Living with bipolar disorder & adenomyosis

"Do you know why it has been this expensive? No doctor ever told me I had endometriosis. They kept treating me for useless things like fibroids, then I end up spending sh16,000 every month because I'm always in this unexplainable pain. They never take time to think away from certain diagnoses. They could've asked, 'How short is your cycle? Is there pain in your right leg?'" - Rosemary Mwaniki

Endometriosis is a costly affair. I should know, I've been managing adenomyosis, a type of endometriosis, for ten years now and it would be years before I understood the condition in my body. I was diagnosed after my first depressive episode and painful menses can interact with mood disorders, here's how:

• Medication — some contraceptives used to manage painful menses interact with mood stabilisers used to treat bipolar disorder and weaken their effectiveness.
• Symptom — chronic pain is debilitating and triggers low mood increasing chances of recurring depressive episodes.

4 questions 4 your doctor

"I once asked a doctor, if he goes home and thinks about each patient he's seen. He sees 50 women a day with different complications, he has his family and his life, what time will he have to wonder what I have and why I am not getting any better?" - Rosemary Mwaniki

A question on so many patients' minds who have spent years waiting for a clear diagnosis. I found out I had been on the wrong medication for adenomyosis for the first three years of treatment after switching to a different gynaecologist. Self-advocacy is the name of the game so if you're living with bipolar disorder and adenomyosis consider asking your doctor these questions:

• What are the symptoms of each condition? Ask for at least four symptoms and insist they give you a fair basic understanding.
• After your assessment, how do you think these symptoms may interact in my case? To help you anticipate the recovery process and how you can collaborate with them because you know your body better.
• What are my treatment options? Ask for case studies of their previous patients including rare and tough cases. The more you know early on, the better.
• Can we document my treatment journey together (e.g. via an email thread)? It makes it easier to share your patient history with other doctors reducing chances of nasty side effects from other medications.

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