Go Gentle into that Dark Night

It is much easier for other people to detect a manic episode in you than it is for you to detect it yourself. There are many ways in which your behavior is strange that are clear to others but simply not apparent to yourself. The problem is believing them, and doing something about it. It may help to agree beforehand with someone close to you, who you can trust, that they tell you when they think you are acting strangely. It may also help to agree on the words they should use to tell you so you don't get offended or angry with them when it occurs.

I always go gently when someone I trust suggests it is time to see the doctor. If they are wrong there is little cost beyond some time off work, the side effects of the drugs, and an unnecessary emergency visit to the doctor. If they are right, catching an episode early can greatly reduce the severity. They have never yet been wrong.

The role of the men in white coats is usually played by people close to me. It makes it a lot easier than trusting to strangers. I have always selected one or two people at work that I can trust and told them that I might require this service of them. Generally they ask how will they know when I am ill. The answer is simply, "You will know." Sure enough, when it happens, they know. When you find yourself in the chief executive's office, telling him exactly what you think he is dong wrong, it helps to have someone close by that understands, someone that can come to the rescue, someone that knows the drill.

I tend to do what I am told when I am ill. I go gently; I take the tablets; I weave my baskets. There is nothing to be gained by fighting those that are trying to help, though it is very hard to apply this when one is ill. One thing that makes it easier to go gently is to know, and trust your doctor. You need to establish a good working relationship with your doctor before you become ill. Trying to select a doctor while you are in the midst of a full manic episode is like trying to answer a call of nature while at sea in a small boat in a big storm — messy whatever approach you take and success owes more to luck than judgement.

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.