I started thinking of labels because of my recent post on tolerance.

After later reading that post I realized it’s not that I’m intolerant of mental illness, per se. I’m scared of it, whether in myself or others. Understandably so, considering that mental illness has wreaked havoc on my life since birth. OK, I’ll toss the intolerant label for myself away. Perhaps hypervigilant would be better. But whatever the label is, the fact of it is still the same.

I get labeled by others too, as do we all, expecially when it comes to being “mentally interesting” or having a mental illness. My labels always strike me as alternately funny and damning. Sometimes the labels are helpful and sometimes they’re not.

I have been diagnosed with Bipolar Disorder - NOS. OK, fair enough. I’d had psychiatrists over the last 20 years say they thought I was probably bipolar, but never saw the up side of it to cement the diagnosis because I kept leaving treatment when I started feeling better because I was getting hypomanic. Why go to the doctor for feeling like superwoman? The bipolar disorder shoe fits, quite clearly.

But what the hell is NOS? Not otherwise specified. I get the unspecified label because… I’m not sure why. I have had mixed manic episodes and hypomanic episodes and major depression episodes on and off since puberty that have no relation to what’s going on in my life, with and without psychotic features. That would be normally labeled bipolar I. The NOS may refer to the rapid cycling issue that occurs some years especially the last few, or it may have been a typo in diagnostic coding, since the same psychiatrist that diagnosed me as bipolar NOS told me that my diagnosis was Bipolar Disorder I, Most Recent Episode Mixed. Who knows. But it’s useful to acknowledge the bipolar disorder in some way, because it means I now have access to meds that actually help, and I can live without suddenly being blindsided by suddenly going loopy one way or another.

Then a few months after getting the official BP-NOS diagnosis, I got an additional label: Borderline Personality Disorder, which was said to be related to the problems I’ve had due to childhood sexual abuse and such. That label was tacked on to my list of mental illness by a mental health professional who’d known me for 12 whole minutes at the time. I find that curious that someone, however nice, can make a good guess at diagnosis after 12 minutes unless one is dancing on the ceiling, catatonic, or some spectacular behavior. However, the popular “fix” for it these days is Dialectical Behavior Therapy. DBT can be helpful to anyone on some level, whether they have a mental illness or not, so I figured, go with the therapy whether they’ve got the diagnosis right or not, it has a scatter shot effect anyway. Unusually enough, after about 2 months, my individual therapist said that I seemed to have a grip on the DBT principles already, and it was obvious my life was improving.

Complex-PTSD came up after 5 or 6 months of seeing my individual DBT therapist. She said that having gotten to know me and done an extensive history, she thought that C-PTSD was a more appropriate label for my problems related to childhood sexual abuse and such rather than BPD. Yes, they have some common features, but they’re not the same thing and are not treated the same. Oh joyous day!

In other words, they’re struggling to find a label or set of labels that fit me. It’s annoying because the mental health care folks treat me differently in terms of respect and hope and care because of one more or less label. So does the public in general. And the treatments for each one vary in emphasis or content, and that causes understandable problems. I’ve been on the label-go-round since I was 12. It took them 30 years to figure out this set of labels, and who knows which are more accurate in the end, but at least the treatments are more helpful than the ones in the past.

Labels aren’t always bad, though they’re often annoying to me. Sometimes they’re useful. I hope your labels are useful to you.

This entry was posted on Sunday, September 7th, 2008 at 2:13 pm and is filed under bipolar, bpd, c-ptsd, mental illness. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.