At DBSA we know sometimes it isn’t only depression or bipolar disorder that someone is living with, but rather multiple diagnoses that impact both physical and mental health. In this Q&A, our DBSA YAC Member Lacee B. shares how she manages to live with both physical and mental health conditions.

What diagnoses do you live with?

My current diagnoses include bipolar disorder, anxiety, PTSD, and POTS (postural orthostatic tachycardia syndrome). My mental health conditions have been present for many years, but I was not diagnosed until I met with a psychiatrist in March of 2020. Since then, I’ve worked with psychiatrists, therapists, and support groups to better live with my symptoms.

On November 28, 2022, I had my first syncopal episode (passing out) related to my POTS, which is a type of dysautonomia. This means my blood pressure drops and my heart rate rises when my body goes from laying to sitting to standing – and it doesn’t regulate back to a safe number. This causes me to pass out. It is likely that the onset of these symptoms, which led to my POTS diagnosis, were brought on by PTSD triggers.

Even though POTS is very much a physical condition, a result of the autonomic nervous system dysfunctioning, my mental health affects them too. The same is true for the reverse. My physical disabilities impact my mental health as well.

How do these diagnoses intersect in your life?

When I’m experiencing a POTS flare up, my mental health suffers. This is because I lose the stability of my physical abilities that I don’t normally have to think about it, like sitting up to get out of bed or walking to the bathroom. This makes my depression and anxiety symptoms increase as I’m frustrated about what my physical body can’t do in the moments of a POTS flare. With POTS, I can’t perform intense exercises anymore. I used to train in kickboxing, compete in powerlifting, and be a CrossFitter. Now, there are days that I need someone else to push me in a wheelchair because the stress on my body is too much. Walking can sometimes cause me to pass out.

On the other hand, when my mental health is not stable, I struggle to manage my physical health, too. For instance, when my anxiety spikes or I experience a manic or depressive episode, my routines are harder to stick to. This affects me mentally and physically. Some of the effects are on tasks like taking my medications at the same times each day, eating meals, or showering.

The hardest effect I’ve dealt with since the POTS diagnosis is needing to reduce my PTSD nightmare medication dosage. My cardiologist and psychiatrist decided this was best because I need to take it but I can’t take the old dose as it lowers my blood pressure to dangerous levels. The benefits and risks always have to be considered for best treatment results.

How has your life been enriched by living with multiple diagnoses?

Living with these diagnoses does sometimes suck! I won’t deny that. But as with all experiences in life, I consider my diagnoses something to learn and unlearn from. I have learned how to advocate for myself and others in capacities I had not fully considered before. This includes advocacy with medical providers, employers, and in community spaces.

I’ve also unlearned the idea that wellness looks like one thing or one body. Being well and feeling well is determined by each individual and their care team. Treatment plans should be determined in the same fashion. Individualized care includes opportunities for collaboration and community building – I’ve loved gaining this knowledge and experience.

What is difficult about living with multiple diagnoses?

Living with multiple diagnoses means having to let go of some past parts of my identity. As I mentioned before, I can’t participate in intense fitness activities now. I also can’t have any caffeine, even when I’m tired, as that negatively interacts with my heart medications.

Perhaps the most difficult aspect I face is trying to help others in my life understand that I don’t need them to save me, and that they will likely have a disability one day as well (if they don’t already). The disability community is one that nearly every person will be part of at some point in their life. It’s past time to not only prepare for that, but to embrace it as well. We are stronger together!

What are some misconceptions about any of your diagnoses?

A misconception about bipolar disorder is that I can’t have healthy relationships. I’ve been told directly, as well as heard indirectly, that someone with bipolar disorder doesn’t have the capacity to “actually” love someone.

I have more healthy relationships in my life now than I ever have before. I think a big credit to that is the fact that I’m so honest about my diagnoses and what I need from others. I set boundaries, and I go to therapy. I work on myself because I know that’s important. I love deeply, and I value that.

How do your connections empower you to live with your diagnoses?

Connecting to the disability justice movement, with intersectionality in mind at all times, has provided me with opportunities to empower others who have my diagnoses to share their stories. I actively self-disclose my disabilities in most areas of my life and with most people, as I trust that sharing my story lessens the stigma that all of us face.

My partner has known me since before I was diagnosed with any of my disabilities. He’s been there through every diagnosis, every medication change, every ER trip, and every hospital stay. He has shown me that people don’t have to leave when times get hard – we can always choose love and light and kindness. We can always learn to adapt.

Learning to adapt has helped me find other connections as well. I’ve found online support groups that I likely would have scoffed at the idea of joining even five years ago. I’ve befriended internet friends and we’ve met up in real life, and some of those people are my closest loved ones. I’ve had to adapt to life changes, and I’ve loved learning that those who love me and connect with me as a person—not just my diagnoses—will adapt, too.

A little love, light, and kindness go a long way. It all strengthens the connections I feel grateful to have.