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After fighting a deep depression for 1½ months, I finally came out and settled in at “normal”.   After a few days I should have been very pleased but I was frustrated. I felt bored. Totally and hopelessly bored and I didn’t know why or what to do with myself.

I had an appointment with my therapist. We talked about my sleep problems, I’d been getting only a couple of hours per night for a few weeks and by afternoon I would feel starved for sleep. We determined it was either my new meds causing it or a rebound effect from coming off the old meds if they helped me sleep.   It could also be a combination of both.

Finally, I told her how bored I felt. She asked me what I have been doing and I told her it was just the same routine stuff—nothing had changed. She said, “Oh, but it has.   How are you feeling?” “Normal.”, I said. And then she blew me away. She said that “normal” has left me with nothing to work hard at. When I’ve been at anything but normal, which is usually most of the time, I’ve had to work hard to continue to live a normal productive life.   It can be incredibly hard work but now I had nothing to work hard at, just routine chores or errands. She was right! It made perfect sense.

I’ve achieved 12 days of “normal”! And I feel free and content. Boredom fled when I realized the reason for it. This is bliss and I have to believe it will stay this way. I know in reality the odds are stacked that I’ll slide up or down again. But negative thinking brings me down. The work now is to stay positive, believe for the best outcome and live in the moment. That’s not very hard work at all.

Last week I went with my husband to see a psychologist he had an appointment with – it was supposed to be about him and how he supports me.  Somehow, the attention turned to me.  The therapist took great interest in me, my bipolar experience and some issues I have.  She asked if I would like to be her patient.  I like her, she’s very direct so I said yes. (My husband will now come with me only occasionally. He is no longer the patient, which was his intent anyway.)  Tomorrow is my very first visit as her patient.

I know she will be asking tons of questions, but I have a few of my own for her too:

  1.  What methods will we be using, CBT or others?  If others please explain them.
  2.  How do you treat a bipolar patient when all goals have been reached?.  When you feel your
    client has mastered all the coping skills, and we have completely covered any other life
    issues, are we done until I have a problem again? Or in the beginning, do we have regular
    follow-up visits every 3 or 6 months to be sure I stay on track? (Past therapists just cut me
    off until I had another problem. I’m not sure if this is good or bad.)  I think 6 month
    or even yearly follow-ups might be a good idea to help me remain focused and tweak coping
    approaches.  Why wait until there is a fire to put out?
  3. Besides honesty, what do you need from me?  What are your expectations so I have a clear
    understanding?

Then there is what I want her to know:

  1. I am a hard worker, compliant with medications and doctors instructions, and I do my best, whatever
    it takes, to achieve wellness and order.
  2. I am a quick learner and will ask questions if I need to understand a concept completely.
  3. I appreciate directness, even if it hurts sometimes. It brings me to the heart of a matter much
    more quickly than dancing around an issue to spare my feelings.

It should prove to be an interesting morning.

What are some questions you would to pose to a therapist you are just getting to know?

One of the first coping skills I learned about after my bipolar diagnosis was that meditation is important to our well-being. It’s a time to quiet down our racing thoughts, emotions and negative thinking. It relaxes the mind and body. I’ve heard some people say they feel rejuvenated after spending awhile meditating.

Some people like to sit and use a particular scent that is pleasing and focus quietly on that. Others like to hold and feel a textured item that is pleasing to focus on. Some focus on something in their minds. Some people like to use prayer as meditation. While focusing on whatever one chooses, it is important to breathe deeply.

Although I pray often, that is not usually my form of meditation. Mine is to go to a special place in my mind. I wrote about it and I want to share it with you. See if you can picture yourself there.

River Peace

Stresses peel away while I listen
Dark, murky water
Lazily follows a ribbon pathway
Gurgling, lapping at the shoreline.
Trees shield the forest floor from afternoon sun
Grateful, I find rest in the cool shade.
Rustling leaves, quiet songs of nature,
Soothing, comforting,
Reassuring that all is right in my world
God is in control.

I sit here for the solitude
Yet life teems all around.
Spiders spin, ants gather food,
Birds chirrup in the green ceiling above me.
Dragonflies flit to and fro above the cool water
Prism wings of purple, green, red-violet.
I belong here, joining God’s creation
Celebrating life’s pure joy in being, simplicity.
I wait to hear His voice.

© Jeanette Chiapperino 9/21/2000

A few years before I received my diagnosis, my doctors were scrambling to find out what was wrong with me. I was referred to a neurologist and then to another group with neurologists and a psychoneurologist. They had me fill out a form with all kinds of questions about what types of things I may or may not have experienced.

Some were: hearing voices, seeing beings that no one else saw, delusions, unreasonable beliefs and on and on it went for many pages.

The problem with this is that I was terrified of giving any positive answers to anything except things about what I was feeling, down, sad, fatigue, etc. I was afraid if I admitted to seeing or hearing things I’d be labeled crazy and thrown in an institution for a long time. My mother had instilled that fear in me because that’s how it used to be years ago. She was terrified that it could happen to her because she suffered with depression. A relative’s first wife was institutionalized at some point for the rest of her life so that compounded her fears. So, full of fear, I was dishonest about a few things.

The result was I was diagnosed with major depression and referred to a psychiatrist who put me on antidepressants, which made me worse.

A year later I moved and was diagnosed as having bipolar disorder. My meds were changed and my life began to get better.

Had I been truthful from the beginning when filling out that sheet, I may have received a correct diagnosis a few years sooner. I wouldn’t have been given antidepressants, which are known for worsening bipolar symptoms. I probably wouldn’t have suffered so much.

So my takeaway from that experience is that I must be completely truthful with my psychiatrist, therapist and physician.   They can’t help me properly if I don’t provide them with the correct information, and all of it—no omissions. Why risk suffering with a problem and it possibly growing worse?

It has been worth the truthfulness. My doctors and I have grown to trust and respect each other and they do their best to help me get and stay well.

When I was first diagnosed with bipolar disorder, my psychiatrist and my husband were the only people that knew. And only my psychiatrist and I knew what meds I was on and why. My family physician didn’t know and I didn’t have a therapist yet.

 I read an article about the importance of sharing information between doctors so that they and I would be my healthcare team. A loved one (my husband) would also take part and be prepared to act as an advocate in case I can’t speak for myself. This really made me think hard.

Why is it so important? Most of us don’t have doctors who talk to each other. My family physician knows my diagnosis so she can be aware of improvements or declines in my condition. She also checks my thyroid and cholesterol levels along with a few other tests to know whether or not my medications are impacting my health. They have in a couple of areas so I was able to report back to my psychiatrist exactly what my physician found. We were then able to discuss whether or not I needed an adjustment or change in my meds

 I eventually did find a therapist and kept him informed of all that was going on medically. He could often tell if there were changes for better or worse and suggest what I might want to discuss with my doctors. He also helped me deal with my early frustrations with just having bipolar and my fears about what the meds might do and were doing to my body. (I just started seeing a new therapist and like her so far.)

I keep my husband informed of all that is discussed with all of these doctors and the therapist. Often, he goes with me to the psychiatrist so he can ask questions because he wants to be a strong support for me..

I am the one at the core of this team, keeping each of them informed of what is happening with the others. And I work hard at leading a healthy and active life. I’ve learned numerous coping skills to help me live a productive and normal life as best as is possible.   And the coping skills that I use are discussed with everyone on my team. I have been reminded by one or the other of them a couple of times to remember to use music or some other method that slipped my mind

My husband, my psychiatrist, my physician, my therapist and I make a good team and I can say I’m quite healthy because of it.

Have you put together a team or plan and has it worked well for you?

There is a great debate, and yes, even shouting, about the issue of medications vs. no medications for treating mental illnesses. And I am addressing bipolar in particular since that is what I am most familiar with.

I have an acquaintance who has tried the no medications s route by using the holistic methods touted by many and yet she is still suffering.   Early in my treatment, I convinced my doctor that I wanted to go med free because I had reached a point of stability and I was afraid of these powerful drugs and what they can do to our bodies over time. Of course, the rapid cycles started again in spite of having great coping skills and I went back to my psychiatrist for help. The drugs are what had helped slowed my cycles down enough to cope well, and those particular drugs never quite worked the same as before I had stopped them. I had messed up with my meds.

That led to an interesting conversation with my psychiatrist and a great revelation to me.  It was one that I had difficulty accepting.  My argument was the meds cause weight gain, increase the risk of diabetes, cardiac problems and a host of other problems besides the side effects associated with them.  I told him that I’ve already begun to have problems, pre-diabetes for one, and would most likely die younger never reaching truly old age.

My psychiatrist’s response was that I was suffering without my meds.  My cycles sped back up to ultra rapid cycling making coping and life difficult.  There is a high risk of suicide with my deepest depressions; it’s in my gene pool which is a great concern.  He stated that it’s a matter of choice as to whether I want a better quality of life or life with suffering, both of which have an impact not just on me, but on my family too—one positive and one negative. He led me to the conclusion that sometimes we have to give up quantity for quality, and quality is a better choice in this case.

I chose quality and haven’t looked back.  I’ll do all I can to live as healthy a life as possible and I’ll enjoy my family and friends while relieving them of any worry about my overall well being.  Life has been far better for all of us this way.

I’ll be on my way to see a psychologist in a couple of hours. It’s someone new. I’ve seen a couple in the past few years and they helped a little with a couple of issues but I just didn’t feel I got support with my bipolar and social/relationship issues (my husband is not a problem). After a few visits I’d be told we’re done for now until you have another issue, but the above issues were not addressed fully. I hope this new woman will be up to working with me. I’m not a difficult person—I’ve been told so. But I do work hard to face up to and overcome my problems. I expect my therapist, who I am paying, to put in a good effort with me while I do the hard work.   But I expect honesty and forthrightness. I want her to be blunt, to challenge me. I don’t understand the messages behind gentleness, coddling or wishy-washy.

Some people like the laid back gentle approach and that’s okay—for them. I need straightforward, let’s get to the point, get to the heart of the matter now approach. If we need to dig deep, lets dig and peel away the layers. I don’t want to dance around them before processing them.

I’m an adult who is smart and capable and I want to be treated that way. I’m not broken.  I want to be whole and well and to continue growing as a person who has something to give to this world.

I hope this woman is up to the challenge. I’m sure there are many people like me out there who want to voice their expectations to their therapist.

My husband likes her and thinks she’ll be good for me. I’ll let you know how it goes.

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