Navigating Psychiatry

It has been awhile since blogging (as of lately) but I sure miss it! I am not going to commit to posting on a consistent basis, yet it is something that I want to try to incorporate into my life more because it is good for my soul. Additionally, I feel I have experiences in areas that could benefit others. So with that I am going to jump right in!

Today I want to discuss a topic that I have recently been walking through. As a person who struggles with managing bipolar disorder, one aspect of treatment that I require is medication. For that medication I have to meet with a psychiatrist on a fairly regular basis. Anywhere from every couple of weeks to every three months if I am in maintenance.

In the last ten years I have seen five psychiatrists and I have an appointment the end of this month for an evaluation with a new one. Why so many you might ask? Well the first misdiagnosed me and put me on medication that drastically made me worse. At the time I was only 16 and they really had no business treating a teenager, but my parents and I didn’t know any better. That could be an entire topic on its own. (Side note, if there is ever a topic that you want me to discuss I am more than happy for the suggestions. I do have an interest in speaking with parents of teenagers or young adults to help them walk through this journey as a family as well. Okay back to me.) The second psychiatrist correctly diagnosed me and I stayed with this one for several years. Eventually I realized I was over-medicated and there was no room for discussion on a reasonable level. I was feeling very unheard. I had an instant connection with the third, but they took a job in a different location which wouldn’t accept my insurance. The joys of the medical system here in the United States. The next psychiatrist I didn’t really connect with, but they listened to me enough and I was able to be remain stable for a couple years. Unfortunately, they had personal reasons and left practice. Between that one and the fifth, I was off medication completely for a year.

There are periods of time where I am able to be off of medication. Slowly and surely though as the months progress, I have a slow and steady decline until I find myself in desperate need of stability. I have been through the cycle of on again off again meds three times and every time is the same. This last time made me realize and finally accept that medication is just going to be part of my life. I have done a great deal to work with my symptoms without medication and I am someone who needs that little extra boost to make my life go from okay and unbalanced to stable and great.

So with that notion, my therapist recommended the fifth one and I have seen them for the past three months. While they are very knowledgeable and we get along okay, I have been around the circle enough times so to speak that I need a little more from someone who is going to effectively manage me for hopefully years to come. Someone to work through issues with me and actually listen to my perspective on how the meds are or are not helping. It is very important to have that two-way form of communication and especially important that you are able to speak up and be assertive when needed. Psychiatrists may hold the “power” (or I like to think about it more as the knowledge) about how and when they prescribe certain things, but you have the power to choose someone who is going to work with you as a team. Find the right one, even if it takes time because with a chronic condition you will want someone in your corner who can form a lasting relationship to make your life the life you want. You are the one that has to deal with the treatment and side effects. They get to go home at night to their life without thinking about your life unless you are in their office. It is only fair you choose one that gives you that undivided attention at your appointments that you need. I am still in the searching phase, yet I have worked with enough psychiatrists to know that there are ones out there who fit my needs. It takes some patience and I don’t always have the patience or stability which is where the assistance of a therapist or other doctor is crucial. You can’t do this alone.

The things I would like people to get from this post today:

  • Medication can be a valuable tool in the treatment of any illness, mental or physical. The stigma that we don’t need medication is harmful and downright dangerous at times.
  • I understand that access to psychiatrists and medication can be a challenge, so find someone who can advocate for you whether that is a therapist, another doctor, even a friend.
  • If you have a crappy psychiatrist or you just need a change – do it! Do not feel obligated to stay with a certain doctor if you don’t like them or they do not fit your needs. We need a team and you need to be able to communicate effectively with each other to make your life stable and enjoyable. Maybe you don’t need to be on some medication now, but it is still a good idea to have a psychiatrist to talk through the symptoms and so they can be there if or when needed.
  • If you are prescribed medication, please take them correctly and on schedule! Don’t go off without talking to a professional just because you feel better or you don’t feel a change. Withdrawal is no joke on some psychiatric meds and trust me going through a small titration, again with a professional, can make that transition the best a situation it can be (still never fun though). If you don’t take the meds properly, they will not work correctly and you won’t get a chance to see if there is a potential for positive change.
  • If your current psychiatrist is working out great for you and they suddenly have changes that won’t allow you to see them anymore, remember they are human beings too with a life outside of their work. It is the hardest when you lose a professional you connected with, but you need to move on and pick yourself up right away to make sure you stay stable and healthy. This situation was very hard for me to deal with and although uncomfortable, moving on to a new one is just what needs to happen.

Bottom line: life can be difficult and unpredictable with bipolar disorder or any mental disorder, but in my experience medication has helped me resume a more normal and enjoyable life. I hope it can for others as well. I am not dismissing the fact that it is difficult to start or change a psychiatrist, but I am here to tell you that you are definitely not alone and millions of people are walking through this same process on a daily basis. Find community and connection and most of all find a treatment team that has your back every step of the way. In a few weeks I hope to update you with good news that this new one has the potential to be in it with me for the long haul. I realize that was a long-winded post but I hope it gave you some perspective on working with a psychiatrist. Have a great weekend!

Authentic Community

My heart has been quite heavy this week with the passing of some very iconic people. Society often forgets that mental illness physically changes a person’s brain chemistry. It is very much a physical illness but this aspect often gets left out of the picture. People still hold on to the belief that material wealth and success can make it all disappear somehow. Headlines of recent show us quite the opposite. Please remember that from the outside you can’t always tell what someone’s ill brain is poisoning them with. Try to embrace the concept that suicide is a symptom of mental illness and that these beautiful humans, and all the beautiful ones taken too early from this life, died from a mental illness, not simply because they killed themselves. Somewhere along the line their brain chemistry became hijacked and they weren’t able to get the help they needed. While it is important for crises numbers or text lines to be available – I will personally attest to the fact that in a moment of crises there was and still is a very slim chance I would ever reach out to a stranger. Others have benefited greatly from these resources which is why it is important to share, but we can do more. I have realized lately that I need to do more as an advocate. I need to make my story more available to others in hopes that it can reflect the fact that recovery is not only attainable, but sustainable. I need to work every day to keep it that way, which is why I need to be one of the people to stop and say here are my tools. Here is how I get through a tough situation or day. I believe honesty and transparency will create a community that allows for people to ask how they can get to a better place too. I know it is hard to ask for help when you are struggling. So I urge others to reach out to people to bridge that gap. Ask two or three people in your life today what they are grateful for. What their passions are. Go beyond the how are you bs and have real conversations. Talk about life and love and dreams and show people you care about them as a person, not just as a formality. There is a lot on my heart but for now I will leave you with a quote from Anthony Bourdain – “If I’m an advocate for anything, it’s to move. As far as you can, as much as you can. Across the ocean, or simple across the river. Walk in someone else’s shoes or at least eat their food. It’s a plus for everybody.”

Reflecting

Year one of graduate school complete!  I don’t get much of a break, but I can breathe a bit.  I know year two will be more challenging due to thesis work and more difficult courses, but I have learned a lot about life and myself in the process to feel confident.  I truly feel balanced.  I went into grad school not knowing how I would fare.  Prior to grad school I had spent a lot of time physically healing from back surgery and mentally healing from the eating disorder.  I had a few classes and completed some important certifications, but ultimately this time was focused on recovery and building a solid foundation.  Jumping back into the real world was both exhilarating and frightening.  It hasn’t all been perfect, I know it’s not supposed to be.  In fact, it has been a bit messy.  Messy and beautiful.  Difficult.  Agonizing.  Tiring.  Wonderful.  Amazing.  All of it.  I haven’t written in a long time because of this last stretch of projects and tests.  Also because I was trying to stay afloat.  I should have been writing and reading and coloring and using all those self-care techniques, but stress got the better of me.  I have enjoyed not being paralyzed with stress and able to do some things not related to school.  This is important for me to remember and realize going forward that taking time to myself and putting school work aside is not selfish.  Stopping to go out to eat and put down the journal articles is not selfish.  Going to bed early is not selfish.  I am so grateful for the people in my life and grateful for my life itself.  My field of work can be difficult some days, but it has taught me a lot about patience and a lot about making your life worthwhile by doing things you love.  So for me, please stop today and take time to do something for yourself.  Reflect on the past few weeks, months, years, and think about if your life is in alignment with your passions and desires.

Progress

Guess what? If you actually follow your meal plan and eat consistently throughout the day, you don’t get overly hungry or full and there is balance! While this may seem intuitive to most people, it is something I needed to be reminded of. Yesterday I followed my meal plan for the first time in a couple of months and I am working on showing my dietician that between now and in two weeks when I see her, that I can follow my plan and hold myself accountable. While I was proud of what I accomplished yesterday and what I am accomplishing today, it remains a difficult mind game. I feel a bit dismayed and the eating disorder likes to think I am a failure. Although I know my weight didn’t drastically change overnight, my body image is shit today. I am going to trust my body and my dietician and follow this damn plan for the next two weeks and see how it goes. I know it is likely some things will be discussed and adjusted at that time, but for now all I can do is try. More than half the battle with me is the actual planning. It is way easier to go about my day and ignore meals all together until later, so stopping to eat seems like a great annoyance. I realize though that actually planning things out ahead of time helps the day go smoother in the end. Like today for example, instead of restricting and putting off lunch or spending a lot of wasted time trying to decide what I should or shouldn’t eat, I have my lunch in the fridge and when my reminder goes off to stop and eat I will. No extra thought involved. I am also working towards increasing my water intake, especially on rest days because I tend to only drink a lot of water during workouts. I am writing this on paper so to speak in order to continue to hold myself accountable. I don’t tend to be vocal about when I struggle, but writing helps to keep me on track. Hope everyone else is having a great day and if you are struggling to stay on your meal plan know that you aren’t alone and we can do this. Just keep moving forward because you will never know the outcome unless you push. I have a feeling that staying on a plan will have a very positive outcome in my life especially mentally.

One of the Lucky Ones

Claim denied. Upon further investigation I had reached my 2, yes t-w-o, therapy appointments covered under insurance. Even then I was only reimbursed half of the cost. I shrugged, used to the system and went about my morning. Later I was sorting through mail again and as I was shredding that denial letter, I was overcome with gratitude in my situation and sadness for others less fortunate. I am one of the lucky ones and I don’t take that lightly. My family has been able to financially support me throughout my entire recovery journey even when insurance would not. Thousands of dollars. For those of you not familiar with mental health coverage benefits, this has been my experience and although every situation is different, I know there are countless others with similar stories. At my worst, I saw a therapist twice a week, a psychiatrist every two weeks, and a nutritionist once a week. Over ten years into this journey I still see a therapist once a month, a psychiatrist every three months unless an issue arises, and a nutritionist on an as need basis. These visits average around $100 and I know others who have spent much more. I will let you do that math, but it adds up very quickly. Without a doubt I know that the only reason I am in a great place in my life is because I was able to have a stable treatment team. With constant monitoring and support, I never had to be placed inpatient, where cost skyrocket into the hundreds of thousands and most are denied after only a few short weeks, leaving them in debt and fighting for other outpatient care. Some give up all together and end up dying from their disorder because they weren’t able to receive the care that they needed and that everyone deserves. I get so angry and frustrated when I think about this whole situation because I am living proof that there is a solution. It is rather simple in my head so why can’t others see it? Stable outpatient resources = recovered. That is my story and I confidently believe that it can be everyone’s story if they are given the opportunity. I am a lucky one and I will never take that for granted. With this anger and passion, I will find ways to get involved in organizations with similar goals. I know I am only a single individual, but I want to make a difference. I want to find others with similar stories to mine showing that full recovery is possible given the opportunity. I also want to hear from all those who have been denied this opportunity. Something needs to change. I know it is a more complex issue than what I present, but why should it be? I am a researcher by nature and I know I could throw fact after fact out if I wanted to write an essay, but this is from my heart. I won’t ramble on, but I hope reading this makes you stop to think, if even for a short moment, about the future of mental health and what it could look like. If you read this and know of organizations committed to this vision please share in the comments because I would love to explore them as well as compile a list so that others can explore them too.

I am grateful to link up with Julia and encourage you to read her recovery roundup on Mondays where people share stories of recovery and perseverance! recovery-round-up-lord-still-loves-me-link-up

How Writing a Thesis can be Compared to Recovery

I tend to fixate too much on the future, especially when it comes to school. I am finding that the hardest thing about writing a thesis is to actually start the writing. I love data collection and actually getting to do the research, but with the writing it seems overwhelming to start. I have an outline, I know the formula, so why is it getting in my way so much? The answer goes back to fixating on the future. Instead of chapters with subheadings nicely broken down, I can’t help but see the deadline for the entire thing and I am left with an overwhelming sense of dread. There is so much to do! I like to be a perfectionist when it comes to about everything in life, which I might add has been mostly a harmful attribute, and it is the same with this. My head gets in the way and just stops me from writing. I want to get it perfect the first time even though rationally I know that isn’t the right mindset.

In my mind this is very relatable to the recovery process. Whether it is addiction or eating disorders or self-harm, or any destructive behavior- if you look at the grand scale of things, it will automatically become overwhelming and you won’t even want to continue. You know what you have to do, yet your head gets in the way and you fail before you even try. Recovery is just like the writing process. There will be several, and I repeat several, “drafts” before things start to fall into the place you want. You will stumble and trip up and succeed and slip and win and lose and the list could go on endlessly. Recovery has become second nature to me now because I took that first step and kept climbing. I also continue to take small steps every day to commit to this new life. Stop focusing on the end goal and start focusing on all the little steps you can do right now in this moment and today that will help you move forwards. Before you know it, your life will change for the better. Trust me in the fact that you may not see it happening, but you will be able to look back after a while and be proud at what you have accomplished. When I put writing a thesis into perspective and comparing it to my recovery, I know that I will succeed. I just need to start, no matter how small and eventually I will have a finished product to be proud of.

Energy

As an athlete I know all too well how my energy can impact my performance. Not only my physical energy, but the energy of my state of mind. Anxiety and excitement are two opposite forms of the same energy that lead to very different results. Anxiety is a negative form of energy that sucks the life out of me, leaving me hopeless and prone to depression. When I am anxious, I pick apart certain skills or movements and am never left satisfied. Excitement is the positive form of anxiety and instead gives me hope and confidence. I work hard on skills and sets with excitement trying to become my best self. In both energy states I work my ass off, but which one produces the results I want? Obvious to any athlete. But what about applying this principle to other aspects of my life? Getting back into a new semester I find myself a bit anxious and stressed concerning my master’s thesis. That energy didn’t do me any favors last semester. As I picked apart every little piece trying to make it perfect, I lost all mindfulness and serenity in life. That energy carried over through the break and it is exhausting. My brain is wired to default to the negative. I am working very hard to re-wire it and be very intentional about mindfulness and gratitude. At first thought it was very hard to think about my master’s thesis as exciting. Yet the more I separate the stress and anxiety, I actually find there is a lot to be excited about. I love the work I am doing with cancer rehabilitation and it is a privilege to get to work with these survivors every day. Each passing week I am closer to the career I want and the life I have envisioned. This is my passion and school is just a stepping stone to get there. Writing can definitely be compared to competing in athletics. You work hard, have many drafts and edits, and eventually end up with something you hope to be proud of. I compete to win and this makes me excited. I am writing in hopes that my thesis will become published and to have a successful defense in order to graduate. That will be a huge victory and this makes me excited. Regardless, I will finish my degree no matter the state of energy. I hope in the coming weeks to continue to be mindful about this topic and use my energy in a positive manner. Thinking this way does transform you. Think about what makes you anxious and then think about how that energy can be converted into excitement. For example, maybe recovery is wrought with anxiety and there is no way for it to be exciting. Really dig deep and come up with your own personal reasons of how it could be exciting. With no exaggeration, I have found recovery to be the most exciting thing in my life. It gave me a new life. I encourage you to take a step back and consider how you can be intentional with your own energy. It is a challenge and as I move forward I strive to stay excited and inspired about life.