Get Weaving

For me, doing the right thing requires pills. Come the first episode after moving to the States I had neither pills, nor a doctor. The first doctor I was referred to believed that the best treatment for mania was for me to talk to him once a week for an hour — no pills, no hospital, no basket to weave, just one session a week of talking to him. He didn't even talk to me, just me talking to him. This was actually harmful because it let the mania develop fully before any effective treatment was given. The men in white coats came.

The earlier a manic episode is recognized, and the earlier effective medication is taken, the shorter the episode will be. If the episode is recognized early enough I can avoid taking the really strong stuff. I can stay at work with minimal impact. If I have to take the strong stuff it is best to take time off work. If I am not at work I need something else. I need a safe place to spend the day where I can be monitored. That's what the baskets are for.

I have made much use of outpatient programs. An outpatient day program is a life-saver for me. It offers removal from my normal situation and any associated stresses. It gives me people to be with but in a safe setting. It gives me professionals to observe my condition. It gives me baskets to weave — after all, you've got to do something with your hands. 

There tend to be a number of activities organized in a day program — the basket weaving. I don't think I have derived any specific benefit from these activities, but it would not work without them. You have to do something. I have found group therapy useful, but not during an episode. I have not found psychoanalysis useful, though I tried it for a while. I have found psychotherapy to be of great use, but not the sit and talk for an hour sort. The psychotherapy I have found useful is the pragmatic sort. The sort that helped me to accept my illness — the sort that helped me work out an emergency pill drill — the sort that helped me to take responsibility for myself and my illness.

So for me, doing the right thing is:

• Take the tablets — I keep my own supply for emergencies.
• An emergency appointment with the doctor, today or tomorrow, never more than that.
• Admission to an outpatient day program (not always required).
• Hospitalization — only necessary if the episode is not caught in the early stages.

New Article: Teaching Wellness

Research has recently demonstrated that teaching illness self-management in addition to medication can significantly improve the quality of life for those with bipolar disorder. This article reviews the scientific evidence.

Reprinted with permission from bp Magazine, Fall 2006.