Until earlier this week when I had my evaluation for a mood disorder, I was left piecing together information and misinformation about anxiety, depression, OCD and bipolar disorder. This was in part due to the types of doctors and treatment I sought. After several years and much experience and wisdom, I discovered I needed to be diagnosed BEFORE seeking a counselor or therapist. I needed a psychiatrist, not a psychologist. I was never guided in this direction by anybody until I sought help for what I thought was PMDD (premenstrual dysphoric disorder). My family doctor referred me to the psychiatrist to rule out any other issues that may be causing me psychological and emotional problems.
I learned that my hormonal fluctuations may trigger manic and depressed episodes. Despite what my hormones may be wreaking on my mind and body, I also have bipolar disorder. My depressed episodes can last for weeks- sometimes I feel like I am in a perpetual state of depression! Other times, my mood is so elevated, I feel so creative for what seems like a long time…several days in a row. Then I forget about my limitations. I enjoy the madness, the happiness, energy, and excitement that come with mania. Let me say that my manic episodes are not so intense that they cause me to do irrational things, at least at this point in my life. Some people have manic episodes that involve risky behavior, reckless driving, drinking, drugs, or a multitude of other volatile behaviors. I would not enjoy manic episodes such as that kind.
When my psychiatrist asked me about anxiety, she noticed that I often blurred my answers with symptoms of not only anxiety but also irritability and OCD. She asked me if I washed my hands, counted or checked things (no, no, and no). Anxiety for me has always been the result of something that makes me feel irritated- crowded spaces make me feel irritated, threatened. The sound of shopping carts crashing in the aisle nearby makes me anxious and irritated. I have always thought that people in the stores are trying to get me mad, or they are purposefully invading my space to issue a challenge to me. A challenge that says, “Yes, I see you are shopping and relaxing, you should not be doing this so I will push my way into your space!” I’m a bit more relaxed about public spaces and shopping centers than I used to be, but these are the thoughts that plagued my mind at those moments. It is also why I have should-checked many shoppers who I have deemed to exhibit rude or obnoxious behavior (i.e., they were loud, they were space hogs, they did not share the aisle/space with me, they seemed to have an air of superiority or something else).
During my late twenties, I saw the origins of my purging disorder starting to develop. In college, I started to get annoyed by everything about my art classes. The media we had to use- chalk and charcoal, had grainy textures. Pencils, I hated them too. I really only liked using ink pens. Despite my aversion to these drawing tools, I got by my drawing classes with good grades. When I married and had my first home, I even managed to save many of my sketches from the art class, but they were drawn on very large sheets of paper which I stored in the attic. The portfolio I kept my artwork was getting worn and tattered. At the time, I felt compelled to discard the drawings without much thought about what I could do with them in the future. Wouldn’t it be nice to show my kids that I was once an aspiring artist? Or would it just be a tale that revealed my failed attempt to be an artist?
About a year after I gave birth to my first child, I experienced domestic violence and alcoholism by my ex-husband. Sometimes cleaning while the baby slept was the only thing that helped me relax. I had also been an alcoholic before I became a parent. Alcohol helped me numb uncomfortable thoughts and moods. Now, I had hormonal issues attributed to post-pregnancy, although I was never officially diagnosed with postpartum depression.
Cleaning and purging back then looked like this: I was disgusted by my husband’s drunkenness, particularly, when he urinated on the couch. I bought a carpet-shampooer from Walmart and used it at least once a week. I used “cleaning” as a diversion, a coping mechanism for many years before I sought help and divorce from my husband. The purging didn’t stop there, however. Anytime I felt overwhelmed, I would mindlessly get rid of things. Some of the stuff was in fact, junk. Other stuff would have been nice to have around, like my old drawing, old poems, etc. This behavior has caused grief to my family because I got rid of certain things without them having the opportunity to say “goodbye” to the items. In my mind, I set a limit of how many storage boxes I would keep in the basement. My daughter the “clothes horse” is able to have several more boxes than me or my son because she has a wider variety of clothing choices than we care to exhibit. Nevertheless, she gets angry when I get rid of stuff, and my son still gets angry at the loss of some things I took for granted.
My psychiatrist asked me how much I clean now. I explained I mop after dinner each night and I can’t focus on anything else until the cleaning has been accomplished. She said that I do not have OCD. The cleaning is something I do when I feel compelled by mania, surges of energy. I still wonder why it is that I clean and purge when I feel emotionally overwhelmed. Perhaps, I need to release the mental clutter, the visual clutter in an unusual attempt to stave off energy surges.
In retrospect, my cleaning and purging were done in a mindless matter. I did not allow myself or my family to process the ritual of discarding possessions. It became their disorder, as well as my own. The purging and cleaning were “masks” to my real problem- managing my moods and managing the stress in my life. The behaviors were diversions, which is what I sought as a mindless remedy. A true remedy involves an action plan, a change, it involves replacing the negative with positive.
With a professional diagnosis, individuals are better equipped to choose if they want to take medication, and which ones. A correct diagnosis helps people from wandering aimless and take steps in the right direction. OCD, anxiety, depression, bipolar disorder- all disorders, sometimes disorders that overlap each other, but very different treatments. Choose to invest energy and knowledge into your mental health issues- understand the differences between family doctors, psychiatrists, and psychologists. Don’t just take the SSRI’s that are prescribed for generalized anxiety or depression.