This is the third of a four-part series on mental health disorders and how real people handle them. These people are your neighbors, brothers, sisters, children, parents, even your grandparents. You know them. They’re around you every day.
Well, not specifically these interviewees, no, but you get the idea. They are perfectly normal people facing big mental health challenges.
We will be looking at the following disorders and how these people have handled them.
- PTSD/Complex PTSD. Note that C-PTSD is not yet a diagnosis in the DSM-V but as with many disorders, it comes on a spectrum, such as Treatment-Resistant Depression.
- Treatment resistant depression. This is a case of Major Depressive Disorder that has been resistant to several drug therapies.
- Bipolar disorder. This is a case where a person has struggled with Bipolar for years and has learned to cope with it.
- Borderline Personality Disorder. This is a case of the much vilified BPD that has shown incredible growth with and without medication.
These interviews have only been edited to protect the identity of the person answering. Gender neutral terms only—and the singular ‘they’—have been used where appropriate. “Spouse” instead of wife or husband. This is to ensure their privacy so they’re free to go into detail on certain things.
I will never reveal my sources, so please do not ask me to do so. I hold confidentiality as sacrosanct and will carry their identities to my grave.
None of these people are or were my patients. I do not confirm or deny how I know them or where from I know them. On my Facebook author page, people were invited to be interviewed and some chose to take me up on my offer and advertisement in the hopes that it would help others.
Case #3 – Bipolar Disorder
When were you first diagnosed with Bipolar Disorder? How was it initially treated?
[I was] diagnosed with Bipolar Disorder at approx age 33. Initially treated with Effexor and psychotherapy.
How did you first respond to Effexor? What was psychotherapy like?
I think I had been on so many different meds by that time that transitioning from Zoloft to Effexor (XR) was a breeze. I don’t specifically remember it helping as a mood stabilizer, although I don’t think I recognized my so-called manic tendencies.
I think I do remember that I felt better overall on Effexor. Getting off Effexor (and onto Cymbalta) was a series of depressive lows and irritable, downright oppositional, highs.
(As a side note, one of my psychs used a “feeling” scale of -3 to +3. Using this scale has really helped me in determining my general mood.)
FINDING A THERAPIST THAT YOU GEL WITH IS IMPERATIVE!! At first, psychotherapy concentrated on my negative and irrational beliefs. I don’t remember the actual person at all, and I don’t remember which came first, meds or therapy. Each therapist I’ve had over the years has said something that has stayed with me. As an example, My first therapist (I remember nothing about this person) told me to change the (cassette) tape in my head (that’s how long ago it was!) so instead of hearing myself saying negative things about myself in my head, I should “re-record” those thoughts to put a positive spin on them. I thought the therapist was crazy, that I deserved all the bad stuff I had in my head that i kept repeating.
When starting, therapy was probably 50/50 on who did the talking. Now it’s probably 80/20 me talking mostly.
When did you realize that your disorder was becoming too much to handle?
I assume you are talking about when I very first sought treatment, before any diagnosis?
Combination of things—I’d moved across the country a year prior to getting this job. I could not find a steady job for that entire year (major stressor).
Finally getting a steady job, I worked for the same company for 4 years. Over that period of time I’d been promoted rather quickly and had a few different managers. The last manager I had insisted I take on an additional responsibility— speaking to groups of 5-25 people (major stressor) once a month about what my department did and how we were available to help them anytime they had questions. I wrote my own script (major stressor) and even had it approved by my manager (which, I found out later, I shouldn’t have done). Of course when giving this speech that I had written, my voice (and legs) were shaking, mouth was dry, etc. That manager critiqued me after my first time public speaking and told me my content was graded a C and my delivery was graded a D. (major stressor)
After me giving these presentations for about 3 months, and no change in grades, it was time for a yearly performance review. [My boss] slammed me, which affected my raise (major stressor).
An analogy I’ve used many times over the years is having a “Winnie the Pooh cloud” over my head. This is how I felt, a dark gray cloud hanging over just me. Needless to say, my job performance suffered after this review and I didn’t know what to do or how to get myself motivated to even go to work. Across the country, One of my siblings was working toward their Masters degree in Special Education, after receiving a BA in psychology.
I’m guessing [one of my parents] spoke to her about what a bitch I’d been for several months on the phone. I guess I was subconsciously looking for a way out of my head but I didn’t know where to start. My sibling suggested seeing someone, they must have said therapist because I’m pretty sure my PCP was the one prescribing meds in the very beginning.
As usual, I did what my sibling said (kind of our M.O. even now).
Crap, I just looked back at my original answer of 38, which is only taking Bipolar into account. The whole big, long paragraph above is related to my first diagnosis of Depression.
How were your family or loved ones affected by your illness? How did the Bipolar Disorder change your ability to function?
After a “breakdown” (I hate that word but can find no other) my sibling had to quickly scramble to find a treatment facility for me. I was admitted into an Intensive Outpatient Psychotherapy program (IOP). My sibling (the family member that lived closest to me) had to spend part of every afternoon checking on me, house call-style, asking me a specific list of questions. There is definitely a genetic component, as [one of my parents] had also been diagnosed with Bipolar Disorder.
In the early months/years following this [diagnosis], my actual functional ability changed in both good and bad ways. Good because that diagnosis fit me better than my previous diagnosis of depression, which allowed me to go easier on myself and not expect perfection when I knew I couldn’t give it. This helped me function with less stress about things I knew I couldn’t control, where previously I would have fought to control everything in my life. Over the years, my [activities of daily living] have not been taken care of as thoroughly/often as they should; I just don’t always have the physical and/or mental energy. It has really worn me down and worn me out.
How did you seek help for your disorder?
Had been seeing a psychiatrist for med checks and quick conversations every 2-3 months. At one point I mentioned an incident that had happened when I was 19. I have no recollection of how this came up.
I think this is what started the psych to think about Bipolar rather than “just” depression. Looking back and knowing what I know now, this was definitely my first manic episode. My meds were adjusted accordingly.
What is life like on medication, if you were given any? How was it at first compared to how it is now?
Better living through pharmaceuticals!!!!! In IOP, Lamictal was added to my list of meds. I am much more aware now about how each med affects me. Hard to separate which drug helps with what, but my basic “cocktail” now seems to work most of time, with little tweaks to dosages occasionally, when I don’t feel quite right, but can’t identify anything specific being wrong. Always, always with my psych’s guidance.
What kind of action plans do you have for a medication check? What is your relapse plan?
I see my current psych about every 3 months. He makes it very clear that if I need to see him before then, he will get me on his schedule ASAP.
Relapse plan, hmmmmm… I don’t specifically have a plan. Currently, I see my therapist every 2-3 weeks with the option of more or less often as I feel the need. I am very (probably overly) tuned in to my mental health and can tell the difference in how I feel from one day and the next. [My therapist] would be my first line of defense against relapsing.
How do you build on one victory to the next?
Little victories mean sooooo much!!!! Victories like take a shower 2 days in a row. Build momentum one tiny “yay me” moment at a time.
What are your “tricks” for staying mentally healthy?
Meds. The right meds. Therapy. I never consider myself mentally healthy. I like the thought of considering myself a work in progress, but how I really think of myself is damaged goods.
Points to Reflect Upon – For People with Bipolar Disorder
What are the ways you can tell you need a medication adjustment? If you have difficulty reading yourself, who around you can help you discover this?
When you think negative things about yourself, how can you “change the tapes” to help think positive things about yourself? What ways can you change those negative beliefs?