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An early diagnosis

Knoxville Journal-Express - 5/12/2017

Jane's first year at Central College has been challenging. She and her roommate did not get along, she was missing home, she felt overwhelmed most of the time - and she was diagnosed with Type 2 bipolar disorder, generalized anxiety disorder and displacement disorder.

Jane's discovery of her early diagnosis came just a few weeks ago, during her freshman year of college.

She began to notice symptoms of depression and hypomania about one year ago toward the end of her senior year in high school. Jane would continue to experience these symptoms during her fall and spring semester at Central College.

"I would go from feeling like I'm on top of the world. Like nothing can stop me.?It was almost like being high on drugs," Jane said. "But at times it felt almost out of my control, and I always knew in the back of my head that this doesn't really feel real. This was going to crash and I'm going to feel like crap."

Jane would bounce between the two extremes. She may feel happy for a week or two, and then come down and feel severely depressed for a week or two.

The amount of time it took her to bounce between the two extremes varied. Sometimes she bounced between both extreme feelings multiple times in one day.

She would also experience other behaviors like pulling an all-nighter and not feel tired the next day.

Aside from her symptoms, she and her roommate did not get along, and her roommate eventually moved out. Jane felt like she was not making many friends, she missed home and she felt overwhelmed much of the time. She decided it was time to pursue counseling.

"There's been a lot of back and forth about [my] diagnostics," Jane said. "I didn't actually get consistent counseling until I came here [Pella]."

Jane had gone to a therapist intermittently in middle school and high school. Her mother was battling anxiety, and had been taken to the hospital for her anxiety.

When her father came home from a long day of work, he sometimes did not have the energy to deal with her mother's anxiety, or he felt too overwhelmed, and felt like he couldn't handle the situation. Jane said they might fight, or her father would decide not deal with it.

The extra stress of handling her mother's anxiety, and helping raise her younger brother during that time, eventually led to her parent's scheduling counseling. However, she was not able to keep a consistent counseling schedule.

In order to go to counseling, Jane would have to miss some school during the appointment, which could only be scheduled during normal business hours, and her parent's were not always convinced that she needed the counseling.

Jane began to go to counseling again when she came to Central College because the service was free, and her schedule was much more flexible, which allowed her to easily make appointments. She began seeing her Central counselor in October.

She told her counselor right away that she did not want to take medication.

She began applying the healthy practices her counselor had given her to deal with her mental health, but she even then, Jane felt like she had hit a barrier. It felt like she was just short of being able to completely get a handle on her unknown disorder at the time.

Her self-described Type A personality and perfectionist attitude helped her complete her classwork while she battled her symptoms and the feeling of being overwhelmed. She was able to maintain a 4.0 GPA at Central, and was placed on the dean's list.

"There would be times when I was writing papers and I would feel really awful," Jane said. "It was probably an unhealthy drive toward achievement, I think, which is the only way I've been able to maintain being so mentally ill, but also getting good grades."

Jane was able to make an appointment to see a psychiatrist in late February or early March. She went to Pine Rest Christian Mental Health Services in Pella, a counseling service.

Jane described all her symptoms, and answered all the psychiatrist's questions.

Some of the symptoms of Jane's diagnosis of Type 2 bipolar disorder, include having exaggerated self confidence, feeling increased energy or the decreased need for sleep and erratic and unhealthy behavior. These hypomanic symptoms would be followed by depressive symptoms.

There are four types of bipolar disorder. Jane had been experiencing many of the Type 2 bipolar disorder symptoms.

"At the end he said, 'I can't tell you for sure what you have. You either have a really nasty combination of unipolar depression and anxiety, or you have Type 2 bipolar disorder,'" Jane said. "'If I prescribe you mood stabilizers and they work, then you have bipolar disorder. If they don't work, then it's the unipolar depression and anxiety.'"

If her psychiatrist had prescribed her the medicine for depression and anxiety, it could make her symptoms worse if she truly had Type II Bipolar disorder. But she could also have a bad reaction to the mood stabilizer.

The risk of making her symptoms worse with the antidepressant outweighed the risk of the mood stabilizer. Jane was slowly introduced to the medicine, taking a quarter of a pill, a half of a pill and the whole pill, in increments.

So far, the prescribed medicine has stabilized her moods and lessened the extreme moods she used to feel. During a follow-up appointment, Jane was informed she had Type 2 bipolar disorder, generalized anxiety disorder and adjustment disorder.

While she was diagnosed when symptoms for bipolar disorders normally begin to show, it's unusual that she would be diagnosed with the disorder so soon, according to Jane's psychiatrist, Dr. Michael Walsh.

Sometimes the bipolar disorder is mistakenly treated as depression. Medication used for depression can often times make the symptoms worse, and patients do not figure out they have bipolar disorder until later.

"Since I started my medication I've noticed my symptoms reducing a lot, in the sense that there would be things that I would normally have broken down crying over," Jane said. "[I] would have gotten really anxious and upset, but now when they happen it's never to that deep extent that it would go before."

Her happiness also feels more genuine, and less artificial like it had felt in the past.

Jane still attends counseling once a week, but said she might consider lessening her counseling over time as her symptoms continue to improve.

She also has a support animal registered through the school.

Jane has found more consistent friendships, and participates in the Symphonic Wind Ensemble, the Mock Trial team, is involved in peer counseling and is an activist for LGBT+ rights.

She's majoring in sociology with minors in political science and psychology, and plans to become a social worker after graduation.

While Jane has her disorder under control, she worries about the possibility of applying for a future job. If she informs her new employer that she is bipolar, she runs the risk of losing the chance at that job.

However, not disclosing bipolar disorder with your employer can also be risky. If your boss finds that you have a bipolar disorder, there could be negative consequences.

"It also just doesn't feel good to feel like you have to lie about something you can't change," Jane said. "It's not a good feeling to feel like you can't be yourself or be honest with others."

She hopes her story will inform people what a bipolar disorder, which can be commonly perceived as just having random mood swings.

"I feel like if I can explain what my experiences have been like, maybe people would understand a little bit more," Jane said. "It's one of those things that even people I've talked to and I'm friends with, had no idea how extensive this all was."

Jane also feels there's a stigma behind having a mental illness. Others either do not understand the mental illness, or they're dismissive of it, she said.

She hopes her story helps others reevaluate what they think of mental illnesses.