This is going to be a long post. I am seeking support. I don't feel well. My mind is spinning and i am trying to get it to stop ....
Quick edit: I want to clarify what i meant by "treatment resistant" -
My therapist was conveying to my psych NP that i may not be cooperative to being medicated - not that ive tried other meds and that they are not working.
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Hello fam... I am trying to ground myself. My safety plan includes reaching out on this subreddit to ask for support - so that is precisely what i am doing this morning... I am sooo grateful for this space 🙏🙏🙏
I've been an active member of this subreddit since June - when I found out that I am bipolar type II. I have posted and shared with folks a little about my story / experiences. I'll provide a quick recap
In a nutshell, my experience with bipolar follows a different trajectory. I am 50 years old and only learned a few months ago that bipolar exists in my family - i have known my whole life that schizophrenia exists in my family and my family members with schizophrenia are diagnosed, they are in treatment, and they are deeply loved and cherished (not without its problems, however!)
Well - as it turns out, bipolar can split from schizophrenia - and now i've come to find out that a number of us in my family are bipolar - including me.
I have always struggled with my mental health. I have been in therapy since the second grade. Somehow, the fact that i have bipolar type II was missed. I am diagnosed with GAD and periodically went to the psychiatrist to treat for depression - took SSRIs .... i know today that was a BIG no no...
I have felt a little timid at times on this subreddit about sharing too much about my experience. I have lived my entire life with undiagnosed and unmedicated bipolar disorder. This is not something i take pride in. It just happened. The reason i often feel at odds about sharing my experiences is that i am 50 and i live a stable* and happy life (stable with an asterisks means that i understand that my definition of stable might be a little different - nevertheless, my life is stable* and mostly predictable from day to day) - one thing that i am very clear about is that i don't want to go around advertising and encouraging people to not medicate their bipolar... that is absolutely NOT where I am coming from at all.
Before I knew that I am bipolar, I was actually on meds to treat anxiety. I was treating with Propranalol - which, i now know, if you have an underlying condition, like bipolar, it can trigger mania. Cue: how I found out i am bipolar ....... (one of the MANY ways I managed to figure it out - its a much longer story than this, of course)
I share that becasue i am trying to make myself very clear to all of you where i come from with regards to mental health treatment. I believe in it. I believe in treatment. I believe in medication. I believe medication can help. Medication HAS helped me throughout my life. I have not always been on meds, but when they work, they work, and i am good with it.
Finding out that I am bipolar was literally one of the biggest shocks of my entire life - i have spent these last 4 months moving in and out of a state of shock and disbelief. Ultimately, i accept it.
In my family, we are pretty open when it comes to talking about mental health. There isn't that a sense of shame and secrecy to it..... My relatives take their meds, they are open about it.
THIS is where i come from.
Please forgive me - i am pretty dysregulated right now
But omfg ... my therapist called me "treatment resistant" ... like WHAT?!!!!!!!!
I am LIVID
I think the reason why this feels so destablizing is because i literally feel betrayed by my therapist.
Something else i have openly shared on this subreddit is that i have been lining up for treatment.
Here is some more context: when i first learned that i am bipolar, i couldn't make sense out of it. My second session with my therapist after learning i am bipolar (literally one week later), my therapist tried to have "the talk" with me about treatment and medication. After that session, i told them to back off and slow their roll. I had only JUST found out and before i could even process all of it, they were already on me about meds.... okay, fine. Not a big deal. But i told them directly that i had only known a week and they needed to slow down....
For more context, my own therapist is also bipolar. I have known this the entire time i have worked with them. My husband is bipolar type I, and working with a therapist who is also bipolar has been really helpful .... i have worked with them for over 2 years and it has been the BEST therapy ive ever had.... so i think this is why all of this stings soooooo deeply and is destabilizing me
In subsequent sessions - i will absolutely share the things that i said to my therapist. I know a lot of people may disagree with me about some of these things, but please bear with me and hear my story in its entirety .....
In the subsequent weeks, i shared with my therapist that i felt hesitant about medicating now that i was out of depression. I had been depressed for 6 years. So coming out of it felt like a huge relief. On top of it, i learned that this is where my baseline is - in a "manic state" ... i didn't understand what any of it meant by this point in the subsequent weeks after i found out i am bipolar. I was literally just trying to understand myself....
I am fucking 50 years old. I am a 50 year old woman. I have spent my whole life trying to arrive at self acceptance. I dont know if what i am saying even makes sense.... but i already arrived at my place of self acceptance when i learned that i am bipolar. I fucking accept it. My ass is bipolar. I have had bipolar my WHOLE life. I was born this way. I am bipolar because there is schizophrenia in my mothers family. I accept it. I accept me.
And then i learned that I do mixed episodes.... EEK!!!!
Yes... i have done them throughout my life - now i know what the HELL that shit is ....
I want to be painfully honest here: when i realized this past july that i do mixed episodes, i was flooded with flashbacks of things that i did to other people when i was in a mixed episode. It's not good. At all. There are two instances in my life that i can think back to where I truly hurt somebody and maybe even violated them somewhat. I definitely caused one person some trauma becasue of how i treated them : (
I take this seriously.
I take this extremely seriously.
I am not okay with walking through this world hurting other people.
I have often thought back to these two moments in my life - never knowing how to make sense of it.... now i understand. I was in a mixed episode when i behaved badly.
From here, it was an easy decision for me to decide to treat with meds.
I made this decision on my own in July. Literally 5 weeks after I learned that I am bipolar.
I informed my therapist. They seemed happy about the decision.
From there, i did it all myself. I began researching and calling psychiatrists, psych NPs. It took me several weeks until i finally landed on somebody that i felt i would really click with ....
I had my first appointment in September. It was a 90 minute appointment. It went very well. I was really happy. I felt really good. Really at ease. There was a plan in place for my treatment.
I am going to start Lamictal. I have done my research - after reading all the things and reading peoples lived experiences iwth it (on this and other bipolar subreddits), lamictal seemed to be exactly what i was looking for. I felt really positively about my decision. And the appointment with my new psych NP felt collaborative and i felt heard, respected and understood. We had scheduled a follow up appointment 3 weeks later to begin to land and solidify decisions. I would get the script and would begin the titration process
Well, my second appointment with my new psych NP was last Friday. The appointment was horrible.
It wasn't collaborative. He went back on a bunch of decisions that he and i discussed. And then at the end of the appointment, he practically yelled at me when i really gently asked him about why he was changing the process on me - and then he ended the appointment.
That appointment absolutely fucked me up. I felt so disrespected. I get the script from the guy, but is this the person i want to be checking in with as i titrate with this medication?
And then Sunday, i remembered something....
I had asked my therapist and my new psych NP to consult with one another between my first and second appointments wtih him. I signed all of the consent to release paperwork - I like to consider myself transparent... especially on mental health stuff.... remember, all, i come from a family where mental health is pretty openly discussed (not all the time, but the shame and stigma is not there in my family) ..... so that was my approach here too
I realized, my therapist has been labeling me "treatment resistant"
They told me that they informed my new psych NP that i am "treatment resistant" - when i reached out to my therapist yesterday to ask them about this - they apologized immediately, understanding that this likely fucked up my relationship wtih my new psych NP
I know full well that i can absolutely find other psych NPs or psychiatrists that i will work well with.... The fact that this breakdown in my treatment process is already starting to create a domino effect in my life - i have put so many things into place in order to support my treatment process ... and thats fine, its not like i cannot rework these processes again. I can and i will
But thats not really what i am struggling with
On top of feeling wholly betrayed by my therapist, i have a genuine question for poeple
I want to know what on earth would possess a mental health professional to label their client / patient as "treatment resistant" when that client is literally taking the onus to plan out an entire treatment plan WITH medication?
Can someone please explain this to me?
Is it because my instant reaction wasn't to automatically and enthusiastically jump into "the talk" that my therapist tried to have with me about meds literally 7 days after i learned (at the age of 50, mind you) that my fucking ass is bipolar????? Like what?
Do mental health professionals expect a scripted canned response from us?
"Oh! I have bipolar disorder. Let me get on the phone right now and call a psychiatrist to get onto meds"
I didn't do that automatically. It took me about 4-6 weeks to process and arrive at that point on my own.
I am 50 years old. That i am also bipolar is also part of my identity. I embrace it. But I cannot undo the 50 years of my life that i lived not knowing i had this condition. There is no way for me to undo that. And i also won't apologize for not knowing. The fact that i have been in mental health treatment my whole life and that bipolar was never "caught" is not my fucking fault. I took responsibiltiy for myself and i have showed up to therapy sessions my whole fucking life week after week after week after week after week for DECADES.
My coping skills toolbox is AWESOME.
I have learned how to "white-knuckle" bipolar disorder my life. Please understand that i am not encouraging other people to "white-knuckle" their bipolar. It's just what happened to me. We all have different stories and experiences with bipolar. I need to talk about my experiences with it too. Just because i spent my whole life not knowing and not treating with meds does not make me bad or irresponsible or wrong.
But why are some people trying to make me feel like i am bad and wrong for that?
I have also shared with people on this subreddit that i come from an immigrant family. I am of color. I also work in healthcare and i understand very very very well that people of color are systematically neglected in the healthcare / mental healthcare spaces and that conditions like bipolar go missed.
Bipolar is NOT the only major condition in my life that was missed by health professionals. That issue is an entirely separate can of worms that also involves missed brain tumors, multiple brain surgeries - and i dont think i really want to open that can of worms at this moment.
It's just to remind myself taht being neglected in the medical space is part of my life experience too. I also know that i am not alone in this experience.
My bipolar was missed my whole life.
It was my bipolar husband who pointed out to me: "honey, you are hypomanic right now - this is what hypomania looks like" is what my husband said to me on the night of June 2nd. My life has not been the same since
I take my bipolar seriously. I do not minimize it. I get that it is serious.
But what i am not okay with is being treated like shit just becasue i am bipolar. Because, lets be honest here, that is also a thing.
I am a healthcare professional. I already knew this fact.
My story of discovering that i am bipolar is a really long story - you all now know that i also had a brain tumor. There is a lot to my story.
What i want to say is that i am already feeling the shift-yness of healthcare professionals because of this discovery. My ass is bipolar. I accept it. I do mixed episodes. I understand this fully. It is a problem. I fucking need to do something about it. This is a hard line i have with myself: I do not wish to walk though this world ever hurting or violating somebody again. That is who I am to the core. I need support with making sure i can get my mixed episodes under control.
But what gives? Why on earth would somebody label me as "treatment resistant"? What i have been doing since July is not waht treatment resistance looks like.
Somebody please help me out. I am fucking going crazy. I am trying to stop spinning.
What stands out to me are the healthcare workers who treated me wtih a lot of dignity before they knew i am bipolar. And now i am noticing something so fucked up that these same professionals, now knowing that i am bipolar, speak to me completely differently (the PA at my primary cares office did a 180 on me - when literally the conversation i had with her right before she learned was pleasant and equitable)
There is a lot of forceful communication. Multiple healthcare workers have raised their voices at me over nothing. Literally my thoughts are, "okay, i'll gladly do __, but you don't need to raise your voice at me to get me to do this task"
I desperately need to name something: i am now experiencing a LOT of coercion in these spaces, where coercion was once not there. I am deeply uncomfortable. There is a "comply or die" tone to everything
Yeah. So that is where i am at today.
I am going to say something really controversial - but i say this hoping that people can understand the deep nuances of my story ....
I almost wish i never learned i am bipolar.
I am trying to do the responsible thing and approach treatment with meds - just like i have always been shown is the norm in my family. My aunts, uncles and cousins who are schizophrenic, all treat wtih medications. I was literally trying to do the same thing that was taught to me.
Learning i am bipolar and trying to do the responsible thing seems to come at a cost for me. I am being humiliated. My therapist of 2+ years fucking labelled me as "treatment resistant" for god knows what the fuck reason, and now that shits following me around and i am getting "punished" like an insolent child.... its like my new NP wanted to sit me down in a corner and force feed me meds when i was already asking for a prescription - is it because i was showing too much agency? Am i too confident and not unstable enough in my presentation? Are they trying to break me in order to justify their treamtment modalities becasue bipolar people can only be desperate and broken and always have their families, careers, and intimate relationships falling apart? (mine aren't)
What the actual fuck happened to me? What the hell is going on? I literally cannot make sense out of this.
All i know is that i want to fire my therapist. I will probably fire my new psych NP as well.
I want to drop out of therapy entirely. I feel so betrayed. I work in healthcare and this is fucking with me badly. I dont tell my colleagues i am bipolar. Now i am too afraid to tell anyone. I have been trying to carry an open demeanor about my discovery... now? 4 months later after dipping toes into this new reality, i want to run away far and fast.
There it is now: treatment resistance.
I am spinning. This was not where i was trying to arrive.
But self fulfilling prophecies are real. Its almost like my mental health team was imposing non-compliance onto me.... literally a figment of their fucking imaginations. But its almost like they had to beat this narrative into my treatment space in order to make it work for them.
Fuck this. I need treatment. I want to be responsible. I am pretty sure that my ass needs to be on lamictal. But i am DEFINITELY not doing it like this.
Am I really treatment resistant? Or am I asshole resistant?
Someone please help me out.... i am genuinely trying my head is spinning and i need help.
Thank you for reading 🙏
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TLDR: I am too dysregulated to provide a synopsis. I am seeking support. My story is really nuanced and if you have the time and energy to read though everything, i would really appreciate the support.
Thank you 🙏