In my opinion, the two most important things you can do to stay well (when you have a mental illness) is attend a Psychiatrist and meet with a Psychotherapist. Medication can help you control Bipolar Disorder, Psychotherapy can help you live with it.
I first attended a Psychiatrist in 1994. I was psychotic and he started me on antipsychotics. It was exactly what I needed. I spent a short time in hospital but would remain on medication for about two years. I don’t remember exactly how long but I got my life back and recommenced my medical career. In retrospect, this episode probably signified the clinical onset of Bipolar Disorder but it would be a few years before I was diagnosed for certain.
I had a severe attack of depression in 1998. My first son was just born and I had begun training in Anaesthesia in Cork. I didn’t want to see a Psychiatrist. I was convinced that if it became known that I had a psychiatric illness, my medical career would be over. Instead, I was prescribed antidepressants by my G.P. and I improved. I took a maintenance dose for years after but I never felt quite right. Life was a constant struggle, my relationship with my wife was strained and I was drinking heavily at weekends.
My current Psychiatrist first saw me in 2003. I was coming off the rails and had become very destructive. My wife persuaded me to meet with him and I reluctantly agreed. It was one of the best decisions of my life. I was admitted to hospital for nearly two months and diagnosed with Bipolar Disorder.
I remember crying when I was told. I knew enough to know that Bipolar Disorder isn’t easy to treat but there was also a great sense of relief. Now we had a focus and could plan to improve things.
Antiepiletics and atypical antipsychotics formed the backbone of my medication. The effect wasn’t immediate but life got easier eventually. I continued to have frequent mood swings and, with reservations, I started Lithium. That’s when the worm turned. Lithium is the key to my well-being. By taking Lithium, I finally admitted that I was Bipolar. Acceptance took much longer.
Over the ensuing years, my Psychiatrist and I tried a number of medication combinations with varying degrees of success and failure. We finally landed on my current regime about three years ago and life is definitely much easier. It takes a long time to get the recipe right. I still have mood swings but they are not as severe nor last as long as previously.
My Psychiatrist has supported me through some of the darkest days of my illness. He listens to me, he believes me and he includes me in the choices we make. That element of self-control is important to me. It empowers me and helps me to believe that I am greater than my illness. It is not the whole.
Through the depressions and the hypomanias, through the hospitalisations my Psychiatrist has guided me. He has also seen me when I’m well and done his best to keep me there.
I would be lost without him.