Raise the Bar on Bipolar Treatment – Hold Your Doctor to Task
Let me be honest. Even when my treatment is at its best, I never get to the place of zero bipolar symptoms. I’m well, I can handle the remaining symptoms with coping skills, I can be happy but there are always lingering symptoms of bipolar disorder.
I give presentations on mental illness in different places, and one of those places is in schools. Kids aged 12-18 get to hear about mental illness, stigma and my personal story of bipolar disorder. This takes around an hour. And after hearing an hour of me speak about my personal challenges and about how I have faced down bipolar disorder are a myriad of treatment failures, the teens often feel a certain closeness with me. I suspect it is for this reason that after the presentation, so many of them come up and talk to me. They talk about how they have been in the hospital or how they have a friend with bipolar or that they think they might have a mental illness.
And, of course, if a teen thinks they have the symptoms of a mental illness I always say, “Have you talked to your parents about this?”
And I always expect them to look at me like I just said something ridiculous because when I was their age, I sure would have found the notion laughable.
But they generally don’t. Many, many of them have, indeed, talked to their parents. And what have the parents done?
Once upon a time I knew a beautiful girl who we’ll call Jane. Jane was curvaceous, feminine, sweet and generous. Jane and I became lovers overnight.
And then life happened and we broke up. My fault, actually. I couldn’t handle having a girlfriend while being in the hospital.
But we remained friends while living our separate lives – very good friends and occasional lovers. It was pleasance punctuated with striking screams.
Then, when I went through electroconvulsive therapy (ECT), I turned to her for help. And help, she did. She stayed with me to help me through the first six treatments of ECT and for this I will be forever grateful. And when she left that day, to return to her life, I said something along the lines of, “Goodbye. I love you. I’ll miss you.” (At least I think I did. The ECT makes it all hazy.)
I started thinking about alcoholism the other day because of some stuff going on with a friend and I started to think about how high-functioning people often don’t consider themselves alcoholics because they’re high-functioning. How can I be an alcoholic; I have a job? A family. A wife. Friends. Money. A house. And so on…
And the same is true for people with bipolar disorder. People think to themselves, “I can’t have a mental illness – I have a job.” Or, “I can’t have a mental illness – I’m a good mother.” Or, “I can’t have a mental illness – I have a degree from a top-tier school.”
But as I have told audiences over and over – mental illness happens, and it can happen to anyone.
Bipolar disorder is a mental illness, but many of the problems that come with bipolar disorder are the actions that it provokes. The illness may be in the brain but much of the harm exists in the life around you. You may act out the illness in many ways through anger, hurt, overreaction, panic, hypersexuality, overspending or others. But the question is, are you responsible for your actions when you are in an acute bipolar episode? If you’re severely depressed or manic, are you accountable for your actions?
Would you like the short answer or the long answer? In short, if you have bipolar disorder, no, you shouldn’t be taking an antidepressant – even if you’re depressed – in many, if not most, cases.
I once had a very nice girl tell me that I was hard to get to know. I was surprised at this. I feel like I’m an open and honest person and if you want to know something about me, you can just ask and I’ll generally answer.
I didn’t prod her for more details when she said it, although I probably should have. What I think she might have meant was that I was hard to get to know emotionally. I think what she was saying is that I wasn’t showing my emotions around her and that was the hard part to get to know. This girl, in particular, wore her emotions on her sleeve, so I can understand the disconnect. She was right. My emotions are hidden. But that’s because not even I want to know them and I can tell you right now, no one else really wants to know them either.
I have attempted suicide. This is not a fact that I wish to wear on my sleeve. This is not a fact a want on my resume. This is a fact that I wish was shoved in a trunk, thrown in a closet and locked away for all eternity.
And I think that most people who have attempted suicide feel the same way. There are many reasons you might want to forget but one of them is the shame associated with a suicide attempt. Many people around you and you, yourself, might consider attempting suicide shameful.
We get the notion of shame from those around us. Imagine looks of scorn if someone happens to belong to a religious community that considers suicide a sin and has no compassion for those who have attempted it. Imagine embarrassed parents forbidding their children to wear short sleeves so that the scars on their wrists are never seen. Imagine the person arriving home from the hospital, after a suicide attempt, not to a welcome home party but to pained silences and looks of pity and contempt. These are the realities that people who have attempted suicide face. And do we feel shame about what we’ve done? Many of us do.
As I have stated, over and over, that to experience bipolar disorder is to experience such inflated emotions that they swallow you whole. Bipolar emotions are bigger than you and the particularly nasty ones are bigger than any therapy or coping skill could ever be.
However, not every emotion is a bipolar emotion. Just because I feel a strong emotion like anger, sadness or elation, that doesn’t mean it’s a bipolar overreaction I’m feeling. It’s not necessarily depression, mania or hypomania. Sometimes, people with bipolar disorder feel just like everyone else. Sometimes we’re just reasonably mad.
But there’s a very underserved community in conjunction with suicide and that is the loved ones left behind by suicide. They are suicide survivors too. These people are left with a void. These people are left with a hole in their hearts and a hole in the information that’s available. But there are things I think you should know if your loved one commits suicide.
So, as it turns out I’m a bit of a mental illness stigma eraser – or at least so sayeth the amazing folks at Didi Hirsch. I’m extremely proud, honoured and humbled to announce that Didi Hirsch will be honouring me at this year’s Erasing the Stigma Leadership Awards in Los Angeles.
Recently I have been talking about bipolar coping skills. Really, I talk about bipolar coping skills all the time. Recently, though, there have been two:
In both cases, I argue that these techniques can help you in your everyday life. These coping skills are things that you can apply every day (pretty much all day) to try to dampen some of the overwhelmingness that is bipolar disorder.
However, practicing bipolar coping skills is a bit of an art. Sure, you could try to use them every moment of the day, and if that works for you, then great, but that’s a lot of pressure to put on yourself. I would suggest that’s not the best way to go about practicing bipolar coping skills.
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