Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Wednesday, December 26, 2007

Thinking

I've been finding it interesting lately that so many of those diagnosed with mental illness are so angry with the medical world. There's a discussion going on at Living with a purple Dog (see links) that has increased my interest.

I guess I come at this from a weird place. I work in the medical establishment. I do use a variety of techniques, but most of what I do is pretty standard. I supplement with vitamins and minerals, but not that extensively as adding things to my cocktail is a bit frightening at this point (too many chances for interactions and we know that if an interaction is possible I will probably react). In the past we've discussed trialing a few supplements but ultimately adding the number of daily pills required meant it wasn't a wise decision. I struggle to take doses more than once a day; I now do twice a day pretty well but it's a fight. Supplements often ask for 3 or more times per day.

I have faith in God and His healing. I am well aware that faith is what keeps me alive. However to date faith has not healed me. It may not do so until I die.

Others talk of treatment with accupuncture and other things in that ballpark. I don't even have those as options without requiring ridiculous travel. So that's going to remain a who knows based on very rural location.

I also have avoided horrible problems with doctors others have experienced. The earliest psychiatrists I had didn't see the disorder, and the last one before diagnosis was an idiot as the atypical presentation was almost gone by the time she was seeing me and it should have been really clear what was wrong with me. But I was diagnosed by a doctor you have heard of if you've done much research on bipolar and treated by a fellow and him for 6 months. At that point I switched to my current doctor who accepted my case after my therapist talked to her. She took it with a committment to complications, long monthly appointments, and frequent contact with me. That was almost 5 years ago. I still see her monthly, usually for 75 minutes. Not a typo. And that is on a Saturday. She does a clinic for VNS patients that day and works me into the schedule. My doctor lets me make decisions. I nearly always pick my med and doses are adjusted by my feelings. Sometimes I'm probably being off the wall, but it is infinetely better that I feel some control. I am never told to take something without extensive explanation. I even get copies of my labs. (Again, acknowledgment that I am a healthcare professional and able to understand them easily). Reasons are always given. For years I've refused to try Seroquel until there weren't other options. I didn't try Seroquel until I had to. Turns out I shouldn't have been afraid of it.

The medical model has not cured me. It has not taken away the pain, nor has it given me a quality of life I'm thrilled about. But it is what I have.

I see a lot of people who are (as I'm sure I was once) so upset and angry because they're taking med combinations that aren't working. I say "as I was once" because I'm referring to people who are on really minimal meds, a first cocktail tried, say. I didn't really get to have that freak-out because I knew the day I started med #2 I'd be starting med #3 soon since I was in a clinical trial. When I started mood stabilizer #4 plus ativan plus inderal for tremors I did panic a bit. Otherwise, for me, the only time I've really panicked about western medicine has been over the last year as it looked like my options were running out. But now that seems to be a non-issue, at least for now. I still have 3 boosts on Seroquel (hopefully) and there is an extended release Seroquel now that I can try if needed. Often I get a boost from extended release. And now that finally an antipsychotic worked for me there's presumably a bit more hope another will if needed down the line.

I guess that even though western medicine is not exactly great at treating me it is the only thing that has kept this disease from killing me. My anger isn't at the lack of progress, as I think there has been a ton of it. Remember, just 35 years ago there wasn't even lithium. In the 5 years I've lived with this there have been so many drugs approved for bipolar as a secondary approval. Do I think this occurs for financial gain and not because the pharmacy companies are wanting to extend their patents? Of course. Do I get sick of paying hundreds of dollars per month for meds? Of course. Is swallowing 28-32 pills every day remotely fun? Nope. Do I know how very fragile my situation is and probably will continue as long as it takes 30 pills/day to feel ok? Of course. I also give counseling a huge amount of credit. It's not a fast process and I know it may never really end, but I've come a long way just in the last 2 years.

But I'm alive. I'm getting well. It may not last long, but all signs point in the right direction. I was doing well before this episode hit, and I am now back to even better than that (aside from low energy).

I know that medicine and doctors cannot cure me. I was told at diagnosis that even remission is probably a pretty far off dream for me. I like to aim for "manageable". And medicine is one of my only physical tools to get there.

As to whether there's a point of "recovery" from bipolar? Well, that's a hard question. I think before that can be answered we have to figure out what BP really is. As discussed other times, I think BP is way over-diagnosed, and I think many people who have been mis-diagnosed can probably be fine. I think a true bipolar is not going to achieve more than control, because that's the definition of BP. I suspect that for a true bipolar it's unusual to do this without meds, but what do I know? I do know that for me, meds are required.

2 comments:

G.J. "Jon" Gregory said...

Hey JM!

Hope the holidays are treating you well.

It's interesting that you saw anger in that discussion on my blog. There was some - Jane (not Jane's Insane) has an axe to grind, and Dreamwriter is suicidal right now, but I thought things were really pretty upbeat and respectful. Your points, as always, are expressed with experience that few other people in the world share. At some point a book is mandatory, you know that...

I hope you didn't consider my response to you less than respectful, I was thinking out loud more than anything.

It's a cliche, but I do mean it: A happy, healthy, and prosperous new year to you.

Just Me said...

See above post for my detailed response.

I don't think there's a lot of anger on your post, just some, but I was also reacting to other times I've seen this come up different places. And in myself.

You didn't say anything remotely wrong. I think it's an interesting topic. It's something I've clearly thought about way too much (see length of posts).:)

I'd imagine a book would have the same problem: 890 pages of bipolar ramblings :). I actually did manage to publish an article from grad school research and getting it short enough was the hardest part.

Happy New Year to you as well.