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Spectrum of various Experiences, Treatment and Coping Means helpful for Bipolar Disorder (manic-depressive illness)

Posted Sep 13 2008 11:48pm

In my first Mission 4 Monday post yesterday, I republished an excerpt "Trust during rough times" from my friend, Marja's book "A Firm Place to Stand."

I am thankful to my friends who took time to stop by, read my post and share your thoughts. One of my readers, Rob, wrote a comment which I would like to share in this post. Rob has bipolar disorder. Thankfully his condition is stable and he is able to go off medication now.

Bipolar Disorder or previously known as manic-depressive illness is a mood disorder with extreme mood swings ie. manic/hypomanic and depression.

Rob wrote on 2nd September 2008,

Hi Nancie,

Let me share a very weird, but also very interesting and I hope illuminating experience I had recently. In a way, although I am not a believer (nor a 100% complete disbeliever), this anecdote will, I hope, be interesting to you and your regular readers, and will be supportive of your theme today.

It has now been almost 2 years since I began reducing lithium, and more than a year and a half since I stopped it completely. I'm proud that I am totally drug-free for the first time in my adult life, but I am also very aware that my good fortune could end at any time. Anyway, I had a physical exam (after more than 2 years), and then a week or so later, I had a visit to my psychiatrist, for the very first time since stopping all drugs. I really like my psychiatrist, and I do not fault him on any decision he (and I) made over the years. I went there hoping to perhaps thank him for his efforts, and to show him that I'd had a clean physical checkup and was feeling "great" (no, not *that* great :-)). My family doctor sent my report to my psychiatrist. I like the fact that they work closely together, and they share information about me. All the minor complaints I'd had seemed to have pretty much disappeared, though there is much more than just a lack of lithium to credit for that.
My family doctor is cynical about psychiatry, and has always wondered why I was clinging to lithium, in spite of all my minor physical complaints, that seemed to just be getting worse as I aged.

Anyway, I entered my psychiatrist's interview room (after waiting one hour). I felt a bit sorry for him because he is now aged 72, and has not retired yet. I wanted to say something to the effect of "thanks for your efforts over the years". He first apologized for making me wait, and I said "oh it's nothing" or something like that. Then, to my total surprise, he acted like no other time in my entire 30 year history with him. Rather than having our usual calm, peaceful, friendly discussion, with him saying not too much, but encouraging me to speak my mind, it was the TOTAL OPPOSITE! I didn't know what to make of it. He was acting extremely hypomanic, while I was trying to stick to my agenda, of asking a few practical tips regarding sleeping, new drugs I might possibly take, etc. in the future etc. He wouldn't shut up. Even when he opened the door of the office to show me out (after 15 minutes), he kept talking and talking, even with other people listening! He made no mention of lithium, and no mention of when I might see him again. I finally managed to squeeze in "I guess I might pop in to see you again in a year or so", to which he didn't answer. He kept on talking about trivial stuff like tennis hurting knee joints or some such nonsense. He was also suggesting that "Oh, I guess you know everything now, and don't need your family doctor or me", to which I replied, "no, not at all". My wife was in the waiting room, and I said he could talk to her if he wanted, but he said he wasn't interested. Finally my wife and I left, both of us scratching our heads...

I later thought, Oh, I get it. He was just doing his job as my doctor. He's not really my friend. He was pulling out all the stops to try to destabilize me and "prove" that I was actually manic, and he was obviously failing to do so, so the end result was to make me somewhat more confident. Good. I feel better... But, I don't completely accept that theory either. A more cynical theory would say:
1. He is worried about a malpractice lawsuit
2. He is going to lose income without me
3. He is embarassed that he finally "lost" the argument with my family doctor
4. He worries that he might retire "in shame" at having kept someone on drugs needlessly, for almost their entire adult life
5. Just before seeing me, I think he took someone else who seemed to be in bad condition, and perhaps that rattled his nerves (I think he may have actually bumped me, in favor of that other person, who my wife later told me, looked quite sick.
6. I partly went to him because I tried to get a prescription for Stelazine filled (as a safety precaution) and it got held up at the pharmacy, because he happened to be on vacation. I then checked if my family doctor could fix that for me. I also then took some Stelazine, with my wife's knowledge, because I'd had some poor sleep recently, and I wanted to verify if I could count on Stelazine to fix that (minor) sleeping issue that had dragged on for a few days, for various reasons
7. Who knows what? Your guess is as good as mine. It just doesn't completely make sense. I still like the guy, but I wanted to share this with other sufferers of mental disorders.

By the way, I'm beginning to seriously believe that peaceful meditation actually works better for me than Stelazine, and has *zero side-effects!*

This is something you might want to consider (briefly), when you decide where to put your "faith".

Thanks for listening -- a slightly puzzled, but still doing OK Rob

I am thankful to Rob for writing in to share his experiences and thoughts with me and my readers. I am thankful that Rob makes time to come by every now and then, and I greatly value his friendship.

As I do have my own personal experiences and opinions pertaining to what Rob has shared, I have decided to write a separate post in answer to Rob. So here's my response to Rob:

Hi Rob,

Thank you for your 2 comments! I delayed in publishing your first comment because I needed time to digest what you wrote and also to think of an appropriate response :-) Thanks for writing again. I have decided to publish your first comment here as a separate post so that I can response and share my personal experiences and opinions too.

Your recent experience with your psychiatrist is truly rather weird :-) I am thankful that you are able to be medicine free and I hope you continue to stay stable!

In my personal opinion, I think there is actually a rather wide spectrum of experiences for those who suffer from bipolar disorder and therefore a wide spectrum of wellness or coping means that suits different individuals.

In my own personal experiences, I have found that Finding a Good Doctor/Psychiatrist is very crucial for me. I am thankful that God has provided a very good and helpful psychiatrist for me. I am newly diagnosed with bipolar disorder last March and still very new on the journey of understanding and managing bipolar disorder. My Doctor's help has been invaluable in my recovery journey!

I have come across several very different experiences among my fellow bloggers.

I know of people who are being helped my medication just like myself. Our mood-stabilisers helped to stabilise our moods in longer run. Some of us are on anti-psychotic medications which helps to manage our manic/hypomanic and sometimes we need anti-depressants to lift us up to a functional level when we have a relapse of depression. So medication does help some of us to be more functional. It would be wonderful to be so stable and functional one day that some of us can be off medication eventually! But that is a case by case basis.

Some of us may have to be on life-long maintenance medication for the sake of stabilising our mood. Medication however is only a part of our treatment and recovery plan. Medicine helps to lift us up to a functional level when we are depressed or helps to calm us down to a functional level when we are too manic, but we also needs to live a balance lifestyle that will contribute to our mental stability and physical as well as spiritual well-being. We need to know what may trigger off relapses, how to recognize early symptoms and what we can do to get better or prevent our conditions from deteriorating. Depending on our makeup and our bipolar condition, what works for us may differ one from another.

I have also known of others who are medicine resistant and who suffer more side effects than benefits from their medications. These have suffered much throughout the years due to unsuitable medications. Some have found help now through alternative medicine or therapy. There are some who have learned to manage their condition so well that they do not need medication at all. Perhaps their condition are also milder than some others. I also have some friends who benefited from ECT treatments when nothing else is helpful and their sufferings were relentless. Thank God for providing something that helps these friends. But again ECT may not be suitable for everyone. I think it is a case by case basis. It may take time to find out our own conditions and what is best to help us maintain stability and enable us to be functional and of maximum benefit to our family and society.

I have shared about some of My Coping Strategies in my previous posts. Personally, I benefitted from Medical Help and Medications. Anti-depressant medication helps to lift me up to a functional level when I am depressed and anti-psychotic medication helps to calm me down to a functional level when I am too manic/hypomanic.

I am learning to use Mood Diarytotrack my moods and learn to recognize early symptoms of possible relapses or impending relapses or worsening symptoms. I work closely with my psychiatrist on how best to troubleshoot and manage my condition. I hope to share more about this in future post.

I have found that getting enough sleep and sleeping at regular hours is very crucial. Insufficient sleep can cause my relapses or may be symptoms that I am going through relapses.

For some months last year I benefited from several counseling sessions with a lady Christian counselor who uses Cognitive Behavioural Therapy( CBT) to help meidentify and correct some faulty thinking patterns. I do have some faulty thinking patterns that can either trigger off my relapses or worsened my condition. In particular I learn to understand some of the myths and facts on mental illness so that I have a more realistic view of my condition. Learning to coping with false guilt during depression is also very crucial to me as there is still such a terrible stigma associated with mental illness even among Christians.

I also found reducing stress and learning to manage stress to be very crucial in my own management of my condition. From past experiences, I am discovering that mismanagement of stress or excessive stress will trigger off my relapses. So I am now prayerfully learning to recognize signs that I am getting stressed up or overly stress, and how best to reduce it to a level I can manage. I learn to pray and commit things to God, and seek His wisdom to manage the various challenges in my life. I also learn to share with my family and friends when I am troubled, stressed or perplexed. In the multitude of counselors there is safety (proverbs)! I find brain-storming and discussing with family and friends helped me to see things from a better perspective and learn to manage the various challenges in my life better.

I am also aware that one of the great source of stress I often experience actually comes from myself! I am some kind of a perfectionist. So in some ways my expectation of myself and others can at times be rather high and unrealistic. The problem is I am not always conscious of this. But this can cause much stress and harm to me in my own life as well as my relationships with others or my works. So I am learning now to be more aware of my unrealistic expectations of myself, of others or of the world in general. I am learning to be kinder to myself :-) and to others :-)

In other words, I am learning to me more aware of my limitations! The problem with bipolar disorder is that whenever I am well, I am a little hypomanic. So I have more energy, more creativity and tend to want to do more things. I tend to take on more projects that I can manage without realizing it. I also tend to want to help as many people as possible without realizing that I am over-stretching myself and trying to do too much! That is why I often suffer burn-out and then clinical depression. The tricky thing for me now is to learn how to estimate how much I can do or I should do. There seemed to be 101 things that I think I should do or I can do! But in reality this is not the case :-) So I am still learning now to pace myself more moderately and prayerfully.

Personally I do not practice meditation. I have a friend whose sister is bipolar and found it put her in a dissociative state whenever she practiced meditation.

For me meditating on God's Words help me. My quiet times in the mornings and evenings are most precious to me. I am learning to pray and commit each day unto God. I spend the time in prayer, reading of the Bible, singing of Psalms and journalling. I find that writing down my thoughts and experiences help me to see things from a more realistic perspective. Prayers help me to unburden and cast my cares on God. As I pray and commit all things to God, I find peace in knowing that He will guide me in the paths He wants me to go. Though God may not always answer my prayers according to my desires, I am learning to submit to His will which is always the best, because He is sovereign, mighty and all-knowing, and He loves me. I find much comfort, direction and encouragements from God's Words daily. I learn to wait upon God to speak to me through His Words and providence, and He is faithful to answer my prayers daily. Filling my mind with the Word of God and meditating on these precious Truths gives me peace, comforts and directions. God's Words strengthens me and help me to cope with various challenges in my life in association with bipolar as well as other aspects of my life. For me this works very well. And this quiet time becomes a very important recovery tool as well as in my management of my condition.

I found that one good way of reducing stress is to be more organized. I have the tendency to want to do too many things at one time. Now I find that if I list down the things I need to do and plan on how to break them down into manageable tasks, I can cut down on stress and get more things done. So now I use a Diary to plan my days.

I have also found exercise to be very crucial to me in my recovery process. I read that the good chemicals that are released during exercise helps with depression. Personally, I enjoy Brisk Walking and have found that it helps to strengthen my body and mind. I feel very refreshed after my exercise and my mood is lifted up. But I understand that not everyone is able to participate in exercise. We need to assess our health and our medical conditions. It is good to consult a physician first if we are unsure. This is to prevent unnecessary injuries and harm due to inappropriate exercises.

I am learning that relaxation and recreations are important to me in my management of bipolar disorder. I also have several therapeutic hobbies which I enjoy very much and helped me to relax. I derive much joy and satisfaction in Photography, Making Bookmarks, making homemade Calendar and Blogging.

I am learning to eat more healthy meals and I also benefit from Omega 3 Fish Oil Supplements.

I realize through this illness, the importance of having the support and prayers of my family and friends, besides professional helps from Doctors, Counsellors and Support Group. The people I love, and who love me, will see me at my best. When my symptoms reappear, they may see me at my worst.

Whenever possible, I will share with them my illness. I give them articles, pamphlets and books to read about bipolar disorder so that they will understand that my behaviour is not always under my control. It will also help them to understand why I am sometimes so different.

For me, I have found blogging to be therapeutic to me and is an important tools in my recovery. It has been a joy and privilege for me to be acquainted with many blogging friends who are suffering from depression, bipolar and other physical or mental conditions. To be able to share and support one another as we seek to learn to understand and manage our conditions has a great impact upon my life. I felt I have grown much over the last half year of blogging through my acquaintance with such dear friends and learning from various people's experiences. I am learning to understand my condition better and to manage it better. Ever since I joined Word-Filled Wednesday (WFW) and Thankful Thursday (TT), God has helped me to grow spiritually. I am greatly blessed by the many encouraging posts many friends shared on WFW and TT. And now that I newly joined Mission 4 Monday I am also greatly blessed and encouraged. I am so thankful that I can get to know you and so many others through blogging! But I am learning to pace myself moderately as I tend to get carried away with blogging as I enjoyed it so much and I can over strain myself unknowingly :-)

I am thankful to God that in this generation there are many resources and helps available to cope with depression, bipolar and other health conditions. I am still learning and discovering what is helpful for myself and how best to manage my condition. I am thankful to God that I can share helpful resources with my readers on this blog as I journey on.

As there is a wide spectrum to the experiences as well as treatment of bipolar disorder, I do not recommend my own coping strategies as the best for everyone. I think it is a case by case basis. I believe many of my coping strategies are those being used by many people and it is helping them. But others might not find them useful. I think we each need to take time to understand our condition and what is most helpful to keep us stable and functional. Most of us will need our physician's help or therapies or counselors help in understanding and managing our conditions.

For me personally, ultimately my faith is not in myself, anyone or anything, but in God and my Lord and Saviour Jesus Christ, Who can restore me using various means or without means. I have survived some 10 or more severe clinical depressive episodes over the last 20 years without medication because I didn't know that it is a medical condition. I realized that without medication I can still recover from clinical depression but with medication my sufferings have been lessened as well as shortened. Without medications, I used to endure at least 3 to 6 months of clinical depression or sometimes longer. Those were very difficult, painful and confusing time. Thank God for preserving and restoring me in those years. Now I am thankful that I am more functional and able to live a more productive life with medical and various other helps. Knowing that my depression is clinical and not due to weakness of my character or lack of faith in God, helps me to banish false guilt and seek medical and other helps. As my depression episodes have become more and more frequent and more and more severe in these recent years with terrible temptation of death, I appreciate the way medication and other helps are helping me. I know there are side-effects with any medication but I have prayed and weighed the matter. It is better for me at this point of time to bear whatever side-effects of medication so that I can be more functional rather than to risk dying from suicide during severe depression relapses. And besides medication, I prayerfully use as many of my other Coping Strategies as possible so that my medication is kept as minimum as necessary.

Thanks again for writing, Rob. I hope your condition continue to remain stable and you can continue to find wellness activities that helps you! You and your wife are in my thoughts and prayers. Take care and keep in touch.

With appreciation,
Nancie

And thanks, friends and visitors, for stopping by. Do share your thoughts and opinions with me by leaving a comment, if you can. I will greatly appreciate it!

Take care and have a blessed day!
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