Wednesday, April 30, 2008

Taking me seriously

I should be working on my final grad school paper EVER (unless I cave and fall into a social work doctoral program...) but I wanted to post about the latest research on bipolar disorder. These are excerpts from an article in the online magazine Psychiatric Times:

The Diagnostic Guidelines Task Force of the International Society for Bipolar Disorder (ISBD) has been examining diagnostic issues since 2004.... The task force brought together some of the world's clinical experts on bipolar disorder and key researchers with the goal of having them develop a more systematic and coherent set of diagnostic guidelines....

Looking at bipolar II, the subgroup concluded "bipolar II disorder is supported as a distinct category within mood disorders, but the definition and boundaries deserve greater clarification in DSM-V and ICD-11." Bipolar II is often underdiagnosed or misdiagnosed, the subgroup said, and it is frequently accompanied by high morbidity and mortality. "Bipolar II disorder, sometimes wrongly called 'soft bipolar disorder,' is actually a severe pathology," the subgroup said. "[It] often implies a higher episode frequency, comorbidity, suicidal behavior, and rapid cycling."

While I'm not happy to have a severe and persistent mental illness, and I'd take bipolar II over I any day, I'm glad my disorder is recognized as serious and difficult to live with. I work very hard to function at a level where I can "pass" as "normal."

"Passing" is a term African Americans used to use to describe how some light-skinned folks pretended they were white folks. (It's also the title of an excellent novel by Nella Larsen.) Some days I really feel like I'm pretending to be something that I'm really not -- "normal." That's how psychologist Fred Frese describes people who don't have mental disorders; he calls them "the normals." He has schizophrenia, so he uses the term somewhat tongue-in-cheek.

Another metaphor I use sometimes is being "in the closet." I'm not gay -- after watching six seasons of The L Word, I think I'd know if I were attracted to women -- but I am concealing a major aspect of my identity that, if known, would almost definitely cause many people to treat me differently, if not openly discriminate against me.

I've written before about the strain I sometimes feel as a prosumer, how I feel I'm not living an entirely authentic life because I can't tell co-workers or clients about my illness and how I live with it. I'm not ashamed -- damn it, I'm proud. I'm going to graduate from my second master's program in less than a month, and the fact that I haven't done my dishes in three weeks is irrelevant. Or is it? I don't think my apartment would pass the section 8 inspections my clients have to undergo -- in fact, I'm sure it wouldn't. They might think I'm a hoarder. (In fact, they almost definitely would, because those Wikipedia photos don't look so aberrant to me.)

But: I'm graduating. My clients are doing well. I'm getting good grades and I got a fantastic final evaluation from Melanie. All this despite a semester of fairly active symptoms, although not as bad as last semester around the time change.

And why shouldn't I be able to tell people who I am? If I don't, I'll never know if they'd accept me as I really am. I identify with gay people who feel that disclosing their sexual orientation would lead to all kinds of problems, and who resort to living a deceptive half-life. They call it the closet because it's stifling.

I promised my parents I wouldn't tell the world about my diagnosis until I got married, got my master's degree, and got a job. Two of those conditions are probably going to happen fairly soon (one definitely is). The other? I don't know if it will ever happen.

And if it's never going to happen, shouldn't I be able to live my single life honestly and authentically? I think I'll pick an age, like 45, and say that if I'm not married by then, I'll step out of the closet. I'll tell my colleagues, fellow alumni, and friends. I'll publish articles about living with my illness -- under my own name. Because anyone who's going to marry me at that age is probably that age or (more likely) older, and hopefully will be wise enough to love me for all the good things that I am and accept my many flaws.
Copyright (c) "Ayelet Survivor"

1 comment:

  1. I don't know whether you should wait that long. Coming out is a rather liberating feeling. We came out right before pesach. (Details offline...)