Blame and causation are slippery bastards and not easy to understand or assign.  I hesitate to even consider the word “blame” here.  I am 100% positive that that new baby girl, Piper, was the product of the induced labor–though she probably would have made an appearance, sooner or later, without the induction part.  I am about 98% certain the the broken tail bone is a direct result of the vaginal birth of that 9 lb, 4 oz baby girl.

The broken back–that’s much harder to pinpoint.  Less dramatically, I have a stress fracture in the 5th lumbar vertebrae. It almost certainly happened before the actual birth.  It may have occurred in the preceding nine months.  The gigantic baby bump pulling at my back could have caused it.  But before that was a previous pregnancy and before that were years of gymnastics as a child and then years of coaching as an adult.  Slippage and/or a stress fracture at L5 are not exactly common for gymnasts, but neither are they unheard of.  It could have been a ticking time bomb, waiting for the added stress of that belly to set it off.  For all I know, it was a ticking time bomb that had gone off during my first pregnancy, or even as far back as when I was a teenager.  I just was never made aware of it until after Piper’s birth.

My broken mind is like my broken back.  Again, less dramatically, I have been diagnosed with bipolar disorder, peripartum onset.  Added to that is what my psychiatrist and I refer to as “general anxiety.”  I show symptoms of social anxiety, general anxiety disorder (GAD), panic disorder.  We just group it as “anxiety” since his treatment plan would be the same, no matter how many names or letters we gave to it.  I will save talk about anxiety for another time, along with the sleep issues I have.  There is only so much crazy you can talk about at a time.

So that’s the official diagnosis–bipolar, peripartum onset.  Beginning before or after childbirth.  I was diagnosed as having peripartum depression at first, and only after seeing a psychiatrist when I wasn’t getting better was the diagnosis changed.  But when did it begin, really?  I had postpartum depression with my first child, Finn.  Was that actually misdiagnosed bipolar?  I search memories from before I had kids.  I was treated for depression, first in college, then in law school.  Was that actually bipolar?  The rush from all nighters pulled in school, working on projects.  Was that “normal” procrastination or something different?  The euphoria I felt at times, that I could win any speech competition, that I was the ultimate stage manager, that I could do ANYTHING.  Normal excitement or hypomania?  I could spend hours picking apart my previous life, trying to see if there was some indication of any manic states.  I HAVE spent hours, picking apart my previous life, doing just that.

Of course, it could have be that I legitimately had postpartum depression and that it triggered bipolar disorder later.

I have finally come to the conclusion that it is impossible to know.  And it probably doesn’t matter.

The most important thing for me to remember is that bipolar, peripartum onset differs from postpartum depression in that it isn’t going anywhere.  I have bipolar disorder and barring some miraculous cure being developed, I will have to treat and manage my bipolar for the rest of my life.  That probably means medication, every day, for the rest of my life.  It means seeing my psychiatrist on a regular basis, for the rest of my life.  It means that while I will hopefully reach and maintain “stable,” I will never NOT have to be vigilant about my mental health, for the rest of my life.  It means that no matter how hard I try, my loved ones and those close to me and even those who have the slightest contact with me, will at some time or another, be affected by my mood disorder, for the rest of my life.

I continue to work with my doctors, and it seems that we have finally found the right mood stabilizer.  We are still working on details and right now my life feels like a mess but it also feels like we are looking in the right direction.

I am privileged to have access to doctors and medications and other therapies.  I am privileged to have a family who loves me and supports me and helps me.  I am privileged to be able to not work.  I am so damn lucky.

But I still have to deal with the reality that my mind is broken, every day, for the rest of my life.