There exists what I’d like to call the PHFBP, or the professional, high-functioning bipolar patient.
When looking at the PHFBP, it would appear that he faces few problems. He is compliant in his treatment. He is successful in his job; he may be married and have children; he has friends, and in essence, he is happy. For the therapist, this patient might be called "the model patient." In reality, although this patient is seen as a "model" patient, he still must cope with several, important life issues. (I know because I’m a PHFBP and have been one for several years.)
The issues are as follows:
1. Do I really need to take my meds?
Medication is a sticky subject. It’s usually visible, either sitting out or in a cabinet, just sitting there for any nosey guest to come along and read the bottle. Medication also can put on the pounds, like around 50. It’s a hassle to take it every day. A nuisance. Life would be much easier without it. Wouldn’t it?
2. Should I "come out" in my family, the neighborhood or at work?
I really want to tell people, but I’m afraid of the after effects. Will they lose trust in me? I feel like an imposter, like I can’t truly be myself. Who am I, really?
3. Can I take (normal and not-so-normal) risks?
I know that if I go to New York City, it might set me off. But I love New York City. There’s no other city like it. Should I go?
4. How do I cope if I start to get ill?
Who will watch my child? Can I work if I’m delusional? I’m in remission now, but there’s no cure to this thing. What will happen if I get sick?
5. Should I marry?
Who would want to marry me? How can I trust a total stranger?
6. Should I have/raise children?
Will I pass the illness to my child? Will children be too much stress? Will anyone let me adopt?
7. How much responsibility can I handle at work?
I love what I’m doing, but I feel like I’m on a tightrope, like I might fall off at any minute. Should I ask for a promotion or stay where I am? Will more work make me sick?
8. How does my illness relate to my spirituality?
I once thought I was Jesus. Does this make me closer or farther from God? If I can’t get out of bed to go to church, will I be pardoned?
9. Will I become seriously ill again?
I can’t go back in the hospital. Someone will find out. I hate how in the hospital you can’t lock your door. Will I survive another hospitalization?
10. Should I be proud of myself?
Does my sickness make me stronger than the average person? If I show the world how well I am, will the sickness come back and bite me in the butt?
Yes, I know what you’re saying. "Life isn’t perfect." This is true. And this is my message for today.
Life isn’t perfect.
You can be a model patient, but you can still live precariously amidst numerous difficult issues.
All we can do is our best with what we are given.
I'm a PHFBP.
Are you?