Friday, June 17, 2011

A Radical Change to my Diagnosis

I was diagnosed with bipolar I back in 2004 by the psychiatric clinic at Northshore University Hospital after a serious manic episode that completely destroyed me. Although I didn’t land in the hospital, I came close. Instead, I sat down and wrote Swiss Chocolate and El Aguila back to back. Yesterday my doctor told me my diagnosis had been changed to bipolar II, anxiety and personality disorder NOS (Not Otherwise Specified).

At first I was floored, and didn’t know how to accept this news, and asked him to please explain what this meant. He told me that although my manic episodes were severe, they were not the kind that landed me in the hospital, like so many of the guys in my group went through. I argued that during some of my manic episodes I was completely off the rails. He agreed, but a large part of what I was expressing was symptomatic of personality disorder. Then he broke it down further.

He explained that there are many classifications of personality disorder, and I did not fit neatly into any particular one, but the ones I came closest to were histrionic personality disorder and borderline personality disorder, more on the borderline side. It is a condition that is usually triggered by intense trauma, like the kind I had grown up with. He further explained that trauma was not the only cause, and that it had biochemical aspects to it just like bipolar disorder. He went on to explain that many of my intense emotional responses to situations and people, my lack of impulse control and intense rage were all symptoms of borderline personality disorder, but I was not fully diagnosed with this condition because I don’t have all the symptoms, and the symptoms I do exhibit are not severe enough to classify me with borderline personality disorder. If my diagnosis was borderline personality disorder, he told me that I would probably be institutionalized and would never have achieved the kind of success I now have. Most people with this condition cannot function in society.

Having read Swiss Chocolate and working with me for the last few years, he was actually quite surprised I had become so successful in such a demanding job. He then told me that the clinic had treatment plans for these symptoms. It is an intensive four-week program consisting of two group sessions and two private sessions with a therapist a day, as well as meeting with your psychiatrist twice a week designed to help you with controlling your emotions and how you deal with others. Considering where I was at, he felt very hopeful because:

a) I was not bipolar I, which made my prognosis much more treatable
b) My personality disorder symptoms were treatable with an excellent success rate
c) I would be able to focus on the areas that were causing the most problems

Previously, my doctor had been following a protocol for treating bipolar disorder, but I noticed I was getting worse, not better. I had destroyed a lot of friendships, and I was becoming more discouraged and despondent. In fact, my impulse control was so bad I had to deactivate my facebook account. I don’t go there under any circumstances. Too dangerous, and a lot of people are scared of me or don’t like me anymore because of some of the terrible things I have done to others in fits of rage.

One of my good friends and I had a long talk about all this last night. Like me, at first he was a little skeptical. He has told me dozens of times that my greatest gift was to accurately assess my mental well being and get help when I need it, which explains why I have stayed out of hospitals. He has seen me when I was pretty manic, and yeah, I was off the rails, but that doesn’t explain the lack of impulse control and rage. Part of being manic is increased irritability and getting into fights with others, but what I was going through was full-on rage and no impulse control. On many occasions I whipped out some venomous emails that were so vitriolic they left my victims stunned. And I have made some outrageous facebook posts that have scared people away from me for good. Everybody knows how angry I am.

My doctor is convinced that my rage can be brought under control with the right treatment. It would mean taking four weeks off from work to go through an intensive program five days a week from 9:00 am until 3:00 pm, but I am all for it, and yesterday my doctor verified that my insurance covered it. My boss has told me on several occasions to take the time off I need to get myself right, but I kept saying no because I didn’t know what the right course of action was. Now I do, and I am hoping I finally find the coping skills to deal with my emotions and interactions with others.

Love to all!

James M. Weil


  1. James,I'm so glad you have found some answers and have found a doctor willing to take the time to help you. I read your story and find myself amazed at how well you understand yourself and your condition. Your story sounds like a medical doctor has written it. You never fail to amaze me. Most with the illness you have been diagnosed with completely shuts themselves off to the world and outsiders or they end up even worse and in worse situations or places. I commend you and the strenth you have within you physically and mentally. The fact you admit what you do and worry about it only makes me respect you as a true honest human. May you find peace James in knowing some do understand and care that you be and become all that you wish to be. Love back to you my friend.

    Jean Johnson

  2. Jean,

    I have made it a policy from when I was first diagnosed with bipolar disorder to be completely open about my disease. Yes, I do have issues, but I battle with them everyday, and I am not afraid to tell people about what goes on in my heart and soul. It's what made Swiss Chocolate so successful.