Can One Alter In A DID System Have A Mood Disorder?

We were diagnosed with DID (Dissociative Identity Disorder) in 2009 by our psychologist, and had the diagnosis confirmed by our psychiatrist in 2010. Since then our psychologist has also diagnosed Bipolar II, but our psychiatrist seems hesitant in confirming that diagnosis.

I think DID can look a little confusing from the outside. If we’re rapidly switching, and everyone is in a different mood, has different energy levels, different concerns, and different priorities it could look like our mood is rapidly changing.

However our system generally isn’t like that. Overall each of us seem to have a relatively stable mood and way of perceiving the world. Except me. As far as I know I’m the only one that has ongoing mood issues. It’s true that, at times, other parts have been unsafe and suicidal, but that’s been related to specific trauma, not mood issues.

I’m struggling to manage my mood with medication. My mood is still up and down no matter what medication I’m taking. Up can be fun if I’m happy and not agitated, but that hasn’t been the case lately. Down is crushing and soul destroying. I’m currently trialling one last medication regime before I go back to my psychiatrist to discuss other options.

What’s interesting is that when my mood is elevated, other alter’s moods are not. Even when I’m severely depressed it’s unusual for other alters to also be depressed. Their moods, thoughts, and perceptions seem entirely separate from my own.

When I’m hypomanic we don’t switch. It seems like I’m so busy, excited, and happy that other parts simply do not get a chance to come out. I also feel much more confident and capable, and experience no anxiety so there seems to be less need for switching.

When I’m depressed we switch more often than when hypomanic. I think that’s because I become so overwhelmed and unsafe that I don’t want to be out, or other parts become so concerned for our safety that they come out to keep us safe. When that happens, whoever comes out is not depressed. They express obvious concern for me and my mood, and our safety, but they do not share the overwhelming depression.

It’s quite confusing. I’m not sure if that’s common or ‘normal’ for people with DID and a mood disorder, but that’s how it works for us. I don’t know if that makes a Bipolar II diagnosis more plausible, or just more confusing. I think I have Bipolar II, but I don’t think other parts do.  Does it mean that I do (or don’t) have Bipolar II? I have no idea.

‘Where have you been?’

‘I haven’t seen you for so long! Where have you been?’

I lost count of the number of times my colleagues asked me this yesterday. It was my second shift back at work in as many weeks. My colleagues can be forgiven for not having seen me. I’m able to work only a small number of hours each week, and my roster changes each week. Often we miss each other because of different shifts.

Where have I been?

Back and forth between healthcare appointments, with the remainder of my time generally spent at home resting. During the peak of the health chaos I’d been to four different hospitals in seven days. Then there were the follow up appointments with my regular healthcare team, as well as specialists. I’m still waiting on two more outpatient specialist appointments, but things have quietened down.

It was very scary and stressful having a potential new health issue come out of nowhere. I’d been feeling my usual ME/CFS symptoms – worn out and sore. I was told the condition I may have could cause serious complications if left untreated, and researching the prognosis online did not help. Thankfully further tests have revealed that it’s unlikely I have the condition. I have further tests and follow up later in the year.

Then (because there’s always more!) my mood spiraled upwards into hypomania. Whilst that’s been fun, entertaining, and refreshing, it’s also destroyed my budget, strained some friendships, and physically worn me out. ME/CFS and Bipolar II are an utterly ridiculous combination, and the hypomania has been more difficult to manage this time.

As for The Committee there have been quite a few changes since our hospital admission over Christmas. Nothing hugely noticeable to anyone on the outside, but some significant shifts inside. Attitudes have changes, and we’re more focussed on working as a team than ever before.

I’m hoping (and crossing my fingers and toes) that I’ll be able to get back to writing more regularly now, but please be patient with us.

What Are Your Warning Signs?

Mondays are therapy days. The one guaranteed day each week that I drag my exhausted, sore body (thanks ME/CFS) out of bed, and out of the house. Today was no exception.

I spent my time in the waiting room chatting to a friend on Facebook. I hadn’t given the upcoming session much thought. Things seemed fairly on track. Stable mood, no suicidal ideation, no self-harm, eating enough, and generally coping. Plus allowing more internal communication and switching.

One hour later, and I had a completely different perspective. My psychologist did a very good job of pointing out the warning signs I hadn’t yet seen, and expressed her concern for the behaviours I’m engaging in.

It’s made me think about the relapse prevention work we did in group whilst in hospital earlier this year. In one group session we had to identify relapse warning signs, and work on strategies to prevent. I dutifully filled in the worksheet and participated in the group discussion. When I came home the worksheet went away, and I haven’t thought about it since.

However, I do know my warning signs. It’s just that this time I’d forgotten to keep an eye out for them. This isn’t a complete list, but these are some of my warning signs.

Eating Disorder
Increased concern and worry about body shape, size, and weight.
Avoiding or restricting specific foods or food groups.
Significantly reducing portion sizes.
Swapping meals for low calorie protein shakes.
Skipping meals.
Ignoring hunger.
Using fibre supplements to avoid eating.
Abusing laxatives.
Bingeing.

Depression
Decrease in social activities.
Decrease in enjoyable activities.
Failing to see the point in engaging in the above activities.
Feeling like there’s no point to life.
Feeling hopeless.
Not seeing a future for myself.
Feeling like a failure.

Hypomania
Increase in enjoyable activities.
Talking more quickly.
Multi-tasking to the extreme.
Starting new creative projects.
Laughing much more than usual.
Swearing a lot more than usual.
The urge to buy things, or actually buying many, many new things.

Dissociation
Increased switching and associated memory loss.
Losing chunks of time (more than several hours).
Increased occurrence of flashbacks and body memories.
Difficulty falling or staying asleep.

Knowing the warning signs isn’t enough to prevent a relapse into unhelpful behaviours. Being aware of them, or having others point them out to you certainly helps, but it’s not enough on it’s own. Awareness is only the first part of preventing a relapse.

My task for the week is to work on tackling some of the symptoms that make up my Eating Disorder warning signs. I haven’t relapsed. This is about staying on track and preventing a relapse. I’ve been warned by my psychologist that a relapse will only lead to another hospital admission. Having already spent 7 weeks in hospital this year, another admission is the last thing I want.

Differing Abilities, and Special Talents in a DID System

We all know that different people are good at different things. You might be excellent at baking, whilst a friend is a star football player, and another has impressive communication skills. Everyone is different, and everyone has their own strengths and weaknesses.

What about strengths and weaknesses in someone with DID? This is where it gets interesting! I don’t think there’s much research to be found on it, but it seems that, within someone with DID, there are many talents, strengths, and special abilities.

In my system Miss and Mr Mid-twenties are excellent communicators, as well as being very patient, and nurturing. Mr Mid-twenties also has an amazing talent for organising, and managing day-to-day life.

Miss 5’s playful, and cheeky nature are things that I see as strengths. She can have fun, play, and enjoy life in a way that I struggle to do.

I’ve discovered that Miss 19 is our resident poet. I knew someone could write poetry, but had no idea who. I couldn’t string a poem together to save my life! However, when Miss 19 is out the words flow much more smoothly than anything I could write. I’m better at more academic type writing, which is how I do so well with university study.

Her latest poem (and one we’re both quite proud of) is about Bipolar II. It’s a diagnosis that’s becoming more, and more likely as time goes on. Repeated hypomanic episodes, followed by either periods of depression, or more stable mood continue to point towards this diagnosis. All of that roller coaster of a journey is for another post though.

 

Merry-go-round

Happy, smiling, laughing, free
Cranky, upset, guilty, needy
Crashing, crying, sad, and low
Up or down, you never know

Today is amazing
You’re high, not low
Tomorrow is looming
You still don’t know

It could be filled with fun and delight
Or you could be crying ready to die
Up and down, on and on
A merry-go-round you can’t get off

Fuck the world, I’ve had enough
Nothing is okay, nothing is right
I’ve had enough, keep out of sight
Watch out, I’ll explode with empty rage

Happy again, smiling too
Creative, energised, ready to go
Ideas, plans, so much to do
Anxiety gone, nothing to lose

Sad and low, hopeless too
Crashing, burning, going under
Ready to die, don’t care anymore
Wanting out, tired of existing.

Hypomanic… Again.

Oh my goodness! I was awake at 5:30am… wide awake despite being physically exhausted. My brain woke up and is all go.

Tidy your room. Fix your squeaky bed. Clean out the fish tank. Research Cupramine and maintaining copper levels in the tank. Finish your jewellery box. Tidy EVERYTHING. Clean out the wardrobe some more. Sort out old uni books to sell/give away. Tidy, tidy, tidy!

My response – screw this. Seriously, screw this. I’ve had enough. I’m sick of the ups and downs. Although, the downs have not been to the point of being suicidal, they’re still not nice. The hypomania is wearing me out. I’m already exhausted – I can not keep going!

I’ve decided to come off the Prozac. I’ve halved my dose again, now it’s only 5mg which is a tiny, tiny dose. I do worry that coming off it completely will leave me feeling very low, suicidal and unsafe, but I can not handle the hypomania any longer.

I’m going to call my psych registrar this morning and discuss it with her, but I’m done. Had enough. Shortly I’ll take some seroquel and hopefully that will slow my brain a little. I won’t hope for sleep, that’s a bit ambitious, but slower would be very much appreciated!