Recognize underlying disorders, tackle them, too

Oh that we could have just one mental illness afflict us at a time.

Many of us diagnosed with one mental illness have another lurking — often undiagnosed or untreated. Doctors call it “co-morbidity.” Others call it “dual-diagnosis.” I call it “unfair.”

Two weeks ago I started sliding. Hours of feeling OK, then hours of feeling down. The OK hours slowly shrunk to OK minutes. The down hours became a day, then another and another. On the second down day the switch between my brain and stomach flicked off.

Three days later, I had already lost 5 pounds. A trainer at the gym told me I was getting too thin. A couple of my girlfriends invited me to dinner. Another threatened an intervention. I ate a sweet potato and a little cup of chicken soup.

My therapist calls this anorexia. I call it lack of appetite. It’s not like I’m a waif you could blow over with a hair dryer. I just don’t want to eat, and I weigh myself twice a day and track the numbers in my weight journal. Did I mention I don’t eat wheat and very little refined sugar? What’s the big deal? Apparently that’s called an “eating disorder.” It’s just one of a few other “disorders” I deal with, like hypomania — a type of bipolar.

My brain plays dominoes with these disorders. A bout of mania knocks over the depression domino, which knocks over the anorexia domino, which knocks over the exercise-drug-alcohol addiction domino, which goes on and on.

It took decades for me to figure this out. It took even longer to realize that the chain-reaction that effortlessly topples the dominoes does not work in reverse. They won’t automatically pop up if I manage to right just one.

Each disorder has its own treatment. Successfully treating one will not necessarily cure the other. A bipolar drug addict who gets clean is still going to have eye-popping mood swings, bursts of energy and paralyzing depression if the bipolar is not treated, too.

A food addict who smokes and gets treatment for her eating disorder but keeps smoking is still addicted to nicotine. Same with the alcoholic who cuts herself. She is not necessarily going to stop cutting just because she gets sober.

Like I said, it’s not fair. It is even worse because many doctors don’t understand this. They treat one illness but fail to diagnose the companion disorder(s). Then we blame the antidepressants or therapy for not working and we quit. Life becomes hell, all over again.

My solution: Surrender. Recognize the other disorders and treat them, too. I don’t think of it as being a loser. I just joined the winning side.

Christine Stapleton writes for The Palm Beach Post. E-mail: cstapleton AT pbpost.com. To read previous columns, go to PalmBeachPost.com/depression