In Treatment

I watched a documentary over the weekend called "Boy Interrupted" on Saturday. It's about a boy who had Bipolar Disorder and took his own life at 15 years of age. It was a fascinating and moving tale. The child began talking about suicide when he was in Kindergarten. He was troubled for a long time, but if I remember correctly, he was stabilized somewhere around 9 years old. I'll get to my reaction at the end in a little while.

I also watched the move "The Soloist" this weekend. While this movie is about a homeless man who is schizophrenic, the scenes where he has episodes of hallucinations hit home very deeply. It reminded me of my own episode with hallucinations and delusions. It was a very realistic portrayal and I related to it on a very visceral level. It didn't mention how he came to be homeless or how it was that he was not receiving treatment, but there was the implication that he had at some point been hospitalized.

These films, combined with my thoughts about my friend that I discussed in my last blog post, got me thinking about treatment. Each of us has our own walk with mental illness, and approaches treatment in a different fashion. I am one of the lucky ones, who accepted her diagnosis immediately. For the most part I am 100% compliant with my treatment regimen. Where I falter and struggle is with my structure. It is a constant challenge to be disciplined in my daily life. Having 3 small children adds to the difficulty. That alone creates it's own brand of chaos. I am much better at creating and complying with structure when I get sick, because all I want is to be well. That is what makes taking my medication and seeing my doctors regularly very easy--the overwhelming desire to do what it takes to be well. It's not that I'm without sympathy for people who struggle with it, but as I have posted before, I do have a hard time understanding self-pity. Compliance is NOT surrender to one's illness. It's quite the opposite, in fact. It is the ultimate resistance. Your treatment plan is your weapon against Bipolar. To follow it to the letter is to launch a full scale war against it. Some battles you win, some you lose, but getting back up and getting right back in there is key. This leads me into my anger at the end of the documentary about the young man who killed himself...

The boy wanted to go off his medication when he was 15. From what I gleaned from the film, he was tired of the side effects of the medication, possibly tired of being different. He and his parents consulted his psychiatrist, who agreed to give it a try. During the weaning process, the boy went to his mother and told him she needed to "keep after him", so she immediately called the doctor and set up an appointment for the following week. Regretfully, the boy did not make it through until then. They interviewed the doctor on camera for the documentary, and he referred to BP as the "cancer" of the mental health community because it kills people. I don't necessarily disagree with that statement. He then went on to say "You can only keep [people with BP] alive for so long" and "they all go off their [meds]...". I was infuriated. The generalization notwithstanding, a medical professional certainly should not give permission to do so. There was no mention that he recommended or tried to convince this young man and his parents to try other medications with lesser or different side effects, or alternative treatments. No reference to a recommendation or counseling as to how very dangerous it could be to do so. It struck me as not only very irresponsible, but downright negligent of this man. How in the world he was not sued and/or reprimanded by the medical board boggles my mind. (Assuming he wasn't).

So, the question begs why is it that people do not accept their diagnosis and/or fail to comply with their treatment regimen? I'm sure that the foregoing is not very common (although I could be quite naive, too) but I do know it's very common for people to simply go off their medication and/or ignore their treatment regimen. It can be denial, it can be the desire not to be tied to a medication, it can be the love of mania, it can even be (regretfully) a financial issue and myriad other reasons.

Then, I started thinking about the big "S" word: STIGMA. Just how many people turn away from their diagnosis out of fear of being stigmatized? Have my opinions about stigma been wrong? For those who haven't been reading my blog all along, I am not one to get hung up on labels, for example. I'll be the first call myself crazy, looney, batshit and various other euphemisms. I've always taken the position that words only have the power we give to them, and desensitization eliminates any negative effect. I have pause to consider otherwise now. Have I inadvertently been contributing to that stigma? Have I been giving permission to others to perpetuate an improper posture toward the mentally ill? Worse yet, have I been so single minded that I've been selfish? While my ideas have worked for me, should I be approaching it differently? Should I be more straight forward and serious? It has begun to plague me. I think just by asking myself the question, I may already have the answer.

The inevitable question follows...What can I do to help? I never fancied myself as a social worker, advocate or activist. Yet, here I am thinking about these types of things. I may not be ready to be wholly involved in something right now, but as I'm taking my baby steps I think this might be a goal worth working toward. I have always lacked a passion for my work, and have never been able to think of anything I might be passionate about. I believe I may have just found one.