Wednesday, October 8, 2008

Does Bipolar Wellness Need to be So Elusive?

PJ's comment on yesterday's post caused me to write today's. She's only been diagnosed within the last year and wonders how long it's going to take to get well, whether she'll still have highs and lows despite medication, and I guess perhaps just wants my perspective on all this.

Dear P.J.,
I guess the best way to start out is to say that I can't be sure how things are going to play out for you. But I will give you my perspective, and hope that others will tell you how they feel. In my own case, you have to realize that I wasn't diagnosed until 25 years after my first depressive episode. And all that time ago, people didn't talk about depression. So while I had these two annual six-week depressive episodes, I had no idea what caused them.

A part of me is glad I wasn't diagnosed when I was younger because I wouldn't have wanted to wear a label when I was 18 years old. Unlike most people, I don't believe in labels and I don't believe in looking at mental illness and physical illness as separate entities. But while that's easy for me to say at 58, it wouldn't have been easy for me to figure out and say when I was in my late teens and early twenties.

So, while I did have these episodes for most of my life, I didn't feel like I was handicapped in any way. I have always fought for what I've wanted and mostly achieved it--even if it turned out that it didn't make me happy.

And maybe, since the career I ultimately pursued is writing--which is so personal and so fraught with rejection--perhaps I needed success in other fields to deal with the rejection and be able to transcend it. (But that's an entirely different topic of discussion.)

In terms of bipolar mood disorder, my own feeling is that medication will never be the full answer--even when it works. I strongly believe that if a person is feeling very stressed and disliking his or her job or having problems in his or her marriage, or having difficulties with friends and/or family members, medication can't solve the problems--and shouldn't be expected to.

If we're not getting exercise, which has been proven to be of greater value than antidepressant medication, then we're going to have problems. If we don't eat nutritional foods, then we won't feel well. If we don't attend to the spiritual aspect of our lives, then we will feel there's something missing. And if we don't continue to grow and evolve--and deal with the difficulties and darkness that's inherent in the very process of life--then we are going to have problems.

Medication cannot solve those problems. We need to develop an understanding of who we are and want we want. We need to develop skills to handle stress. We need to read about adult development so we can anticipate life stages. We need to deal directly with the people and situations that are bothering us so that we can resolve issues and figure out whether we want those people to remain in our lives or whether we will be happier without having them in our lives.

If people are psychotic, medication can help. If they are always so depressed they feel like killing themselves, then medication can help. If they hear voices, medication can help.

But, if they are rapid cycling and weren't before they started taking medication, they need to ask themselves if the medication is causing the problem. If they are hoping that whatever ails them is biochemical (whatever that truly means) rather than facing their true life problems, then their diagnosis is only a crutch and I don't believe they'll ever get well.

In answer to your question, "No, I don't think it needs to take years to figure all of this out." I did seek help when I was younger and saw a number of counselors and psychologists and I have never met less insightful people in my life. But I know that some people who are reading this blog do have counselors or therapists whose advice they treasure. And advice can come from friends and family members as well as spiritual advisers.

I guess my best advice is to say, "Whether we believe in labels or not, I believe we are each responsible for our own lives. And the disservice that a diagnosis can play--in my opinion--is that it suggests you aren't responsible for your life because you have a chemical imbalance. The truth is that diabetes or high blood pressure or cancer can be attributed to a chemical imbalance as well.

So I believe that whatever illnesses we have, we need to get the best medical care we can, but ultimately we can all be self-healers. We need to look inward as well as outward to figure out how to live our lives. We need to make sure we're not only living authentic lives, but that we are living lives that are satisfying to us...not to others.

P.J., I think if I had understood this when I was younger, I could have healed myself far earlier. I'm not sure why it took so long, but I still have years left to live so I'm grateful I've finally figured things out for now.

All my best in your journey!




Jazz said...

What you say makes so much sense. I wish someone had been there to say those things to me when I was newly diagnosed and freaking out about the bleak future I saw before me.

Wellness Writer said...

Dear Jazz,
I wish that someone had said the same thing to me when I was newly diagnosed. Perhaps one of the reasons I had to figure it out was that they didn't.


P.J. said...

Susan – First of all, thank you so much for taking the time to write this post for me! Wow, you sure have a lot of experience, ideas, and knowledge and I am grateful that you are sharing some of that with me.

I wasn’t diagnosed until I was 28, but even then that seems so young. I know there are people MUCH younger than that being told they have bipolar, and had that have been me, I don’t think I would have handled it as well as I have. I don’t like the whole labeling people thing either. I am still learning not to separate my physical from my mental – all of it together makes me!

I do, sometimes, feel like I have a handicap. That being said, I have never used it as a way to get out of something or as an excuse for bad behavior. I sometimes wonder if I’m a fighter. I am when it comes to certain things, but I tend to be more passive and accept things for how they are.
You are right in saying that medication cannot solve “life problems”. If they could, everyone would be on a “Life Pill” and this world would be simple.

Regardless of what health issues people have, there will always be normal life stuff. You are right.
One thing I need to do is exercise. I work while the kids are in school, then I have them with me the rest of the day. When do I get time for myself to exercise? I need a treadmill at home. I think that would do some good. There are so many aspects of life that need to be taken into account.

I know that medication can’t solve all these problems, but I think I’ve become too medicine dependant. If there’s an easy road that has little friction, that’s the one I’m going to take. I am getting better at managing my stress, and that is a real bonus. I can talk to those I have issues with and I am happy about that. I do have more freedom since being on medication, because it helps me overcome a lot of the games that were going on in my head.

I’m glad it doesn’t need to take years to figure it all out. I know that I found you, and other bloggers, for a reason. I have found more help, answers and information from my blog friends that I ever thought possible. Experience is the best teacher!!

I was thinking about bipolar being the same as diabetes, for example, and my thoughts were this: Diabetics take insulin, but still need to watch their diet. Those with migraines take medication, but still need to reduce their intake of their triggers (chocolate, etc). Since I have bipolar, I can take medication, but I still have to adjust my lifestyle to lower stress, etc. Things made more sense to me after I had that mini revelation.

I am glad that I am young and working on this. I’m glad that I was diagnosed when I was so that I didn’t have to live in that hell any longer. I don’t know if I’ll ever be totally balanced all the time, but as long as I do the best I can with what I’ve got and know, and always keep learning, then I can live a successful, satisfying , rich life.

Thanks again, Susan, for the thought and effort put into this post for me. I hope it helps many others as well!!!

Wellness Writer said...

Dear P.J.,
You're welcome. One of the reasons I admire you is because you're trying so hard to figure all this out, and are dealing with it so honestly.

I agree with the diabetes analogy, and have used that one myself. Some people who are diabetic can control it with diet. Others, like my mom, need(ed) to take insulin. But unless diabetics stop eating sugar and refrain from drinking alcohol and carefully watch what they eat, they're going to have major problems.

People will bipolar disorder may need medication, but hopefully will realize that it's only one part of the wellness equation. At best, it will allow them to feel well enough to address the other issues that might be contributing to their illness.

Anyway, know that I applaud your hard work in seeking wellness. And I recognize that it's not easy to balance your life when you're married, working full-time, and have two young children.

But you have a positive attitude and you're willing to work hard to achieve wellness, and that's half the battle!



marja said...

I wasn't given a diagnosis until I had been sick for - I don't know - 20 years maybe? There was one (scizophrenia) but no one bothered to tell me. I think they were protecting me. And I never asked. I thought I was unique. I thought I was the only person with such a brain disorder.

In many ways I think that helped me. If I'd had a label, I might have given up on myself. I might not have worked as hard at being well.

As you know, Susan, that initial diagnosis was wrong. The schizophrenia I was being treated for turned out to be bipolar. I then was finally given the mood stabilizing medication that helped me turn around. (Up to that point I had only been on antipsychotics. Helpful, but not enough.)

You are so very right in learning how to live a healthy life being every bit as important as the meds we take. If we fill our prescriptions, take our pills, and then go sit on the sofa, twiddling our thumbs, waiting to get better, it's just not going to happen. We need to find a purpose for our lives - a reason to live that will encourage us to take the best possible care of ourselves that we can. Because if we do, we'll find wellness.

(Good to be back here, Susan.)


Wellness Writer said...

Glad to have you back. You and I have both been through all this for many years, and I appreciate your thoughtful answer. I also know that you're going through a tough time with your mother and my thoughts and prayers are with you and her!


Tamara said...

I was diagnosed almost 20 years ago and put on a ridiculous amount of medication which I think only added to my problems. It has taken years of therapy, getting off all medications and learning to understand and accept myself.

In addition to exercise, which is HUGE, I would also say that sleep has been very important to me. I can make myself more manic by sleeping less and I can bring on more depression by sleeping too much. I now have a set bedtime and get up time 7 days a week no matter what.

I agree that eating healthfully and keeping blood sugar levels balanced is also very helpful in keeping my moods more stable.

I think that there may be times for short term meds if things getting really out of control. Mostly, however, I have found that I can much better balance myself by my daily actions. Even being aware that sometimes I need to be by myself and sometimes it is important that I get out and be around people a bit more. I even have my DVD's categorized so that I can easily choose the right movie when I need a bit of help with balancing my moods.

I feel that I am rambling a bit here but I guess, for me, the bottom line is just really knowing myself and being able to adjust based on what I feel I need each day. Keeping journals for 20 years and a mood chart have been indispensable in helping me treat my bipolar.

Hope some of this is helpful.


Wellness Writer said...

Dear Tamara,
Thanks so very much for sharing your story. It seems like you and I have a very similar outlook on all this. And yes, I agree that sleep is very important as well.

And I also agree that there are small things we can do--whether it's watching a certain type of DVD or in my case, playing or listening to music, that can change a mood.

I, too, find that sometimes it's good to be with people and sometimes I really need time alone.

And I also agree about the important of a mood chart and journals.

What's so great is that there seems to be a small group of us, who have truly been able to "cure" ourselves by learning about who we are, and what we need, and doing what needs to be done.