A "deficiency" or mental illness?

I was discussing my blog with my father over the weekend because I was still torn over the issue of whether or not to disclose my true identity in my writing. He and I both agree on the point that there is an incredible amount of stigma still attached to the label of bipolar in our society, and then he said something that really made me think. He told me that he doesn't consider me to have a mental illness, per say, he feels that I simply have a "deficiency in my brain chemistry" which causes me to become psychologically impaired during times when I am unmedicated. Humph. Good point Dad. Especially because all three of my hospitalizations prior to the first where we had no clue that I was Bipolar, happened when I was not on my medications.

But are you saying this simply so that you do not have to be constantly reminded that your child has a psychiatric condition? I guess "deficiency" just makes it feel better.

I mean, I see your reasoning. And it does make sense. It is true that I really only require a small amount of Lithium to function at a completely normal level. So, as long as I take my meds (which I do religiously - my past has taught me some very valuable lessons, let me tell you) I'm normal. Balanced. Sane.

Not mentally ill.


History has proven for me that within a week of going off my medication, I'm spinning out of control and am clinically psychotic. It takes a couple of weeks on anti-psychotics to bring me back to the middle.

So yeah, I guess you could say that my brain is deficient. It's so weird to me that all it takes to keep me normal is a small amount of a naturally occurring salt. When I looked up Lithium Carbonate on Wikipedia, I wasn't surprised to read this:

Upon ingestion, lithium becomes widely distributed in the central nervous system and interacts with a number of neurotransmitters and receptors, decreasing norepinephrine release and increasing serotonin synthesis.

After my most recent hospitalization, I was released to the care of my regular psychiatrist who had been helping me try to stay off Lithium during the pregnancy since I wanted to be medication-free for the first trimester to give the heart time to form without being exposed to Lithium. At my first appointment with her post-hospital, she and I agreed to continue using the anti-psychotic, but to try to stay away from the Lithium as long as possible. That next month was really hard. I literally had trouble putting words together to form sentences. I couldn't talk right. I jumbled my speech. I couldn't write with a pen and paper. I avoided my friends because I didn't want them to see me that way. I remember telling my psychiatrist, months later once I was stabilized again on Lithium, that at the time it felt like the neurons in my brain were broken, they weren't firing the way they should have been so that I could think and make sense of things. It was awful. I needed Lithium in my blood.

I specifically remember the morning that I called my high-risk OB-GYN to tell him I had recently come home from a hospitalization. I told him I wanted to stay off the Lithium for the first trimester, but he said it sounded like I needed it. That was when I made the decision to go back on it. It was a good decision. The benefits outweighed the risks.

But back to my original topic - deficiency or mental illness? I don't know. I'm still torn on this. Bipolar Disorder is a mental illness which people live with their entire lives. Just like heart disease, once diagnosed, is a condition that a person lives with the rest of their life. Sure, there is a deficiency in my brain chemistry that when treated allows me to function at a normal level. But that doesn't mean that I don't live with this diagnosis for the rest of my life. I still think about it about twenty times a day, on an average day. And if I don't take my meds, or they suddenly stop working for me, then yes, I will become mentally ill.


It's just that 99.8% of my life has been spent not feeling mentally ill. And I'd like it to stay that way.

What's your take?