Friday, May 23, 2008

Before We Were Bipolar (Part 2)

As I mentioned yesterday in response to a comment by Meredith, I believe there's a big difference between those of us who weren't diagnosed for many years, and who still aren't sure the diagnosis is correct, and those who are much younger, and feel it's an accurate diagnosis.

I also think there's a big difference between people who try a few medications, stabilize, and feel good within a reasonable time frame--and those of us who don't. And maybe sometime in the future, I'll be able to say there's a difference between those who are diagnosed, begin an exercise program, participate in neural path therapy, change their diet, receive insightful counseling, and stabilize--and those of us for whom it took a much longer period to reach the same outcome.

For me personally, unipolar depression turned into bipolar disorder after many years of undiagnosed episodes combined with antidepressants. When an illness is medication-induced (and perhaps even when it's not), I don't think it's unusual to mourn our "lost healthy self," which was the topic of yesterday's post.

While Ellen Frank, Ph.D., author of Treating Bipolar Disorder: A Clinician's Guide to Interpersonal and Social Rhythm Therapy, and her colleagues may have found that mourning our "lost healthy self," is unique among bipolar patients, her reasoning why this is so, astounds and infuriates me!
She writes, "Some of our colleagues who are experts in IPT for unipolar disorder have argued that this problem area is more appropriately thought of as a subset of the role transition problem area, but we have found that presenting it to patients as a form of grief has a very profound impact and tends to motivate them to work on this issue in a way that presenting it as a role transition does not. Perhaps this is because 'becoming bipolar' has a kind of unalterability that is more like a death than the loss of a job or even a divorce."
And it's this very paragraph, which represents everything I despise about the psychiatric profession's attitude toward bipolar disorder. To present a bipolar diagnosis as a form of death is exactly what so many psychiatrists do--either knowingly or not. In one fell swoop, they destroy a patient's hope for achieving wellness, and their dreams of living a life with any possibility of normalcy.

One only has to substitute any other illness for bipolar disorder to see just how ridiculous it is. What if a diabetes researcher wrote, "Perhaps this is because 'becoming diabetic' has a kind of unalterability that is more like a death than the loss of a job or even a divorce."

I can guarantee you that researcher would be publicly condemned--within the medical and diabetic communities. What's so strangely awful is that Dr. Frank has a wonderful reputation and has done some excellent research in the bipolar field. But if she doesn't really have a clue what a huge disservice it is to tell bipolar patients that their illness is more "like a death than the loss of a job or even a divorce" than it's no wonder the suicide rate for bipolars is so high.

And, we who disagree with "the death knell analogy" need to find some way to voice our disapproval so loudly and so publicly that our voices will be heard from Washington D.C. to Ottawa to London to Canberra to Manila to Moscow to Beijing and beyond!

P.S. While I'm focusing on Ellen Frank in this article, I don't truly mean to single her out. As far as I'm concerned, her attitude typifies every bipolar researcher in the field who preaches despair rather than hope, and dwells on illness rather than wellness.

23 comments:

Jazz said...

Oh, that infuriate me, too, Susan. The whole psychiatric profession infuriates me. If they refuse to give us any hope, then what is our motivation to even try to get better? I have never understood why this attitude seems to be so ingrained into the profession of psychiatry when there are so many inspiring recovery stories out there.

And if you do present them a recovery story--like I did with psychiatrist I saw in January--you are told that you are just having a long period of stability, that you will become ill again, and that you are taking a huge risk not being on medication.

What a damaging thing to tell someone who has worked hard to get where they are! Are they so frightened of their own potential liability that they must drug us all senseless whether we are ill or not?

Gianna said...

Certainly with the tone I was given when diagnosed--the argument that I would never get better. (I was yelled at by a psychiatrist!! Telling me if I didn't admit I was sick and would be for the rest of my life I would die!)

Certainly with the despair passed on to me from psych doc to psych doc, I did feel like a part of me had died.

I am only now coming alive. And darn it all, I will be alive!!

this is when anger can be self-empowering. I've been too angry in the past but as I let go of the toxic anger the self empowering one steps in!!

naturalgal said...

Yes, Jazz, they are scared. They are scared that you will have an episode. And they will be blamed.

Bipolar Wellness Writer said...

Jazz,
It seems like your experience is fairly typical, and yet I wonder why. They say bipolar disorder is a spectrum illness, and yet what about cancer?

When a woman with breast cancer is cancer free for five years, she's considered "cured." And yet sometimes cancer recurs years later (and sometimes it doesn't).

Yet, when a person doesn't have a depressive or manic episode for 10 or even 15 years, they're a manic -depressive who's waiting for the next incident to happen.

In what other profession do doctors have such a negative view of patient recovery? And who's to say it isn't a self-fulling prophesy?

Susan

Bipolar Wellness Writer said...

Gianna,
And yet, bipolar mood disorder isn't a terminal illness. So...isn't it like living in the Twilight Zone to think that a doctor would scream at you that you're going to die if you're "not compliant," and yet the best treatment they offer you is medication that is highly toxic, makes many people feel worse, and have never proven to be effective?

Susan

Bipolar Wellness Writer said...

Naturalgal,
If they're that scared to be blamed for future episodes, they should work that much harder to provide enlightened support services, like Bipolar Wellness Centers that offer exercise programs, nutritional counseling, writing to heal classes, neural path therapy counseling, and so much more.

Susan

Jazz said...

Susan, I wonder if the difference in the way remission is treated inbipolar disorder vs. cancer has to do with the bad rap bipolar has? I mean, when you have cancer, you're generally not going to go off the rails and infringe on someone else's rights...whereas with bipolar disorder, they are looking at the possiblity that you will end up doing something monumentally stupid and taking someone else with you.

What I find really infuriating, though, is the fact that even if you take your meds, there is no guarantee that is not going to happen.

I agree with you completely. Enlightened support services are desperately needed. I despise the current practice of labeling someone who has found alternatives to medication as "non-compliant."

Bipolar Wellness Writer said...

Jazz,
I agree. But maybe...some of the reasons why people do "monumentally stupid things" is that their doctors don't alert them about typical symptoms and teach them skills for controlling them.

In my experience, they just threw the medication at me and sent me out the door.

I don't know about you, but I had to figure out all my symptoms myself, although these days, they're listed in books. But I've read no books that provide helpful ways for dealing with them without a tone that suggests you're a "damaged" or "sick" person if you have them.

Susan

Gianna said...

Susan,
I don't believe there is anything special about "bipolar" behavior. There are lots of books on Buddhism for example (and endless varieties of them so almost anyone can find something that suits them---a lot of them are not religious at all---like Jon Kabat Zinn for example) that talk about behavior and the human condition. I use these kind of books---also not limited to Buddhism, but books about being human and dealing...books on ACT, and CBT that don't pathologize everything can also help learn to deal with our dysfunctional behavior. My problems weren't ever being bipolar...they were being human...

Cheri Huber is a good Buddhist Teacher that deals with depression in a non-religious way...talks about accepting...embracing...

I talk a bit about this in my next post...not sure when it's going up...since the long weekend is upon us

Meredith said...

Wow, thanks for referencing me! I too believe there's a huge difference between my case and yours. I have several other college-aged friends who have been diagnosed recently, and their feeling on the subject is much the same--it's more of a oh, so this is it! rather than a huge shock. However, many of them still feel the same hopelessness. I credit my lack of that for, among other things, stumbling upon your blog within about my first month of diagnosis--you're a huge inspiration, and it's enabled me to ignore the dire words of several psychiatrists. (Though one incompetent one I saw last fall actually questioned my diagnosis, even though I came in and said, look, I'm having issues with stability. Apparently you have to be frothing at the mouth or something to have a problem?)

So, what I'm trying to say is, even for those of us who "accept" the diagnosis, it's still a battle as Jazz said trying to get doctors to recognize that the condition's not truly hopeless. I'm just pleased that my current doc is pretty good. I've been so amazingly lucky with all of this, and I recognize that. I would never presume to tell someone else that they were doing it wrong or that they're just not accepting things or whatever, because I do believe people are misdiagnosed and improperly drugged up.

One more thing in this lengthy comment--I think those of us who are young and diagnosed today have it way better off than those of us who are not in their 20s or whatever and diagnosed today (or even a while back) because there's so much more awareness and there are many more treatments available to stop the disease (and I do believe it's such) before it progresses further. I look at it as freezing the clock. It's hard to get back to a "normal" state (though obviously as many of us have said it's very possible), but at the very least, you can stop from getting worse, and the earlier you catch it, the better.

Jazz said...

Susan,
That is so true. Same thing happened to me--my doctor threw meds at me, told me if I had a problem with taking meds I should be in therapy, and suggested I read Fuller Torrey's book (yuck!), which only emphasizes the meds-for-life approach. I was given no advice on how to recognize or head off episodes, other than that I should keep a "mood chart", which I found only led to me being hypersensitive to every change in mood, and pathologizing every experience I had, and him wanting to increase my meds at every visit as a result. Neither of which is very helpful if achieving wellness is the goal.

It seems to me, though, that the goal of most psychiatrists is damage control rather than wellness. Which is very sad, because I think there are a lot of people out there who are having the life medicated out of them for no good reason.

Bipolar Wellness Writer said...

Dear Meredith,
Well, you made my day! I knew you contacted me soon after you started your blog, but I didn't realize I've made such an impact. Thanks for letting me know.

In terms of what you've said, it's a really important perspective. Everything is different these days, and access to information is quite unbelievable.

I also must tell you that I've had similar doctor experiences. In my case, no one ever treated my depressions seriously enough. I was dying inside, and they were talking to me like I was a little under the weather.

I finally had to say, "Just because I'm well-dressed, and my hair is blown-dry, and I can articulate my thoughts doesn't mean I'm not feeling as bad as people who don't bathe, don't comb their hair, and drool." (Alright, I would admit the last comment of the three did lack a bit of sensitivity, but I was tired of being treated so cavalierly.)

It stunned them, but they finally got my point!

Susan

Coco said...

Would I rather die from the disorder, unmedicated, or be dead inside my entire life from what they would have me take? I've already lost the past 14 years of my life.

Bipolar Wellness Writer said...

Dear Coco,
If you feel that way, I'm so sorry I left the comment I did on your blog. I have been terribly concerned about you, and hoped I wasn't part of the problem in terms of your feeling so bad, yet feeling the need to go off medication.

I still people some people need it, and hopefully they will find the right medication.

Also know that I have every hope that you will achieve wellness --however you decide to pursue it!

Susan

Bipolar Wellness Writer said...

Dear Gianna,
I'm not sure I agree with you about bipolar symptoms, but perhaps we can agree to disagree.

I do agree that the bipolar books blame us for our behavior, label it dysfunctional, and make us feel bad at every turn.

I will check out Cheri Huber! I'm off on errands. Hope you have a nice day! Look forward to reading your post later.

Susan

Gianna said...

by the way...rumor has it Cheri Huber was bipolar once upon a time...

P.J. said...

I don't like the comment that implies that bipolar is like a death sentence. I don't see that, at all. Instead, I have new found freedom.

There are a few os blogging about the same type of topic right now. My post from yesterday is about me and my behavior before and after medication. Interesting stuff!!

discoverandrecover said...

Susan,

I appreciate so much of what you write. You give a good name to others who have this label - simply by being who you are - obviously, a very intellegent woman, who searches for answers.

I don't have them all, but certainly enjoy what I learn from you and your readers.

Have a peaceful and restful Memorial Day Weekend.

Duane

Bipolar Wellness Writer said...

Gianna,
Interesting about Cheri Huber. I've ordered one of her books! Thanks for letting me know about her.

Susan

Bipolar Wellness Writer said...

Dear PJ,
I've been out most of the day, but I'll drop by your blog a little later.

Susan

Bipolar Wellness Writer said...

Dear Duane,
Thank you so much! You are a treasured supporter!

Susan

"Dootz" said...

Two thoughts, not exactly related to your latest post, Susan, but wanted to interject them.

First, the brothers of the CEO of the world's largest publicly listed real estate company, based here in Hong Kong, are trying to oust their eldest brother on the suspicion of his being bipolar and unfit to manage the company. Now, there's a lot more to the story (this elder brother has embarrassed the company with his romantic dalliances), but that bipolar would be a leverage is not surprising, but it is disturbing.

Second, I have found a way to make it through depressive episodes more easily using some relaxation techniques, which I'll have to figure out how to put into words and then let you know. I, too, feel I suffer more from these bipolar depressions than from mania, and I certainly hate the depressions more than the mania!

I'll let you know.

Hope you're well.

Bipolar Wellness Writer said...

Dear Dootz,
The story about the brother is a bit chilling. One of our readers from Singapore says she must tell employers she is bipolar when she applies for jobs--which, of course, considerably lessens her chances of getting them.

I'd be most interesting in knowing about your relaxation techniques once you figure them out.

Again, your piece about Hong Kong was great!

Susan

Susan