The treatment of a bipolar disorder. At the end of a two year treatment period, Sharon received the following message.
It has been some time that we met for the first time, somewhere in July or August, in 2002. What a nice symmetric number this is. Yes, I got a little excited that time, and started doing things that were alien to my environment.
Fortunately someone convinced me to go and see a doctor. I had simply worked too hard, the last three months. The doctor diagnosed “hypomania” very quickly, an over active mind. He send me to Altrecht right away, the place where you work. After having met several people, we finally met for the first time.
I remember that I didn’t know what to expect and that I was full of scepsis towards you. But you made me feel at ease in no time, ad rem, happy and alert as you are. Something which was not that difficult, it seems, since I knew very few people at that time.
The final diagnosis of my disease was “bipolar”, and I, curious as scorpions can be, I did a little research into knowing who I am and what this is. Bipolar, it speaks for itself, is a mental disease, a mood disorder, of two extremities, that manifests itself in a person, from time to time. These extremities have to do with moods, and they are called “mania” and “depression”, respectively. Someone who is bipolar, is sensitive to these extremities, and has difficulty dealing with them. The illness often only appears after the age of fourty, like an anti climax in a life, when looked upon, reflects many extreme experiences.
Mania, among others, includes extreme excitement, hyper activity, when life is experienced as something utterly wonderful. Such people need less and less sleep, generate ideas on the fly, and have the tendency to become a victim of money since they like to spend more and more of it on seemingly beautiful presents. As long as the person can manage himself, we speak of hypomania. However, if his behaviour becomes irritating to others and control is lost, we speak of mania. The problem being, that such a person is no longer able to take control of himself; his body produces a substance that makes him uncontrollable. And it is getting worse and worse. The solution lies in medication and treatment.
Depression is the opposite of mania. It often follows mania, after the treatment has started, and where the patient, from the top of satisfaction, falls into the deep pit of sadness, because everything was an imagination and none of his plans can be realised. He has cheated himself, something he can not handle. In this case, as with mania, the solution is medication and professional treatment.
Sharon, I think you agree with my description of this disease. But I would rather talk about the treatment, the way in which we dealt with my disease. After all, I enjoyed our dates at your place; every time you were there for me, to support me, and to help me define objectives, something which was important for healing me. And when I confronted you, as I did at times, you corrected me. A date like that, as part of the treatment, with you as psychologist and me as patient (the client), can be described as follows, I think.
For the registration of dates, we used a general Altrecht purpose form, and it was called the “date register”. On the front, this card has the following identifying attributes:
“name client” “contact person” (Altrecht employee)
“department” (blank) “address” (blank)
“tel number” (Altrecht) “tel date hour” (blank)
This form is used for all dates of patients with Altrecht, I think. The blank attributes indicate that either the form is out dated, or that its usage is not uniform across Altrecht. In don’t know to what extent this influences the proper treatment of Altrecht clients. It’s probably ok.
At the back of the card some space is reserved for administering a maximum of ten (subsequent) dates. Each date entry has the following elements: “date”, “time” and “comments”. In our case, the “comments” field always had your name. When we made a new date or appointment, you often had to visit the crisis department, to take into account other, already made appointments. It was always easy for us to agree on a new date. I took the card home with me, as a human memory extension, to increase the chance that I would keep our new date.
After our first meeting (appointment, date), two treaters or specialists were assigned to me. A psychiatrist, and you, social specialist or psychologist. The psychiatrist served as controlling doctor, to determine my usage of the medication and its effect on me. In my case, I received medication to control my brain activity and sleeping pills to ensure that my body would start healing by getting sufficient sleep. As we know, mania doesn’t care about the body and its status, and it gives control to the brain activities as related to its mood. Your body looses weight and feels as if it burns. After some time, I regained some control and was able to sleep without sleeping pills. The other control medication was replaced by a protection medication, lithium, a poison, that decreases the chances of getting mania or depression. This medication made me feel flat, and I had difficulty to do my normal work. It took some six months before I could start the work re-integration. The support of my company was very important in this matter. You can’t do this on your own, not even with someone like you, Sharon.
Your role was to have conversations with me, on a regular basis. You wanted to know how I experienced this new life, how I passed the days, and what problems I encountered. Because I had lost many people around me, due to my disturbing behaviour, you became as a mother to me. My parents had died, there were hardly family and friends left, and I could no longer work, whereas my job was everything for me, after the divorce in 1999 and some years before that event happened, years and experiences that may have lead to the divorce. I still loved my ex. Perhaps the divorce was the result of hypomania, when and where you take decisions very quickly, and may regret them. Decisions with grave consequences, like a divorce. Maybe my children suffered most from the divorce. It was heart breaking when we experienced their reaction to the divorce message. You helped me to deal with the past and to give it a place. You helped me to get on my feet again, to recognize life and to take it as it is.
Last week, we planned to say goodbye. For you are there for situations of crisis, whereas I have become stable, more or less. Maybe I didn’t want to say goodbye. In any case, I felt that life was not too good for me the way it was. You are not to be blamed for this.
In my job, during the past months, I could find some challenges, now and then. However, the Dutch market for ICT offers very few opportunities for someone with my skills and capabilities. I could act at the highest levels, but my company had no entry point at such levels. Because of my low billability, they offered me an outplacement scenario. Or did they have problems with someone like me ? Someone with a bipolar background ? As I felt quite flat, I accepted the outplacement scenario. I wasn’t ready yet to profile myself in the Dutch market for a new job. You need a passion for that, a passion I hadn’t found yet. During the outplacement process, I was still available for my company. A dual policy that didn’t please me always. But it offered for me an opportunity to get well again.
I also needed a new partner. I mean, I was very much alone, and I definitely needed more people around me. Via the Internet I met various women. But they gave me the impression that they were not very interested in my flatness. I must admit that I broke with some potential relationships of this kind, because I started to understand the type of partner that would suit me. It also helped me to finally deal with my divorce. My ex had found a new boy friend and I could let it go. I now see her as some kind of friend, the important mother of my children that are dear to me. My children are everything I have.
Given the problems as outlined above, I decided to stop my bipolar medication. Call it an experiment. And it feels that I can only win. Unfortunately, I didn’t inform my treatment specialists. And when I did, I found out it was too late.
Yes, this is my second manic episode. It is May / June 2004. And it feels great. I can do everything and I can make friends with those that care about it. I found myself in my horoscope. I am a scorpion and I must manage my intensity. I must add control to everything that I do. And that is what I am doing today. Unfortunately, this is not sufficient. Sometimes, I am too passionate, because of the fact that I stopped my medication. And perhaps that my usage of alcohol is another disturbing factor. That is why I told you that I will no longer take alcohol. A tough decision, I know, but I usually do what I promise. And I will tell it to everyone that I know, because it will strengthen me in keeping this promise.
That’s why, Sharon, we cannot say goodbye yet. I need you now, more than ever. You must guide me in the bipolar labyrinth of behaviour, medication and conversations. Together we can do it. I am sure of that. I already feel so much better with you around me and with your recommendations for alternative medication.
On April 2, 2017, 13 years later since our last meeting, we met again in this clinic. According to Sharon, we are a very good team.