Thursday, January 10, 2008

Therapy

Tonight, my husband and I talked about how difficult it was for me in therapy to disclose some of the horror I experienced in my depressive episodes. For some reason, it wasn't a part of my make-up to share the "bad stuff." But once I did, the response was so unhelpful and the lack of insight so appalling--that it made me feel worse.

It's also inconceivable that it took five therapists and one psychiatrist more than 25 years to diagnose this illness. I was depressed--although fully functional--during my entire undergraduate career. Once I began working, I experienced two semi-annual six week depressive episodes. For most of my life, I could still work during them but the pain and suffering took its toll.

I asked my husband how it could be that so many of the therapists I saw were so incompetent. While I had a difficult time expressing my feelings aloud, it would have been easy for me to write about them. I wonder why that isn't an option. And had any of these therapists ever asked me whether I was experiencing some of the classical symptoms of a depressive episode, the answer would have been crystal clear.

Anyway, I'm wondering if any of you have had better therapeutic relationships. It would be nice to think there are insightful people out there--who actually help people heal.

7 comments:

Kawana Aminata Oliver said...

You know I think I may be Bi-Polar, I am in denial if I am ;-) Nice blog.

Syd said...

I have had a similar experience with therapists. Had they only asked the right questions, I think they would have been able to diagnose and treat my depressions much earlier and more effectively.

Thankfully though, I've finally come to think of my time spent in therapy they way my grad advisor suggested that I think of my graduate school education. She said that the purpose of grad school wasn't to see how many facts we could memorze - that's what law school was for. :) She said instead that if while we were there we learned to (1) recognize what we don't know, (2) figure out the right questions, and (3) figure out how to go about finding the answers, that our time would have been well spent. It's funny (or maybe it's not), but that's just about the only thing I remember from my days at Ga Tech!

Anyway, while the therapy itself has not been helpful through the years, I learned a lot from the process. In the past year or so, I've practiced being my own therapist - asking myself the tough questions that no therapist had asked me before and forcing myself to be honest about the answers. It may not be scientifically sound, but I've grown more in the last 12 months than I have in the prior 20. Now if I just could have paid myself what I paid those other "trained professionals". :)

JayPeeFreely said...

Syd hits on a good point. Seems the best therapist is likely yourself.

Let's face it: a really involved therapist does not exist. The structure of diagnosis, treatment, closeness to their client is not very conducive to finding out what gives. If they get too close, or know too much "how you feel" it might be they are as bad off as you are. (Sorry.)

My mood probably isn't allowing me to write a positive thought, but I think you have some nice ideas of things to do. (As I think Bipolar gives us the option to dream of, if not complete at times.)

See you "Ruby Tuesday."
"Who could hang a name on you?
When you change with every new day
Still I'm gonna miss you."

Bipolar Wellness Writer said...

JayPeeFreely,
I'm reading this from Berkeley where I'm so stressed out, it's unbelievable. Once again you made me laugh!

Susan

Iris said...

My heart dropped when I stopped in and saw that you were depressed again. I'm not there now, but seeing you like this takes me right back.

I have been helped by therapy, but in a different way. Having a therapist gives structure to my life in the times that I have needed it, and gives me someone that I can say whatever the hell I want to without worrying about it once a week. I've had some nice therapists and they are good listeners.

Here's the issue that I've had with therapy, and I think it might be what you are experiencing, too. I went about 18 years undiagnosed as depressed and although I think my p-doc is well aware that I am bipolar, he has never written it down on a piece of paper or said it aloud to me. This is all because unless you need to be sent somewhere or someone else has to be aware of your condition to help care for you in a very immediate sense, I don't think psychologists (or even sometimes psychiatrists) will formally diagnose you. I think it is a combination of not being entirely sure because you present as highly functional, and not wanting to put a label on you in writing that might later be used against you professionally (sadly).

I know that I would have been happy just to have someone confirm in solid terms what I had concluded about myself with depression, and I really wish that someone had helped me identify the mania - which it took me a long time to figure out. The thing is that I just don't think it's nearly as easy to see in a highly functional person, such as yourself. Even on your worst days, I am guessing that if you absolutely must, you pull it together, and find a way to maintain your life so that you have something to return to when you feel human again. I do. I don't think our therapists see that much, and it confuses them.

My most recent p-doc is my best. The first day I came in, I was in the kind of place that it sounds like you are in now. I just couldn't handle the cycle anymore and really didn't see how I was going to go on. He took down my entire story and he said, "You are going to be fine. Look at you and all that you manage to do with your life. This can cripple so many people, and yet somehow you manage to succeed. Do not be so hard on yourself." And then he confided that it was very difficult for him most of the day, because there were so many people who had lives that were as out of control as their minds, and that it would be much harder for him to help them than it would be for him to help me. Basically, all I needed was the right pills. Therapists help you get your life in order, but if you've already got that under control, even in what may seem to you to be in a very precarious way, they are really best for just listening. Sometimes that isn't particularly satisfying, because you want answers, but the fact is if you've figured out how to maintain your life and your relationship, I think you have all the answers they are able to give you.

Now, don't think for a minute that I think my functionality (or yours) is due to my willpower alone. It isn't. I lost my brother to bipolar, and I know that the only thing that separates us is dumb freaking luck. We both worked hard, and he worked harder to stay alive than anyone I know. But since you do have the ability to function through this crap, see that for what it is - a great and rare gift. Perhaps that will help you to accept less from your therapist than what you want, or even better, just something different.

I have only read your blog in little spurts over the last year, so there is much that I don't know about you. I think you said that your bipolar was resistant to drugs. I would suggest trying again if you think you can. Finding the right one sucks - you feel like a guinea pig, and you can experience some of the worst side-effects that I can imagine. At times it terrified me. But as soon as you find something that allows you to feel "normal," it is worth every bit of that suffering and uncertainty. I'm not sure exactly how long I've spent cycling - possibly as long as my very early teens. I didn't start to identify what was going on until right after college, and even then I didn't understand the mania, because it was so mild and I still had normal periods. In the 6 years since my brother died, I had no "normal" time at all - until the last five months. I sleep 8 hours a night (as opposed to 5 or 13), I'm creative, but I don't get obsessed with working on things, I'm not nearly as irritable and can connect with my husband without making an effort to do so (when I am depressed he is a crutch and when I am manic he appears to be an obstacle) - you know what I am saying. Much of this is due to willpower and luck, but the tipping factor for me has been lamictal. If there is any way you think there might still be something out there that can help you, I strongly suggest trying. If you want to correspond about it sometime, you can reach me at my screen name @gmail.com. Sorry for leaving such a long comment, but I hope that in some way it helps. You have often been inspiring to me, and if there is any way I can give back, I would like to.

Bipolar Wellness Writer said...

Dear Iris,
What an amazing comment. I can't tell you how much I appreciate it. I think that what you've written is one of the best descriptions and explanations of what we experience that I've ever read--anywhere. I want to continue responding offline before I write any more on this.

Susan

Bipolar Wellness Writer said...

Dear Iris,
I tried to email you at Iris@gmail.com and also used the lower-case version but it didn't go through. If there's some other way, let me know.

Susan

P.S. I'm gone for a few hours so won't try again until later.