Can You Thrive with a Mood Disorder?

dr_greg_simonGregory Simon, MD, MPH
Investigator, Center for Health Studies Group Health Cooperative

Can You Thrive with a Mood Disorder?

The Depression and Bipolar Support Alliance has designated 2014 as the Year of Thriving. Throughout the year, they are challenging the organization and the mental health community to set higher goals, to shift the conversation from “surviving” or “managing” a mood disorder to truly thriving.

In a recent DBSA podcast, Dr. Joseph Calabrese and I discuss the limitations of current treatment options for mood disorders and the need within the clinical and patient communities to shift expectations and raise treatment goals to complete remission of symptoms and sustained wellness.

We are challenging our entire field—clinicians, researchers, administrators, and policy makers—to set higher goals for mental health treatment. Our goal is not simply to control or reduce symptoms, but to eliminate them.

Is eliminating symptoms of depression or bipolar disorder a realistic goal? We think so. What we have now is not what we hope for, and we should not allow the inadequacies of our current treatments to diminish the importance of our long-term goals. Our current tools for treatment of mood disorders—medications, psychotherapies, and other treatments —often fall far short of eliminating symptoms and sometimes cause significant side effects or create long-term risks. With those far-from-perfect tools, patients may occasionally reach the target of zero symptoms. But most do not. If we hope to reach our target all of the time—or even most of the time—we clearly need more effective treatments.

In addition to better tools or treatments, we need a significant attitude adjustment at all levels of our treatment system. Our patients should expect—and even demand—better results of treatment. Sadly, consumers are, on average, quite satisfied with mental health treatment that is simply not very effective. Clinicians also need to re-orient toward higher goals. Our traditional metrics (like 50% reduction in symptoms or reducing symptoms to “subthreshold” levels) don’t help people to thrive. Most of us would prefer not to carry around a Hamilton Depression Rating Scale score of 12, even if it is 50% improved from what it used to be.

Thriving is, of course, about more than treatment to eliminate symptoms. Thriving is about total health—mental and physical. Thriving goes beyond eliminating the negative. It’s about developing the positive, and reaching personal goals in work and love and play.

In the podcast, Dr. Calabrese suggests that too much emphasis is placed on negative symptoms.  Dr. Calabrese states, “we almost never target positive symptoms of recovery… feelings of calm, rested or cheerfulness.”

DBSA’s Target Zero campaign to support the Year of Thriving suggests a paradigm shift from the traditional concept of remission in two ways:

  • First, it is a more ambitious goal: eliminating symptoms rather than reducing them to a tolerable level
  • Second, it is a verb. It is about action

Embracing research that broadens the definition of remission to include the presence of positive symptoms, not just the decrease of negative symptoms is a major attitude shift. As the mental health community explores attitude adjustments around the word “remission”, I challenge researchers, policy makers, and providers to broaden their perspective.

Your Turn

  • What can you tell your clinician as you aim to achieve zero symptoms?
  • Should researchers, policy makers and the medical community include positive symptoms as a marker for successful treatment?
  • How might policies change to re-orient treatment to achieve zero symptoms?

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30 comments
edwartfruitman
edwartfruitman

Depression is sometimes great for professional growth. People with depression treatment continuing are often asked to spend more time in work because their free minds get depressed. As a result, their growth is faster than average in professional life due to which they get more successful. 

StephenBonin
StephenBonin

Marcie2835, Thank you for this positive report. I am invigorated. Stephen

StephenBonin
StephenBonin

Marcie2836, Thank you for a positive report. I feel invigorated! Stephen

marcie2836
marcie2836

Faith in God and Jesus are life saving with any "illness" life throws your way

marcie2836
marcie2836

Hello!! I'm a 60 year old female who has experienced three depressions (one in 79 that was post-partum) other two in 2009 and 2010.  After tying over 30 different medications and basically losing almost 3 years of my life to the disease, I was fortunate to meet up with a doctor who performs ECT when someone with re-occurring depression is deemed "drug resistant"  It took 11 treatments of ECT until I turned the corner but oh what a wonderful thing!! Saved my life and gave me m life back! I then had 6 more treats to maintain.  I started ECT treatment Nov 2012 and ended March 2013.  My psych dr is conservative and keeps me on 10mg Prozac and 200mg of Lamictal with resteroil as a sleep aid but basically I am depression (bi-polar depressive) free!  Living a thriving life with lots of volunteer work, workout at the local YMCA and healthy family relationships. Life is great again! I see my counselor who polices my moods as it is not known for how long the ECT will keep the depression in remission and my psych doctors goal is to have me off my meds within the year but always points out I may need more ECT to achieve that should the beast of suicidal depression return.  Just wanted to share my positive experience of ECT when meds fail, which they do in 20% of the cases of.  It was painless and I was treated with respect in the outpatient setting.  I credit the doctor you recommended it and the doctor who performed it with saving my life.  You can go to the archives of the Dr Oz show and their camera's filmed what modern day ECT is like.  I hope this helps someone whose doctors have talked ECT with them when all meds have failed.  Life is again once great, full of productive goals and happiness!!

StephenBonin
StephenBonin

Jancheer, regarding your depression about your weight and health issues, I commend you for admitting, and encourage you to realize that we live in a culture that idolizes skinny/thin/llean/"curvy"/sexy. I hate it. We writers in this program are becoming more knowledgeable about WELLNESS. We have limited control about our bodies--for example our medication side effects that cause weight gain. If we eat well, exercise three times a week minimum for 20 to 30 minutes, we can--along with the other recommended activities--draw closer to wellness. It's a balancing act. Stay positive! Find a support group, if you do not have one. As for me and my weight issue, I am 5'5", 200 pounds. I could look better minus 35 to 50 pounds; however, I FEEL lighter. I walk--no vehicle--EVERY day. Stay positive, please, and if you need to, email me at braumscleaner51@gmail.com

careforyourmind
careforyourmind moderator

Today, achieving zero symptoms is unfortunately unrealistic for many, though not all, individuals living with mood disorders.DBSA's Target Zero campaign readily acknowledges that fact.

If you don’t have a treatment team that believes wellness is possible; if you do but time and other limitations prevent that team from working with you towards that goal; if treatment options (of all kinds) aren’t available for you to go beyond “measurable improvement”; if you aren’t given the hope that wellness is possible—then achieving zero symptoms can be an uphill battle. 

That is why DBSA has initiated this campaign. To start the conversation about how we collectively (clinicians, researchers, people living with and affected by mood disorders) can work to change this. And to discuss how we can use the tools that do exist today to get us closer while we work towards that change—because while achieving zero symptoms today might be unrealistic for many, thankfully achieving wellness, as defined by a full and extraordinary life, is not unrealistic. The journey is not easy, but wellness—however you define it—is possible! In fact, although the road is often hard and long, many, many people living with mood disorders do find treatments that work well, support to help them when they need encouragement or assistance, and personal strategies to help them lead full and extraordinary lives! We simply believe that the closer we get to zero symptoms, the easier the journey will be and the more likely wellness will be a reality for more people.

DBSA honors every person’s unique journey to wellness and looks to our peers to inspire us, to give us hope along the way that life need not be limited by a diagnosis.

marcie2836
marcie2836

Hello, I am new to the site as I am currently starting up a support group to help those hurting with a mental disorder and their family members/loved ones.  I had 17 shock treatments starting Nov 2012 and ending March 2012 as I was deemed drug resistant to the over 30 different anti-depressants I was prescribed. My depression went into remission after treatment number 11 and the next 6 were spaced out to be maint.  I would be happy to talk with any whose medical professional has discussed with them the possibility of ECT

JoannaMandellTipple
JoannaMandellTipple

I was diagnosed bi-polar, 2nd tier last year but for years have been diagnosed and lived with depression.  When on meds, life was mostly what it was meant to be - except for some high emotion melt-downs.  Yet there were days when I could truly say, if this were my last day, I'd be happy.  With therapy and friends and suppport I went from surviving to thriving.  I had clear self-awareness, I could function responsibly, I could experience emotions appropriately.  I believe that with patient/consumer insistence, more people will be able to reach a state of living without being bounced around by the many symptoms of mood disorders.  I also think it is true that some people will not be able to.  Full recovery for everyone I have no doubt is a possibility but not in my life time.  I don't think we should give up on working towards it however.  Right now I'd be happy to be where I was a couple of years ago, with meds working and things ok.  These last 2 years have been hell.  Mania of any kind not really evident but despair and ongoing crying jags make up my days.  My psychiatrist has tried several different mixes - hopefully this last combo works.  That God for Lorazapam to get through the hell house moments - although I've noticed that my CVS prescription does not seem to work the same as when I used Rite Aid pharmacy.  I guess at this point I'm trusting that yes, I will once again thrive in spite of the damn condition. 

jancheer
jancheer

I hope my 3 answers made it to yall seems more people need to take interest in this NAMI needs to be involved

jancheer
jancheer

It sounds Good, Although I feel my clincian/psyc. has strived for presence of positive along with my counselor. My pscy. has been aware of my medications systoms negative sideeffects but some positive systoms as how it has slowed down numeroues episodes. Am I episode free no.So... I would offer a suggestion of some treatment thatcould help me diet,excercise...Maybe ask for trial sponsorship from professional diet and excercise Professionals example Dr. Oz/Dr. Phil even (I could benefit from his experts he has on staff) You know we hear of few celebrities that have Bi-Polar but thats all you hear don't hear of their struggles.? Why is right because they have all the experts getting them on right meds (if needed) professionals leading them on proper diet and excercise rigmen. I am depressed with my weight and health issues.No I don't feel am offered solutions on treatments for theissues mention although my bi-polar and meds are factored in for these issues. Rambling and far fetch suggestion I'm sure . Consider the source giving feedback toquestion #1.   Yes of course all medical reseachers,doctors,clinicsand medical community should and should be always include positive systoms as a marker for successful treatment answer to #2  I think i answered #1 which answered #3 for me......

afish
afish

After reading the comments below and also seeing that Phyllis was able to get my previous comments up on livefyre, I do want to add a few additional thoughts about to Dr. Simon's remarks.  It is absolutely essential when one is in therapy with a psych doc, psychologist or trained and experience social worker or other mental health providers that stressing the positive behaviors and achievements we patients make is so important.  For almost 5-6+ years I was seeing a well-known psych doc in D.C. and eventually terminated with him last year because one, i could no longer afford to pay him out of pocket after he opted out of Medicare, even though he reduced his hourly rate by about $10 dollars or so and I wasn't getting better.  If anything, I was getting worse, even though he always returned my calls when I was in crisis.    However, what was more important, and i guess because of my professional training as a clinical social worker and having been in and out of therapy for years, at this point in my life, the psych meds being prescribed for my bi-polar dx were too much for me to handle, re: side effects and I did better with just one or two.  This particular psych doc really knew about psychopharmacology, but not too great with clinical interventions.  He has been in practice for quite sometime, understood my illness, didn't really push the meds too much and had to really walk a fine line when I was feeling suicidal and allowed me to make the decision to have a voluntary admit to an in-pt psych unit.  For that I give him a thumbs up and know that I was often faced with clients who were suicidal and had to make the difficult choices about what to do.  At any rate, when I finally terminated with this psych doc last year, one of the most important things I told him was that he never addressed my positive skills and abilities to know how to handle stuff when I knew I needed to get back into treatment and he finally acknowledged in my final talk with him when I asked him what he had learned from me was that he needed to address the positive aspects of patients during treatment.  I really don't have time/patience to be teaching any mental health providers how to do therapy!!!  And yes, psych docs are trained much differently then clinical social workers and psychologists.

So again I say, psychiatry is an art not a science and 95% of our "recovery/getting back into control" is our relationship with our therapist and about 5% is related to meds.  Now that I am needing to get back into treatment, I cannot find any experienced mental health providers who are accepting Medicare and although I understand why, i.e., the coding system, reimbursement rate, paperwork, etc., I think what I would do if I were in private practice.  One thought I have had is to ask the therapist if they would accept the Medicare reimbursement rate that I would be paying out of pocket and not submitting bill to Medicare, since that's so messed up.  At least paying out of pocket the Medicare rate would certainly be much lower for me then having to pay $175.00-$200.00+ dollars for short term tx and 2 visits a month. Eliminating my bi-polar dx won't happen and really won't happen to any of us who have this dx.  Its really a tough one to treat.  However, finding a good therapist as I did when I moved back to Balto. in 1998 who gave me many good behavioral coping skills to practice, along with continued positive feedback.  Also, one psych doc I had in Seattle also taught me when to know I have to "drop out" for a while in order to get myself back into control, whether that meant just staying in my apt., taking some meds and also doing alternative tx.  I will say that I learn a lot of stuff from the many psych docs I have seen over the years which for me is a positive thing as a clinical social worker.  Therapy is a 2-way street and listening to what patients have to say as it relates to meds, life style and understanding that the mind and the body work together with this illness.  Eliminating "symptoms" for me happens when I know I'm in trouble, getting help and then going about doing the things I like to do and not continuing to focus on my mental health issues and having fun and laughing, etc.


So I hope I haven't gone on too long with my thoughts and comments and am now continuing to try and find a therapist now that I can either afford to pay or someone who will except Medicare and know what they are doing!!!  I have too much professional experience to go thru a teaching hospital wherein I would be seen by a resident who then has to consult with his/her psychiatrist supervisor.  I would make "chop liver" out of that poor resident and can't waste my time with that now!!!  I believe we patients (hate the word consumer) have much to teach to various mental health folks who have been in practice for a while and are willing to listen rather then "shutting down" because they think they have all the answers. For those of you who have now found a really good person, good for you and keep doing whatever it is you're doing to manage our illness and move on with your life!!





kimgallen
kimgallen

In terms of how to address this topic with clinicians, I speak in literal terms, meaning that I say I "am going to achieve zero symptoms and here is what that looks like". Zero symptoms for me means I am swimming a few times per week, going to the gym at least twice per week, wearing clothes that fit me, as compared to things that "hide" me, so to speak, initiating calls to friends, attending business luncheons etc… I think that clinicians may usually hear things when we are a bit down, perhaps. I think going in to therapy or going to see the doctor on "good days" is very, very important! I also call varying doctors etc… who have helped me over the years on holidays and say "thank you; I am alive, well, and really, really happy!" They seem to be very affected by that, so that is my way of "gifting" them, too! They work hard with and for me and I want to celebrate with them, too!


Margot59
Margot59

It is possible to control and thrive with a mood disorder, and without drugs.  I have Bipolar I, and control it with exercise, diet, and meditation.  I am fully engaged with life, started my own business, work on several community volunteer projects, and have a very active social life.  My moods no longer fluctuate.  What this required was identifying my particular "triggers" and learning how to manage my health so that stress no longer was able to push me into a crisis state.

Savannah Sparrow
Savannah Sparrow

I guess for me, it's kind of hard to think of "thriving" and "bipolar" in the same sentence. In order to thrive, you'd have to eliminate bipolar. There is no other way of doing it. And you can't really eliminate bipolar without eliminating the person, it is an integral part of who we are. Right now I suppose you could call me "thriving." I am symptom free unless I mess up with my meds, but it has reduced me to an emotional shell of a human being. I can't FEEL like a normal person. I recently experienced a traumatic life event and I had people telling me I was so calm and they couldn't believe how well I was taking it. And part of me was glad, because who wants to feel pain? But there was a part of me that wanted to feel SOMETHING. I can cry a little, but full out body wracking sobbing? No.  I suppose I thrive. I get things done. I check off a to-do list every day. My house is as clean as it can get. I take care of myself. I do everything right, but there is no sense of intense satisfaction. Recently I tried to go down in my medication, thinking that if I was "a little" bipolar it might mean I could be more normal. It might mean I could get back the parts I lost when I became stable, like my creativity. I'm a writer, but no longer have inspiration or inclination to write. I grieve for that. But Instead of discovering that lost part of myself, instead of getting to feel anything intensely again, the disease returned in diminished, but still powerful fury, and I was once again reduced to a miserable, incapacitated, lost human being. I was human, yes. I was ME. Because this IS me. Meds are like contact lenses, they can change your eye color for all the world to see, they look good in the mirror, too. But when you take them off, the your eyes are just as blue as the genes dictated them to be, unchanged.


Yes, there are side effects I'm not happy with. No, it's not perfect. But it took me about 15 years of med combination and trials to get me here. I have a life to live. Maybe if I was in an institution and that's all there was, I'd be willing to experiment with them again. But I have a daughter to raise, I'm going back to school to get a Master's degree, to start a career. Previously I could not work full time, but I think I might have a chance now. I am moving on. 


I may not have the emotional ability a normal person has, but I can still be a productive and successful human being. I can be a good mom like this. I can be a good productive citizen. A good friend. A contributor. I don't want to give another moment of my life to this disease. I don't want to give it even the slightest chance of taking back my life. I am sincerely convinced this is as good as it's going to get. I feel lucky because I know a lot of people don't even come close.


I may be symptom free, but I am not thriving. Thriving insinuates that you are indeed growing. That you are overcoming, healing. My meds...they're a patch. Feeling calm, rested or cheerful? Yes I can do that. But does it feel the same as before? No. It's like a prosthetic brain. Just like, but not quite.


To me, to truly thrive, there would need to be a cure. Is there a way to cut out or re-knit the bad genes? Can you cure a genetic disease? Can you cut out the bad parts of the brain, like you can cure cancer by cutting out the bad cells? THAT I would like to know.

StephenBonin
StephenBonin

Hi everybody! I read Annabelle's message in my In Box after posting my response about 25 minutes ago. I returned thinking I'd see her response; I hope to see it and everybody else's when I return from my Easter break starting today.

Oh, thought by association. . .the mention of Easter triggered a thought about beautiful colors. My new psychologist has a box of 48 Crayons on the small, round table that he and I conduct business on. Also a pad of art paper. Never before, in psychologists' and psychiatrists' offices since 1986 has the clinician had Crayons! Last week I asked Lennard if it was okay if I used them; I don't know what I would have done if he would have said, "No!" While he and I talked, I drew something I've drawn multitudinous times--an old, oak tree, with ancient roots, and bold, far-reaching branches. He asked me to explain my drawing. I talked about the symbolism of the family--the roots symbolizing generations of ancestors, the branches symbolizing the present and future generations. I felt delight quoting to him a portion of a song from the Broadway musical _Dreamgirls_: "We are a family, like a giant tree/branching up to the sky. We are a family; we are so much more than just you and I."

So where is all this going? Well, I'll tell ya! In writing to question #3 about an hour ago, I referred to the strengths of peer support organizations that the psychiatrists and psychologists can glean lessons from for engaging better with their clients. Regarding the arts specifically, we all know that music and dance and visual art play a crucial role in therapy and in healing of us consumers. Sadly, though, in my inpatient history of nine times since 1986, only once was an arts therapy used; that was painting. We would paint on these 4' by 3' surfaces. I was in such emotional pain, that being my first hospitalization that you read about previously, the one that cost Dad $45,000. I will say the positive of that one-month stay was that art therapy.

Sadly, my eight other inpatients have had too much television running, and no arts therapy. Hey, colleagues! This is a veritable area of advocacy! I will likely color during sessions with Lennard in the future. Let's put our heads and hearts and souls together to achieve arts therapy psychiatrists' and psychologists' practices!

And to finish this off, during the early '90s I was steadily conducting research in to the cognitive benefits of the arts for high school students/ graduates matriculating into college/ university. Also, I've been involved in the arts all my life. So, you know my credibility.

StephenBonin
StephenBonin

1. What can I tell my clinician as I aim to achieve zero symptoms? 2. Should researchers, policy makers, and the medical community include positive symptoms as a marker for successful treatment? 3. How might policies change to re-orient treatment to achieve zero symptoms?

1. and 2.  When I met with my psychiatrist two weeks ago, I told him that even though my weight is 200 pounds (5' to 5 1/2'), I emphasized that I am thriving because I walk up to three and a half hours per day in order to accomplish my daily tasks. My vehicle was repossessed in 2006, and that has turned out just fine because I am receiving ample sunshine, having fun, and--mixed in to the equation--riding with people with whom the time spent together means furthering the friendship. I'm having fun this season hearing the birds sing, seeing the Texas Bluebonnets, Indian Paint Bushes, and more glorious bursts of color. The green canopies on our majestic, awe-inspiring trees in our city seem to have appeared overnight! Yes, yes, yes--researchers, policy makers, and the medical community deserves to hear my positive symptoms of taking delight in the morning stillness, just when the sun is new and the sky is fresh blue, because for most of my adult life the dominance of mental illness meant I could not notice, could not rejoice.

Very soon the Texas Summer will be hear, and scorching temperatures will linger, getting more intense in August and September because other parts of the country are on the wane. Walking slower and calling more often for rides will occur. Therefore, will report to my medical community--including psychologist and support group--my tremendous gratefulness for friends. As with the inability to rest in nature, for most of my adult life I have not had friends. A major breakthrough in therapy and in healing  occurred in October, 2013, and I have continued in CBT. Add to this the Advocacy Training that we began in January, which has made me a happy, voracious sponge--eager to swallow as much information as possible.

The result? I am talking with people I just meet, and people I am acquainted with, and with friends EVERYDAY! And I am thrilled to look forward to the Washington, D.C., experience in August, to train in person with you important people. My medical team deserves to know this. Yes, yes, yes they do! My senses are thriving! I am in the absolute best health I have ever been, and I thoroughly enjoy the joyous expressions of my support group, psychologist, and psychiatrist when I report to them the great achievements.

In our DBSA support group, we emphasize HOPE. I fervently believe that as I have spent all this space talking about the positive benefits of communicating that which is in the category "headed toward zero symptoms." that I am helping the "hope quotient"
.

3. Regarding the change of policies to reorient treatment to achieve zero symptoms, I think that the psychiatrist and psychologist part of the medical team need to take a cue from the support group part. The support groups--NAMI, DBSA, Bring Change to Mind, Mental Health America, and more--are Educational, Peer-to-Peer Support, and Advocacy organizations.

It so happens I just changed psychologists, after five years. This psychologist does what I am talking about. Interviewing me about my strengths and needs on the second meeting day--the first being a basic listening day with some note-taking on his part--he filled in this wonderful template on the computer which has well-articulated Mission Statement, Goals, Objectives. I have basic homework to journal to that outline throughout the week between meetings. Also, he gives me homework, in the first case, a three-page read and write per the topics we discussed.

I am shouting "WOW". Thank you, Lakes MHMR, for your participation in what I hope is the future of psychological treatment. Very well ordered, with teaching components.

troygirl1
troygirl1

@marcie2836  Thank you for writing-- I'm 61, struggling with depression on & off for 10 yrs. Still "drug resistant" I have been researching ECT for over a yr. My doctors feel this is a viable option for me since multiple forms of treatment drugs, therapy etc. have been unsuccessful. I am "getting tired" of relapses which are longer in duration each time. More & more side effects surface & the severity of the episodes are frightening & debilitating. I've never been suicidal but can understand why other patients would go down that road. It becomes harder & harder to "keep the faith" and move forward. I'm feeling that ECT may be my next step in my journey toward wellness. Your experiences have given me hope. Thanks

kimgallen
kimgallen

@marcie2836  I am so glad that you took these actions and experienced relief. It is very inspiring to read about. I will pass this information along to a friend I have who has not experienced relief on any medication. Thank you. 



StephenBonin
StephenBonin

@careforyourmind I've been reading entry after entry by my peer wellness specialists / mental health advocates in training. I am hearing a collective voice that thriving/ zero symptoms is not possible. Finally, I'm ready to say that I had not yet included detail about my Christian faith; because of it--yes, the personal relationship with Jesus, and the joy of being part of a vibrant Catholic, Christian church family--I fully belief in a potentially symptom freedom. I respect every person's spirituality; I just believe it is crucial to have one that pivots on faith, hope, and love (including forgiveness), while accepting this flawed world as it is.

Secondly, I have been involved in psychiatric and psychological services for 28 years, and there was a major breakthrough last September. Third, I started drawing closer to a peer support group member over lunch today--and shared a major laugh over my mania madness of two years ago.

To wrap up this comment on the salience of having a spiritual life, I would like to have dialogue with those who have basically said "thrive not possible." I don't watch t.v., listen to public and Christian radio, do not look at spurious magazines, do not watch movies, do not read newspapers daily, read two "good news"/ "God's power is alive today" magazines, read edifying materials. What is this leading up to? I'm wondering what the media habits are of my colleagues of this mindset.

I am blessed to examine my life in light of God's paradigm AND those of my diagnoses, following closely Godly ways, AND DBSA guidelines.l

jancheer
jancheer

@afish I really liked all your input and feel your fustration when it comes to having to change psyc. doc's. forwhatever reason.I had a hard time having to chg. Doc's when 1st diaganoisedsp? with Bi-Polar full blown, due tobeing on Medicad a nightmare it was. I havea question for you . You mention Bi-Polar dx? What does that stand for, I have been seeing my pscy Doc over 7 yr. and psychologist 13+ yr. I not ever heard that term used. I beenin hospitals numerous times and surprised I have not heardof this tagged ontoBi-polar.? Also, you mention eliminating Bi-Polar not going to happen for you nor anyone else with dx attatched ? What doyou mean by that statement. ? Because I really don't see my Bi-Polar illness being eliminated not in this life time, remission maybe if I have a better understanding what Bi-Polar remission looks likeor entails.. I hope you don't think I'm mocking you I'm just a bi-polar patient with inquiry mind..Thanks oh HAPPY EASTER MAY GOD BLESS YOU

StephenBonin
StephenBonin

@Margot59 Thank you for sharing the minority voice. As you can see (my view in detail is posted under  moderator), I agree with the reality of thriving.

Keep participating, Margot! Stephen

StephenBonin
StephenBonin

@Savannah Sparrow I felt glad to follow your logical argument. It has one exception to logic, though, for us who believe that genetic predisposition AND traumatic events are BOTH causes of mental illness.

Thank you for participating, Savannah!

Stephen

kimgallen
kimgallen

@Savannah Sparrow  This is a really interesting commentary and I can relate to this quite a bit. I know exactly what you mean. Though I do well a lot of the time, I will agree that there is a part of me that is no longer there, so to speak. I kind of long for a bit of mania to help me out, but any action on my end that includes messing around with my meds throws me right back into having a very "tough go" of things. At any rate, thank you for your candor and your level of detail in this writing. I appreciate your thoughts and descriptors. 

kimgallen
kimgallen

@StephenBonin  I have a great resource in Austin for art therapy, so you know. Let me know if you would like any information. 

evandaniel
evandaniel

@jancheer, "Dx" is just an abbreviation for the word "diagnosis."

afish
afish

@jancheer @afish

after reading your comments and questions, from my professional clinical social work experience, I am troubled that your therapists, i.e., psychiatrist and psychologist have not defined this diagnosis and or explained to you what bi-polar means.  Bi indicates two different types of mood swings - either depression or mania.  Uni-bipolar speaks to only one mood issue, usually depression.  I really would suggest that you ask both of your therapist what your mental issues are.  Bi-polar and/or major depression or something else. These various psychiatric diagnosis are needed in order for your mental health provider to bill your insurance carrier, whether it is Medicaid, Medicare or some other insurance company.  I'm not a fan of having to label us patients, but in order for mental health providers to be reimbursed, they need to have a DSM-V code/diagnosis, (Diagnostic Statistical Manuel "bible" for providers to code for mental health).   So I really hope the next time you see one of your therapists you ask them what is your mental health diagnosis, what does it mean and any other questions you have.  If they can't or won't answer your questions, its time to find someone else, especially since you have been in treatment for sometime.  Do understand that since you are a Medicaid patient it might be difficult to find a new therapist, but you have every right as a patient to have your diagnosis explained to you no matter who is paying the bill.  The same thing would hold true if you had a physical diagnosis.  Hopes this helps.  Good luck.

StephenBonin
StephenBonin

@kimgallen @StephenBonin Yes! I would. My physical address is 1020 Northwood Blvd. #9. Corsicana, TX  75110, if you need to transfer it this way. Thank you, and thank you for the affirmation, Kim.