It has been over two months since I first learned I might be bipolar. Since then, I have emerged out of depression and its medications, and into the experience of bipolarity, and its medications. I wonder, what would have happened if I hadn't asked about bipolar disorder in that appointment with the doctor? In my family, we speak of mental health and illness in our everyday language. My uncle is manic, another bipolar, another ADHD. My father is depressed. Everyone drinks far too much. We know the vocabulary and speak lightly about the need for addressing our concerns clinically. Perhaps we lack the self-scrutiny or the ability to do the "work" of classifying our own psychosocial experiences into the dichotomy of healthy and not-healthy.  To translate this into a new and different realm of intervention felt quite foreign to me, until this year.

It was easy to pose the question about bipolar disorder that day. I read an ethnography of bipolar sufferers and I empathized with their diverse expressions of moods. While elation, exuberance, and enthusiasm were characteristic of much of my adult life thus far, living post-trauma, and feeling its true lows and fears, brought a new sense of urgency -- I could not take care of myself. I could not make myself better. I became diagnosed, I sought treatment. My ability to express myself and my feelings in new, biomedical idioms increased. I could define the many nuances between well and not-well. And at that one appointment, I knew my well-ness was transforming back into ill-ness. And I was terrified. Was my half-hearted question of whether I might be bipolar just an attempt to grab at new language, new categories, to explain this change? Why did this psychiatrist accept my concern so willingly? How could I possibly know better than she? It happened so quickly -- a series of new questions -- unmoored from life context. Trauma caused the depression? Or did depression influence my post-traumatic distress? Was I genuinely an energetic, exuberant person, or were their other depressed periods interrupting these. My repertoire of identifying moods in the biomedical-sense came only after my trauma. The conversation reduced to a few truths: I have had consistent trouble sleeping, and I've had a stressful year. Sleep issues + Stress equals a ripe environment for the emergence of bipolar illness in a genetically-optimized individual. I knew something needed to change, however. I accepted new medications.

To test this diagnosis, you look at how the individual responds to medications. One could stop at the interpretation, "if the drug works, keep taking it," especially given that psychiatric medications are increasingly used for a whole range of issues. I was encouraged to think this way by my therapist. The anxiety of labels and drugs was too much. Not everyone who takes lamictal is bipolar, after all. But for my psychiatrist, this was definitive. And the speed and joy and energy that I felt in getting better was not lost on her. This shift exemplified the mood changes among bipolars. She was concerned about the anti-depressants causing this "hypo-mania." They were tapered. She drew me a graph, with depressive moods covered by lamictal, manic moods covered by lithium, and the gray areas "tweaked" by seroquel, an atypical anti-psychotic. She was concerned. I was leaving the country in less than two months, which did not give her enough time to initiate the lithium. Would I consider postponing my research abroad this summer? No. I can't. The prospect of lithium was frightening. Something I had only heard of among the really mentally ill. I was not depressed. I felt good. I felt tired.

Seroquel was meant to make you drowsy. Across every internet site I read, people both celebrated and lamented this side effect. In combination with a benzo -- klonopin, this time -- I should sleep soundly. The echoes of what it mean to take an anti-psychotic, particularly in the absence of psychosis, were quieted by my desire to sleep well. Between my doctor and me, this was our common concern. But the problem of my fieldwork loomed large. My insurance coverage for drugs was nearly up. How can I get enough seroquel to last me the summer? I had to spend down my account in order to qualify for patient assistance. I needed records demonstrating this. While the account was nearly spent down, getting documentation of this was much more of a headache. I never received the document in the mail, and after a couple weeks wait, I got an urgent phone call from the doctor. Her tone was different. I had barely slept that night, could barely focus, and had no answers for why I couldn't produce this document. I think she sensed that I was not treating this need seriously, and I could not leave the country without these medications. I was bordering on non-compliant: "You are bipolar." She said it to make her point clear. It echoed and echoed. And then, to make it worse, in trying to figure out my disrupted sleeping patterns, we realized it was because I was taking double the dosage of lamictal than I should have been taking. I was confused. "You are cognitively impaired." The dosage was fixed. This conversation was so discomfortingly black-and-white. These were no longer definitions and symptoms listed for insurance purposes. I was defined.

I exhaustively exhumed the internet for information on these terms, on people's experiences with bipolar concerns. Do I fit in? I don't feel it. No one around me would guess that this drama has followed me for the past two months. I have only told a couple people, but it's a sanitized version -- devoid of the affect I'm attempting to insert here. I am gaining weight drastically, and worry about what people must be thinking. Klonopin was too strong, so I stopped that. Seroquel isn't much of a help in getting me to fall asleep, only at keeping me asleep, for a solid 7-9 hours, and dreaming malaria-like dreams.

I tried today to express my pessimism to the psychiatrist about seroquel. She said that switching meds at this point -- given that I'm leaving in a week -- just isn't possible. She listed off the back of her hand the other drugs, and all of their limitations. I suppose it was just to prove her point She said, "so we'll keep you on board with seroquel as your anti-psychotic." Again, another one of those moments. My anti-psychotic. It's mine -- belonging to me, and part of my very physiology.  Because I need it. For...something. Something I can't readily identify in myself. It is not just a sleeping pill, which I had myself convinced of before. It's used for so many other things -- but not being able to identify the bridge between the medications and the "thing" that is causing distress is...frightening. This doctor no longer looks at me and wonders how the distress of my trauma will next manifest itself emotionally or physiologically. PTSD is far too complicated and too personalized to wrap one's head around. She sees something much more concrete now. Something with a future -- an entire lifetime. I repeat in my head that latter half of her statement over and over "your anti-psychotic," as if there is something hidden away inside me, something psychotic, enmeshed in my neurons and synapses, waiting for the next trigger. I don't believe it. I just can't.