The Wrong Thing: The Hazards of Misdiagnosis

By Sheila O’Shea

[Trigger warning: suicidal ideation]

I knew it wasn’t Attention Deficit Disorder.

I went through a battery of tests for ADD—pointing at pictures of aliens and reciting their names, holding a metal rod steady so it wouldn’t touch the inside of a metal ring, filling out questionnaires—and the doctor concluded that I didn’t have ADD. He suggested that I dropped the ambitious projects I’d started because I’d lost interest and that a writing coach could keep me on track. I couldn’t afford a writing coach, so I left it there, with at least one possible explanation for why I was struggling crossed off. Whatever the right thing was, ADD was the wrong thing.

It was a primary care physician who told me it was depression. I’d been dealing with relentless insomnia that caused me to oversleep when daylight came, which had cost me a perfectly good job. I detailed my symptoms and he said, “It sounds like depression.” I left with a prescription for antidepressants and a sense of relief that comes from finally figuring something out. It explained so much—the times I spent pressed to the bed by an undefinable weight, the periodic inability to focus on things, the moments when I would look at something beautiful and not feel a thing.

It explained why I lacked the motivation to look for work teaching English in Japan after I went there with nothing but a suitcase, a hotel reservation, and a list of schools to call. It didn’t explain where I got the energy and unshakable confidence to book the flight in the first place.

But depression it was. I put on the identity of a depressed person and took an increasing number of medications to treat this condition, medications that would work a while and then fade in their potency, so the depression would creep back in. But sometimes they would work and I would have the boldness to sing at the top of my lungs in the middle of the lobby of a luxury hotel.

One day, I learned about high sensitivity—which I checked off every box for—and learned that when highly sensitive people get overstimulated, it can burn off their supply of serotonin. At last! An explanation that made sense. It clarified why I got depressed but didn’t always get depressed. It was clear to me that depression was the wrong thing. Soon after, I weaned my way off of the drugs that I was still taking and switched to amino acids and other supplements.

And it worked. Mostly. I’d have to periodically lock myself in my bedroom with the lights out to decompress from the stresses of living, but the depressive moments passed eventually and I would have times when I felt like I could conquer the world.

Then I found work with a large law firm and was fired within a year. I either worked too slowly due to my bouts of low energy, or I was convinced I knew better than my bosses and stepped on toes accordingly. I found work at a smaller law firm and decided that the large law firm was simply too much for me to handle, so I would be fine in a more modest one.

One morning, I got to the office early like usual and fixed myself a cup of tea. I looked out the window at the city and couldn’t grasp the beauty of the summer morning.

I could be happy here, I thought, if I weren’t so unhappy.

I went back on antidepressants. When I asked the internet if the antidepressants would interfere with another drug that I was using, I tumbled down a rabbit hole of links to find out about bipolar disorder type 2. I’d never even known that bipolar disorder came in gradations and that it didn’t have to go to the extremes that I associated with it. Perhaps high sensitivity was the wrong thing. I kept the diagnosis in my back pocket for consideration.

One fine Monday at the office, I found myself grappling with a fit of suicidal ideation that first sent me home, then sent me to a psychiatric treatment facility. I’d dealt with suicidal thoughts for decades, but I’d always talked myself down from them. This time, I decided to take it seriously.

I was there for five days. I was given a new medication regimen and a tentative diagnosis of either bipolar disorder or borderline personality disorder. They weren’t sure. I left without being told which one was the wrong thing.

The diagnostic process at Skyland Trail was done even more thoroughly than my ADD tests. I took intelligence tests, talked to psychiatrists, and even had blood drawn to make sure there wasn’t another physical cause to my problems. Finally, I sat down with my parents and Dr. Kotwicki and he broke the news. It was bipolar disorder type 2.

“That’s about what I expected,” I said.

“That’s an atypical reaction,” Dr. Kotwicki remarked.

I threw my hands above my head and shouted, “I CALLED IT!”

I spent about four months at Skyland Trail, learning what my illness meant and how to handle it. I established a new regimen of medication, with the unheard process of discussing with my psychiatrist what I would be taking instead of having a prescription slip written out and shoved into my hand. I learned to monitor my moods and to know what to do when they start to veer in one direction or another.

Am I cured? No. I never really will be. Sometimes the black-eyed dog of depression comes by and starts barking, and I have to dig out my tools to whack it on the nose. But, as with any problem, I now have the knowledge that makes managing my bipolar disorder much easier. The knowledge that makes solving any problem easier, in fact; the knowledge of what you’re up against.

I lost about a decade and a half to a diagnosis that failed to examine all the aspects of my condition. I can’t get those years back. All I can do is move forward and do my best.

If you’re out there and you’re living with a diagnosis of mental illness that doesn’t quite fit you and doesn’t seem to be responding to treatment, I urge you to get a second opinion and a thorough diagnosis. It can change everything.

Don’t lose years of your life trying to fix the wrong thing.

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