Oh no MsRobyn, no fights being picked here. How could anyone pick a fight with you anyway, always posting such good stuff/advice. I understand your POV completely. I’m sad you saw such inept therapists. There are a fair number of us out there that are good at what we do. I am merely a psychologist. IANA Therapist. In fact I’m an instructor at a college - clinical psych never agreed with me. However, I do have a lot of professional collegues who are good therapists. The gap between PhD’d therapists being able to prescribe meds in shortening I must say.
What bothers me most about this whole post is the use of the word “cured.” That seems to me that there is an end, a surcease to the condition, and there isn’t one. Maybe longer frequency between moods, or different coping strategies for when you are up or down, but that’s no more a cure than you can cure MS or diabetes.
I’ve done lots of therapy in the past. It hasn’t been useful to me. I seem to find all the burned out therapists that can do little more than say, “So, what I’m hearing you say is that you are depressed.” Seemed to be the therapy du jour when I went looking for help. It wasn’t very helpful, so that stopped quickly.
But I’m not discounting it entirely either. I can recognize that I’m in no state of mind to pay any attention to what a therapist says no matter how helpful or valuable the advice might be. Hence returning to medication to at least get me on a keel even enough to listen to them. And then perhaps I could learn different coping stategies. I might even be able to get off of the medication some day once I’ve learned better methods. But it still won’t be a cure.
I know that sounds pessemistic, but it has taken me a long time to come to grips with this being something I cannot take care of myself and I need help in some shape or form, whether it is medication or therapy. It is no longer a condition I can let slide. This is something that I’m going to have to monitor and get help for. Since I’m not going to be “cured,” I can at least keep it in check.
even sven-have you ever even had just THERAPY? What you are describing is NOT just “the way you are”, it’s a disorder.
If you’re so depressed you want to die at times, but you can’t even muster the strength to move-then you are ill. You need help.
I’m not saying this to be nasty. I’m not bipolar, but I AM Obsessive Compulsive. And you know what? It does have its advantages (like organizational skills, and being extra thurough), but I’d give it all up in a heartbeat NOT to have to deal with crippling depression.
And in case anyone is wondering, I normally saw both a therapist AND a psychiatrist.
Exactly how I feel, CB. I’m a mental health patient myself (Borderline Personality Disorder), and it’s taken me several years to have it sink in that, while I will always have this condition (and it is medical as well as psychological), I (and to a lesser extent my mental health care professional) have a responsibility to manage it so that it doesn’t interfere with my ability to function. The more I take an active role in that management, the better the results. Very much like my friend the diabetic who has to check her blood sugar level, plan meals wisely, and administer insulin to herself. I’m fortunate in that I respond well to low levels of meds and to DBT therapy (when I use it!).
I’ve had people with psych degrees or counseling backgrounds express concern when I’ve told them that my MHNP thinks I should be on meds for life. I think there is a certain amount of competition and even enmity between pyschologists and psychiatrists, and the way in which the psychologists tend to come at it (I believe) is to be scornful of the use of psychopharmeceuticals for all but the most psychotic. I was never helped by a LCSW; it took until I received the medical care I needed as well as the therapy before I started to have improvement in my life.
My mother is manic-depressive. When I was younger, it could be fun when she was manic, as she’d buy me lots of presents. But it was also confusing, as she would start crying for no reason, or sleep in really late and not spend much time with me (my parents were divorced and I lived with my dad, so I didn’t have a whole lot of time to spend with her as it was).
Now that I’m older and have studied the disorder more, I can definitely where she is in her mood cycle. She has meds, but has frequently gone off them. Whether because she couldn’t afford them, she thought she was getting better, or because of side effects (IIRC, one of the side effects of depakote is diarrhea).
This frustrates me, because I don’t think she realizes what an effect it has on my life. I’m her only child, and she’s not remarried, so she will call me when she’s feeling depressed, and there’s not much I can do about it. She complains about us not being as close as we used to, but when she’s feeling manic, she always interrupts me and never listens to me. She disappeared for about 6 weeks when I was in high school (this was when I was first realizing what it meant for her to be M.D.), shortly after she started dating a new guy, and it worried me terribly. She was actually in the hospital for her M.D., but wouldn’t let anyone tell me what was going on.
Okay, I’m rambling a bit and getting a bit too personal. To bring things back on track, I know it can’t be cured, but I think it can be treated. But the treatment usually has to be ongoing. This is another stumbling block with my relationship with my mother, because sometimes I think she doesn’t want to be treated, because as long as she’s showing obvious symptoms, she can use her disorder to excuse her behavior.
Even if you regard manic-depressive disorder as a “tragic mismatch with the world,” it is important to recognize that your actions, choices, and behaviors (including whether to seek treatment or not) can and do affect your loved ones. If medication and therapy can improve your functioning in society, I think that that is a good thing. I don’t know about creativity levels on and off treatment, so I can’t comment on that.
**
If addiction is considered a disease why wouldn’t an imbalance of your neural transmitters also be a disease? Maybe you could tell us why because it doesn’t make any sense to me.
Marc
MGibson - Addiction is a disease when you are in an Alcoholics Anonymous meeting, or a NA meeting. When you get down to it, an imbalance in your neural-transmitters is a laymans way of saying your brain doesn’t produce enough of a certain chemical needed to keep your brain functioning correctly. Many times it is environmental factors affecting the chemical imbalance. Essentially a disease is something that impairs normal functioning. That can be a result of any of a thousand environmental or elemental reasonings.
Take someone with Crohns Disease. Crohn’s disease is a disorder of the gastrointestinal tract that is characterized by inflammation and deep ulcer formation in the lining of any region of the tract from the mouth to the anus. My example is only to illustrate that disease has many different definitions. Calling manic depression a disease just doesn’t do it justice for one who is out to cure it through non-medicinal or light medicinal pathways. Crohns disease can be cured through medicinal needs only. Put it this way would you council someone to get rid of their crohns disease? No, you’d medicate them. Would you council someone who has depression? Yes, it can have visible verifiable results.
I’ll check back in tomorrow, I’m off to get a cat…Check IMHO for reasoning.
Phlosphr, I honestly don’t understand a damned word you’re saying. Perhaps you could help me by defining what you use the word “disease” for, because every definition in English would define bipolar disorder as a disease. It’s a disease. There’s no debate to be had here.
The fact that it can be partially treated through counselling doesn’t mean it isn’t a disease. Counselling is a valid medical treatment for bipolar disorder. What’s unusual about that? Lots of diseases involve more types of treatment than just taking drugs. Counselling is just… physiotherapy for the brain, to put it one way.
The fact that you have particularly strong opinions about what type of treatment should be adopted does not change the central fact that bipolar disorder is a disease.
First of all, even sven, as of this moment there is no “cure” for diabetes, either type 1 or 2. If insulin were a “cure” then I would only have to take one or two courses of it, like I do antibiotics when I get, say, a sinus infection.
However, your comparison between diabetes and bipolar disorder were right on the money, in my opinion. I have to take insulin for the rest of my life becuase it is merely a treatment, not a cure. However, without it, I would be dead in a matter of days.
So you have to take medication the rest of your life - that’s undesirable simply becuase it is not a cure? You have to take it forever instead of just a little while, so skip it altogether?
Or maybe I’m missing one of your many points.
Phlosphr, I, too, am confused about how you differentiate between a “disorder” and a “disease”. By your reasoning, my diabetes is not a disease but instead a disorder, because it’s simply my body not producing a chemical it needs to function. In that respect, dopamine = insulin, no?
I think she’s saying that she feels her manic states are worth it. Or that perhaps instead of a disorder, it’s merely a personality feature some people have.
And I worry about her, reading this.
Okay, now I’m confused. I zeroed in on the term “behavior therapist” in phlosphrsfirst post:
If I understood correctly, this is not about “I act out because my mom didn’t love me,” this is about learning that there always consequences to your actions, the your have responsibilities to yourself and others, etc. etc. That sort of thing might seem simple, but, you know, people with problems need extra help.
Phlosphr
Do you not think that depression and manic-depression impair normal functioning? I have chronic depression. Sometimes it is bad enough to require hospitalization. Most of the time it is less intense but I still have the symjptoms of mood swings, problems with regulating sleep, and problems with concentration. That certainly impairs normal functioning. I have been receiving a disability pension from the state pension fund that I have contributed to. I also receive permanent disability payments from Social Security. I have been receiving these payments for fourteen years now.
I have considered my illness to be a disease, but I am willing to listen to whatever distinctions that you make. Maybe I am mistaken. I do know that like manic-depression, it is a mood disorder. Can disorders be diseases?
I know that there are several different kinds of depression and that what is appropriate treatment for one may not be appropriate for someone else.
In the early years, my access to counselling was limited. I had to travel 200 miles round trip. But even the little bit of counselling that I got was helpful. I took medications that weren’t terribly helpful and I had a lot of electrical shock therapy. (I don’t remember the latest term for that.) That was forty years ago. The shock treatments then were much different from the shock treatments of today. It took away my symptoms but left me with a lot of memory problems.
When I moved to the city, I saw both psychologists and psychiatrists (though not at the same time). These sessions were for about fifty minutes once a week. The counselling was helpful to me because in addition to depression, I had a lot of childhood issues to be resolved and I needed to learn how to parent myself.
For the last fourteen years I have seen my psychiatrist once a month for twenty-thirty minutes. We focus on the present and not the past. It is usually a check up on how I am handling stress, family and relationships, my medications and symptoms related to the illness. My understanding is that these short once a month sessions are being used more and more often in the treatment of depression. Someone else with depression may need intense counselling.
Well, if we are going to bicker about the symantics of disease and disorder now, in my opinion, a disease has some sort of pathogen whether it is a virus, bacteria, parasite, prion, whatever. If it invokes an immunine resonse, it’s a disease. If it’s genetic, it’s a disorder. Bi-polar is a disorder and so is diabetes. In my opinion. I like that reasoning better, because in my mind calling bi-polar a disease is like pointing and yelling “unclean!” I’m being oversenstive, I know. In any case, disease seems to have an external source whether curable or not.
However, according to the 2nd edition of Springhouse’s Handbook of Diseases that while bi-polar and alcoholism are “disorders,” diabetes is a “disease.” How even the book of disease makes the distinction is unclear. Perhaps disease is a general term, while disorder is more specific subset.
It isn’t that clear cut. It is notoriously hard to get manic-depressives to stay on their medication because when they feel good, they feel that they don’t need the medicine. So, when they stop feeling good, they are no longer motivated to take the medicine. It’s not so much undesirable for meds, but the inability to stay with the meds. Bi-polar isn’t analogous to diabetes in that diabetes will indeed kill you if you don’t take your insulin. You don’t necessarily end up dead without your lithium. Mortality isn’t driving us to maintain the use of our meds. I’ve gone a very long time without it.
However, I don’t think bi-polar’s can be treated by therapy alone. The meds are a foot in the door while the therapy is there to help keep you on them and understand what is going on and how to deal best with it. More effective survival skills in essence.
even sven, maybe you can find some helpful suggestions at this site:
Bishamon:
I did not intend to sound as if I were bickering. I asked for clarification from Phlosphr since he is a psychologist.
I do see “mental illness” and “mental disease” used interchangeably on other websites, but that doesn’t mean they are necessarily correct.
I wasn’t asking for an opinion on what a disease is. I was asking for factual information.
I would agree with most of this. I am not a clinician, I already said that. My job is to teach expose college students to all psychology has to offer. That’s what I do. I specialized in Environmental psychology, and thats what I have my PhD in. MOst people know that about me here.
As Zoe said, I do not intend on bickering either. Anyway you cut the cake even sven needs some help. I don’t want to grapple with whether or not he needs medication, or the efficacy therein of any particular drug. Someone said that psychologists and Psychiatrists have had their differences throughout the years. This is some what accurate. Psychiatry and psychology vary between individuals. They may have the credentials but any joe can run into a dumbass psychiatrist or therapist.
I’m also not going to speak anymore about what the definition of a disease is. Thats just a hijack to what we are supposed to be talking about here. For some interesting reading on the subject I will provide a good link to the National Center for Biotechnology. They have great definitions of what a disease is at the genetic level.
Even Sven my best to you. I do wish you good health and luck with your future Endeavor…
Even Sven , have you ever read Touched with Fire or An Unquiet Mind by Kay Redfild Jaminson? She is a psychologist who writes about her own manic depression and the relationship between manic depression and creativity. I’ve not made it all the way through both books yet but so far they are fairly interesting.
Personally I’ve had four serious bouts of depression – we’re talking psychotic level at some points (I don’t want to get too much into that here) and have had an occasional hypomanic spell. I know that I have almost a 100% chance of recurrence at this point even with my medication (8 pills per day!). I see it as a part of me now – a part that I can manage with meds and therapy but something that my identity will never let go of.
As to whether someone should take medication for bipolar disorder, it is pretty much up to the individual unless the patient is involuntarily hospitalized and as a result must take medication.
Even Sven , could you give us some examples of the “many artists” who produce their best work during manic periods, but get dull after treatment? Say we put depressive disorders out of a medical model, and I’ll concede that various mental imbalances can give unique insights.
However, art–writing, painting, composing, or any other form–involves a lot of sheer hard work and self-criticism. Inspiration may come in a brilliant flood, but you might need to spend an amazing chunk of time and energy, not to mention planning, realizing that inspiration. Some coherence is needed. Few I have known are really capable of that in a manic state. Perhaps you’re luckier than most.
I think the ‘lone genius’ image is more of an archetype than a reality, today or in the past. An artist has to be able to deal with the ‘real world’ on at least a basic level, even if it’s writing up a grant application so you can continue to be divinely mismatched. 
Is it really such a good thing when your brain chemistry prevents you from accomplishing the most basic work?
It was easier to romanticize my disorder, and those of others, when I was 20 or so. Not nearly so much time had been lost to the low periods, and the idiosyncrasies of college life buffered it.
As MsRobyn notes, if a medication makes someone feel like he’s lost an essential part of his personality, it’s the wrong med. The proper one won’t do that.
Interesting OP, and I agree that people should be able to decide for themselves when and if to get treatment for bi-polar disorders. That said, your experiences are very different from mine (I am bi-polar as well). I do not have any desire to hang onto this condition, if it could be wiped away with a wand I would do it. The highs can be nice, and they really do inspire me to be artistic. Still, I don’t find the balance to work out in my favor, the lows dominate most of the time. So while in your case perhaps you spend more of your time riding the crest of the wave, lots of us are being dragged along the bottom for the majority of the experience. This is the very reason I agree that everyone should get to choose for themselves based upon the very different experiences individuals have.
I suffer from bipolar disease.
I thank the gods everyday for lamictal, topomax, and wellbutrin, as they have literally given me my life back over the past year. If I have to take 10 seconds out of my day for the rest of my life taking these meds so be it. I’d NEVER want to go back to feeling the way I did before.
Added creativity unmedicated? I was either too tired to move or too ansty to concentrate. Now I’m actually starting to write again, and the feeling is indescribable.
I am a walking, talking, example of just how much good the right meds can do for a manic depressive.
Therapy? YMMV, but it never did diddle for me. I’m not disputing it works wonders for some people, but I’m not one of them.
Even Sven, good luck.