Day 05: What treatment, therapy etc do you do?
Most people who I’ve spoken to that are afflicted with bipolar have a psychiatrist monitoring their progress, medication and moods. In fact, I would go so far as to say that having a psychiatrist is pretty much a prerequisite for someone suffering from an illness as serious as bipolar. However, as the last appointment I had with a psychiatrist went so badly, I no longer have any trust for people in this particular profession. Thus, I am left to navigate the ups and downs of bipolar all on my lonesome.
But that doesn’t mean I don’t undertake treatment, I do, and here are six examples to prove it:
First and foremost, there is medication, something that pretty much everyone who is diagnosed with bipolar has to contend with. I say contend with because some of the side effects of psychiatric medication can be pretty brutal, as I discovered this year, but regardless of these side effects, medication is quintessential for dealing with bipolar.
At this point in my life my medication regime is: an antidepressant (Fluoxetine, 40mg/daily), an anti-psychotic (Solian, 100mg/daily) and a second anti-psychotic (Abilify, 10mg/daily). For those who have some knowledge of bipolar, or medication in general, you will notice something pretty obvious is missing from this chemical cocktail…and that is a mood stabiliser.
I had been taking Sodium Valproate (aka Epilim) at 1000mg/daily, but this was immediately cessated in January 2015 after it caused a particularly nasty bout of acute pancreatitis that saw me hospitalised for two and a half weeks. Since then, I have had numerous conversations with my GP about starting an alternative mood stabiliser, as my mood as been rather unstable over the last three months. He ruminated over starting me on Lithium, a drug that works exceptionally well for me, but because it negatively interacts with the Fluoxetine he decided against it. Whether or not I will ever be back on a mood stabiliser is beyond my control. Personally, I would be happy to stop the Fluoxetine in favour of Lithium, but my opinion is neither here nor there. All I do know is that without a mood stabiliser, my moods will continue to fluctuate wildly, and it’s doubtful I will be able to stabilise myself, regardless of how many anti-psychotics I’m taking.
My only form of real-world contact comes from the weekly appointments I have with my support worker. In all honesty we don’t do all that much, mainly because my anxiety prevents me from opening up to her. So our appointments are basically her battling to get me to say anything whilst occasionally recommending a particular course of action for me to take.
This is yet another example of how my anxiety impacts on my life. It would be wonderful to have an open and honest relationship with my support worker, but no matter how much effort I put in toward achieving this, anxiety rears its ugly head and prevents me from saying anything. It’s frustrating. It’s annoying. It’s all manner of badness. In fact, more than anything, it’s gloriously ironic. Here’s a person who could potentially help me manage my anxiety, but I can’t talk to them because of my anxiety. Grrrr!
Okay, I’m being a little cheeky here. As I write this I’m not technically undertaking any form of talking therapy. I don’t have a counselor. I don’t have a therapist. I certainly don’t have a psychiatrist. But I am hoping that I will soon have a psychologist with whom to examine the intricacies of my life.
During my last visit to my GP I informed him of how difficult it is to deal with my anxiety, to deal with my PTSD and to deal with the fluctuations of mood that bipolar causes. He suggested I see a psychologist (it’s been several years since I last saw one) and dutifully referred me to someone.
I’m still waiting to hear from them about my first appointment (if I haven’t heard by tomorrow, I’ll be calling them next week) so will keep you abreast of developments in this area of treatment.
CBT and DBT
Without someone to help me with these forms of therapy, I am left to navigate them all on my lonesome. This may sound difficult, and it is, but I have a number of books on both subjects that have helped me understand the basics of each form of therapy and allowed me to partake in them as and when I’ve been focused enough to do so.
I have to be honest, I am hoping that the psychologist I’ve been referred to will be a practitioner of DBT, as I believe it would be of tremendous value to have someone assist me in working through this particular form of treatment. Fingers crossed!
Acceptance and Commitment Therapy
This is something I’ve been practicing since I first learned of its existence in 2013. Back in that heady year of mayhem, busyness and fun I undertook an ACT based psychosocial rehabilitation group and learnt many of the exercises and metaphors that populate this method of treatment.
Some posts I’ve written on Acceptance and Commitment Therapy (in case you were interested!):
Although my blogging isn’t as prolific as it was in 2012-2013, it is still one of the primary methods of therapy that I undertake. There is something gloriously cathartic about writing about your life, feelings, emotions, moods and thoughts before sharing them with the world. Even if no-one reads, likes or comments on a post, I am still proud of myself for having the courage to put it out there in the first place, especially as my anxiety often interferes with my blogging and works to prevent me from posting anything at all.