I actually began thinking about this yesterday, after reading something by our newest blogger, James Claims.  His post, Comorbid Migraines and Other Health Issues, as well as the comments it generated, started me writing in my head.  Then I read another post by our ManicMuses, Abilify and Agoraphobia?, and since I couldn’t sleep for the thoughts doing a tumbling routine in my mind, I decided I should write it all out and share it with you (you’re welcome).

In James‘ post he mentioned migraines specifically.  In ManicMuses‘ she spoke more about anxiety disorders.  The comments on the former brought up the chicken and egg debate, what causes what.  That’s a great deal of the reason I wanted to write this post, because while I cannot definitively tell you what brought about what in me, with two notable exceptions, I can tell you which came first, second, and so on.  I think this is a great deal more than most people with comorbid psychiatric conditions can do.

As to comorbid, Merriam-Webster’s Medical Dictionary defines it as “existing simultaneously with and usually independently of another medical condition” (italics are mine).  I emphasize this point because it fits me well, and also because the word is often understood incorrectly.

So a brief history of me.  I would be the Alphabet Soup in the title of this post.  First came the generalized anxiety disorder (GAD).  I can tell you a specific primary cause for this one.  When I was quite young and growing up in Pittsburgh, PA, my mother would often cry out melodramatically, “I’m going to jump off a bridge!” when my sister and I drove her crazy.  Now, my mom and I have always been quite close, and growing up in the city with the greatest number of bridges in the world, this seemed like a real and valid threat.  But considering my sister never developed a disorder because of this – well, maybe I was overstating things a bit by calling it a specific primary cause.  But it certainly took a seed within me and gave it amazingly fertile conditions in which to bloom.

Childhood was also when an extremely mild case of obsessive-compulsive disorder (OCD), sub-clinical but present, first showed itself.  It got considerably worse later in life, but I’m attempting to keep things chronological.

And of course there were the headaches.  Were they migraines back then?  I can’t really tell you.  My mother remembers (as I do) that I had terrible headaches even as a very small child, but generally the pediatrician does not diagnose migraines, not as such, in a four-year-old.  They continued and were formally diagnosed as “common migraines” (I’ll spare you the details between common versus complex migraines) in my teen years.  But they definitely established themselves long before I had any symptoms of manic-depression.

The manic-depression (for purposes of the Alphabet Soup reference, the clinical shorthand for bipolar disorder is BD) preceded my first episodes of panic disorder (PD) by months at most.  I did not have signs of pediatric onset bipolar disorder, as so many people feel they did.  That smacked me upside the head probably around 13, although I didn’t seek help or receive a formal diagnosis for more than a decade.

Impulse control disorder (ICD) flourished during that time, and I still don’t have a firm grip on that one.  It has been well established that much of what I did impulsively was not a result of mania, and the behaviors certainly meet the criteria for ICD, though not the severe type that manifests as pyromania or kleptomania.  Mostly I shopped.  I still do.

The most recent lodger at the inn (or in the can) is post-traumatic stress disorder (PTSD).  I can tell you exactly what caused that.  I was coerced and manipulated into electroconvulsive therapy when I was at my most weak and vulnerable.  So while the manic-depression may have led to the PTSD – if I had never sought psychiatric help I never would have had my trust violated and abused in such a profound way (because that’s what caused the PTSD, the ECT just exacerbated it) – it was in a very roundabout fashion, and it certainly did not cause it.

It’s interesting to me, because one of the comments on James‘ post was from our own lovely Lulu, who asked me if I ever get sick of being labeled.  Probably I used to, at first, but now I take the diagnostic labels for what they’re worth.  They give me a direction for management of the various conditions.  That’s all.  They don’t stick to me, nor do they define me in any way.

I hope you all had a lovely meal at Ruby’s Diner.  Specializing in psychological, psychiatric, and somatic disorders since. . .  Oh no.  You’re not getting my age from me.  😉

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