Dedicated to my friends, met and unmet, who have bipolar disorder
Yes, it’s that time of year when your mom, pushing 80, phones me and says, Will you give Eric a call? He stopped taking his meds and he’s suicidal again.
Look, taking meds are a drag. No one knows that more than I do. They’re expensive. They have side effects. They may make you feel weird. They remind you, when you see them sitting on your kitchen table or your desk, that you’ve really got a problem. An illness. A disorder. And it won’t go away.
You did the right thing, Eric, going off your meds, once or twice. The majority of people with bipolar disorder do this. However, almost without exception, they learn the illness comes back. With a vengeance, of course. The illness is mean, we know that. And when we go off, we think, “Perhaps I can make it this time.” I believe you’ve been going off your meds once a year since your diagnosis 15 years ago. Yes, we must question everything in life. Is there a God? Should I become a vegetarian? Is that a maple or an elm tree? Do I really need meds?
Your mom tells me you can’t find a psychiatrist you like. Or a therapist or a support group. I understand. I too am choosy. We must be. I go by the rule of thumb that only 10 percent of all professionals are excellent. Excellence is what we strive for. What we must have.
Since you live in the Northeast Corridor, Eric, you must have hit the 90 percent substandard shrinks. A good shrink should have two qualities: competency and personality.
His or her competency should encompass top knowledge about the psychopharmacopeia. He should be well-read about new developments and new meds. The doctor must be a good listener. His practice consists of seeing one sick person after another. He must have the stamina to remain fresh -– and wide awake -- when he sees you. He must devote total attention to you, as if you are his own sweet child. Yes, we demand that of our healers.
And, know that he demands no less of himself. That is, if he is one of the Top Ten.
Doctors have their favorite drugs. Let’s say that “Dr Marshall” prefers lithium to treat his bipolar patients. But you, Eric, as a well-informed individual, do not want lithium. Dr. Marshall must respect your opinion. If not, we toss him out. We are very very particular about the man or woman who is medicating our minds.
If competency is the number one quality we seek in a psychiatrist, what role does their personality play? A huge role. We all come with a personality. We’re attracted to certain people, repelled by others. It’s awfully difficult to follow a doctor’s orders if we don’t feel a connection with them.
That’s why I suggest you find a highly recommended psychiatrist and have an initial telephone exchange with them. Here’s a subtlety few people know about. A doctor-recommended psychiatrist is not the same as a patient-recommended one. You must get a recommendation from a lay person, a fellow patient, not a professional. Then go with your gut feeling.
Knowing you, Eric, you are probably asking yourself, Why do I need to see a therapist? Aren’t meds enough? Allow me to be blunt. No, medication is not enough. Meds are the first defense against the illness, but did you know that through psychotherapy -– the conversation that ensues between ourselves and a competent caring therapist –- that changes actually occur in our brain? Positive changes that are nearly as effective –- sometimes even moreso –- than our meds?
The goal of therapy is to help you evolve into your best possible self. To bring out the “greatness” inherent in every individual. Most people diagnosed with bipolar disorder feel shame for this diagnosis. You will want to address this with your therapist and then move on. Through therapy you will get to know yourself. And, believe it or not, with a therapist’s help you can learn to change things about yourself you don’t like. Goal-setting is paramount. You are mid-life. A Top Ten therapist can help you achieve your dreams.
No good support groups in the Northeast? Hmmm. Questionable. Since support groups are comprised by nature of numerous individuals, there’s more to find fault with in a support group than a single individual. So, here you will learn to strengthen your Tolerance and Compassion. (Read Thich Nhat Hanh, my favorite man of compassion. He’s a Buddhist monk.)
I readily acknowledge the difficulty of attending a support group. You will see others with your same condition. Some may be attorneys or schoolteachers, others subsisting on Disability, barely able to get out of bed to make a meeting. Some may have been destroyed, temporarily, by one of our outlandish ‘highs’ where we lose everything as our illness turns us into a profligate. And then there are the self-medicators among us who lost everything through abuse of various substances. Our disorder casts a wide net.
Attending a support group takes all our courage. For –- guess what? -– it is at the support group that we meet ourselves, face to face. The ultimate mirror held up showing every crease, every freckle, every eyelash, every wrinkle. “Take it away! Take it away!” you may cry.
Who are we really, Eric? Who are we at the core? We certainly are not our illness. The illness exerts only a small influence on our being, if we properly manage it. If, that is, we choose to manage it through medication and therapy. Only you can decide what to do with the rest of your life. To go or stay. To take or not to take. To live or die.
Freedom demands we understand obstacles that get in the way of our living our very best life. My wish for you, Eric, is that you make the very best choice to reside happily in the world with your mother who loves you, your two beautiful children who love you, and yourself, who you may learn to love, if you ask for help.
Ruth Z Deming, MGPGP
New Directions Support Group of Abington PA