A fellow blogger forwarded me an article published in April in the New York Times Magazine. The article was beautifully written by Linda Logan and details her 20 year journey living with bipolar. She does an excellent job of detailing the hell that it can be living with a mood disorder and the loss of self in the process. Her early years when she began understanding her depression resonates with me. I was confused as to what was happening and wondered why I was so strange and had a feeling of not belonging.
I don’t think there is a particular point at which I can say I became depressed. My illness was insidious, gradual and inexorable…
I shuddered as she described wanting to commit suicide. I too spent many hours playing the details of my plan over and over again in my head. At one point it was probably the only coherent thing I could focus on.
…several nights a week, I drove to the reservoir near my home, sat under a tree and, as joggers and their dogs ran past, thought about ending it all. There was a gun shop on the way to my poetry group; I knew exactly where to go when the time came.
I feared the first time I was hospitalized. Once again, she had entered my brain and was writing my experience. Detailing the horrible period of trying and retrying meds to find the right cocktail. Many times the side effects were worse than the disease itself.
The moment the psych-unit doors locked behind me, I was stripped of my identity as wife, mother, teacher and writer and transformed into patient, room number and diagnosis.
My doctor used my first hospitalization as a so-called washout, a period during which he planned to take me off the medication I was on and introduce several drugs in several different combinations. The prospect of polypharmacy — taking many drugs at once — seemed foreboding. I read about Prozac’s giving some people entirely new personalities: happier, lighter, even buoyant. “Who are you going to turn me into?” I asked my doctor.
I was losing myself quickly, With each new day I laughed less, I had difficulty speaking, and, heaven forbid, someone try to have a conversation with me. I spoke in half sentences and then had to look at the people around me and ask what I was talking about. I was frightened and ashamed. My illness was tearing down who I was. I could tell people were concerned about me. I was sure many pitied me. Trying and retrying one medication after another only served to increase my lack of coherence. My husband, Maurice loved me unconditionally through it all, but even he has his limits. I remember the day when, in tears, he told me he missed me. I understood. I missed me too.
With time, and a good combination of meds, I began to put some aspects of my life back together. Going to Depression and Bipolar Alliance (DBSA) meetings helped. These are peer led groups. Not 12 step programs, but still similar to A.A. One person with a mood disorder helping another. Sharing ideas of overcoming obstacles, highlighting successes, and sometimes to be around a group of people who don’t make you feel embarrassed when you cry.
Over the years, I’ve talked to clinicians about why the self is rarely mentioned in treating patients who suffer from mental illnesses that damage their sense of who they are. If anything, it seems that psychiatry is moving away from a model in which the self could be discussed. For many psychiatrists, mental disorders are medical problems to be treated with medications, and a patient’s crisis of self is not very likely to come up in a 15-minute session with a psychopharmacologist.
For many people with mental disorders, the transformation of the self is one of the most disturbing things about being ill. And their despair is heightened when doctors don’t engage with the issue, don’t ask about what parts of the self have vanished and don’t help figure out strategies to deal with that loss.
How do we change our current system? I’m sorry, but I have no idea. While most people I know see both a psychiatrist and a therapist, it’s still the psychiatrist who makes the decisions regarding medication. 15 minute psychiatrist visits is the norm nowadays. What does a psychiatrist do in 15 minutes? Not much. Maybe 10 minutes of listening to how you’re doing and then filling out prescriptions. Did the doctor listen to me? What will it be this month? Will he increase my dosage? Decrease it? Change it completely? Or leave it alone. It’s easy to have your meds pull you into mania or into depression, when the goal overall is to maintain a balance. And balance can come at a heavy price. I may be “balanced” because I’m not manic or depressed, but the cost may be losing self. Difficulty being who I think I am, or who I may have been.
I’m happy to say that things did get better for me. I may be taking 6 pills a day but apparently, for me, they are the right combination. I am able to carry on a conversation. And I love and can feel loved. Things aren’t perfect and not every day is filled with sunshine and lollipops, but I’m having more better days than bad days. I do have a sense of self and for that I am grateful. I think of the many months that tears would roll down my face and I’d ask, “Is this it? Is this as good as it gets?” Fortunately it did get better. There were days I thought I’d lost me forever, but I was wrong. It’s good to feel alive again. It’s good to be me.