Perhaps each new square she checks off is a step forward, not a total game restart.
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My 24-year-old daughter, Willow, has a bipolar disorder. In so many ways, our family is very lucky because she is med-compliant, and her meds work for her. She has a job that allows her to support herself financially, and she lives on her own. But this somewhat rosy life is complicated by the hideous number of comorbidities that rear their ugly, whack-a-mole heads just when we think that we are sort of home-free. It starts to feel like Willow walks around with a bingo card with squares labeled with possible new struggles she’ll have to face. Those same squares, however, may also represent new possibilities for improved functioning.
Willow lives in Boston and works a good corporate job, but either my husband or I spend a lot of time visiting her. This is intentional and part of how she helps maintain her stability. When Willow starts deviating from the patterns of behavior that she and her team have decided represent her “normal” or euthymic state, she reaches out, or we do — like the time that I realized she had uncharacteristically stayed out all night, and I knew this happened because we all agreed that we’d still track her on Life360.
Recently, we had one of those events that resulted in Willow’s metaphorical “Bipolar Bingo Card” getting a new completed square — she was diagnosed with ADHD. The diagnosis came up because Willow began to cycle while she searched for a new apartment. She found that she couldn’t manage the activities required to find a new place to live in an expensive and tight housing market like Boston. Her psychiatrist and therapist had both previously suggested ADHD as a possible comorbidity for her bipolar disorder, but she didn’t want to rock a medication boat that was still floating. Willow was happy with her bipolar medication regimen and worried that adding a new medication would rock the boat and lead to instability. However, when the apartment hunt threatened to drown her even without med changes, she and her team decided it was time to try medicating for ADHD.
As we looked at the sheer number of comorbidities Willow has already checked off, including eating disorders, mysterious neurological issues, social anxiety, and PTSD, it was initially disheartening to add ADHD to the mix. There are many comorbidities people with bipolar disorders suffer from, and untangling this hideous Gordian knot of comorbidities seems daunting and discouraging. As an inherently (and possibly annoyingly) positive person, I choose to believe instead that this new addition to Willow’s list of challenges is not a setback. Instead, perhaps she is finding new avenues to live her life fully and competently.
I have no reason to complain about this new diagnosis, even though I have been sleeping on an air mattress in Willow’s tiny (new) Boston apartment for more than a month now as she adjusts to a new medication. ADHD medication has made a huge difference in her ability to thrive — not just function. She is enjoying her life more and can do so many more things that I had doubts about her ever being able to do, like tackle her laundry, put dishes in the dishwasher, or throw away her garbage. She is creative and focused at work, and she is enjoying her job in new ways.
It turns out that ADHD, coupled with her bipolar disorder, made it basically impossible for Willow to do things that did not interest her. She beat herself up for this so much — she knew that no one liked doing dishes or laundry, but she had no idea why others could manage chores when she could only manage to get into bed and pull the (probably somewhat dirty) covers over her head. Her self-image has greatly improved since beginning ADHD treatment because she found the energy and concentration to work a full day and to still manage her obligations at home.
When Willow came to the realization that maybe she couldn’t focus due to chemical reasons, she began to see that perhaps her harsh self-talk, which suggested she had a personality flaw or was simply lazy, was incorrect.
As a parent, I have been told that I will be a part of my daughter’s efforts to stay stable for my whole life, or until she finds a healthy and committed partner to help her. At one point, her healthcare team told me she would never be able to live alone and that I would need to always keep a vigilant watch on a grown woman who is mainly very functional. This hasn’t ended up being the case, and I credit Willow’s grit and determination to whack those comorbid moles every time they rise out of their fetid hiding places.
I am so happy that this newest ADHD diagnosis has resulted in real improvements in her quality of life (and also in the amount of clean laundry she now has). But, paradoxically, I also feel extreme guilt every time we find a new mole hole to fill. This time, it was, “What if she isn’t even bipolar?”
When she was in fourth grade, her teacher said that Willow had trouble paying attention to the teacher, even though she was apparently listening and could answer questions on the topic. What if, instead of being pretty pissed that the teacher was being so picky, I had gotten Willow checked out for ADHD? Maybe her whole life would have been so much better, and she wouldn’t have gotten a bipolar diagnosis. What if we have been medicating her for eight years with something totally unnecessary?
This new guilt layers quietly on the guilt I feel for not understanding that social media bullying might have a psychological impact on her because I had no social media while growing up. And the secret, unspoken fear always whispers to me at night, “What if this came from your genes? What if YOU did this to her?”
I try to do what my therapist says and tell myself the things that a kind friend would tell me — I did the best I could with the information I had; I can’t change my genes — and that helps some. But what really helps as my sweet daughter ponders her virtual bipolar bingo card is thinking that perhaps each new square she checks off is a step forward, not a total game restart.
Struggles and Triumphs: Adding New Diagnoses to a Bipolar Disorder was originally published in Invisible Illness on Medium, where people are continuing the conversation by highlighting and responding to this story.