Treatment Plans and How to Stick to ’em

Hypomania is creepin’ in, boys and girls.

I work in a small office, and my coworkers have noticed. Great. I am very lucky they are supportive. Today, they have been sending me on errands.

I’ve been to the post office three different times this afternoon.

I’ve picked up a Rx for someone.

And even offered to pick up lunch for the whole office.

For the past two hours, I’ve been sitting at my desk with headphones on, listening to music and trying to resist the urge to chatter on about every single thought that pops into my head.

(NOTE: Unless you are able to actually get up and dance, the Ramones’ Greatest Hits is probably not the best album to listen to when you’re feeling hypo.)

Since my mind is a bit speedy right now, instead of trying to develop something out of that crazy mess, I thought I would chime in on a couple of other bloggers’ posts that resonated with me, today. They both talk about psych meds. More specifically–the discontinuation of psych meds. I won’t ask for a show of hands, but I’m guessing I’m not the only one who has decided (usually in a manic wheeeeeeeeeeeeeeeee! state) that I am invincible and no longer need medication to stay healthy.

Yesterday, Corey, over at Treating Mood Disorders, had this to say, in his post that focused on embarrassment/shame and mental illness:

“…Unfortunately, many of us feel that we can fix ourselves if we just had enough fortitude, belief, or determination. We cycle, going off our medications, quitting therapy, telling ourselves that this time we have the determination to stay healthy without the “crutch” of a counselor, medication, or doctor. This is our illness lying to us.”

The entire blog post is great, but this paragraph in particular really spoke to me. So much so, that I now have “This is our illness lying to us.”  written on a sticky note, stuck to the inside of my desk drawer. There will be times, I’m sure, when I will need this reminder.

The other blog post I read was Natasha Tracy’s What to Do When Someone Refuses to Take Their Medication–Treatment Noncompliance.

Ms. Tracy talks about the variety of reasons someone might not adhere to their treatment plan, including side effects, ineffectiveness of the meds, and (surprise, surprise!) the false sense of security we’re lulled into when the meds are  working.

She included a brief section called Helping a Person Who Refuses Medication.

I’m fairly predictable. When my meds are working and I feel “normal” pretty consistently for a long period of time, it just takes one mild episode of mania to decide to go off my meds. Despite having done this multiple times over the past decade or so, when I am in that particular mind-space, I just can’t seem to remember that the reason I feel normal is because I am on the damned meds!

So, I taper down, and wean myself off of them, and low and behold, I find myself knee-deep in the deadly swamps of sadness.

Having bipolar II disorder, I struggle to keep myself from sinking into depression on a fairly regular basis–medicated or not. So, I am particularly hard on myself when I have to admit that I’ve made a mistake and have to start treatment again. I feel ashamed. And defeated. And broken.

My therapist and I decided, about a year ago (the last  time I took myself off my meds), that I needed a plan. She suggested a contract. Part of the plan is, if I get that particular itch, I must discuss it with three people, before I discontinue treatment. My people are:

  1. Michael–Of course, as he an integral part of my treatment plan. Also he tends to notice my mood shifts even before I do. This is helpful. Plus, I feel like I have an obligation to stay healthy not just for myself, but for him, too. It’s not fair for me to create chaos in our life together, if I can help it.
  2. My best friend–She’s known me since we were 14, and we are long past sugar-coating things to spare the others’ feelings. She loves me and will give it to me straight, in order to help me stay healthy.
  3. My stepmom–Dona is a beautiful and supportive second mother to me. She used to be a therapist, and will use her magic therapy skills to reign me back in.

The contract also states that Michael is to have my shrink’s contact info, and my preferred hospital (where my shrink has privileges, basically), so that if I ever find myself swallowed up by depression, or unable to make good decisions for myself, he knows who to reach out to.

There is still a big part of me that feels like I shouldn’t have to have a plan. I should be able to handle things well enough on my own. But that is just not realistic. And I need to learn to accept this.

Maybe one day I will. But for now…I have a contract. And a treatment plan that seems to be working…sure, it has a few kinks here and there, but so far, when I’m looking at the big picture, it’s working.

Now, if you’ll excuse me, I have some dancing to do.





3 thoughts on “Treatment Plans and How to Stick to ’em

  1. I love this plan. I also have a list if individuals who I have to contact before I try to take myself off of my meds. Top on my list is my sweetheart, followed by my mentor, and finally my partners at work. I’m not sure how to re-blog your blog, but I sure would like to. It’s spot on.

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