Tuesday, October 9, 2012

On Being Bipolar: Recovery? Stability? A Cure?

There’s a word that I’ve been seeing a lot over the past two days after disclosing my most recent (nearly 8 months) exacerbation of my bipolar diagnosis...RECOVERY. I’m getting some well wishes for recovery but in reality is it possible for a person with bipolar disorder to be cured? IMHO I think not. You see, bipolar is caused by a chemical imbalance in the brain, heredity, socio-environmental  events and /or the ingestion of chemicals whether they be prescribed or illicit. While my own personal neuro-chemical makeup cannot be determined without thousands of dollars worth of tests, I have the unfortunate genetic factor in my favor with a recently found history of bipolar in my family to a known family history of alcoholism, growing up as a child who was molested, having a truly dysfunctional life growing up, losing my father at the age of 8 and being forced to plan his funeral because I was the only living relative since my parents were divorced which led into a very poor and extremely strained relationship with my mother. I've only done marijuana once as a teenager but drank fairly heavily (resulting in essentially a rape by a fellow airman because I was too intoxicated at the age of 17 to realize what was happening...you can imaging my horror when I woke up in bed with this person who I hated with a passion and disliked all aspects of his persona even though he was a fellow student leader). I see these as the major life factors feeding my already present brain disorder and only served to bring out the illness in an intensely stressful period of my life.

When you Google the word recovery the most applicable definition you see is:  “A return to a normal state of health, mind, or strength. A return to a normal state of health, mind, or strength.” The problem with this definition is that the idea of “normal” differs for everyone.  To me my “normal” is to be able to function in any situation whether it’s recovering patient from a sudden cardiac arrest or being able to go into a building with bad memories without having an anxiety attack. “Normal” is no longer in my vocabulary.

I don’t seek “recovery” per se. All I want is “stability.”  The ability to know approximately when my mood swings are going to come.  Knowing the anticipated length of the depressive and manic episodes.  Knowing when the warning signs start showing up to recognize them and take preventative measures.  For the past 3 years that stability hasn’t been there. Things have not been quite as bad as 2009-early 2011 when my life consisted of hysterical crying for the majority of the day, daily/hourly suicidal ideation & complete hopelessness/helplessness. But the last 8 months or so have been pretty much hell. Trying to look like everything is OK on in outside yet on the inside I’m  internalizing not only my issues but that of everyone around me as well. I want stability where my episodes stop cycling every few days or at times a few short hours so I at least know what to expect most of the time.

Is there a cure for bipolar? Simply put, no. Some may see a decrease or leveling off of their symptoms but unfortunately I am in that group whose symptoms worsen as they age. I went from single severe episode every few years to cycling episodes that last anywhere from hours to days to months. In any case, recovery for a person with bipolar is a lot like a recovering alcoholic in that this is something  that we will be struggling with for the rest of our lives.

Maybe one day there will be a medication that I can take via injection that will control my symptomology for months at a time (much like the medication Prolixin for schizophrenia). While such meds are in the work I’ll have to try to take my daily, twice a day and three times a  day medications…something I’m not great at ( this is “non-adherance” in medical lingo and  I am at times non-adherent to my medication regimen which causes a whole new world of problems). Like the saying goes nurses & doctors make the worst patients. Because when in a manic or hypomanic state, the bipolar patient including myself, will feel that they are in fact “cured” and don’t need the medications and therefore stop taking them all together. Unfortunately because of my more that lay person knowledge of medications I tend to diagnose and change my doses (so, maybe my FNP and almost completed PMH-NP education worked a little too well). Always a bad choice on my part.

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