Thursday, May 22, 2008

Before We Were Bipolar (Part 1)

I would like to share the following quote from Treating Bipolar Disorder: A Clinician's Guide to Interpersonal and Social Rhythm Therapy by Dr. Ellen Frank.

"After many years of working with patients who suffered exclusively from unipolar depression, we began a major program involving those with bipolar I disorder. We were immediately struck by the tendency (which we had never observed in the unipolar patients we had treated) of the people with bipolar disorder to divide their lives in two: before their diagnosis and after their diagnosis.

"We soon realized that in this new group, a patient often saw him- or herself almost as two different people: the person he or she had been before developing bipolar disorder and the person he or she was now. We began to talk about the idea of grief over the 'lost healthy self' as another form of unresolved grief that was common among people with bipolar disorder."

I'm hoping you'll share your thoughts about Ellen Frank's observation. I'll tell you how I feel about it tomorrow.


Mariposa said...

I would say I am the same person. I have always said, bipolar will never stop me from becoming me. The difference if there is, is that, before, I'm not mindful of some behavior patterns that I have, and most often it creates gap between me and my environment. Now, I am able to manage it...and the people close to me are able to understand me better and make themselves available for me when I need them, for there are times I may not be aware of it.

I don't think so much about my illness...I am more on trying to take care of myself and avoid things that will trigger stress in my life...

I have always said...there are 3 Bs in my life...that I am tragically Blessed...Beautifully cursed...I am Bipolar. Despite I'm Bipolar...I feel blessed...and life is still beautiful.

Gianna said...

I think it also involves internalized stigma---self hate---brought about my doctors telling us we're defective and never going to get better...

That litany starts the day you're diagnosed and life sure as heck is never the same.

Jazz said...

Susan, I think the reason for bipolar patients seeing themselves as two people--before and after diagnosis--has a lot to do with the fact that the mental health system gives very little hope to bipolar patients. We are told that we must be on medication for life. We are told that we must monitor our moods very carefully. We are told that we must be mindful of our sleep patterns and always always always take our meds. And even if we do all of those things, we will still have episodes.

Whereas with people who are unipolar (and I see this is several of my friends who are being treated for depression), the depression is seen as a temporary situation which will eventually go away with time and the proper medication.

Unipolar depressives aren't treated as if they are chronically ill--at least, the ones I know are not--but bipolar patients are.

naturalgal said...

Oh my goodness! My life changed drastically after I was diagnosed!

I remember looking at my psych doc and saying "You mean I'm mentally ill!!!!"

"Your not mentally ill," he said. To this day, I have no idea why he said I wasn't mentally ill after giving me this diagnosis.

After my diagnosis, I was obsessed with my condition. I read books. This was before the Internet. I read, read, read. It occupied my mind constantly...maybe I do have an OCD problem. I was obsessed about being Bipolar and mentally ill.

Then my mom became obsessed with it. I couldn't talk to her without her bringing up the topic. EVERY single conversation included something about being Bipolar....which I hated.
I tried to stop thinking about occupied my every thought.

And then I wanted to get away from these thoughts.

The only way I could get rid of my thoughts was to get out and mix with people. Mixing with others became my therapy. When I concentrated on them and what they were doing or their interests, I would feel better.

Bipolar Wellness Writer said...

Dear Mariposa,
It seems like you adjusted well to this. The diagnosis allowed you to understand some behavioral patterns, let the people who love you help you, and utilize your knowledge to manage your environment.

Months ago, you said that from the beginning you sought help with a spiritual adviser rather than a psychiatrist. So, perhaps that too has made a difference.

Thanks for sharing your thoughts on this. So glad to have you back!


Bipolar Wellness Writer said...

Dear Gianna,
That's another side of the equation, and I wonder how many people feel like that?


P.J. said...

Since being diagnosed, I know my life has changed - for the better. Am I a different person? No. Same person, just far more knowledgeable and stable. I love my life more now than I did a year ago.

I did find though, that I needed to grieve. I still have areas of grief that I need to work through.

Yet, I press on and gather strength from as many people and resources as I can. The more I share the more I learn, and the the more "okay with it" I become. That is part of the grieveing process for me.

Gianna said...

You may still be writing comments, but it seems to me Jazz feels the same any case I agreed completely with how she expressed it and felt like it was a more extensive expression of what I was saying.

correct me if I'm wrong, Jazz.

Bipolar Wellness Writer said...

Dear Jazz,
All important points, and I think you truly differentiate between why unipolars and bipolars face their situations differently. Thank you!


Bipolar Wellness Writer said...

Dear Naturalgal,
That must have been an extraordinarily painful time for you--and I'm sure it is for others as well.

While I knew that being bipolar was considered a "mental illness," and the reality of it hit me for one night, I never believed I was mentally ill.

But perhaps it was because I'd lived so many years without the label. How could I possibly be so "normal" and highly functioning for 43 years, and suddenly become "mentally ill" overnight.

Still, I can't imagine how devastating it must be to change your entire perception of yourself because of a diagnosis. I think both you and Gianna make this point very clearly!


Bipolar Wellness Writer said...

Dear PJ,
Thanks for explaining it. Because you were recently diagnosed, I can't tell you how heartening it is to know that you're learning so much so quickly, and integrating it into your life. You're going to be a great role model for a lot of people.


Bipolar Wellness Writer said...

Dear Gianna,
When I first read your comment, I thought your attitude was more like Naturalgal's, and mentioned it. Then I saw your second comment where you liken it to Jazz's POV. Sorry if I misinterpreted your feelings. I'll let you clarify it.


P.J. said...

Thanks, Susan, that means a lot. It's hearing words of encouragement like that which makes each day easier to get through. Lookin' at the positive... :)

Bipolar Wellness Writer said...

You're welcome!

samanthagms said...

After I read your post, I went through each of the comments. I was diagnosed with unipolar depression; however my experience has been that I also identify several before and after stages in my life. From what I have read so far that seems atypical, but I have also been told that the way my depression presents itself isn't common, whatever that means.

Jazz commented that the unipolars they know are not treated as if they are chronically ill, but this has not been my experience either. When I was a teenager, I was told that this was a problem I would have for the rest of my life. I was resistive to this, but now I am not so sure as I have experienced several major depressions since then that last for months as a time. I can also identify with what was said in the original post about grieving for wellness.

Susan, I want to thank you for directing me to the Therapeutic Lifestyle Change site. I have read through it and it looks like something that could work for me. Thanks again,


Bipolar Wellness Writer said...

Dear Samantha,
You're welcome. I hesitate to write this, but it is what I believe. Sometimes, depressions come back because all your doctor provides is medication rather than helping you identify the underlying causal factors for the depression, or encouraging different behavioral patterns.

I strongly believe that unipolar depression can be "cured" by talk therapy (if it's the right person), and developing new healthy patterns for dealing with life and with stressors.

I also believe that while antidepressants may help pull you out of a severe depression, they aren't a long-term solution, and can end up doing more harm than good.


BipolarGirl said...

This really spoke to me. I always think of myself as the person I am now --a grounded, careful, wounded warrior-- and who I was before -- mostly manic and completely different. I struggled with which was my true self for a long time, but it's so bipolar to think that way. Why does it have to be one or the other? I'm somewhere in the middle, and I'll always be moving toward that place.

Meredith said...

I'm definitely the same person, but for sure I tend to see my life before and after. The difference for me, I think, is that the "after" made so much more sense than the "before." The diagnosis was sort of a "duh!" moment. Everything clicked into place. As I've said before, I'm pretty much a textbook case, so there was never that period of uncertainty, and my quality of life is so much better now. As for the mental illness part? I've never felt so mentally well in my life now that I actually am listening to what's going on up there. :)

Bipolar Wellness Writer said...

Dear Bipolargirl,
Welcome to my blog. That's sounds like a really healthy way to feel. Congrats!


Bipolar Wellness Writer said...

Dear Meredith,
Once again, it's good to hear your opinion on this. I think what's quite different about people who are college age and diagnosed--and for whom their treatment is working--and those of us for whom it took many years to get a diagnosis (and we're still not sure it's the right one)is significant. But, I'm delighted you're doing so very well!


Nancie said...

Dear Susan,

For me, my diagnosis with proneness to bipolar disorder, was a relief to me because it helps me to understand my confusing past and enable me to seek medical and other helps so that I am more functional.

I think I am still me. But knowing that I have bipolar and how it affects me, is helping me to make the best out of it and live a useful life. Managing it is a great challenge daily and I failed in many ways but I think I am also making good progress slowly.

Bipolar shapes my thoughts, feelings and actions. It is a part of me and what makes me unique. The depression is awful beyond words but it also strengthens me and changes me in many wonderful ways. It makes me more tender towards the suffering of other people and helps me to cherish each day of wellness.

My manic makes me productive and creative. No doubt I get into trouble with talking or writing too much or inappropriately at times :) But I am thankful for every opportunity to be useful through these creativity when manic.

Thanks for this great discussion. I enjoyed reading your post and everyone's comments.

Take care. Hope you have a most wonderful weekends!


Bipolar Wellness Writer said...

Dear Nancie,
Thank you so much for contributing to the discussion. I have learned a lot this week about how different people feel about this illness, and it clarifies things for me.


gaianchild said...

Curiously, I felt like a split individual before the diagnosis ever happened - the mood swings (even though I couldn't even recognise them as mood swings at that stage!) made me wonder if I had Multiple Personality Disorder, or something.

Now, that's all merged into 'The Illness'; I know now that I'm one person, underneath all of this. I don't really think in terms of 'before the diagnosis' and 'after the diagnosis', but rather what is the illness, and what isn't.

Bipolar Wellness Writer said...

Dear Gaianchild,
Yet, another way to view it!


Andrea said...

I agree with a number of people here; my division came not with the diagnosis, but with the medication. I am a much different person since the medication.

I had no idea how other people experienced life: no cycles, no living through to the next "fit."

It took a lot of adjustment, and I'm definitely a different person now. - Andrea

Bipolar Wellness Writer said...

Dear Andrea,
Welcome to my blog and thanks for participating in this discussion.