Relating Feelings & Symptoms to Your Doctor

I’ve been writing, lately (though not here), about the situation surrounding my first hospitalization.

At the beginning of this year I requested my file from Fairfax hospital because I was having trouble pinpointing when I was diagnosed. Their notes state that their idea that I had bipolar disorder was a guess (at best) because they really had no evidence beyond the depression I had been having.

But there was evidence, plenty of it. The problem was that I couldn’t convey the feelings I was having, and, being young, I had no idea which feelings were normal and which weren’t.

So instead of telling the doctors about these things, about feeling like there was electricity pulsing through my veins sometimes, about random and voilent sounding outbursts, about the slough of days where I couldn’t sleep, I kept that all to myself. I didn’t realize that these things were even related. I don’t think I even described the psychotic break I had the way it really was, all I told them was that I “ran away from home”.

And by the time they had turned their full attention on me I had decided that I would do everything in my power to escape. In fact, I can remember the exact moment when my mood switched when I was there (it would be years before realizing that I’m an ultradian cycler) and I felt fine. My mind had already moved on to something else, which was going home and pretending that none of this ever happened.

I was told by the psychiatrist that I was handed off to that my issue was probably just a singular incidence of depression. Obviously I wasn’t telling him the whole truth either.

I suppose I was in pretty extreme denial about the whole thing, but the feelings of hypomania can make deep depression look like a thing so far in the past that it could never catch up to you. Somehow I never thought it would.

Looking back, I wish I would’ve been more honest with the doctors. It might’ve saved me some trouble down the road.

If you’re newly diagnosed with bipolar disorder (or any mental illness) I have a few suggestions.

Most people are encouraged to journal when first diagnosed (and forever after that) and there are ways to help use that in your care, beyond just venting or writing stream-of-consciousness type entries. I would particularly suggest writing about the following:

  1. any time you feel strong urges about something, like suicide, sex, spending money, drinking, extreme romantic feelings, drug use, etc. write it down.
  2. any time you feel depressed, try to pinpoint what is going on in your body. Write about how you feel physically, as well as about cognitive things like thought loops or obsessive thoughts. What are the sorts of things you keep thinking about?
  3. any time you feel physically or emotionally different than your normal self, even if the experience is positive, you should write about it. If you feel energized, elated, overly optimistic, or aggressive, agitated, or irritable, write it down.
  4. write about how often you are (or aren’t) sleeping
  5. any time you hear or see something out of the ordinary. I realize that this is tricky and can potentially be one of the most embarrassing things to admit, but noticing when this is happening is extremely important. Hallucinations are often an indication that medical attention is needed immediately.

There are tons of other things you can write about depending on what effects you, anxiety, paranoia, you name it. The idea, though, is to write down the different feelings you’re having at the time you will best be able to describe how they feel.

Seeing your doctor/psychiatrist/therapist can be stressful when you have a very limited amount of time to relate how you’ve been feeling, so look through what you’ve written and try to summarize what you’ve been feeling with a short, outline type list.

For example,

  • feeling compelled to spend money
  • energized and excited
  • sleeping 4 hours a night
  • gone out with my friends to the bar 4 nights this week

Relating this list to your doctor might suggest that you’re hypomanic. Of course, if you’ve never heard that term before or don’t know much about bipolar disorder, that may seem like a shock! To anyone else, this might be considered a typical pre-holiday week.

It is ok if you don’t have a word for how you’re feeling, I often find I have many different sorts of symptoms/feelings all rolled into a ball that doesn’t have a general name (besides just being called “mixed”). If you have to describe these states to your doctor that is ok, the point is just to be able to accurately convey the mental states you have been experiencing in order to receive the best treatment available.

Like many others, it was very hard for me to come to terms with having bipolar disorder. Many people, though, know right away upon reading about it or hearing about it from others if it is something they probably have. My last suggestion is to begin learning as much as you can about this disorder. Both reading about it and talking to others will help you be able to put your feelings in to words much easier and more quickly the next time around. All it takes is a little knowledge and practice, and soon you’ll be helping to help yourself.

3 responses to “Relating Feelings & Symptoms to Your Doctor

  1. I’ve always said this. No one ever goes to the doctor for hypomania. Why would I go to the doctor if I’m feeling good? My personality was still in development. Everyone told me I was just going through a phase. I remember looking my mother dead in the eye one day when she said that and replied, “This is not a phase. I will feel like this forever.” I was right. There was something in me that would make me feel that way for the rest of my life.

    And in some cases, in dysphoric hypomania, it can really mimic a tantrum. Teenagers and temper tantrums? Like chocolate and peanut butter to most. But, I wasn’t spoiled. There was no money to spoil me. I was frustrated and irritable. My mother would always tell me, “You have to get a grip.” And I would insist that I couldn’t. The truth was, I really couldn’t! Even as an adult in treatment, there are moments where I really can’t, no matter how hard I try.

    When a person is young, how are they to know that these things aren’t commonplace? There are a lot of changes happening at the time and nothing feels solid. It was only once I became an adult that the divide between my stable states and my other states became noticeable. A sharp divide occurred. I had always known about my depression, but I didn’t know that my volatile and impulsive behaviors were outside the scope of my personality. I had embraced them, thinking that it was just part of my development.

    I do love this article though. It is so difficult for young people to know that this may be the root of their problems. Psychiatric professionals are ready to stick every teen with an anxiety and / or depression diagnosis. My sister and I went through it. And now, our littlest sister is going through it. We’re doing everything in our power to step in and point out the possibility of BP.

  2. I wish I had read this 4 years ago when I was just diagnosed. Your advice is awesome!

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