Approximately four months ago, my psychiatrist placed my Bipolar 1 Disorder in partial remission. Since, I have struggled, grappled, with the word “partial.” How is it possible that I am only partially towards remission? Where is the line drawn in the division of these categories, where does the curtain fall – symptomatic, partially symptomatic, fully asymptomatic? The application of “partial” poses discomfort for me on several levels, the very first being my perceived lack of control. As the entity experiencing the disorder, how can an outsider peer in and see the inner clock working, ticking, turning of my mind and know, with a certainty, I have progressed up the ladder? I feel quite wary of such a distinction. I see mental illnesses as fluid disorders, not remaining in exact, crystallized forms for extended periods of time. Thus, as I continue to have episodes of mania and depression, I squirm with angst and frustration that such emotions should have been annihilated by now, as I am in partial remission, correct? I am constantly flowing in and out of states, and these two words attempt to hit a fragment of my existence like a dart to a bullseye and obliterate all outlying symptoms. At least this is how my mind perceives it to be. Rather, as I have discovered in the medical world, labels are just an issue of semantics, present only for clear and consistent communication among medical professionals and for the direction of effective treatment.
If I can entertain the notion of casting all labels aside and truly examine my progress, there rests marked improvement. One year ago, I was still receiving electroconvulsive therapy treatments, and much of my episodes surrounded suicidal thoughts and intrusive thoughts of self-harm. Episodes lasted weeks, even months, despite aggressive treatment. If asked what my greatest worry for the future was, I most likely would have answered suicide.
I had my final official meeting with my psychiatric nurse case manager yesterday. We were discussing my progress and impending ability, due to vast improvements, to be discharged from the intensive care program. She posed the question, what are you most worried about in the coming year? My immediate, knee jerk response was “not getting into grad school programs.” What a departure from a year ago, twelve months ago, three-hundred sixty-five days ago. It was in this moment that I could see how significantly my perspectives have changed, have shifted. Instead of contemplating the unsure existence of life in the near future, I imagine a place in which I live, I am successful, and I humanly exist.
To battle words is a futile battle. One must recognize that words only hold the power that you allow or wish for them to hold. And why can words not be fluid as well? In consideration, can the word partial possibly be considered fluid and dynamic, for does it not imply a sort of limbo? How more advantageous it would be to see it as a realm of existence where I can experience a spectrum of differing symptoms, yet still exist in a space of reduced symptomatic expression. I do not have to imagine lines and curtains, theatrical representations of the process of remission. The underlying, driving emotion in this wrestling match is fear, in two parts. As I progress into partial remission, does there lie an impending regression into severe illness once again? Or alternately, as I move from partial remission to a possible full remission in the future, will I lose the mind I have and hold so dearly, or my depth of experience, as well?
I can take a shower and perform morning ablutions without washing my hands repeatedly to avoid contamination. When things do not occur within increments of four, I no longer freak out. It only takes me a few minutes to leave my apartment, checking all faucets and appliances and the door only a few times. These rituals, but a small part of my cornucopia of symptoms, were all-consuming. The other day I realized I did not massage my scalp to the count of four as I was shampooing, and that was okay. Anxiety had abated, and I could wash my hair without the abacus clicking within my head. Instead of focusing on semantics, I vow to focus on my improvements, my victories in the face of crises. Why get hung up on words when I can drink the sweet wine of life?