The first thing I like to say when I hear people struggling with a new diagnosis of anything is: "thank god you can now start figuring out a treatment to help you feel better/to help your life get put back together/to help you stop hurting so much". In my previous post I ended saying, "why do we love the diagnosis..." because we can finally start getting treatment. I have been reading a lot of bipolar memoirs lately (Kay Redfield Jamison' An Unquiet Mind: A Memoir of Moods and Madness, Lizzie Simon's Detour: My Bipolar Road Trip in 4-D, and Marya Hornbacher's Madness: A Bipolar Life.) In each of these, and from many individuals I have spoken to personally, I hear the pain that accompanies the diagnosis. The questions of "Does this define me?" "Will this be forever?" "Where is the separation between my personality and the illness?" "Am I going to have to be on meds for the rest of my life?" These were the questions I had. These were the worries I had, but at the same time I felt the relief of "at least now we know what we're working with..."
So, let's now imagine the you have a diagnosis. You know that you are bipolar (or fill in the blank). You know that prozac/other medications do not work for you because they make you manic/etc. And now its time to figure out what does work. In order to give you an idea of the process from diagnosis to treatment I thought I would give you a little glimpse at my slow path towards treatment:
When I was first diagnosed I was in a hospital having willfully checked myself in after a near suicide attempt. I was at the point where I was having psychotic suicidal ruminations that lead me to have a one on one aid that watched my every move. In the hospital I was told that I was bipolar II. This seemed very strange to me having only repeatedly experienced extreme depths of depression. I thought, where are the manias, or hyper-manias? I knew however that there was something more, something deeper than just being sad. It was a constant sadness to my core, and I knew it was something that needed fixing, that needed soothing, before I did something drastic. So I drank, a lot, and I started cutting, and I smoked pot, and tried drugs I wouldn't have done had I not been trying my hardest to fight off the seductions of suicide. At the time, I assumed these were my treatments prior to the hospital. These proved inefficient when I found myself blindly checking myself in with those magic words, "I don't feel safe".
In the hospital I was very unresponsive to all types of treatment. I fell into such a dangerous place that extreme measures had to be taken. I could not be left alone for one second because they knew I was watching, searching, for anything I could get my hands on to end the pain. This is when they offered me two options. They said, "we can send you to the state institution where you can wait until you find the right drug, which may take several months, or you can try electro-convulsive therapy". Now at this point I was beyond any other options, and taking the extreme route seemed like the best idea. I told myself "well, ECT will either kill me or fix me" so I begged my parents for the treatment (they of course did not know this thought process at the time) but eventually, full of uncertainty and fear, agreed. I am not going to go into details at the moment about all my experiences with ECT right now. It is a very controversial thing and I want to make sure that I do it justice and help people truly understand more about it, so I am just going to tell you two things: it is much more humane now, (no more One Flew Over the Cuckoo's Nest), and, it saved my life. After the first treatment the "thoughts", that urge to hunt down anything I could to kill myself with, were gone. Gone. I was still very veryvery depressed, but I eventually got to the point where I lost the constant eyes watching me and even got to shave my legs (a very big deal at the time).
After the hospital I went back to my normal college kid life, still feeling slightly blue, but on the whole much better. It was at this point that I was prescribed my 5th or 6th pill, that miracle drug, Prozac. My first day with Prozac was amazing. Suddenly everything was so much better. I did a much better job at work, I got all my house work done, I went for a run...and then everything sped up. Suddenly I was spinning beyond control. No amount of running could help me. No amount of anything could help me. At first the high was addicting, I started drinking more, partying more, spending more, doing drugs I wouldn't do. I started cutting again. I was starting to have very strange, un-Linea, thoughts ("maybe I should jump off the roof" "I wonder if it would hurt if I chopped off one of my fingers...") I was not suicidal, just very very manic. The addictive beautiful high that I experienced in the beginning was gone. I was no longer super-woman, but a paranoid, anxious, agitated child. I was breaking things. I couldn't have a conversation because my thoughts were going to fast to spit out.
Knowing something was very wrong I finally called my doctor. He told me to stop taking the Prozac immediately and prescribed me some anti-anxiety pills. Still being very impulsive, and having increasingly scary thoughts I took one. Just to calm down. Just to make things stop. To keep myself from doing something stupid. Just to keep my mind from accidentally killing itself. And then I kept taking them. I think there was a point where I told myself "I need help. It's time to go to the hospital." And then I took them all. Thirty something pills. And then I walked over to school, turned in my homework, told my teachers I wasn't feeling well and wouldn't be at their classes, and nearly passed out waiting for an ex-boyfriend/best friend to get out of class and take me to the hospital. I knew who to go to. I knew who would take the best care of me. This was not a suicide attempt. I did not want to die. I just wanted the thoughts to stop. I wanted to keep myself from jumping off the roof or in front of a subway train.
After this incident my diagnosis changed. I was not bipolar II. I could not take certain pills. Out of the hospital I made a decision to take care of myself. I decided to get the treatment I needed and though I had a few bumps along the way, (trying to cope through bulimia), I eventually committed myself to finding, and following, a healthy treatment plan. This plan incorporated close work with doctors, psychologists, and psychiatrists. It involved trust in my doctors to find a medication that made me well enough to try other treatment options. It involved asking for help when I needed it, telling the truth about my feelings, and knowing that hospitals are not shameful, but needed at times. It eventually involved a healthy change in lifestyle--no more drugs, alcohol, no more staying up all night, exercising, eating healthy, meditating, and a regular sleep cycle. I will go into my current treatments in a future post, but I felt it necessary to discuss the difficulty finding, getting, and sticking with healthy treatment. Had I not found the treatment I have now I would be nowhere close to where I am today. I may not even be here at all. In conclusion, the diagnosis is indescribably painful, finding treatment seems impossibly hard, but with perseverance, a little bit of luck, good resources, self advocacy, and at times, pure trust that things will work out, people can find a better life and get the help they need and hopefully end those terrible statistics involving extremely high rates of homelessness, incarceration, and suicide for those struggling with a mental health conditions. Treatment works, and I will also give you some resources to find good treatment in my next post.