The worst tests for bipolar

So this question of bipolar disorder has reared it’s head again and I *still* don’t know if I actually have it or not. It’s very frustrating to not know what’s wrong with you except that you know you don’t function properly. I had post-natal depression 100% but when I look at the mood scale from Bipolar UK I literally only fluctuate between a 7 and a 3 most of the time.

Which I don’t think is necessarily clinically significant to necessitate a BD diagnosis. I also don’t have underlying “phases” (usually… that PND really brought this home to me). There’s some evidence that ADHD’s hyperactive side can look a lot like hypomania and there’s little to separate them.

As a side-note, I feel like that mood scale linked above ought to be mandatory for everyone who is trying to mood chart because without it you’re trying to draw a map without a key. I now know why I failed at mood charting back in 2015.

While I’m waiting to get hold of a psychiatrist (again… RIP salary), I looked online and basically all the “test yourself for bipolar” quizzes go like this:

  1. Have you had mania? (well, duh, if I knew the answer to this I’d surely know if I had bipolar)
  2. Have you had hypomania? (gosh golly, if I knew the answer to this surely I’d already have a diagnosis… the nuances of hypomania and the difference between hypomanic symptoms and a hypomanic episode are utterly lost on some people)
  3. Have you had depression? (again, what counts as clinical depression and if it’s very obviously Post Natal Depression or Complex Grief, do those count or not?)
  4. Insert a bunch more questions to make it look like we didn’t half-ass this quiz
  5. Give us your email address so we can harass you forevermore send you your results.

The cyclothymia tests are actually nonexistent. Indeed, it seems no two clinicians can agree upon what cyclothymia actually is. I did read a really good chapter on it in “The treatment of bipolar disorder” published by Oxford University Press. That chapter is basically the only thing I’ve seen that actually makes sense of cyclothymia as a clinical entity.

The best part is, cyclothymia is milder than bipolar disorder (but still comes with suicide impulsivity) yet despite the fact that it’s generally agreed these days that people with bipolar don’t always need lifelong meds, the NHS guidelines say people with cyclothymia need to be on meds (that aren’t even approved for use for cyclothymia because literally nothing is) for the rest of their life.

Whut?

“In case it develops into full-blown bipolar.”

Riiiiiiight.

So they’re proposing I take very serious meds that will take years off my life when I don’t actually need them, despite the fact that the latest research says people with cyclothymia have a distinctly different set of debilitating symptoms than people with bipolar, it’s not just “soft bipolar” as some idiot clinicians call it, and never mind that people with cyclothymia are very sensitive to meds in general.

Frustratingly, the NHS can say whatever they want about cyclothymia because there are no NICE guidelines for it. That’s right. NICE recognizes cyclothymia but couldn’t be bothered to actually write any guidelines for how to define, diagnose or treat it, and they clearly state multiple times in their bipolar guidelines that they are not dealing with cyclothymia.

My current therapist is adamant I have bipolar, she doesn’t seem to know what cyclothymia is, she has dismissed ADHD as “not relevant” to my problems, and she seems to think I have no insight which makes no sense because everyone else I’ve ever seen always tells me I have lots of insight into my condition.

This whole thing is such a mess. And my husband, the biggest voice of doubt, keeps saying “I don’t think you have bipolar” like, do I need to borrow an elephant with “she has bipolar” written on the side of… of… those rug things elephants wear?! And does anyone know what those rug things are called?

Arrrgh how did I end up here again with the bipolar stuff? Should I be on meds? Who knows! I wish Blahpolar was still here because I know she would have talked this through with me and helped me work out where to go from here.

Or maybe she would have just made an appropriately-timed bipolar vegetable joke.

That would also help.

To be fair, I wish she was still here even if she never liked or commented on anything I ever wrote again.

I had a maternal request elective C-section for tokophobia

I’ve just posted this somewhere else but I wanted to mention it here too because I think there’s too much stigma surrounding Tokophobia (fear of childbirth) and maybe it will help someone else:

 

I have always had tokophobia and it put me off wanting children for years because I was so scared of childbirth. I thought we would adopt instead, and justified it because the world is overpopulated (and isn’t it the height of self-indulgence to be a Millennial in the position of being able to afford a child). I had so many little justifications but underneath it all, I wanted kids. Twenty of them. Enough to fill a minibus or a classroom. Smashing the Idiocracy, one baby at a time.
 
With my first (unsuccessful) pregnancy I got such bad hyperemesis and I think a large part of it was because I was so anxious about giving birth, despite desperately wanting a baby. I was sure I would die. I ended up in hospital on IV fluids because I was so scared of having a baby that my body stopped digesting food. At the time, maternal-request C-section was not an option in England. In many parts of England, it still isn’t, and I find that abominable while on the other hand we tell women to trust their instincts about reduced foetal movement etc.
 
With my most recent and finally successful pregnancy, I had all my antenatal care in China where a C-section is the norm, which took away 99% of the stress. I got “normal” amounts of morning sickness, which isn’t great, but it also made me realize just how bad my hyperemesis had been several years earlier, despite so many people dismissing it as part and parcel of pregnancy.
I finally allowed myself to learn all about pregnancy and childbirth, and the whole thing fascinated me. I think I talked about random obstetric facts non-stop whenever my husband was home. I found myself craving the British model of pregnancy – midwife-led care, with emphasis on normality. In China, a doctor makes all your decisions and they get quite offended if you refuse any tests they’ve recommended (and they loved recommending tests).
When I got to Northern Ireland, there was uncertainty about my due date so they wanted me to have an induction. This was something I hadn’t really read about because I didn’t like it as a concept. It seemed unnatural to fill the body with gloop to force a baby out when it wasn’t ready. It really didn’t sit right with me, but no one said I had any alternative, and the baby had to come out somehow, so I actually psyched myself up to go for an induction.
I think I would have been okay except I had a cervical sweep three days before the induction and it was agonizing, and it left me unable to walk very well (I suspect this is when the baby accidentally got turned). I still kept telling myself I could do this induction, but now I had a lot less confidence because if that was just a little membrane sweep, how much worse was labour going to be. I was resolved that I was going to try and have a normal birth though (in between bouts of crying and telling my husband I was going to die because I was completely terrified).
I tried practising hypnobirthing and meditation, and even wrote a birth plan about 2 days before the induction date. On the day, I spent 6 hours having the worst and longest anxiety attack of my entire life, convinced my baby would die and so would I, while the poor midwife in the induction bay was trying to calm me down because I was crying and shaking, blood pressure through the roof, and she ended up getting the registrar to come and go through what an ELCS would entail with me.
 
Until a C-section was offered, I’d been too scared to ask for one in case they said no.
 
The registrar then did a scan to look at my baby and said he’d shifted to an oblique lie so couldn’t have come out any other way. She drew a diagram in my notes and everything, but I still don’t know if she was just trying to make me feel better.
 
When I was going into theatre to have the CS the consultant-midwife asked me why I was having it and I said about the baby being oblique because I was too ashamed of how scared I’d been. Of course, she could see my notes so I should have just been upfront but anxiety isn’t rational.
 
My notes say “maternal request c-section” but that doesn’t quite cover the time I spent agonizing over this, feeling like I’d let my baby down because I was too scared to try and push him out, or the fact I still mourned the loss of my envisioned “perfect” birth, a waterbirth, surrounded by delicious snacks, with my husband in the water with me and holding my hand. It doesn’t come close to making me feel better about what happened, when I know what the statistics say about C-sections and the chance of babies developing respiratory issues and digestive problems.
 
I dreaded having to tell my family what had happened so I didn’t tell anyone I’d had a C-section for weeks before I finally admitted it, and everyone was fine about it. This is the first time I’ve openly admitted it was partly down to my own terror of childbirth.
 
It’s taken me months to come to terms with the fact I “failed” at having a baby the “proper” way but I know now that a lot of that stigma comes from within me, from the phobia of having a baby, not from other people’s genuine opinions. Literally no one has said anything nasty to me about having had a C-section.
 
I wish I’d been honest with my consultant about my fears and felt brave enough to ask for a C-section when I first got back to the UK instead of letting the situation go on for weeks with me thinking I was going to be able to try for a vaginal birth. But I know why I didn’t. I was hoping I’d just “get on with it” on the day. Within minutes of us arriving for the induction I’d been told I was too high risk for a waterbirth because of the baby’s size (because he was broad-shouldered), and that was when my anxiety got the better of me and everything fell in on itself in my mind.
 
I also wish I’d been honest about my history of mental health issues, but there is a lot of pressure on us as women to be fine when we’re not, and I was trying so damn hard to be ok with something I just couldn’t do. If the baby had been low-risk, I would have gone home and waited for labour (and maybe even freebirthed) but I was terrified of refusing the induction and putting my baby at risk of death so I got paralysed with anxiety.
I was also terrified of social services being alerted that I had a history of bipolar on my medical notes (we still don’t know what’s actually wrong with me, currently Autism, type II bipolar, borderline and ADHD are all being floated around) and taking my baby away. I was convinced they were going to take my baby and nothing anyone said could divest me of this belief. I might have had a teensy bit of psychosis over this but it seems to have resolved itself and I managed to keep enough of a lid on it that I didn’t get mental health sectioned over it (just C-sectioned haha) despite being sure at several points over the last few months that I was going to be an inpatient and separated from my baby (we don’t have mother and baby units in Northern Ireland so women with post natal psychosis or severe post natal depression get sectioned and put in a normal psychiatric hospital).
And despite at least 2 suicide attempts post-partum I am still at home and with my baby. Turns out NI don’t really intervene beyond community mental health teams unless you’ve set yourself on fire so that’s relieving because I don’t think being imprisoned in a mental hospital without my Jellyfish would help me to recover very well, and anyway I’d have to stop breastfeeding.
 
Overall, I am glad I had a C-section rather than a prolonged birth in a strange place where I couldn’t be myself because there were too many strangers, and where my husband would get sent home outside visiting hours. But I still really wish I could have had that water birth. I’m looking towards a second baby, and I’m pretty certain I want a homebirth (homebirth after C-section, or HBAC, is allowed in Northern Ireland and the rest of the UK but as far as I know it’s not allowed in Southern Ireland) with a birthing pool. I’ve seen some beautiful videos on Youtube of vloggers who had natural waterbirths at home. 
 
The first mental health keyworker I saw said to me that it doesn’t matter how your baby came out as long as they are healthy. This effectively shut down the conversation about why I was there, lost in the depths of post-natal depression. While I do think a birth is just a means to an end, at the same time it is a part of our story and lived experience as a woman and for that reason we should respect each other’s decisions and hear each other’s words about birth, especially when that has deeply affected someone’s outlook or mental wellbeing. I don’t think dismissing this as unimportant actually moves anyone forward or helps them get over things.
If I am lucky enough to get onto a midwifery course (yeah I haven’t told the fam about that, either, because I might not get on a course), this is how I want to work for my pregnant ladies; I want to ensure they know their options and get the closest thing possible to the birth they want.

Changing things up

So I got up at 10am this morning, which was an achievement. The flipside is, my eyes have been trying to close since about 11:30am.

Baby Jellyfish is teething again, we found out last night. He already has his front lower two teeth, which came through at once. The dentist told me his top two front teeth would come next.

Nope. Not my jellyfish. He’s getting his pointy top teeth, they’re both just breaking through the gums right now, so he’s basically biting down on everything and in a day or two, I’m going to have adorable baby-sized fang indents everywhere where he’s bitten me. He bites me a lot.

Baby vampire do dooo do do do do…

I’ve decided to change my blog’s web address and title and so on. Longtime readers know I’ve been unhappy with my blog address for about five years but didn’t know what to change it to. I wanted MsAdventure, but by the time I actually got around to trying to buy a new domain, it was taken.

Mama Adventure works too. I bought it about a month ago but I’d forgotten how to change the domain in WordPress. There are more changes coming. Slowly, probably. I work at glacial speeds at the moment because I’m doing that thing where I run around in circles trying to do too many things, badly.

I’m trying to create an online learning course helping people know how to homeschool during this lockdown. It’s going to be free. But of course I need to get to grips with the software and so on.

At the same time, it’s been two days and I’m still sure that I want to be a midwife, so I need to flesh out the post thinking it all through properly, as well.