Being "Better" versus Being "Well"

I must make something very clear. I am not anti- psychiatry. Not by a long shot. Were it not for my psychiatrist, Dr. Bob, I wouldn't be the person I am today, sitting here at 6:48 a.m. writing to you, which, by the way, I consider an enormous privilege.

However… I just wish that Psychiatry would more openly and genuinely embrace Recovery.

Too many people tell me their psychiatrists insist that they have bipolar disorder and they'll never be well. That it's a chronic disease like diabetes which must be controlled by medication, like insulin, that they must take for the rest of their lives. I hear this all the time. It really upsets me, especially when the medication these people are prescribed often makes them feel awful.

This doesn’t have to be true. Medication is a tool. In many cases, it doesn't need to be taken for life. That's a decision the person who is taking their medication must decide. Often the decision rests between two polarities.

Are you going to be ill for the rest of your life? Or are you going to begin your recovery journey to wellness.

That journey may involve your taking some medication, for a while. Or not. It's your body. It's your life. You decide.

Recently, Dr. Bob and I had this discussion because I was thinking about going off my medication. He left the decision up to me and I decided, for now, to stay on my Tegretol, an anticonvulsant, which is my mood stabilizer and keeps me from becoming manic. Had I decided to go off it, Dr. Bob would have taken me off the drug very gradually, as it has dramatic implications on the way the other drugs I take for my kidney transplant react in my body. It’s a tricky business.

Dr. Bob is a most unusual psychiatrist. He cares about the whole person – all of me. Mind. Body. Soul. Spirit. My health and wellness. He treats me, and I'm sure all the people with whom he works, with enormous respect and dignity. He is a humble man despite his enormous accomplishments.

Let me tell you a story. It's true.

Once years ago, he was planning an academic one-day conference for all the in-patient doctors, nurses, psychologists and occupational therapists working at the hospital where he is clinical head of the psychiatric  in-patient ward. The topic of this conference, I recall, was how to improve the in-patient unit and in-patient care. Dr. Bob asked me if I would be willing to speak for about 10 or 15 minutes at the beginning of the day about what I thought might make things better for in-patients, as I had been a guest on his unit several times.

Not only that, he offered to pay me for my time.

The point is, how many psychiatrists in his position would turn to one of their patients to enlighten doctors, nurses, and all the professionals working on a psych ward about how to improve conditions for their in-patients?

Brilliant idea, when you think about it.

Who knows better than a patient? But how many patients are invited to present at medical or psychiatric conferences about this, our field of expertise?

I cannot remember what I said, but apparently, my remarks set the tone for the day. Have things changed? I don't know. I haven't been back, but knowing Dr. Bob, they probably have.

Recently, I was reading John McManamy's wonderful blog on at BipolarConnect and he made a fascinating point.

If you haven't read John, I recommend him. He's one of the "experts" writing at BipolarConnnect and as you'll see from his profile, he is eminently qualified to write about bipolar disorder as he's the author of Living Well with Depression and Bipolar Disorder: What Your Doctor Doesn't Tell You... That You Need To Know, the first and most comprehensive book on mood disorders from a patient's perspective. He has several different online venues and he’s definitely worth a look.

In one of his postings about Recovery, here's what John wrote about psychiatric medication – getting better and being well – which are not the same.

"Meds will make us better, after all, but they will not necessarily make us well," McManamy wrote. "Psychiatry is very good at getting us to 'better.' The success rates for 'better' are very high, backed by impressive research. 'Well' is far more problematic. Virtually no research exists. There is no evidence base, no way of determining how successful psychiatry is in this regard, if at all."

Do you want to be better? Do you want to be well?

You can be both, but it takes time and a lot more than popping pills.

Tomorrow, I turn 60. I've been in psychotherapy of several different kinds over the last 48 years. I've been hospitalized about 20 times for mania. I've read a great deal about the mind and mental illnesses and mental health. I am constantly learning and open to new ideas. I've also spoken at a variety of conferences all over Canada and in some spots south of the border. Knowledge about psychiatry and mysteries of the mind and the brain is growing exponentially. It's hard to keep up, but I'm learning all the time.

This is a life-long journey. I'll never graduate with my PhD in me, but the course is fascinating because there's so much to learn. It's never ending. How exciting!

Be well!

Comments

[Sonia]

Good morning Sandy,

First, thank you Dr. Bob for valuing Sandy's contribution so many years ago. And (bad English, but fun here), Congratulations Sandy for such a validating experience as presenting to people in the health sector (profession, industry, etc.).

I have taken a few days to prepare my comment on this topic, as this is a fine point not only in language and prescription, but especially in self-perception.

I like sentences such as, "I've had better days" and "I've felt worse" because they convey an implicit range of self-perception to someone who is listening.

Regardless of how we feel at the time of these utterances, once said, to someone who cares, we (often) almost immediately feel better - no drug, no reference to a specialist.

When I critically examine what I have lived, I see two huge categories: what was done to me without consent, and what I have done for myself.

Since I cannot undo the past, I have little hope of ever being "well", so I have learned to appreciate "better" as it presents itself, without expectations. This often leads to MUCH better than before.

Meeting you (on this blog, and on Oct 15), definitely fits in the second grouping: spending time with healthy people is a gift to enjoy on the path to better living.

Thank you,

Sonia

[Melodie Burkett]

Hello Sandy, I wrote to you twice as Mrs.Onion or something??? because you had talked of finding wellness by peeling off self doubt and family perceptions like layers of an onion that would lead us to accepting ourselves and our uniqueness and gaining self confidence back from the sources that stole it from us by the ignorance and fear that created the labels. I was thrilled that you emailed me, my Mother was with me for a holiday week end and I sat her in front of my lap top to read your Blogs. She suffers from chronic depression, had shock treatments at 19 went the lithium route with kidney problems as well. Now she is at a 5 star retirement residence and only on a mild dose of Zoloft.
She has made a remarkable recovery. The routine, companionship,healthy food on a regular basis has given her back her life. I remember years ago when she was thrilled that the thinkers of the time decided that Manic Depression was a chemical imbalance. She could then not blame herself. It was a step that helped at the time but she seemed self destructive in that she would not eat good or in any regular fashion, she would stop going to AA but remained sober. She would stay in the same clothes and sleep most of the winter and I suspect took too many pills or not enough pills and would have nerves so raw that she needed help. I have always "rescued" I truly believe now that "ATTITUDE" effects quality of life. I finally went for councilling to learn how not be co-dependent.
I thought my constant "advice" was showing love and concern. It must have been hell for her. I was a nag! I also had resentment. A mother is supposed to help the child, not the role reversal that we had. Now at 58 and her 79 we can be REAL friends and We are both grateful. I keep it lite, brief, loving and work at my own well being "one day at a time". I know that not everyone can be in a wonderful residence. I think that being in a hospital on the phych floor is too heartbreaking for people, period. Doctors and Nurses and even the Janitor without even realizing it "Treat Mentally ill people with a cold detatchment " that is humiliating. I pray that you Sandy, NEVER NEVER give up the good fight. You are bringing lightness into a dark world that most people fear to tread. Now after reading all your blog today, I am afraid that you are working too hard. I wish the Star would give you a million dollars a year just so you could slow down on your other jobs. I'm selfish. I don't want to lose you, the world needs your insight.
It took three alcoholics to give birth to A.A. It took you, one nice and very smart lady to give birth to "Coming Out Crazy" Only God can measure the value of the impact you are making in peoples lives. I had a good relationship with a very nice Doctor, who has spent his life helping people. Unfortunately, He was stuck in a groove and I had to find my own way. I thank him for his time and tender heart. I thank God for always being there when I am ready to listen with my heart. I won't miss your next meeting and I will bring 249 friends so you won't have an empty seat in the house! Melodie Burkett (YES YOU CAN PUT MY NAME ON THE FRONT PAGE OF THE STAR IF YOU WANT!) I'm PROUD that I am Unique. AND YES WE CAN make a difference!