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

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