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Breaking Bipolar

At some point in the past 40 years some (undoubtedly) new-age guru decided saying nice things to yourself in the mirror was the key to happiness. "Yay me. I'm so great. Look at me go." Really? Seriously? You need to look in the mirror and say that to yourself? And you're buying it? Are you four?
Recently I switched from antipsychoticX (aX) to antipsychoticY (aY). I despise changing medications; however, this change was necessary due to the general lack of success of the previous cocktail. And in spite of the fact that given the tiny doses there shouldn’t have been any dramatic effects from this change, naturally, there were. A medication change is pretty much always pain on a stick (that hits you, a lot).
People with mental illness have various levels of functioning. Sometimes a good day is when you talk in your group therapy session at the psych ward. Sometimes a good day is getting out of bed. Sometimes a good day is going to the doctor. And sometimes a good day is giving successful presentation to a bunch of executives. It varies from person to person. And while anyone can tell you to “take your meds,” that doesn’t really tell you how to get from non-functional to functional. It’s true no one has the exact answer, 33 high-functioning people with bipolar disorder identified six things that keep them moving forward.
I’ve written about what to do when your doctor gives up on you and while I consider this to be unacceptable, it does happen. And you have to deal with it. But sometimes, you need to give up on them. Sometimes you need to fire your doctor.
As most people know, when a drug is developed, the drug manufacturer receives a patent on that drug. The patent means no one else may produce that drug for a period of time. Drug patents in the US are 20 years, but these patents begin before clinical testing, so really, the drug manufacturer has about 7-12 years of patent protection once the drug is on the market. After the patent expires, other companies may produce the drug, these are called generics. Do you really need to pay the high price for brand name Prozac or is the generic, fluoxetine, just as good?
This week saw the passing of Schizophrenia Awareness Day and I think it's time to take a moment to learn some facts about this much stigmatized mental illness.
Recently I read a great article on the use of brand names when referring to drugs. The author, a doctor, decries the practice and says doctors should use the name of the drug rather than the brand name. The brand name of the drug, after all, was chosen by a marketer and a focus group and is really just advertising for the drug. The only trouble is, patients don't know, or can't remember, the actual names for drugs.
I recently read an impassioned plea from a doctor for health care professionals to stop referring to drug by their brand name. The brand name, he argued, was basically just an advertisement for the drug. This got me to thinking, how do drugs get their names anyway? The answer is marketers, researchers, doctors, focus groups, the FDA and about $2 million. Really.
If you follow me here, or particularly elsewhere, you might have noticed there are some very vocal people who hate me. Mental illness is contentious, and some people take it to a personal level. That’s people for you. Sometimes I talk about these people. I call them “the nasties.” But today is not about them. Today is about celebrating all the wonderful, amazing people who support me, Breaking Bipolar and the mental health community in general.
I’ve written about this several times, but never said it quite this directly: No one is a diagnosis. No one fits the criteria for “bipolar” or “depression” exactly. No one is a “Patient Like You.” It’s why someone only has to have five out of eight characteristics to be diagnosed with depression. Because there is recognition within the medical community that “depression” isn’t a single thing, much as “bipolar” isn’t a single thing. Those words represent diagnoses that exist along a spectrum. In writings elsewhere I have suggested what I call a “dimensional” diagnosis. (And this is probably because I’m a computer science-y kind of gal.) Basically you have symptoms and diagnoses that exist along multiple axes. Then, depending on where the dots cluster, you essentially have a Venn diagram of diagnoses. It’s OK if you didn’t quite follow that. I know. It’s complicated. But humans are complicated creatures. I like chocolate ice cream, you like vanilla. Humans are a heterogeneous bunch. Why then, if we understand this, do we have names in the first place? Is the term “bipolar” really even useful? In short, yes, it is. And yes, we need those labels, even if they are ill-fitting.