficulty understanding, given that her words wouldn't stick in my mind. She hung up, and, dejected, I waited another week before trying again.
During that week, and during the next month, my work performance deteriorated, and my lack of ability to gauge emotions made it too difficult for me to participate in business meetings. I became more depressed than I had ever been in my life, but I also realized that quitting work wouldn't make anything better. My reduced intelligence wouldn't make life any better sitting at home in front of the TV. I kept going to work every day, and I finally was able to get someone on the phone who scheduled an appointment with a therapist.
The therapist didn't help at all. While she insisted that I was imagining most of my symptoms, and I accepted that she might be right, I simply couldn't remember what she was saying. By the time each session ended, I had forgotten what was said at the beginning. I kept going because there was no better course of action, but how can one benefit from therapy if he can't remember what happens during the sessions? Everyone said that the symptoms were being imagined, and that talking to someone would help, so who was I to argue?
Next, I visited a general practitioner to rule out a medical cause for my problem. I desperately hoped that what was wrong was curable and that my stupid decision to take the Sam-E hadn't caused permanent damage, because life certainly wasn't worth living in such a state. The doctor performed a standard physical exam, took some blood tests, and asked me if I was depressed. Of course I was depressed, given that I was unable to think clearly anymore, so he said that an antidepressant would clear up all the symptoms and that would be that.
I went home and started taking the Remeron that he prescribed. Sure enough, it did eliminate the depression. Now, instead of feeling depressed, I just felt "stupidly happy" - I still was dumb and couldn't think, but I didn't feel bad about it. I called the doctor back and he said that the medication just needed more time to work. After another week, I decided that, since I was "depressed," I needed a second opinion from a psychiatrist.
The psychiatrist recommended by the therapist wasn't available for another month, so I sat around in a fog for that month until I could finally obtain an appointment. When I saw him, he prescribed an additional antidepressant, saying that the first hadn't worked because I was sitting around all the time. Of course, I wanted to be able to do something else than sit around all the time, but my lack of intelligence and the inability to process emotions prevented me from doing so.
I took both pills as prescribed, but there was no change in my state other than feeling slightly better about things, so after three weeks I got fed up and scheduled another appointment. But this doctor wasn't available for several more weeks, so I scheduled my appointment and dealt with a new symptom that had appeared: insomnia. The insomnia became so bad that I was unable to sleep for 48 hours at a time. For nights at a time, I laid in bed the entire night without being able to fall asleep at all, and the complete inability to sleep made me even more depressed, if that were even possible. Eventually, I would get up for work, where my performance suffered even further from the sleep deprivation. The highest dosages of sleep aids were completely ineffective.
At the next appointment, the doctor asked me if I felt "happy," to which I responded that I was more depressed than I ever was in my entire life. He decided to prescribe lamotrigine, stating that he now thought I had dysthymia, a chronic low-level depression that had persisted for years before becoming worse. He said that the Sam-E had nothing to do with the "dysthymia" and that I would start to feel better soon. The lamotrigine seemed to lengthen the time I could keep thoughts in my head, but it made the insomnia even worse. When I called back and told the doctor about the insomnia, he said that he had never heard of insomnia caused by lamotrigine and that something else must be causing it; I should continue taking the drugs and see him in another month.
I sought a third opinion, and after two months I was finally able to obtain an appointment. After all I had gone through, this doctor took only twenty minutes to state that I was suffering from a "mixed state," in which mania and depression are both present at the same time. He said to stop taking the antidepressants and start taking anticonvulsants. The new regimen was the first that actually made any significant difference.
Later, I asked the doctor how I could have had a manic episode but yet been more depressed than ever before, and he said that such a situation is not rare. He said that mania can be thought of as a disease of excess energy levels, not as the mood disease that is portrayed in the media. Many people can stay up for days at a time and enjoy doing so, but I simply wanted to live a normal life - and instead of speaking excessively as many manic people do, I avoided people to avoid a loss of control. And whereas many people believe their thoughts are racing a mile per minute, I experienced these racing thoughts as being unable to reason effectively for any period of time.
After his diagnosis, the condition brought on by taking the Sam-E and which was worsened by repeated misdiagnoses required two additional years before I finally overcame it. The symptoms went away by 2008, but I decided to quit my job, move several hundred miles away, and start fresh. I had performed so poorly at work that I would never have any opportunity for advancement there, so getting a new job where I could perform well from day one was a necessity. Since I had been up for a promotion a week after the episode began, however, I still have not recovered in salary or prestige, even at my new position. I also lost most of the friends I had had before moving, because I had been forced to withdraw to avoid acting inappropriately. I may have also acted inappropriately toward them; I simply don't remember what happened at the time. Whereas the disease was able to be cured relatively quickly after it was finally diagnosed, the time before the diagnosis led to these many non-health consequences, from which some may require many years to recover.
The main problem with the medical establishment, as is the case with our society in general, is simply a lack of respect and care. If someone had taken thirty seconds to use their superior knowledge and consider whether something out of the ordinary might be wrong, then perhaps I would not have suffered for months and decided to start a new life. The lack of respect from doctors, receptionists, and psychiatrists was breathtaking. These people are paid to listen to others, but most of them seemed more concerned about their plans for the weekend. Some people say that the patient is "imagining" the symptoms - and don't listen when the patient explains to the person that they understand that the definition of mental illness is that the symptoms are imagined. It doesn't matter whether symptoms are real or imagined anyway - they still must be treated.
While doctors see patients and evaluate their symptoms, they have no idea what being ill with those symptoms is actually like. They go home at the end of the day and cut the grass, while the patients go home and suffer from the anxiety and depression of not knowing when, or whether they will ever, be cured of their ailments. The doctors make mistakes, prescribing antidepressants that can worsen mania, and don't own up to them when confronted later. They ignore medical literature and insist that a pill can't cause a condition simply because they've never encountered any patients who had the same reaction previously. They fail to realize that their patents' entire existence has been changed, and that they have no choice but to live in their new limited view of the Universe.
Worst of all, the medical system is merciless towards sick people. Even if you can't stand up, you're still required to sign those insurance forms. And when the insurance companies deny treatment or when they overcharge, as they almost always do, they expect you to call on the phone and argue with them. I lost over a thousand dollars to UnitedHealthcare because I was not able to track the complex "prior authorization" requirements for their services. Receptionists at doctors' offices don't care what your state is because their primary concern is to get their money, whatever happens. People who have never been seriously ill can simply not comprehend how ruthless and broken, from the doctors down to the billing agents, the system is.
For most people there is hope of recovery from most mental illnesses. The roadblocks are no longer technological but bureaucratic, and people undoubtedly slip through the cracks every day to suffer or even commit suicide. The next time you encounter someone who is struggling with a mental condition, take just one minute and pay him or her some respect. Consider what you would do if your intelligence dropped by 20 IQ points overnight. You might just change someone's life and save years of hardship.
