Welcome to Bipolar in Focus. I am Jane Pauley.
One of the hard parts is accepting the diagnosis of bipolar. Dr. David Miklowitz is the author of "The Bipolar Survival Guide" and people have different reasons for resisting the diagnosis.
I think there are a number of different reasons.
One of the reasons is simply that is very painful to accept any long-term illness whether that be a heart disease, asthma, diabetes, bipolar disorder.
It's very difficult to think, "I have to get ongoing treatment that makes me different from other people."
There is a stigma that goes along with the disorder. How do I explain this to people?
Will people not go out with me on dates because I have this illness? Will I not be hired? Will I not be able to finish school?
Those painful questions make people want to interpret the symptoms in a different way.
Your mind looks for these alternative explanations understandably because they provide a framework for understanding these painful events that have occurred.
It's much harder to think I have a biologically genetically based disorder of the brain that is going to recur over time, and for which I needed to take medications.
What does acceptance mean anyway?
Well, Jane, I think when somebody gets a diagnosis of bipolar disorder, they go through an emotional process.
They go through an emotional process of recognizing a current illness.
It's another matter to come out of that episode and realize, there is something biologically or genetically wrong with me or even emotionally or psychologically wrong with me that needs treatment.
We believe it is a lifetime chronic illness. That's correct.
And that's a big package to swallow.
Absolutely! It's a big package and that's why I think a lot of people, after they have had one or two episodes, they aren't really ready to think about it as a recurrent long-term illness.
That's why I think it's incumbent upon doctors to recognize early on that we need to focus the person on the immediate future, not the long-term future.
It's counterproductive to imply the long, long, long, long road. It's more productive to do it--
I think if you have a young person, 19, 20 years old who has had one episode, that person is not ready to hear you have a lifelong illness that's going to recur throughout your entire adulthood --
-- and into your old age, and you need a medication that you're going to have to be on for the rest of your life.
And we're going to get much better cooperation from the person and they're going to get more out of treatment if they can think what are their immediate goals
and what kind of treatment do they need now as opposed to when they're going to be 50 or 60.
Why is it so important that the patient be educated about the disorder?
It's very important for families and particularly the person with the disorder to learn about the disorder: what the treatments are, why there are these different classes of medications recommended.
The fact that you may be on a different medication when you're acutely ill versus when you are stabilized,
the notion of prevention that we take medications to prevent certain things from recurring as well as treat current symptoms.
It's important for family members to understand where this came from, what kinds of symptoms we're looking to prevent.
If everybody is on the same page about what the disorder is, I think it's going to make far more harmonious treatment plan.
So to educate yourself about it is both understanding, a very complicated scenario and accepting that and also understanding that life somehow gets lived between the lines.
Yes. That's a good way to put it. I think what happens is people, they learn the facts
and that's one level of understanding and acceptance to be able, for example, to recite the symptoms of bipolar disorder or here's what I look like when I become ill.
It's another emotional process for both the person with the disorder and the family to recognize this can recur.
Those are very hard pills to swallow and I think part of it is learning what does the future hold and to recognize that you have to live your life even in the face of these treatments.
So what's the take away?
I think if you stick with the treatment regimen now, there's no reason you can't reach your life goals. You might have to modify them. You might have to delay certain things you want --
but there is no reason to think you can't achieve your life goals even with this illness.
Thank you so much.
And thank you for watching Bipolar in Focus.