Disclosure, privacy and having fucks to give.

I’m a little bit cantankerous today. You may want to bear that in mind as you read this.

I didn’t get enough sleep last night. And it’s Monday. And I just read an irksome piece by someone who describes herself as an “influential mental health writer” about why she doesn’t discuss the specifics of her bipolar treatment plan, and why we shouldn’t either. It basically boils down to, “nunya business”.

Well, true. 

But when you’re putting yourself out there as a patient expert, having someone ask about your treatment plan–including medications–seems like a common occurrence. And it seems perfectly appropriate. Why get so defensive?

People ask because they are gathering information; either they are trying to understand, or they are trying to make an informed decision about their own treatment.

I don’t think it’s because “people want to be like” you.

I don’t think it’s because they want to judge you.

If people are judging you, they are most likely judging you for having a mental illness. The particulars of your treatment plan isn’t something about which those people are going to have fucks to give.

There are only a handful of drugs available to treat this disorder, but there are various combinations. And only a few talk/behavioral therapies that are geared towards treating the bipolar brain. When I made the decision to start a mood stabilizer, I talked to my doctor about my options. I then researched my options on my own, through various websites and by reading the Product Information sheets from the different pharmaceutical companies. I also spent a lot of time talking to other people in the bipolar community, to get a general feel for what side effects are really  like. This allowed me to make the best possible decision about my treatment. This helped me prepare for what might be in store for me.

I realize that everyone has a different comfort level.

And, of course, this writer has every right to choose which bits of personal information she shares with the world.

I’m just puzzled because this particular piece of information seems less personal, to me, than other bits she shares freely in her (please excuse my cattiness…) rather self-indulgent blog.

(“Ahem,”  you say?  “Aren’t you writing this in your very own self-indulgent blog?”  Yes, that’s exactly what I’m doing. The irony isn’t lost on me, at all.)

Isn’t this kind of disclosure, when you’re already putting yourself out there, empowering?

And doesn’t encouraging an open dialogue about bipolar disorder and the treatments available for it, benefit us all?

Shutting it down, particularly in such a snarky way, feels self-stigmatizing to me.

Am I being hypercritical? Too sensitive?

Maybe my struggle with self-stigma has made this a touchy subject for me. Maybe I’m being myopic and am only seeing this in black and white. Maybe I’m just being a pain in the ass today. Who knows?

I’d love to hear your thoughts on the matter.

How open are you about your treatment plan? Particularly in this forum?

Your insight is greatly welcomed.

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6 thoughts on “Disclosure, privacy and having fucks to give.

  1. From your experiences presented here, I think my response to said blogger would be: please stop making this all about yourself

    I love that you share details about your treatment plan which you feel are safe for your disclosure and subsequent empowerment. If a person shows so much angst and defensiveness about the idea sharing particular details on mental health blogs, I think they might be taking themselves just a little too seriously.

    • I guess what I should really do is stop following this person on Twitter. I’m not learning anything new from her blog and this particular post just rubbed me the wrong way. I should save myself the aggravation.

  2. Hmmmm….

    I’m quite certain that I’m not “influential” and I’ll let you tell me if I’m a writer or not, but I am a mental health clinician and I do have bipolar and I ‘self disclose’ to all my clients (some of whom have bipolar and others of whom struggle with different issues.) My experience has been that the more ‘out’ I am, the less stigma I experience (whether self induced or otherwise). At this point (I’ve been ‘out’ at work since 2003) my attitude is 100% wtf. If you’re going to feel negatively about me for being me, we might as well put that on the table right away. I don’t have a problem with ‘me’; and if you’ve got a problem, well, it’s YOUR problem (right?)

    As far as discussing treatment plans, I’m happy to discuss anything — but I’m quick to tell folks that everybody’s med situation is unique. I take 300 mg Wellbutrin, 40 mg Prozac, 250 mg Lamictal. I’m not going to keep it a secret, but my ‘scripts are my own. They’re not going to ‘fit’ anybody else.

    I do have things to say about psychiatrist visits though — I tell peers to remember that you’re the boss. The shrink has the MD, but you have all the power in the relationship. S/he works for you in an advisory capacity. If the advice is helpful, take it. If it’s not helpful, then don’t be shy about saying it. Any doc who has an ego problem with you taking responsibility for your own body and your own health is a doc you don’t want to be near! I also say, when it comes to your psychiatrist, “tell the truth, the whole truth and nothing but the truth.” You don’t need her/his approval — you need to be WELL. The better the information you can provide, the better able your doc is to help you get well.

    Also, insist on the best. You don’t want to be kinda/sorta well. You want to be 100% well. And you don’t want somebody telling you that there’s nothing that can be done about unpleasant side effects. Being fat, and sleepy, and bald, and sexually incapacitated, and spastic is not what you want. Don’t let the doc say, “that’s the best we can do.” Screw it! You deserve a good life, and you deserve to surround yourself with people who are on board with you living a good life.

    Enough!

    Peace,

    Paul

    • Thanks for commenting, Paul. That’s great advice on psych visits. I work for a non-profit that focuses on raising money for cancer research, and we have quite a lot of contact with patients. This is very much what we tell patients–be your own advocate and remember the docs work for you.

  3. I don’t follow said person on Twitter because said person is downright obnoxious with RT’ing any tweets that mention said person. And I totally agree, the piece in question was a bit, um, distorted in perspective? Like seriously, why do you think other crazies want to be crazy like you? I doubt it. We’ve all got our own crap to handle.

    Anyway, looks like said person has a slightly inflated sense of self-importance (surprising? not really, but disappointing) so we shouldn’t take it too seriously. Do your own thing and don’t worry about what other self-absorbed bloggers have to say.

    • DeeDee, yeah, I think you’re right. I stopped following her on Twitter so I’m less pissy now. =)

      BTW, “Crazy Like You” sounds like the title of a biography! Erm, or a song my ex-boyfriend could have written about me. Heh.

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