Alyssa’s Story: Bipolar II Disorder, Anxiety, and PTSD

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Alyssa never used to talk about her problems. She felt ashamed and blamed herself for poor decisions, bad behavior, and acting impulsively. She would stay out for days, hang out with friends all night, drink too much. There was another side to her though, a thoughtful, introspective young woman who deep down knew something wasn’t right. There was all the anxiety, the panic attacks, the poor sleep, the nightmares. Sometimes it felt like she didn’t have any self-control. Sometimes she felt so good, happy, and care-free. Then her mood would take a nosedive, and she would feel flooded with sadness, anxiety, guilt, fear, self-hatred.  She remembers looking in the mirror and thinking to herself, “You’re disgusting.” At the age of 21, it was time to get some professional help.

Alyssa had never been to a psychiatrist before. The waiting room felt strange. She sat in one of the few unmatched chairs that seemed cobbled together from different times and places. On the coffee table were a few New Yorker magazines, but she didn’t feel like reading right now. There was a slight musty smell, and the whirr of a white-noise machine on the floor, just outside the closed door, where the sign read, “in session.” What was happening in there?  She was at once terrified and optimistic about taking this step.

“Learning about myself, getting help, and taking medication changed everything – and, in some ways, nothing as I am still the same person, just more aware.”

Into the office

In the psychiatrist’s office, she sunk into a big, comfy chair, rubbing her hands together as she told her story. She knew she needed help and the only way to get it was to start opening up. The doctor told her he suspected Bipolar II and Generalized Anxiety Disorders. Suddenly everything changed. Someone finally gave names to her problems. But then again, nothing changed. She still felt the same. She wondered, what do these labels even mean? When she got home, after a brief “freak out,” she got busy doing some research on her own. She wanted to get as much information as she could.  It was a lot to digest, but it made sense after a while, and it sure seemed to fit. She reflects, “Learning about myself, getting help, and taking medication changed everything – and, in some ways, nothing as I am still the same person, just more aware.”

The doctor prescribed some medication to help stabilize her moods and calm her anxiety. She started seeing a therapist, and talking about everything seemed to make it feel less taboo, less stigmatizing. But it also became apparent why she’d avoided opening up for so long. Talking about things can awaken demons. In other words, things can get worse before they get better. Alyssa started having more vivid nightmares, ones that would twist the past into an agonizing present. She sometimes woke up screaming. That wasn’t part of what she had researched.

Mental health during pregnancy

She fell in love and got pregnant; she had to stop all medication during pregnancy. Twice during the pregnancy, she was taken to the Emergency Room for what turned out to be panic attacks and, although she was given Xanax to be used as needed for severe attacks, she survived the full-term without any other medication. She recalls one of the ER visits, “At one point my heart rate went up to over 165 during a panic attack. I’ve also passed out because my anxiety was so high. I get anxiety while driving, or when I’ve made plans for something, and the date is coming up. I’ve canceled plans at the last minute countless times.”

After her son was born, she thought she knew herself so well, and had mastered her illnesses. She thought she had it all figured out; unfortunately, that was wishful thinking. One can manage the symptoms of Bipolar and Post-traumatic stress disorders, but they seldom go away completely. Over time, she ran up close to $10,000 in debt, started losing relationships, and most of her social connections. She sometimes found it impossible to get out of the house, drive, or go anywhere.

As time went on, Alyssa saw more clearly that this whole “taking medications and opening up in therapy” thing was probably going to be her key to survival, and she fully embraced the process. Alyssa began to untangle the past and talk about some of the worst things that had happened to her. But there was one she held in. Finally, during one session, she opened up and told her therapist about how one of those so-called “friends” she used to hang with as a teenager, had raped her.

Discovering PTSD

Alyssa recalled someone had once told her that Post-traumatic stress disorder (PTSD) was something reserved for the military – people with “real problems,” so she was pretty surprised when her therapist brought it up. The therapist explained that, while it’s true that PTSD is common among combat veterans, there are many forms of trauma. Nightmares, flashbacks, always feeling on edge were some of the telltale signs. So, one more “diagnosis” added to her list.

One of the key features of PTSD is intense reactions to external cues that can remind a person of the original traumatic event. For Alyssa, these triggers turned up in unexpected places: background music on a TV commercial, an online picture, a sensation in her body. “The other day, the dog fell asleep on my leg. It was quiet, and there was nothing wrong. Suddenly, my leg went numb from the weight of the dog. A panic attack exploded out of nowhere. I later realized that the sensation had triggered a memory of being held down against my will, unable to escape. The night that I was raped.”

Alyssa pushed through and decided to go back to school, taking some online classes. She finds it is somewhat easier to take on such challenges when her mood is on an upswing. She calls these “the gains of hypomania.” She has also sought out other interests such as knitting that can soothe her.

Living with mental illness

Alyssa still sometimes skips a meal due to stomach upset, nausea, or dizziness connected with her anxiety. Sometimes she stays up all night or wakes up in terror from a nightmare. Alyssa’s anxiety can be triggered if there is too much going on, a kind of sensory overload. When the baby is singing, the television is on, the dog starts barking, and suddenly someone needs to talk to her, “I don’t mean to yell, but I just cannot take that one extra thing.” She keeps going to therapy, taking her medications, and is ever-diligent about self-care.

There is so much that is positive and good in her life, but the anxiety and the mood swings can be overwhelming at times. She advises, “the worst thing a person can do is deny or ignore their behavior. The best advice I can offer is that by the time one or two atypical things happen, you should seek the advice of a professional, you may need help. I cannot change who I am. Either way, these illnesses are as much part of me as any other, and I would not, could not change that. Once you begin to trust your therapist, it is still so hard to talk about your past and find ways to calm yourself in the present. I keep track of warning signals and avoid triggers that could send me off. I am diligent and try every day to accept who I am.”