Thursday, July 12, 2007

Some Thoughts on Bipolar Mood Disorder

I started this series in response to a comment by Carla who's medication resistant, undergoing a depression, and in need of advice. I felt compelled to write to her because I know what it's like to be diagnosed as bipolar, fail to get better after taking tons of different medication, receive little to no help from psychiatrists, read the most depressing stuff online, know that medication-resistant patients are the most difficult to treat, and try to survive while experiencing the devastation of a depression.

While my advice is for Carla, it's really much broader than that. After a decade of being very ill with bipolar mood disorder--and believing what my psychiatrists said, which is that it's biochemical in nature and there's not much I could do to "cure myself" other than find the right medication--I no longer adhere to that philosophy at all.

Now, I must state upfront that I come to this illness from the depressive side. It's quite possible that if my initial depressive episode, which I experienced when I was an 18-year-old freshman at UC Berkeley had been diagnosed, and if I had received good counseling, and if the therapist or counselor had known about the importance of life event stressors, I may never have gotten sick.

But, it didn't happen that way. Although I sought help, it took 25 years for me to get a diagnosis. I have survived 120 depressive episodes over 39 years. Still, I can't speak for anyone but myself. However, I believe the following:

1. Yes, untreated depression gets worse but I'm not necessarily in favor of giving medication to college students and others who are experiencing a depressive episode but who haven't participated in counseling or therapy.

2. I do believe that if a person is severely depressed, the only way out may be medication. However, I don't see it as a long-term solution. I believe it is only part of a long-term solution and that some of us can make such significant life changes that we can effectively stop taking medication or that we can take it only during depressive episodes. (Again, I'm not speaking about people who come to this illness from the manic side, who suffer from psychosis, or who have some underlying pathology.)

3. I cannot tell you how important it is to understand what "event" or "events" triggered your first depressive episode. I believe that you not only need to understand it but to resolve it in order to get better.

4. I don't believe that bipolar disorder should be as debilitating as it is. I do believe that the treatment of this illness is awful and that the drugs are ineffective for many of us because aside from Lithium and perhaps Lamictal, they haven't been developed for this illness. I also believe that in many cases, they make people feel worse rather than better.

5. I believe that lifestyle has a huge impact on this illness. I strongly believe that exercise is critical and that every single bipolar person should be participating in an exercise program.

6. I believe that diet and nutrition are very important and every bipolar person should be given free nutritional counseling.

7. I believe it's critical to know what your stressors are and how to alleviate them.

8. Personally, I believe in the following adjunctive therapies: music therapy, horticultural therapy, massage, exercise and movement therapy, pet therapy, counseling (or some sort of talk therapy), light therapy, prayer, positive thinking, humor therapy, expressive writing therapy, and a host of others.

9. I believe that dwelling on illness rather than seeking wellness makes people feel worse.

10. I believe that finding one's life work makes a huge difference.

Finally, I believe that loving relationships with family members and friends makes life worth living.


Meredith said...

I replied to your post in my blog. My response was too long to post here.

Howard said...

Susan, I agree with all your recommendations and would underscore that exercise - when I've been disciplined to keep it up! - has been key for me. Writing has been very important, obviously, and your last point about family members is vital: if I didn't have Karen alongside me who knows the signs of both mania and depression, then I'd be in hot water much more often.

Carrie said...

Susan, thank you for sharing your thoughts. Something that has also helped me is coloring mandalas - its easy and inexpensive, but helps me focus and understand my moods better.

Still looking forward to your thoughts on my idea. :-)