November 18, 2021

A Diagnosis is not a Comfy Armchair, nor a Badge to Wear—It is This.


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When suffering with a mental illness, everything is in flux and we crave stability.

That stability often comes from getting a name for our ailments and then administering a treatment plan. When we are fully settled into a diagnosis, the description of it feels like a comfy armchair.

Each mental illness has a particular flavour, and more importantly, carries a perception in the wider public mind. With bipolar there are the positives of high energy, infinite drive, and a strong-willed personality. When we think of it, we’re instantly drawn to the famous sufferers of this mental illness, such as Kanye West, Stephen Fry, Carrie Fisher, and of course Kurt Cobain. These are brilliant people whom we may aspire to be a little like.

We wear the illness like a coat and accept the negative perceptions. People reaching for the famous sufferers as a reference point can negate some of the negativity—we can become like them in the eyes of others.

I had accepted bipolar as what was wrong with me—with that comes a feeling about the condition and a set of tropes that concert with it.

So, what happens after we have accepted one name for our condition and then new diagnoses are added on? What happens when a psychiatrist bursts this bubble and throws less trendy illnesses into the mix? How do we readjust to a new set of names to describe our state when we’ve been so comfortable accepting a single word to call ourselves?

This is where I find myself now. The psychiatrist has told me that I may be suffering from autism and borderline personality disorder (BPD), in addition to bipolar. It has kicked me in the stomach. It is infinitely jarring to the psyche.

How each of these conditions interact and affect me is hard to define, according to him. It appears as though I was undiagnosed as autistic, which led to BPD, and was then finally joined with a nice big hit of bipolar as I got older and more hurt by the world and my own fractured personality.

Autism seems chronic and has been portrayed in many movies. It instantly conjures up the image of Dustin Hoffman in “Rain Man,” counting straws or wanting to watch “Wheel of Fortune” and having a meltdown if he can’t. I just don’t see myself in this way. BPD sounds harsh to me, like my personality is sh*t. Who would like to have a disordered personality, borderline or otherwise? Who would want all three conditions together?

How do we handle something so massive? Especially when we had settled so cosily into the bipolar armchair.

After accepting bipolar and informing others of my predicament, I feel like a fraud, or like I have hidden parts of me in an inauthentic manner. I do not know how to assimilate this new information into my apparently “disordered” personality. How do I assimilate and accept anything when I have a disorderly personality? It’s a conundrum and a soul sucking drain of infinite depths.

Being autistic, if I am, is a disability, and carries so many different and new connotations to accept. I don’t see myself as disabled, but clearly I am. I’m not able to be on my own, to go out on my own, to make financial decisions, and the list goes on. All of the aforementioned fill me with anxiety and despair, and I f*cking hate myself for not being “able.”

It feels unfair that I have been cursed to suffer from three serious mental illnesses. It’s as if I’m angry that I had grown used to what bipolar means to me and to the wider public perception. I’m exhausted by all the thinking these new tags bring about in me.

I cannot think of any role models who have bipolar, BPD, and autism together. This should not matter—but it does. I feel furious at this new twist in the plot of my story. I’m angry at me, the psychiatrist, the world, and all the people who will potentially judge me in my new three-pronged diagnosis.

The worst part is, I think that it is my own perception of the conditions that has jarred me. I’m maybe prejudging what it means negatively and saying “that’s not who I want to be.” I’m scared and ashamed to say that it may come down to plain old vanity and self-perception. I don’t like the thought of being autistic or having a borderline disordered personality. It’s not something I can accept right now. I don’t want it. I reject it wholeheartedly.

I am left with an awful inner conflict and how to escape it beguiles me. It evades the set of coping strategies I have at present.

What I need to remember though is why we receive a diagnosis—what diagnoses are for. They are for treatment and to help us cope. They are not a comfy sofa to sit on, or a badge to wear. They do not form our identity and are instead only a part of who we are.

These terms are diagnostic tools for clinicians to prescribe medication, select appropriate therapies, and provide support. This is done for the purpose of making our quality of life better and to help us weather the storms of life.

I’m hopeful that in time I’ll move to acceptance and that the medications will in turn do their job and further give me the strength to be able to say, “I’m Stu, and I’m okay at the moment,” instead of listing a group of diagnostic words that are for a clinician to use.

They are not for me to own and wear as an identity.

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