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Denial – Or, how I learned to love Bipolar. I remember quite clearly the first time my family doctor mentioned lithium in
passing to me during a consultation. At that time he had been treating me for
major depression and had been ramping up my anti depressants with only some
success. He had mentioned it in the context of some people with major recurring
depression benefiting from mood stabilisers as well as anti depressants for
management of their illness. He also mentioned that he would have a word with a
personal friend of his from Medical School that was a top class consultant
psychiatrist and get some advice on the latest medications available for my
‘depression’. Now my family doctor is brilliant at reading people. He was already
suspecting that I had Bipolar disorder rather than another dose of major
depression alone, but he knew that if I heard the old term ‘manic-depression’, I
wouldn’t take it very well at that point. He just had that knack of dropping
enough hints so that you would be led in the right direction at your own pace!
He was also sensitive to know that I wasn’t ready emotionally to think about
seeing a psychiatrist again and by using the method of talking to a friend about
medications it gave me an opening to become used to the idea. I went away after the consultation okay. Then a few days later suddenly
“Lithium” jumped up at hit me. Hang on! Lithium! That was only for real
‘nutcases’ not for people like me with just a bit of depression. My doctor must
have it wrong; surely he didn’t mean that and obviously had used the wrong word
when he meant just another form of anti depressant. The only experience I had had with someone on lithium was with someone a few
years ago that was really seriously disturbed and was so doped up most of the
time that he could barely function – that obviously wasn’t me! No, my doctor
must have made a mistake! Well, I brooded and stewed on this problem (by the way – I have First Class
Honours in this) and by the time I got to my next appointment I was well into
denying that there was any need to consider anything else but anti depressants.
What my doctor should do is simply change my medications if they were not
working – I did not have anything serious enough to need medication as heavy as
lithium. So I let my doctor have it! Which is exactly where he wanted me! After my head of steam had run out, he
used the opening I had given him to explain the Bipolar Spectrum and how some
people only ever had moderate highs and lows, not the classic swing so loved by
the TV and movies. He then went on to correct my misconceptions about lithium
and it’s uses and benefits and other mood stabilisers. I asked him did he really think that I was suffering from Bipolar not
depression and again, reading me well, said that it was a possibility, but we
would need to have a look at it more and when I felt ready, he would like me to
see his psychiatrist friend, but, he stressed, only to help with advice on
medications to suit me. I said that I would think about it, as I really wasn’t
ready to concede yet. I was sent away from the consultation with a mood chart to start filling in
every day to see if indeed my moods were swinging rather than the depressive
pattern I had been diagnosed with previously. It really didn’t take long using the chart to see that I was up and down in
my moods along with changes in anxiety and irritation. I wasn’t sure how to take
it and was still reluctant to recognise what this was. However, by the time of
my next appointment I was ready to accept that maybe there was something to be
looked at, and agreed to make an appointment with the psychiatrist. Denial was slowly coming around to – thinking about it. Fortunately, I felt comfortable with the psychiatrist and was able to make
the most of my first session. He went through the different medication options
available to help my moods to stabilize and thoroughly explained why the
important thing was to help me feel more comfortable first and then worry about
the official diagnosis later. The way he said that from a medication point of view, he would be treating me
the same way if I had medication resistant depression or a form of Bipolar
disorder made me feel more at ease with what was happening. He explained that
because of my more quickly changing moods – he would be prescribing Sodium
Valproate not lithium and this also made me feel more comfortable about the
whole deal. The rest of course is now history. A few sessions down the track, especially
when the mood stabilizer had taken effect, and my fears of being
‘manic-depressive’ had eased and the therapy had started I realized that I had
Bipolar, manic-depression, whatever term is more comfortable and that life does
go on. I also realized that if I wanted to have control over my Bipolar rather than
the other way around, I first had to fully admit that I had it, and come to
terms with the changes I needed to make in my life. I suddenly really understood that I had made the step that my mother simply
couldn’t. That I did have a chronic mental illness. It was treatable and life
not only went on – in time it would get better again as I adjusted. The great secret was to not to deny the possibilities and be open to various
options. Then the Bipolar started to become just part of me rather than the
whole of me; and my life started to be mine to control again. Try it – it works. Graham Brown 17 February 2003 |
