Bipolar Disorder: Not Letting Yourself Down

Recently I was watching a 10-part TV series about World War II, called, “Band of Brothers.” The series documented the experience of one company as it fought in the European Theatre of the war. At the beginning of each one-hour segment, there would be commentary by real-life veterans about different aspects of being a soldier in battle.

In one segment these veterans talked about fear and the various ways they dealt with it. Many spoke to the issue of not letting their comrades down. There was one sentiment that struck me. It was the statement, “I didn’t want to let myself down.” Not only was this man being loyal to his fellow soldiers, he was being loyal to himself.

This struck me as a stance one can take in any struggle, including recovery from mental illness. It was certainly true of mine. Though fearful at times when doing new things and facing down hospitalization, medication, and the anxiety and stress of the work world, I willed myself to move forward because I didn’t want to let myself down. Though filled with trepidation, I would not allow myself to settle for a limited existence. I couldn’t let go of myself as a whole, healthy person, despite the knowledge I have a disability that brings darkness which sows seeds of confusion and doubt.

For a long time I was uncertain which way to turn at various crossroads of my life. I made decisions I could not be sure were the right ones. Often, there was no clear marker to base a decision on. So, I proceeded into the unknown, fear of failing at life my constant companion. Over time my road became a little clearer until the time when I began to feel a small amount of confidence.

I was doing helpful things to recover. Little by little my terror subsided, and as I constantly pushed myself to be true to myself, I succeeded.

Many may now be in the same place I was when I began my recovery. Instead of recovering for the sake of those who hope for your return to mental health, do it for yourself. Believe in yourself and have faith in your ability to do the right thing. Like the soldier in E Company of “The Band of Brothers,” do something because you don’t want to let yourself down. It’s a value and ethic to live by. To address life’s struggles straight on is difficult, but to be true to oneself is its own reward. It also goes by the name of “having character,” and who can say, “ those with mental illness can’t have character.”

One Aspect on the Road to Bipolar Recovery

Recently, while speaking with my sister, the topic of conversation was my adult niece who has bipolar disorder. She needs to get into therapy, my sister said, but she keeps avoiding the diagnosis.

Although diagnosed in her twenties, she had been on again off again about taking medication, but at this point in time, she had finally come to terms with her illness; enough so that she now takes her meds regularly. It is the one concession she has made to her bipolar disorder diagnosis. If she would see a therapist also, my sister commented, she would at least get educated about her illness. My sister often laments my niece's lack of interest and curiosity about an illness that so pervades her life on an everyday basis. Our discussion carried me back to my earlier attitude then about my own bipolar diagnosis. It eerily rang similar to my niece’s attitude. This struck me as odd since I had read innumerable books on the subject and deal with the illness every day as a specialty in my psychotherapy practice.

Maybe she’s not ready for it, I told my sister.

But, isn’t that the preferred treatment, medication and psychotherapy? She isn’t taking care of herself and would be doing so much better if she’d just educate herself.

This same conversation reminded me of one I’d had with my wife early on in our marriage, more than 20 years ago. Upon asking me what I knew about my bipolar diagnosis, I answered, not much.

But, don’t you want to know more about something that impacts your life so profoundly?

I lived it for over twelve years, I said. I don’t care about learning, I just want to resume my life and be normal. That’s all I care about. I take my medication, and it works for me.

We now know medication and psychotherapy are the best combination for successful treatment of bipolar illness, and at the same time, I understand the reluctance to take meds and seek help, my niece’s stance, though it may conflict with my given wisdom.

Eventually, I did choose to seek education and treatment until today I have become an expert on the illness, writing and speaking publicly about it. Let me live my life; let me recover my bearings and move forward on the every day factors that mean the most: work, relationship, and social life. Let me just feel normal again. Stepping back from the abyss of mental illness and the chaos it brings, let me rejoin the world. Education can wait, until the first step in recovery — to feel human again. When the terror of life-long stigma and disability begins to subside, all things come in time. Patience, I counsel, Patience.

Bipolar Disorder – The Fifth Commandment

I never understood the fifth commandment, “Honor Thy Father and Mother,” never that is until my father died. I was not certain I understood what, “Honoring Thy Father,” meant. I loved and respected him, but wasn’t of like mindset and didn’t particularly share his view of life. In 1979, the year he died, I assumed that would be the end of our relationship. I couldn’t have been more wrong. Still, what does “honoring” mean? And why is that relevant to a blog post related to mental illness?

My mother, who lived to see my recovery from bipolar disorder, was instrumental to my recovery. She saw me marry, attain a master’s degree, and have a relationship with my stepdaughters. My father did not. He only knew me as mentally ill. While not contentious, there was a gap between my father and me. I never felt I understood him, what had driven him, or what his past looked like to him.

Having had a strong recovery since 1984, I often reflect on what my father would say if he saw me today, 25 years on meds without an episode, a successful mental health professional with a private practice, a 22 year marriage, and two grandsons. He would be proud. In the ensuing years since my stabilization, I have come to understand him through my own experience as an aging adult with a painful back that can make me feel irritable and silent, while trying to also ignore my pain and the struggles of self-employment in a time of a turndown in the economy.

My relationship with my father did not end when he died. He is with me when life’s markers are celebrated; he is with me when I wonder what his response would be to the success I am so proud of; he is with me when I make a difficult decision and choose wisely.

My father still continues to give wise counsel when I think of how he would see things. For me, my life struggle has been to recover and remain recovered from bipolar disorder. I know my father would be proud of my diligence to the task at hand.

Now stabilized, I am able to understand clearly the man my father was. I respect and appreciate him for the values he raised me with, and the tenacity and persistence I have gained from his example. I could not express my gratitude when in the throes of an episode. And so, I honor to the man my father was. To honor is to remember with gratitude

The Value of a Mental Health Support Group

Whether you are a consumer of mental health services or a family member of someone with a mental illness, support groups may be helpful. Coping with mental illness can be a challenge, leaving you feeling discouraged and overwhelmed.

The operative word in the term, “support group,” is support. Having the strength of others who have a similar issue can relieve that feeling of isolation, which often accompanies being confronted with issues that seem beyond our depth and capacity. Shouldering the burden of new and alien behaviors in a loved one, or attempting to understand what has happened in our own thinking, can be dealt with through the experience of those who have had the same path to follow.

Stigma, particularly self-stigma, is a constant companion when mental illness surfaces. Being with others normalizes our experience and leaves us with the feeling our illness is not quite so onerous that we cannot deal with it. The sense of shame attached to a mental disorder, that scary image that is conjured up when we think of “mental,” is reduced when we think it is reduced to a tolerable level. The idea is, “If they can do it, so can I.”

When I was newly diagnosed, I attended a consumer support group at the day treatment center I was enrolled in. Hearing others’ stories of their disrupted lives made me think my situation wasn’t too bad. Their support helped promote a new vision of what my life would become, and I could cope with what had seemed an impossible quandary. As well, I made new friends

Going to that group became a weekly vigil, which helped offer structure to my life at a time when I didn’t have a lot happening. Seeing a therapist, checking in with my psychiatrist, and attending support group meetings was all I had to fill my weeks. Feeling stale, under-challenged, and bored, I was happy just having that group meeting to anchor me to a place where my isolation was being displaced by activity with others.

Support groups are not for everyone. Some people are disturbed by seeing those who share their diagnosis. Hearing members talk about their symptoms can fill one with dread that their condition may worsen. Getting too much information can fan the flames of fear and alarm at what seems a barrage of emotions set loose by the difficulties of others. Sometimes it is too much information. If this is you, keep in mind the group experience may be something to come back to when you are further along the path to recovery. Individual therapy with a mental health professional may be a better alternative.

Support group attendance may also be a gateway to further action in the community as an advocate for mental illness; fighting the fight to reduce stigma and to normalize and educate others. Support groups give support to everyone: the mentally ill, a loved one, and the community-at-large.

Organizations That Offer Mental Illness Support Groups and/or Support

1. NAMI
2. Bipolar Support Alliance
3. Mental Health America (The Mental Health Association)
4. Recovery Inc.
5. Your local community Department of Mental Health
6. Twelve step programs
7. Local hospitals
8. Private therapists who work with the mentally ill
9. Your local church and clergy
10. Phone help lines that offer referral information

Answer to Request for Bipolar Information

I recently received an email request from an individual outside of the United States, asking for help regarding treatment for bipolar disorder beyond medication. I am publishing my reply and hope that it will be of assistance to others who are similarly interested:

Dear Ruben:

I received your email and am hoping I can be of some assistance to you.

As you may know, the medication taken for bipolar disorder is critical to recovery. While there are co-existing treatments that stabilize biochemistry, I believe medication is essential.

As well, "talk" therapy is helpful in sorting out the issues which arise from having a mood disorder. Breakdown in communication with friends and loved ones can occur in the midst of an episode, and we must learn to confront and take responsibility for the consequences of our behavior at those times.

My not knowing the culture in your country is a drawback because I am not able to assess the amount of stigma there may be in seeking psychological therapy and whether that is an option for you. Regardless, going for counseling is also an important therapy.

Support groups may be helpful in maintaining self-esteem. Being with others who share your diagnosis can be helpful and relaxing to the tension which can surround a diagnosis. Often, the feedback of others can reduce stigma and help you feel connected and less isolated.

One organization you can contact in the U.S. is the National Alliance for the Mentally Ill, or Nami as it is called. They may be able to put you in touch with treatment options closer to you. Their website address is: www.nami.org.

Also, the Depression and Bipolar Support Alliance (DBSA) is a helpful organization for those with bipolar disorder. You can contact them at: DBSAlliance.org. for information about the illness, its treatment, and referral to professionals who can help. They may have more information about treatment.

Cognitive-Behavioral Therapy has been found to be helpful as a psychotherapy for bipolar disorder. Doing a search of the internet will give you more information on this. It is the type of therapy that stresses our mind's ability to control our behavior.

As well, educating yourself about your illness is the most important thing you can do to help treat it. Learning what you are up against, and dispelling untruths about mental illness can be one of the key things you can do to empower yourself to persist in recovery.

Websites like PsyhcCentral, FinkShrink, and StableMoods are but a few of many sites that can increase and expand your knowledge and sense of well-being.

Lastly, don't be discouraged. With persistence, you can have a life and maybe someday help others to learn more, maybe even start your own support group in your own country.

Good Luck,

Donald Kern, MFT
email: info@kerntherapy.com
Author: Mind Gone Awry
website: kerntherapy.com
blog: bipolarbychance.blogspot.com

BIPOLAR AND PSYCHOTHERAPY: The Other Part of Recovery

Taking a pill is not the only solution to bipolar disorder. Though the need for biochemical treatment to offset the imbalance of human chemistry is key, it does not alone insure a complete resolution of symptoms. Acceptance of a mental disability and attention to the social consequences of bipolar dysfunction is critical to living a life impacted by manic and depressive impulses.

Along with the ravages of personal dysfunction, which is a hallmark of bipolar disorder, there are the aftershocks of behavior that are often tumultuous for personal relationships. Hypersexuality, which can be a consequence of a manic excess, affects your relationship with your partner and/or your image of yourself. Guilt and embarrassment follow in the aftermath. So, too, financial misbehavior affects your functioning, sometimes for years to come. Grandiosity, when finally brought to ground, disrupts the connection we have with others close to us. In short, there is a need for mending fences with those near to us, as well as ourselves. Simply rebalancing the biochemistry is not going to address what we do now to reclaim our lives. That is where counseling and psychotherapy come into the picture.

Sitting down with a therapist and sorting out our feelings about having a mental illness can go a long way toward reducing the stigma we often experience within ourselves and from others. Clearing away the debris of a life lived without restraint, unleashed and unapologetic, can only be addressed by a thoughtful coming to terms with our excesses in a therapeutic environment.

Support from a friend or family member is helpful to recovery. Often, however, the deeper feelings of self-loathing and regret for episodic excess can only be addressed with someone trained in the art of listening objectively and offering perspective untainted by personal biases. This is true of both depressive and manic occurrences.

A therapist at his best is an ally and advocate, someone who can be there for you. Whether education, support, or analysis is called for, a therapist can pave the way for your acceptance and understanding. He can also be a bridge between dysfunction and redeeming your life.

Sometimes we need a guiding hand. Psychotherapy is that step-up. Along with medication it is our strongest antidote to the confusion and chaos that often results from an illness gone awry. Reach out for a fuller recovery for yourself and your loved ones. You needn’t be alone as you traverse the road to recovery. Sometimes you need an honest broker to hold up a mirror to yourself; sometimes you need a caring listener to set your fears at rest; and sometimes you need the support of an ally to walk with you for awhile, someone who can help you find the answers to your inner turmoil and confusion. As a friend of mine once said, “Don’t be afraid to call the doctor if there’s nobody else at home.”

A Work Ethic for the Recovering Manic Depressive

There is much lost in initiative when one is struck with mental illness. Drive dries up like autumn leaves cast adrift by the wind. Caught in a mental maelstrom, one is often imprisoned in the world of the mind. The enduring quality of mental aberration often leads to a paralysis of activity and action. The best-trained and raised with an attitude of productivity often become enmeshed in a net of mental stricture which leaves one immobile and uninspired. Stamina is lost.

Recovery takes work, and success takes tenacity. How do you cultivate an ethic of work that will carry you through the successes and failures of creating a life, when motivation seems to have left you behind? Not only is mental illness fraught with inaction and faintness of heart, but its course over time leads to a loss of vitality and a lack of impulse to act. With this in mind, here are some ideas to help carry you through:

Never take no for an answer. When in treatment, don’t be discouraged by early failures. Turn frustration into persistence.

Angry at the rejection of a job application? Allow your anger to be channeled into positive action. Depressed at the daily lack of routine? Allow your melancholy to form a response. Shy and withdrawn after an episode of mania leaves you unsure of yourself?

Sit and let the discouragement wash over you. Use it as an expression of impotence. When you get done with feeling sorry for yourself, make a resolution to fight back. You are not a failure.

Read books and attend lectures that promote hope and a positive image. Take your life one day at a time. Make a list of daily tasks to complete, and do your best to complete them. Gauge your ability to persist as you go through your list. Acknowledge that your ability to persist will vary from day to day. Over time, your ability to pursue a goal will fluctuate. Accept this as you accept the need to push yourself.

Though anxiety may be your opponent, never let it define you. Learn from your struggle with depression and anxiety. Know you are more than your illness and don’t let others (professionals included) define you. When all seems lost, rest. Rest as long as you need.

When you lose hope, allow time for hope to return. In the end, motivation will surface, perhaps slowly and in small pieces. Let it move you. Eventually it will come.

Like a muscle atrophied after disuse, hope and tenacity must be toned and retrained. Be patient with yourself. Know you are more than your illness. The ethic of work is in your attitude. It is to that you must apply yourself. And so, a work ethic is born or recovered.

Learning to Find Creativity After Medication for Bipolar

There are some creative individuals who are burdened by a mental disorder. For many, the issue of creativity is tied to mania. They deal with their finest displays of artistic fervor and accomplishment in their manic phase of a bipolar diagnosis. The flame of original thinking combined with an expansive self-confidence propels them into a productive frenzy. At these times, artistic, bipolar types revel in the quantity and endurance one needs to take on a project.

Mania is tied to the creative impulse. While prolific as one can be in mania, a mood shift dispels original thinking. When an episode has run its course, the artist finds himself in an odd position, yearning for creative release, but too depressed to reclaim it. The artist gives way to the patient. Medication comes with normalcy and life takes on a drab, passionless existence. The artistic, bipolar patient decries his situation, but inspiration is nowhere to be found.

A common complaint of bipolar clients is their level of creative expression. It comes as no surprise that many such persons choose their creative manias over medicated normalcy, while others give up, take their pills, and make the best out of a stale existence. When mania is suppressed, boredom steps in; or so goes the given wisdom. This is true in the short term, but not necessarily the long.

In the immediate, medication locks down the fountain of creative urge. The switch is flipped off abruptly as a fantasy life is replaced by the more immediate needs of everyday. Often there is the sense that life has been drained of its essence, and this state is all there is, a spiritual wasteland governed by the pills one must take for stability.

My experience of 35 years says otherwise. There is a creative life after medication. It just takes time and persistence to resurface. Inspiration reasserts itself a bit at a time and needs to be nurtured. Once a stable platform is rebuilt, thoughts turn from the mundane. While initially stability struggles with staleness, appreciation of the commonplace spawns shoots of possibility. This takes time, and patience is of primary value. One reacquaints oneself with a creative vision a piece at a time. Eventually, hope for the ridiculous and the sublime re-emerge. Medication cannot hold back the urge to a larger view of life.

Thirty five years of living with manic depression has taught me that even when I give up in despair, I keep on growing, although I am unaware of this at the time. Life grows at its own pace. Becoming aware and being thankful are accomplished in small steps.

Twenty five years ago when I was newly recovering, there was no urge to write, sing, make music, or shape metal. At the time, I simply wanted to get back my life. I wasn’t interested in anything else. It was difficult enough to discipline myself to get up and go to work everyday. Eventually, that learned, I progressed to venturing out to meet others, to engage in uncomfortable but pursuant conversation. It was five years before I picked up a pen to write. I had nothing to say before that. Eventually my ear for music returned, and learning to share myself with others began. All of this led to a vitality in my everyday life.

During this time, I was, as I still am, on medication. It’s about a regrowth of spirit that helps us reclaim our lives. Life is a verb. It’s about doing. Medication cannot teach us this, only a life lived can do that. It’s like being in a dark closet. You keep bumping into walls whichever way you turn as you feel the bruises form. Eventually, the pain goes away and some light creeps in. You find that the walls you bumped into were actually mirrors. The longer you look, the more light seeps in. You see yourself again and again, always in a new and different way. And so, creative endeavor emerges over time. Medication can’t take that away. In fact, it can help.

Notable Quotables For Bipolar Inspiration #2

1. All problems become smaller if you don’t dodge them, but confront them. --- William Halsey
2. Let us not look back in anger, nor forward in fear, but around us in awareness. --- James Thurber
3. The greatest test of courage on earth is to bear defeat without losing heart. --- Robert G. Ingersoll
4. Always bear in mind that your own resolution to success is more important than any other one thing. --- Abraham Lincoln
5. Man does not live as he thinks; he thinks as he lives. --- Reverend Vaughan Quinn
6. Even if you’re on the right track, you’ll get run over if you just sit there. --- Will Rogers
7. So high you can’t get over it, so low you can’t get under it, so wide you can’t get around it, you gotta go through the door. --- Old folk song lyric
8. It ain’t over ‘till it’s over. --- Yogi Berra
9. There’s nothing that cleanses your soul like getting the hell kicked out of you. --- Woody Hayes
10. The highest courage is to dare to appear to be what one is. --- John Lancaster Spalding
11. He who loses wealth loses much; he who loses a friend loses more; but he who loses his courage loses all. --- Miguel de Cervantes
12. The rumors of my death have been greatly exaggerated. --- Mark Twain

Recognizing the Need for Treatment of Bipolar Disorder

Bipolar disorder is one of the most elusive illnesses we know of. Recognizing our thoughts are askew and our judgment is impaired is a risky business for those struggling with a mental illness. It all seems so sensible in our delusional state. We need to come to the conclusion there is an impairment in our functioning that prevents us from living life normally. Sometimes life is the best teacher.

As the morning overcast burned off, I pondered my pending appointment with a psychiatrist. Up until his point I had been able to work and take care of myself. I stood on the sidewalk in front of a shabby hotel. I had been offered a job painting a room in exchange for rent. Prepared to paint the room, my thoughts raced as I worked. I became less and less able to function. Lost in thought, I could not seem to retrieve my focusing ability. My mind wandered. At the end of the day, I had less than one wall painted. I had cause for alarm as I realized I could not concentrate enough to work.

I never did finish painting that room. I knew that something major had happened to me, but I didn’t understand the ramifications. Part of me felt disbelief at the thought I had a major illness, a major mental illness. It would be a long time and further episodes before my denial would give way to a desire to understand the illness.

Fifteen Ways to Recognize It’s Time For Treatment

1. Lack of focus.
2. A decrease in ability to do activities of daily living.
3. Difficulty expressing oneself.
4. Distrust of those around you.
5. Ignoring stressors.
6. Perseveration----Constant going over thoughts.
7. Avoidance of contact with others.
8. Questioning the motives of others.
9. Irritability.
10. Extended periods of sleeplessness.
11. Decrease in self-care.
12. Inability to do work.
13. Isolating yourself.
14. Excessive energy.
15. Inability to relax.

Bipolar Yesterdays

In 1967, at 19 years old, I joined the army. Actually, I was drafted. As I became more confident, I came to know my own mind, teenage confusion giving way to a value system in the army that I could support and relate to. The army was a breeding ground for others like me who were looking for answers to the question of their own identity.

Bipolar disorder was still five years off into the future, though my depressive episodes of high school vintage gave way at this time to anxiety. Fearful of being sent into combat, I managed to set my anxiety aside and attend to my daily duties with certainty and resolve. Giving no further thought to depression and anxiety, I sloughed it off like one might cast off an unwanted burden. I was growing into a man. I felt admirable, proud of my ability to cope.

Introduced to psychology in the army, I decided to major in it at college and in 1969, during a period of social upheaval and radicalism, I adopted a mindset based on my own values, some which conflicted with my parents’. I was passionate about my views, which was a change from the fears of high school. Though I lived on the edge, my emotional balance was still intact. Passion hadn’t yet given way to grandiosity and delusion.

Enthralled with adventure and drama, I spent the next several years after college traveling the U.S. and living in the mountains; following my own view of life and rejecting the mainstream for that of the counter culture. I was certain I was on the right track for me. Living for a year in the isolation of a small mountain community created the stress and drop in self-confidence that culminated in a manic break. Serious about life, the time was growing close when I would fall off the edge into mental illness. I never saw it coming.

It took several years to hit bottom, years spent trying to understand the delusional, fantasy world I inhabited. I moved from a safe mountain homestead to the flophouses of downtown Berkeley. I lived with confusion and fear as I deflated. I had no friends. My delusions were my friends.

Riding on a Greyhound bus through the dark night of Central California, I imagined a hole in the Universe, as I stared at the glowing ember of a cigarette tip. As if it were the entry to a distant Galaxy, I conversed with a higher alien race. Waiting for understanding of my manic high to emerge, it never did. I was now a remnant of who I’d been at the beginning of adulthood, so frightened, so anxious, so isolated.

Who I was became an open question. On a good day, I was a gardener, or an artist, or a storyteller of madness. On a bad day, I was dizzy from the snow-like haze in front of my eyes, unrelentingly stalled.

It’s a wonder I recovered at all. It has taken me 30 years to become who I am now. I have come a long way down a dark road, back to the real world. Grandfather, citizen, husband, chronicler and therapist, a wounded healer trying to make sense of it all.

Coming to Terms with Bipolar Disorder

I sit in my office, the pause in conversation becoming brittle. My client, settling into the silence, is a study in frustration. Sitting next to him, his young wife stares pensively. “The diagnosis isn’t an end; it’s a beginning,” I hear myself say. The words, Bipolar Disorder, hang languidly over the room.

I recall my own diagnosis and manic episodes. Education comes to mind. I must help this couple understand this illness. A label means little without explanation. These young people have just received the diagnosis of bipolar disorder by a psychiatrist whose perspective is to somehow rebalance this young father’s biochemistry.

Defenses have been moved into place. As much as this patient wants relief, he doesn’t feel ready and is ambivalent when venturing further into the treatment of mental illness, a dreaded explanation of his bizarre thoughts and strange behavior. To educate is to enlighten this family. Yet, there is resistance. Later, this couple will go home to try to pick up the pieces of what had been an idyllic life: family, children, and connection to others. What I have to say is splintered by denial and fear, or just plain unfocused thoughts that will inhibit taking in what I am trying to present to them. How you educate people about mental illness is stymied by shock and ignorance as much as fatigue, anger, and the desire by some to be anywhere but in this room at this time.

I proceed with explanations, recognizing the limitations I am up against. No doubt, this couple will not remember what I have said. “Why didn’t you tell me?” they will say. “What is this thing called bipolar disorder? I was never told.” And so, we’ll begin again, the clients’ defenses lowered by painful acceptance this mind disorder is not going to go away.

Patience, I think, be patient. It took me 12 years to understand my mental illness. Can it be any different for my clients? Can my presence make a difference? Patience, my mantra; “So, let me tell you about my experience,” I hear myself say. And so, on it goes.

Bipolar Disorder - Defining Recovery

Recovery means many things, depending on whom you talk to. The term is used to define various scenarios in mental illness. The concept of recovery implies a cessation of symptoms and a return to some baseline of normalcy. Compliance with a medication regimen that stifles delusional states is also viewed as recovery.

One thing recovery doesn't infer when it comes to mental illness is a cure. There is no cure for mental illness. Instead, recovery applies to adherence to a medical and psychological treatment and perhaps, a spiritual orientation as well. The implied directive here is that by following a treatment plan, your mental health can be “earned back.” The diagnosis of mental illness is often in conjunction with a substance abuse diagnosis that needs to be treated at the same time. The term dual diagnosis has sprung up to treat the twin diagnoses of substance abuse and mood disorder. Since bipolar disorder is connected to and bears a lifetime of treatment, like alcoholism, we talk about recovery in the same way.

There is a point here to be made. The addiction model often applies to bipolar disorder. Patients enjoy their symptoms and mania is seductive. Instead of a drug, they want their “adrenaline high.” “Don’t take away my symptoms,” they cry. “Save my delusions, those soothing daydreams.”

We need to stay focused. Our objective is to create better mental health for the patients and their loved ones. Getting lost in a confrontation over symptoms and side effects only moves us off the main track, recovery, and onto a siding where we neutralize and avoid difficult decisions. We must stay centered on getting better. Hope, compliance, and a positive attitude are essential to the recovery process. Recovery comes with acceptance.

Five Ways to Enhance Recovery

1. Compliance with a medication regimen
2. Seeking psychotherapy
3. Attending a support group
4. Developing a spiritual outlook
5. Keeping an open attitude

BIPOLAR DISORDER Recovery Following Success

My recovery from Bipolar Disorder has been nothing short of miraculous. On medication without a relapse for almost a quarter of a century, I have had the great fortune to have a career, a family, and a window on the world of mental health. But, it isn’t without its struggles.

In the beginning of my recovery, 12 years into my bipolar disorder, I thought, “If only this would last, I would be saved forever.” And, when success came, I deemed it a gift from the Gods. I thought my ultimate success put me on an endless plateau of well-being. I’ve found, however, attainment isn’t one static thing, but something achieved over and over again. I believed my struggles with mental illness gave me a virtue that inoculated me against future distress, and that God had granted me perpetual triumph. I was wrong.

I found that the attainment of my private practice, which I took as permanent, could be threatened, threatened with loss; and that crises of illness and fear could touch my family. So, once again, I set out on a journey, a journey of living with ambiguity. There is no end to the demons we must slay. To quote T.S. Eliot in the Love Song of J. Alfred Prufrock, “In a minute there is time for decisions and revisions which a moment will reverse.”