I've spent the last 2 months wrestling with my new diagnosis. I read somewhere in an anonymous forum that the American people are obsessed with diagnoses - more often than not, according to this anonymous poster, a person would seek out and search for a diagnosis to categorize themselves, missing the treatment of symptoms altogether. I can't say that I disagree with this anon; humans like labels as a matter of evolution and survival - we have a primal need to belong and to understand. To name a thing is to claim knowledge of that thing, or so they say, so why wouldn't humans want to have names and labels to cling to?
The point, dear readers, was not that a label is harmful or unnecessary, but that often we overlook treatable symptoms when searching for the magical answer that will make you whole life fall into line. Dearest reader, I will now burst that bubble as tenderly as possible. Our mental state can be, in its most basic form, broken down into 2 foundational factors: nature and nurture. While part of your mental health relies on your wiring, your coding if you will, the rest relies on the environment in which you live - both physically and mentally. Stressors that become present later in life might be the catalyst that causes your brain to project voices or push your depression over the deep end. It is never just one thing, and balancing between your genetics and your environment is tricky. As a newly diagnosed, newly on "the path to freedom" patient, it's important to have patience - something I clearly lack tonight. However, this nightly burst of energy has given me the time and focus to put this down to paper - my advice to myself and anyone like me.
1 - It is okay to slow down, like, way down.
If you are bipolar like me (or know someone who is), you may also have trouble letting go of your productive mania, like me. My S.O. will comment from time to time that, he's "glad I stopped doing so much" or that my over-activity "caught up with me" - These couldn't be farther from the truth. I thrive when I have to multitask, I relish in the pressure of deadlines and deliverables - or, at least, I did when I was in a bought of mania. Now that I'm learning to be stable, I have to let go of so many things that bring me joy - hobbies, group commitments, ambitions. The fear of never getting to do them again lingers like a cloud heavy with rain, threatening to spill over any minute. On particularly bad days, I feel like I'm giving up pieces of myself by saying "no" to that activity or stepping back from plans.
But - if I would listen to my own advice - I would tell myself that it is okay to step back. I have plenty of time in my life to come back to things that make my happy later on, but my energy is finite resource these days, and it is okay to ration it appropriately.
2 - It's a long road, but there are checkpoints along the way
The other deflating notion about my new diagnosis is that I will battle this dragon for life. Even now, when my depression is at bay and I feel fine in the world, I must maintain constant vigilance. As my psychiatrist put it, "If you have high blood pressure, you take medication to bring it down. Once the blood pressure is where you want it to be, you don't stop taking the medicine, else your pressure goes back up". Likewise, once my depressive symptoms stop, I can't just say jolly good and nix the pills - I will be in a cycle of adjustment for years to come. While I am on this journey, I will be modifying a whole host of behaviors that once brought me joy - limiting shopping sprees, no alcohol, no night time activities after 7pm. The road feels impossibly long and full of perils. At times, I want to swerve off of it.
But - if I would listen to my own advice - I would tell myself that this is all temporary. That, although the road may seem long, years pass by quicker than you think, and even though you are not able to indulge yourself today doesn't mean you will not get there. You will cross those thresholds and learn how to have 1 beer, and then 2. You will learn the warning signs of mania-induced shopping sprees and keep your spending in line. You will persevere.
3. And, at the end of the day, you're still steering the car.
Something my psychiatrist told me this time around made all the difference - see about 2 years ago, I was working with a different set of clinicians and doctors, and my symptoms were taking over my life so I knew I needed something to make them stop. At the time, I was new to the world of psychoses, and against my own judgment I let the doctor I was seeing at the time give me a total of 5 different prescriptions, each to treat symptoms from the last. This is, unfortunately, every patient's nightmare, and the whole situation left me with a sour taste in my mouth for any kind of medical help. So - when the symptoms came back around, I waited until I was near hospitalization to seek the help I needed. In the first session, like all decent psychiatrists, my doctor let me speak about my symptoms and past treatment history - he didn't try to correct my self-deprecating humor or belittle me for jumping off my medication before. After getting everything off my chest, my psychiatrist nodded, recommended some starting treatments, and then looked me in eye to tell me this: "You know... myself, your therapist, your family and friends - we are all on team Rachel. But you - you are the captain of the team. I'll give you my honest medical opinion, but you call the plays."
So, this one I did take my own advice, to some extent. While I still feel impotent at times, having the right combination for my "team" has given me the confidence to take control of my health outcomes. If I don't like a side effect, I write it down to discuss it at my next appointment. If I think my dosage is too high, or more realistically, too low right now, I'll clearly communicate that. The power of control of your own life is uplifting, and often I feel better just knowing that I have that control back, the same control this disease robbed me of.
I would feel remiss to close this post without offering some meaningful, actionable advice. What I've written above reads more as a lamentation of my current woes, but I'd like to helpful if I might. So - with the helpful spirit in mind, here is my advice on things you can actually do rather simply:
- Routine is key - find one that works for your "must haves" in life (work, school, family, etc.) and set about making it a habit - remember, it takes somewhere around 90 days to form a new habit.
- Don't lie or overplay your symptoms. It's human nature for many of us to ignore or sometimes amplify our symptoms because we think that it's what people want to hear - don't fall into that trap, especially with your doctor. It's okay to be in crisis, and it's okay to be "okay". Doesn't diminish your struggle one bit.
- Physical health is important, too - there's so many reasons why eating balanced meals, sleeping, and mild exercise can impact your mental health, but I'll explain it simply. When your base needs (food, shelter, sleep) are met, your body and brain have time and energy to work on your higher level needs.
- Focus on one area to improve at a time. I don't know about you, dear reader, but I've gained nearly 20 pounds in 2 months. There's a part of me that wants to focus on dieting and complex exercise routines, but in reality it's enough just to focus on staying positive and meeting all of my work obligations. Once I have my routine better ingrained, then it will be time to move on to adding fitness to the mix, but it's okay to be just "okay" for now.
- Celebrate your triumphs, no matter how small. Tell yourself you're awesome for getting out of bed. Darn right you brushed your teeth! You go girl with the freshly washed hair. Sometimes the little things deserve praise. Come to terms with the state of "okay" - joy and elation are not the opposite of depression. Being "okay" and just making due each day with the basics (cleanliness, work or school, required tasks, etc.) is fantastic.
With those tips, I am not under any illusions that I've laid down earth-shattering news to anyone. However, I hope hearing it once more from a fellow sufferer helps you be at ease with your change in life. Until next time~
