Imagine being seated on a comfortable sofa in a warm, well-appointed office designed to make you feel at home, fidgeting nervously and struggling to find a neutral position as the man across the table from you delivers his findings in a kind, but regretful tone. "I'm diagnosing you with (fancy medical term) disorder," he says, shattering your world into a billion pieces even as he clearly wishes he didn't have to. "We need to talk about starting you on some meds."
You've suspected this was coming for months....maybe even years. But thinking you might have a condition is one thing; you can still play the denial game and lose yourself in all sorts of imaginings, with both happily-ever-afters and tragedy as possible outcomes.
Knowing you have a real, life-threatening illness---hearing the words said out loud by an impartial observer and seeing them written on a piece of paper---is a whole other ballgame. First, all you can see is the problems....dear God, how do I tell my family? My boss? Will these meds work? What will they do to me? What if they DON'T work? And worst of all: will I ever be the same?
That last one is perhaps one of the cruelest aspects of being diagnosed with a psychiatric disorder. You go along living your life for three, four, even five or so decades, believing yourself to be a decent sort and being more or less contented with who you've become as you've aged........then suddenly a sucker-punch comes flying in out of nowhere and knocks you into the middle of next week.
There you are, flat on your assets in the dirt, reeling from the shock and surprise and wondering what to do. Then panic sets in as you realize there are no answers forthcoming, because nobody tells you how to survive the initial shock, let alone the emotional devastation that immediately follows it. There are publications galore that deal with medications, treatments, therapy, and other useful information, but what are you supposed to do when you've just lost the person you thought you knew best---yourself?
For me, that's been the most difficult aspect of all. I'd just turned 53 when I was literally forced into a psychiatry referral by my internist; that's a lot of years to build a life and a persona that, although certainly flawed, were good enough for me. I was successful in my nursing career, had a good marriage and four wonderful grown children to prove it. I had enough material goods and earned more money in a year than my parents ever saw in five. I had my church activities, my involvement here at Allnurses, and no shortage of friends. So what in Heaven's name drove me to go and mess it all up, time after time after time?
Yes, I'd suspected bipolar for a number of years, and confirmation was an enormous relief at first. Finally, there was something (besides perversity and what my mother had called "mule-headed stubbornness" to explain why I've had such horrid mood swings and done so many stupid, reckless, self-destructive things in my life. But that didn't last long, and I was soon engulfed in grief for the loss of the woman I'd thought I was.
Who am I now that I have this label? I asked myself during one of my deeper, darker moods---the one that hit me shortly after being diagnosed---when I'd make the 25-mile commute home in the evening and fantasize about crashing my car into a tree at 75 MPH. I'd lost count of the times I've had to start over, and I honestly didn't think I had enough strength left to do it yet again. I was too old.......too tired.....and I just didn't want to.
The next few weeks were some of the most brutal I've ever been through, as I mourned my old self-image and tried to deny the very existence of the illness. I could not bring myself to think of it as a part of me; I wanted to put it over in a corner and tell it to stay there and behave while I resumed my appointed rounds. Better yet, I told my bipolar self, just go away and leave me alone.
It wasn't until I joined a support group and met people who had already walked this same lonesome valley that I understood: We are still ourselves. We don't lose that when we receive a diagnosis of mental illness; all we do is carry some extra baggage. In fact, we've ALWAYS carried it---the only difference is we know about it. And knowledge, as they say, is power.
So until someone much smarter than I figures out a cure for what ails us, it would benefit anyone with a psychiatric disorder to learn to gently accept oneself as s/he is, and put away all notions of how things "ought" to be. Dwelling on what can never be is unhealthy, and worse, it gives our minds an excuse to wander along dark and dangerous pathways best left unexplored.
As odd as it sounds, there's never been a better time to be depressed, anxious, manic, paranoid, delusional, or neurotic. Medications and other therapies are constantly being developed and improved; scientists and other mental health experts continue to learn better ways of recognizing problems while they are more easily treated. And while the mentally ill are still stigmatized in some ways, more and more of you "normal" folk are realizing that we work alongside you, live next door to you, and even make life-or-death decisions for you on occasion. In fact, we're a lot like you.
We ARE you.
