I'm rather fond of a quote from a book I've never read by the author Darynda Jones.
"I don't think I get enough credit for the fact that I do all of this unmedicated."
A year and six months ago, Mr. PNU and I embarked on an affective adventure. We wanted to have a child, and in order to safely become pregnant I needed to go off my meds—all of them. The first two months or so I felt the steadiness of salt slip away, night after Lithium-lacking night, until my moods barely wobbled and the earth felt solid beneath me regardless of unmasked emotive fibrillation.
I kept checking in with both psychiatrist and therapist on a regular basis, and even though I felt slight adjustments in my mood's tectonic plates from time to time nothing clinical ever erupted. We waited for a positive on a pee stick for six months, and nothing happened. Meanwhile, Mr. PNU did note changes in my affective states—a little more enthusiasm here, a bit more introspection there—which he asserted were nothing so out of the ordinary that they raised alarm. Remember, he's a psychiatric ethicist. He's worked directly with a number of Bipolar individuals, and is well acquainted with red flags for mood fluctuation. We pushed into our seventh month of trying to conceive when the stroke rearranged my husband's cranial geographic landscape.
In the eleven months since, I've briefly attempted restarting two mood stabilizers and occasionally resorted to using anti-anxiety meds. But it's been months since I've taken more than fish oil supplements as any sort of proactive psychiatric safety net.
My therapist and I have rehashed my early diagnosis in my teens on numerous occasion. I concede there exists a pattern of mood disturbance coincident with use of both prescribed and illicit drugs from age 13—when my mother sought to medicate a perceived case of ADD with Ritalin—to my mid-30s. In 2006, following the cessation of an antidepressant that I'd taken daily for nearly ten years, my manic swings completely stopped. My last manic episode occurred in January that year, and in the ten years since I've only experienced short-lived hypomaniac states in conjunction with considerable caffeine use. Any depressive episodes I've experienced since 2006 coincide directly with casual alcohol use or domestic trauma. Otherwise, I've exhibited what my therapist calls "unexplainable calm."
In January I brought up the possibility with my therapist that my diagnosis might be wrong, even conceding that a personality disorder resulting from my upbringing may play culprit to some of my long history of mood instability. She encouraged me to approach the matter with my psychiatrist.