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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?
Add a Comment56 Comments
Kristin: Thanks for the great clarification...
March 28, 2009 - 6:03pmThis Comment
Anonymous: I'm glad I'm not romanticizing the disorder. Thanks.
March 26, 2009 - 5:30pmThis Comment
Anonymous: Let's b strong!
March 26, 2009 - 5:29pmThis Comment
Anonymous: I like the idea of fleshing this piece out and suggesting ways to deal with these problems. Thanks for the great idea.
March 26, 2009 - 5:28pmThis Comment
Kristin: I'm sorry your life has been so hard. I'm going to try my best to be a good mother to my son.
March 26, 2009 - 5:27pmThis Comment
Laura, I know you'll do an awesome job with your son! In my mom's case, she wasn't diagnosed until just two years ago. So she lived through over 65 years suffering from the devastating cycles of this disorder, not knowing how ill she was, and existing in complete denial. That's why I mentioned that she really shouldn't have had children. You, on the other hand, are empowered with knowledge and you are doing incredibly courageous and insightful work on yourself. I'm sure you're a great mom.
I've suffered from horrible, chronic depression for much of my life (don't you just love genetics?!?), but because of the experience of being the daughter of someone who was mentally ill but didn't seek help, I've worked really hard to break out of that cycle and become healthy so I wouldn't be the kind of mother my mom was. It can be scary, because sometimes I doubt myself. But, like you said -- "all we can do is our best with what we are given." And I think often we have a lot more strength, deep inside and untouched by mental illness, than we realize.
March 26, 2009 - 8:50pmThis Comment
This is good! These are exactly the kind of questions I have (but never codified) about the condition we share. She's been there and done that and doesn't romanticize it.
March 26, 2009 - 3:23pm-- Another PHFBP
This Comment
i am clinically diagnosed bipolar and i can feel every possible question and cant possibly offer any answers other than...."lets b strong"
.....why is it human kinds' needs to think so much? esp in a complexed emotional mine as someone dealing with an emotional disorder.
March 26, 2009 - 11:15amThis Comment
Lately I have been wrestling with #8. I heard a wonderful sermon at church recently asking about what kept us from deepening our personal relationship with God, and for me I have to say I am terrified of falling into religious mania.
I feel I cannot practice my faith properly as I am so fearful of becoming crazy obsessive or delusional.
(I am proud of how well I am doing with most of these issues however. Perhaps this piece could be fleshed out to talk about the specific tools that can get us through most of these?)
March 25, 2009 - 5:46amThis Comment
I am a bipolar who, when symptomatic, thinks God is against me. It's a love/hate relationship that correlates with my mood swings.
So my question is: How does a bipolar have a true relationship with God?
March 27, 2009 - 7:24amThis Comment