Underwear and Jesus (part 2)

August 22, 2011 in General

A few months ago, I told you about a profound conversation about depression I had with a gay Christian in my underwear while in Melbourne.

Last week, he got in touch with me to tell me how he was getting along. I’m going to let him take up the story from here:

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“Things have taken quite a turn for me recently. A few days ago I was diagnosed as being on the bipolar spectrum and I’m now on a mood stabilizer.

The diagnosis is actually related to meeting you in Melbourne. When I was there, I bumped into you at the UnderBear party at The Laird and I also met up with another friend of mine who has Bipolar I. While you have been open and communicative about your triumphs and struggles with dealing with being bipolar, he is a very closed book. He doesn’t want to talk about it even though it was obvious when I met him in Melbourne he was going through one of his manic phases.

Indeed, he has suffered some of the worst effects of dealing with bipolar disorder. A few months ago he broke up with his boyfriend who had been supporting him, and so when I was Melbourne in June, he was homeless with no money. He refused my offers to help him out. Fortunately things are looking better for him now, he has financial support from the Australian government and he’s renting a room.

So after meeting you both, when I got back to Hobart I decided to learn more about bipolar disorder so I could better understand how to help. It was a path of self-discovery.

I have a family history of bipolar disorder. On my dad’s side of the family, my uncle has Bipolar I and requires medication to keep it under control. His late aunt (my great aunt) had Bipolar I severely and was institutionalized for a number of periods in her life for severe manic episodes that inevitably ended with severe depressive episodes, or “crashes” as we used to call them. Unfortunately back in her day they didn’t have effective treatments.

Towards the end of his life, my dad had depression yet would go through phases of obsessive raving for hours and being paranoid and even slightly delusional. Unfortunately dad was too stubborn and distrusting to allow himself to be treated, so we never found out what the real diagnosis was. My mum thinks dad sometimes behaved like his bipolar brother, but unfortunately it wasn’t diagnosed or treated. It wasn’t dementia and sadly, dad died of cancer at only 68 years old back in 1998.

Despite the family history, while I have had some episodes of severe depression I had never experienced the really extreme manic symptoms they had, except for one period. So I had never until now considered I could be bipolar.

I’ve only been on anti-depressants once in my life, about 8 years ago. I was put on Fluoxetine (Prozac) for depression and anxiety by my GP. The first week I was on Fluoxetine I had a severe case of dysphoric hypomania. It felt was like being continually euphoric, but without any pleasure. It lasted a week, and it was the worst psychological experience of my life – far worse than the crippling depression or anxiety it was supposed to treat. It nearly drove me crazy, but it only lasted a week and then stopped.

By the time I saw my GP again (two weeks after I started on the medication), my mood had returned to neutral. I assumed that the mania I had was just a normal part of adjusting to the anti-depressant and not a serious side-effect. I had never experienced anything like it, and so I didn’t have the terminology to describe what it was like to the doctor. I merely told him that I had a “really bad” first week and was feeling better. So the doctor didn’t pick up what the real problem was and I was prescribed Fluoxetine for another 18 months. For that period I didn’t feel happy or sad, just “grey” all the time. It was better than having depression, but life was dull and colourless. So in retrospect I should have never stayed on it.

During that period I did some Cognitive Behavoural Therapy (CBT) to try and reconcile being Christian and gay, as well as feelings of rejection of others and body image issues. I’m pale skinned, thin and not muscly, and I wish I wasn’t such a weakling, but I have had to come to terms with that, especially as gay sub-cultures are so judgmental about body image. All of these things are still things that I occasionally struggle with, but not nearly as much as before. After 18 months I went off the Fluoxetine and felt normal again.

So things went relatively ok with me until about 18 months ago when I started to be intensely bullied at work.

The stress of dealing with that means I haven’t pursued the matter of being excommunicated from my local Anglican church for being gay. I have been in such a bad way that I don’t have the emotional resources to deal with extra sources of stress. I’d like to challenge the matter of being excommunicated with the church hierarchy at some point, but I feel I need to be better again before I can deal with it. Needless to say, being mistreated and rejected by the local church didn’t help my mental state either.

I wonder how you are able to deal with the scorn of bigoted religious people while you are also coping with bipolar disorder? I certainly can’t.

My mood hasn’t improved. Apart of the depression and anxiety, I get flashbacks, panic attacks, irritability, angry feelings, an inability to concentrate and my mind races incessantly. The mind racing thing has occurred for years whenever I get stressed, but it usually abates. For the last few months it hasn’t been doing so, and is very distressing to me. My thoughts are sometimes so chaotic I can’t think straight. I have a PhD and work in a demanding IT position, so my ability to think quickly and creatively solve difficult problems under pressure are very important to me.

So, when I got back to Hobart after Southern Hibernation and started reading about bipolar disorder, I discovered that the more recent research suggests it’s a spectrum rather than a set of discrete separate illnesses. Bipolar I is as one end, with Bipolar II, Cyclothymia and “Bipolar Not Otherwise Specified” in between. Unipolar depression is at the other end. Bipolar spectrum disorders are usually not treated in the same way as unipolar depression.

I discovered that there exist people who sit slightly within the bipolar spectrum, near but not quite at the Unipolar depression end. They often have a family history of bipolar, and they sometimes get misdiagnosed as having pure Unipolar depression and then have manic reactions to anti-depressants. They don’t necessarily have full blown manic or hypo-manic episodes, instead the manic features can be as subtle things like irritability, an inability to concentrate, mind racing and so forth but co-existing with severe depression.

Of course, this is exactly what I’ve been experiencing. Last week, I talked to my psychologist about all this newly found insight, and she recommended I experiment with anti-depressants again and see a psychiatrist to deal with bipolar and drug treatments. When I saw my GP a few days later he believed that anti-depressants alone would just induce mania and fail, and so instead I’ve been put on a mood stabilizer. His diagnosis is that I’m on the bipolar spectrum.

Of course this is rather a shock. Before I thought that I just had occasional bouts of depression that were induced by external stress factors. Now I’m having to deal with the fact that I have a mental disorder that I will have to carefully manage for the rest of my life. On the positive side, now that I better understand the reason why I’ve felt so unstable during periods in my life, I can get proper treatment and hopefully live a happier life.

I’ve just started a course of 400 mg a day of a mood stabilizer called Sodium Valproate (Epilim). I’ve been told it will take about a month to work, so it’s possibly too early to tell if that will help, only time will tell. I’ve been a bit sleepy, but I hope I don’t get hair loss! Another side effect of putting on weight might fit with the “bear thing” though.

So bumping into a certain Bipolar Bear in my underpants in a gay bar has lead to a journey of self-discovery that promises to greatly improve my life, so I’m stoked about that! Who would have ever guessed that would result from such a chance meeting?”

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I’m hoping some of you out there will have some words of wisdom and support for my Tasmanian friend and what he’s going through right now, and also for his long-term partner whom he lives with.

Everyone has a story, and I’m pleased to have been able to be the vehicle to share this one with you today.

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