Eight

Hi, my name is Sarah and in 2012 I was diagnosed with bipolar disorder II or maybe it was depression and anxiety. I also have ADHD. Maybe. Perhaps not. Truth is, I don't care.

Naming Things

We like to put names on things and put them into categories. Depression is not just depression. Depression is Major Depressive Disorder, Persistant Depressive Disorder, Premenstrual Dysphoric Disorder, Substance/Medication Induced Depressive Disorder, Depressive Disorder due to another medical condition.

Major Depressive Disorder can be mild, moderate, or severe. You can have it with anxiety (as part of the depression not as a separate illness but you can also have a separate anxiety disorder). There's the type with melancholy (the sadness most people think of) and you could have catatonic behaviour. There's the 'atypical' type that's more common than it's name implies. Seasonal affective disorder and postpartum depression which are both subtypes of major depressive disprder. There's the depression that looks similar to bipolar disorder and of course any of these could be a depressive episode of bipolar disorder.

Clearly there is no shortage of names, and at nearly 1,000 pages, the current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) - THE guide to diagnosing mental disorders - there is clearly no shortage of criteria for categorizing.

A What to Get a How

Many people will go to great lengths to avoid having a name for their problems. I didn't use to understand that. Except that for decades I adamently rejected the idea that I could be depressed.

If you don't have a name for the what then how can you have a how for 'fixing' it? Well, this is where our categories start to have problems. Schizophrenia and the psychotic symptoms of bipolar disorder are so similar that a person may be diagnosed with schizoaffective disorder until doctors can figure things out. ADHD and anxiety can both result in fidgeting, difficulty focusing, and impulsiveness. It is not, to my knowledge, possible to tell the difference between depression and the depressive phase of bipolar disorder. It is possible to received on diagnosis from one doctor and another diagnosis from another doctor, or maybe they'll just give you two and call it a day.

But that's ok because antidepressants are used to treat anxiety, depression, OCD, PTSD, and bipolar disorder (in some cases). Antipsychotics and atypical antipsychotics are used to treat severe depression, bipolar disorder, and schizophrenia. Anti-seizure drugs are used off-label in treating anxiety and as a 'booster' for anti-depressants. Even lithium is used to treat more than just bipolar disorder.

In other words, what you call it doesn't have as much of an impact on how you treat it as one might think.

Good Thing I Like My Doctor

Medications are more effective when use in conjunction with therapy, but which medications seem to matter less. In fact, having a good relationship with the doctor who writes the prescription improves a person's response to antidepressants. Some research has shown that having a good relationship with your therapist is more important than the type of therapy (e.g. cognitive behaviorial therapy).

So I guess as long as I like my psychiatrist, I'll be fine. Good thing he's not 72.

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