When I was a bit younger, I used to have really bad PMS. It was probably bad enough to be diagnosed as PMDD, but if anybody ever did diagnose me as such, they didn’t tell me. Every time I attempted suicide, I think it was just before or during my period. The worst thing about it was that my period was also extremely irregular, so I never even knew when the PMS was coming. Although there was a good side to that, too — I’d suddenly become intensely suicidal, but when my period would come, I’d be so relieved to know that there was a concrete reason for my mood, I wasn’t “going crazy” again, and I’d be feeling better in a few days. That’s an amazing sense of relief to have.

This was a major issue for me until I started taking the birth control pill. I wanted to start taking it a few years before I actually did, but I couldn’t find a doctor who would prescribe it for me. The reason? I was on Topamax, and Topamax can sometimes make oral contraceptives less effective. This only holds true if you’re on 200 mg or more daily, and I think I was on 100 mg at the time, but who’s counting?

How did I eventually get prescribed oral contraceptives? Well, one day I went to a clinic to get the morning after pill (yes, we’d been using protection, but we had a condom breakage issue) and when the doctor was asking me some questions, I told her that this was the third or fourth occasion that I’d taken emergency contraceptives (over a span of three years).

She said, “Polly, Polly, Polly, what are we going to do with you?”

She had never seen me before in her life.

I said, “Well, for starters, somebody could prescribe me the birth control pill!”

And so she did. Yes, she knew that I was taking Topamax and that it could make the Pill less effective. I should point out that the other doctors I’d asked about birth control had all been male.

I never took the morning after pill again. I have never been pregnant. A couple years later, I stopped taking Topamax.

I know that oral contraceptives cause really bad mood swings in some women, but they actually help prevent them for me. It’s also nice having my menstrual cycle regulated, so that I know when a possible time of PMS is coming up. On the other hand, since I now only rarely get depressed and irritable before I get my period, there’s still that element of surprise. If I’ve gone for many months without PMS, I’m not expecting it to happen.

Which is why last week, I spent a couple of days feeling like I wanted to go lie down in traffic, but was cheered up when I realized that I only felt that was because of PMS. Then I got a little too cheered up, because I had an insomnia thing going on, and I got hypomanic. I was so jumpy and hyper that I was seriously afraid that I was going to have to call in sick to work one day because of it. I had a cup of coffee the day before, like an idiot — I try not to drink coffee at all normally, and when I’m hypomanic, coffee is an incredibly bad idea. IT MAKES MY BRAIN FEEL LIKE IT IS JUMPING UP AND DOWN. AND IT MAKES ME FEEL LIKE EVERY NERVE IN MY BODY IS JUMPING UP AND DOWN INSIDE MY SKIN, TOO. And that’s actually a lot of fun, even if my pitiful, inaccurate attempts to describe it make it sound uncomfortable. The uncomfortable part comes because I. Can’t. Keep. Still. and any situation that would require me to stay still is horrible for me. If I’ve got free rein to climb on stuff and do whatever I want, then it’s tons of fun.

You see why this might be a problem when I’m at work, though.

I guess caffeine does this to a lot of people, but if you are not manic-depressive, I don’t think that ONE CUP OF COFFEE can make you feel like this for TWELVE HOURS STRAIGHT before you start to come down a little.

Anyway, I somehow started feeling a lot more subdued, and I was able to go to work, and it was all good.

Um, I have no idea where I was going with this. I’m still a wee bit on the hypomanic side, but not in a bad way. Oh, yeah. I wanted to mention that although I don’t eat as well as I should, for a long time now I’ve been doing really well at trying to make sure my sleep schedule is as regular as possible, because I know how important it is for me to sleep properly if I want to stay well.

Ha ha ha, I’m standing up at the computer again because I’m still not so awesome with the sitting still. Sit down, you.

Anyway, my sleep being messed up through no fault of my own and the subsequent consequences provided me with additional proof that I should definitely stick to a regular sleeping schedule. I’m so much more stable when I do. I know, duh, right? Although the insomnia wasn’t brought on by anything I did, for a few days I didn’t try hard enough to get my schedule back on track, and that only served to remind me that it is dumb not to try to get enough sleep. It is also dumb for me to oversleep, or to sleep at weird times, especially since I have a more-or-less nine-to-five kind of job.

I’m trying harder now, though. For really.

Hey, student nurse. Yes, you, the girl who recently did a rotation on a psychiatric ward. I don’t think that while you are riding on the bus, you are supposed to be telling detailed stories to your friend about the patients in the hospital. You know everybody else around you on the bus can hear you, too, right? But you don’t care at all, do you? Of course not. Most mental health workers I’ve seen don’t give a damn about patient confidentiality, so why should you be any different, student nurse? I bet you think that since you didn’t mention any names, everything is cool, right? Well, guess what. It’s not. By the way, those were human beings you were poking fun at. I understand that dark humour has a place among health care workers, to help them cope with the things they have to deal with in their work. That place is not on the bus, however.

Hey, guy from the bus a month or two ago. I overheard you when you were saying, “It seems like everybody I grew up with is dying. One guy died of a drug overdose. Another friend of mine killed herself in jail in Ontario.”

I wanted to say, “You were friends with Ashley Smith? Man, I’m so sorry about what happened to her.”

But, of course, I didn’t say anything.

Surprisingly, nothing horrible happened over the holidays. A “Christmas miracle,” if you will. I’d been afraid that my brother would do something dumb, because he’d been saying all along that he was going to call his ex-girlfriend on Boxing Day and it never goes well when he calls her, but he didn’t call. Whew.

He’s on Seroquel. He’s gained forty pounds and he’s tired all the time.

“It can’t be making him tired all day, though,” my mother said to me. “His psychiatrist said that if he took the Seroquel around ten at night, he shouldn’t be tired anymore by the time he gets up in the morning.”

Maybe it was wrong of me to laugh at her, but I couldn’t help it. I have told her twelve million times that antipsychotics can make you very, very tired. This psychiatrist is someone who I kind of know (I know his family), so I’d thought he wouldn’t be dumb and he wouldn’t act like a jerk. But here he is, saying that the side effects that one of his patients is experiencing from a drug do not exist.

I had more faith in this guy than that. This is disappointing. It makes me want to scream. My brother is possibly the least motivated person in the world — I can’t see how antipsychotics are supposed to change that for the better.

Oh, yeah. They’re not.

My younger brother is like the poster boy for borderline personality disorder, but since mental health professionals seem to be looking only for BPD poster girls, none of them had ever considered this diagnosis for him. No, I’m not sure whether I think BPD is a useful construct, but he does fit the criteria to a T (except, as far as I know, the last one, “transient, stress-related paranoid ideation or severe dissociative symptoms”).

Last week, I kept mentally writing a blog post in which I would describe all the ways he fit the criteria for BPD, but refer to him as “she” until the end of the post, where I would say that there was one major lie in the post and to switch all the pronouns, I’m actually talking about a guy, not a girl. My brother can be awfully exasperating, but what really bugs me, and what that post would have really been about, is sexism in the mental health profession. About how I, a girl, have been called personality-disordered simply because I used to cut myself or because sometimes I’ve disagreed with doctors’ opinions about something, but someone who very obviously fits eight of the nine criteria for BPD isn’t diagnosed with it because he’s a guy. I’m not really interested in amateur diagnosis of anybody other than myself, but it seemed appalling that behaviour that would get a female slapped with the BPD label was ignored in a male. I never did write that post, because 1) it would have wound up being awfully long and I’m lazy, and 2) it seemed malicious to write a post delineating all of my brother’s very worst qualities when he is one of my favourite people in the world and one of my best friends.

Now there is another reason to never write that post, which is that a doctor has finally considered that he might have BPD. Until the other day, my brother’s official diagnosis was generalized anxiety disorder, but he’s been in the hospital for a couple of days because of suicidality. One doctor is saying bipolar spectrum disorder and another is saying borderline personality disorder.

As for how he is doing in there, it varies. He went voluntarily, but then when he said he wanted to leave and it was stupid and he should have just killed himself instead of going to the hospital, of course they changed his status to involuntary. For a while he was really mad that he’s stuck there because he wants to go online and see if his girlfriend is terribly worried about him, as he wants her to be. He was doing a countdown online to the day he planned to kill himself and dramatically telling his friends that it would be his “last day on Earth.” His girlfriend has a good summer job on the other side of the country and he is upset about that because he would prefer that she come home to her apartment and work at the part time waitress job that she had before she found the better job. He thinks that her wanting to make money to pay the rent for her apartment, where he sometimes lives with her for free as he has no job, means that she doesn’t really love him. My mother said today, though, that he is feeling less angry about being in the hospital now because he thinks he should stay until he feels safe.

Feelings can shift so rapidly in the hospital sometimes, can’t they? Most of the time, it’s very boring, so when anything at all happens, sometime it seems monumental and you can overreact.

This is not an anti-BPD post. My brother behaves like a stereotypical, worst-case-scenario borderline, and of course I’m going to vent about that. I realize that most people diagnosed with BPD aren’t actually like him, and I’m hopeful that whatever the hell is wrong with him, whether it’s BPD or something else or BPD and something else, he will soon get some appropriate help and will feel better and not be such a pain in the ass. Even if he is bipolar without BPD, I’m glad that somebody has finally noticed that something other than GAD is going on.

thememoryartist recently made an excellent post, A new proposal for the DSM, which “outlines and categorizes the features of Mental Health Professional Personality Disorders.” It’s funny because it’s true. Which also, of course, makes it sad. I’ve seen plenty of mental health professionals whose behaviours and attitudes are outlined very well by those criteria.

In a comment, Gianna mentioned that the post might be educational for mental health professionals. I’ve met some MHPs who would appreciate it very much… but they’re not the ones who tend to exhibit any of the listed behaviours. I think the ones who actually exhibit the “symptoms” would see that piece of writing as an example of a patient being narcissistic and overly hostile, and would never recognize themselves in the criteria.

There are also a lot of interesting comments on this post about PTSD misdiagnosed as BPD.

I am doing okay physically with the Zoloft and Epival withdrawal. I didn’t even have any of the brief dizzy spells yesterday. I was, however, staring at a word on a computer screen when I saw it suddenly jump several inches to the left, even though this did not really happen. I am hoping that this is just a regular hazard of the twenty-first century, as opposed to a withdrawal thing.

As I mentioned in a comment on my last post, medication withdrawal has made me kind of stupid lately, though. I can’t remember anything, my attention span is even worse than usual, and… um, I already forgot what I was going to write in the last part of this sentence. Oh, yeah, I’m constantly almost late for stuff. Since none of this has been interfering with my work performance, it’s not really all that important. It just bugs me.

Tomorrow I get to see my GP and I hope I’ll get my prescriptions. I have to pay forty freaking dollars for the cab ride there and back, because there’s a shortage of family doctors here, no bus service to the neighbouring town where my doctor is, and I don’t have a car.