How to live and work with a psychiatric diagnosis: transcribing the ether, part 1



Hello again, Habr.



Two weeks ago, I wrote a post with a coming out that I work in IT with a severe mental disorder and invited me to ask questions. And the form of responses just exploded! For the first time during my time on the set, I saw the human part of our community so close.



Therefore, before publishing the transcript, I want to say thank you for your support and trust. I tried to answer all the questions during the broadcast - it came out long, so the transcript will be released in two parts: in general about life with bipolar disorder and practical questions, like how to find a doctor.



Under the cut, part one is about life with a BAR.





My name is Sania Galimova, I want to talk about mental disorders, stigma, and how to live with a diagnosis and at the same time work and stay in the ranks. There will be many triggers and the story will be violent, so you better get the kids off the screens.



A reflection that tries to break the mirror and kill you is a tough thing, have you had this regularly? Do you remember this clearly? If so, why did you not see a doctor for a long time?



I think that's a good place to start the story. I did not go to the doctor for a very long time, because I had no idea that there was something wrong in my condition. The first 25 years of my life were pretty hardcore, a lot of things happened to my life that made me feel unhappy - that is, I had objective reasons to be unhappy and stressed, and I blamed everything on that.



It all started when I left for school with a boarding house. Then I was 11 years old. We studied a lot, there were 12 hours of each of the two languages ā€‹ā€‹a week, a lot of assignments, poor food. Although I am grateful to the school for the knowledge, for the opportunities, it was difficult. Plus, to the stress of my studies, the fact that (as it turned out) the school was sponsored by an extremist religious organization was added - and I ended up in a religious sect. I read namaz and wore closed dresses. It was not a "madrasah", but simply for gifted children from villages with a boarding house, where it was rather difficult to get to.



In the 9th grade, I read about sects in a social science textbook and began to think: this secret organizational structure, which our teachers support and on which everything is built, somehow strongly resembled a sect. I was terribly chatty and starting to think about it, I began to discuss it: I began to talk about my doubts to my friends - despite the fact that six months ago I almost pulled them into this organization myself.



The peculiarity of the sect is that while you are in it, you feel good. As soon as you try to escape, they cut off your oxygen. Imagine a teenager living without parents in a school that has loved and respected teachers (and I really respected my teachers, they were people who raised me, raised and cared for me) - and suddenly he realizes that these people are manipulating him. This is a difficult inner conflict even for an adult.



Plus, when I started these conversations, the teachers started to pressure me. At some point, the classroom called me in for a conversation and said that "if you don't stop doing this, I will turn your life into hell." And then my life turned into hell for the first time.



At the same time, my disease debuted, the first depressive episode happened. After school, I quickly became pregnant at 17 and decided to leave the child - I really wanted to give birth and raise him, it was a wonderful experience, but physically difficult. Then there were the years when I barely earned a living for myself and my child - imagine an 18-year-old girl with a child in her arms in Moscow. You need to work without stopping. During the day I was sitting with the child, at night I was coding bad sites in php - this allowed me to somehow hold on.



Then there was the next stress: in the wake of mania, I decided to leave for St. Petersburg and open a business related to the production of desserts. I succeeded, but then again there were 2 years of continuous work. I again slept little and worked a lot: I either walked towards the target, or crawled, or lay in its direction. In general, it was hardcore, and I always had a reason to feel tired and not completely happy. There were no discrepancies with reality and my inner state.



But at some point I turned 23 and I decided that was enough. I made a list of the things in my life that make me unhappy: little money, no time to rest, no good relationships, uncomfortable housing, and so on. I closed my business and went into IT, and somehow I managed to close the list. I lived in St. Petersburg, I liked the city and the new job, there was enough money, a cool guy appeared. But I got depressed again. Then I made a logical conclusion that something is wrong with me - not with the circumstances, but within me. So I went to a psychotherapist and honestly told everything: about suicidal thoughts, that my chest hurts, that I sleep for a long time. She referred me to a psychiatrist.



As for hallucinations and delusional states: I always found an explanation: stress, fatigue, lack of sleep, vivid imagination, I dreamed. Therefore, I did not go to the doctor. In my defense, it is worth saying that I once tried to ask for help back in school, when the first time depression began and I first had the feeling that a knife had been stuck in my solar plexus: it was hard to breathe, sleep, eat, walk. I told my mother that I felt bad and asked to take me to a psychologist.



And since then, I don't trust psychologists. This woman did not even realize that something was wrong with me. I still cannot understand myself how it is - I recognize adolescents who are clearly in borderline states, even when I meet them in the subway: they have cut hands, a desperate, bad look. Such a person clearly needs help, and it is easy to identify him, especially if he himself came to see you. But this psychologist didnā€™t say anything to mom, she didnā€™t say ā€œyour child is depressed, your child cuts his hands, something needs to be doneā€, but only ā€œyes, come back to the sessionā€. I donā€™t go to psychotherapy because I donā€™t trust psychologists, and if I come, I donā€™t tell anything important. This is my trauma from psychotherapy.



When an illness is caused by an imbalance at the level of chemistry, psychotherapy may not be needed?



For example, if a person has an impaired serotonin reuptake and the joy of life has disappeared, then when the serotonin level normalizes, the feeling of happiness will return, and the therapist has nothing to do.



When you are diagnosed with a chemical imbalance in the brain, with a biological cause, psychotherapy is necessary in order to go through the stage of accepting the diagnosis and a new lifestyle. Itā€™s very hard to believe that youā€™re crazy, even harder to accept it. It is necessary to regularly take medications and not jump off them - therefore, the person is offered support in the form of psychotherapy. Therefore, you do not need to forget about it, especially if you have problems accepting the diagnosis.



You're all about problems at work, but what about your personal life? Except travel and career



It used to be bad. Bipolar people are over-emotional people who often cannot control these emotions. A man in mania can behave irresponsibly - for example, withdraw all the money from the account and lose, enter into casual relationships, just behave ugly: from the outside it may seem that he is some kind of freak, although he simply cannot control himself because of illness and does not see himself from the outside.



Previously, in relationships and in life, I was not very. When I started getting treatment and went into relative remission, it became much easier to maintain relationships with friends. Before, life just rushed, there was no time even to write a text message, and only those people who themselves somehow maintained a relationship remained with me. There were many of them, and I am grateful to them.



But when remission began, I realized that not all problems are due to illness. It all depends on whether you respect other people, whether you recognize their right to think differently, have different interests, and act differently from what you want. To grow into an adult, with whom it is normal to live, and study, and work, and spend time, I needed not only pills, but also work on myself.



How about productivity or creativity? Are the challenging projects and ideas that come up during the manic phase at all feasible?



Yes. In general, all the worthwhile projects I have done were not done in one click; the implementation of the project may require 2-3 months of included work, when you pay attention to both contractors and colleagues, solve issues. I am a manager, it is important for me to be involved in all tasks.



Mania can speed you up to a certain point, say, by 7 days, but after that depression will turn you off for 2 months, projects will be ruined, everyone will scatter and you will be fired. Mania is not the key to anything at all, it seems so only in theory.



What tests need to be done; if there is a problem with biochemistry, are the tests a clear indicator?



Unfortunately, there is no analysis that could accurately prove and show whether there is a "biochemical" diagnosis. The diagnosis is made by a psychiatrist based on long conversations with you, my first appointment lasted 4 hours, they asked very specific things: when did I feel bad for the first time, what did I feel then, were there such or such thoughts, did it hurt in different places, how many months did it lasted. All this must be remembered; I was lucky because I kept diaries all my life - I tried to speak out, to understand what happened to me.



When I was in school, I somehow jokingly drew a "graph of my suffering" - and when I received the diagnosis, I opened an article on Wikipedia, saw an almost identical graph and laughed. Carry all your notes to the appointment. Tests can be done on the thyroid gland - sometimes hormonal imbalance causes emotional outbursts. If you have to take lithium medications, first check your liver and kidneys - they suffer from it; then, when the appointment goes, you will need to regularly check the level of lithium in the blood. It has a very small therapeutic window - it needs to be no more and no less than certain values, and if the concentration is exceeded, there can be bad consequences for the central nervous system.



How to overcome yourself and go to see a psychiatrist?



I can tell you how I overcame myself. In that conversation with the psychotherapist, in which I honestly told everything, she said: you now have a borderline state, perhaps - borderline personality disorder.



I asked: that is, I need to see a psychiatrist?

She said: yes, you need to check.



I came home and realized that here he is - that knife in my chest, because of which I am in pain, and I cannot be happy. It may just be in my head that I am sick and therefore feel bad, and the only chance to do something about it is to go to a psychiatrist now, find out how everything is, and if everything is bad, start treatment. I had no other choice. I have already done so much to get a good job, raised a child to 4 years old - it was 4 years of struggle, and found a guy with whom I wanted to build a relationship - and I could lose all this. And I had to go to the doctor for a chance to win the battle and keep it all. Therefore, I immediately, on the same day, made an appointment. I was very scared, I could not bring myself to go by myself, so I asked a friend to come with me - we just left the office in the middle of the working day, took a taxi and drove off.He sat for 4 hours and waited for me, and when I left, in complete prostration, with a diagnosis, as it seemed then fatal - he just took me home.



That is, you need to understand what you want from life. If you want to win, you have to go to the appointment, this is inevitable.



What is it like for your colleagues to work with you? Diagnosis involves sudden mood swings and communication problems



This is a question for my colleagues. But in the last two jobs, my colleagues never saw me during episodes, because I have been in remission for 3 years. If I again fell into one of the states, I would take a vacation, and they would not see me anyway.



Did the colleagues (not the management) know in advance what kind of person comes to the team, or did they learn after the fact from the article?



I didn't tell any of my colleagues. They, of course, could google and find out everything - I am not hiding anything, but I am not telling it on purpose either. Why burden and upset people? A separate bow to my boss: before I posted the article, he carefully warned colleagues, so after that the PM did not start torn from questions.



I see my wife's characteristic signs of bipolar disorder, how can I help her to become aware of the condition and begin consistent treatment? In part, she understands that something is wrong with her unstable mood, but she categorically refuses to recognize herself as "psychic" (this is a quote)



I see a denial, a negative perception of the very idea of ā€‹ā€‹mental problems. I understand that it is impossible to treat another person without her desire and without understanding the situation, but it is also impossible to live like that. Nervous "swings", storms in a glass, endless grievances out of the blue are extremely exhausting, but I don't want to part with her.



That's a very difficult question. But I have an answer to it, and it is cruel: NO. If a person denies and does not want to be treated, does not realize that he needs to be treated, then you will not do anything. I will tell you why: I talked a lot with other bipolar patients and people with diagnoses in general; when I found out my diagnosis, subscribed to all telegram channels about it, I was interested to know how it was.



And it turns out that almost no one goes into remission, although I got out pretty quickly. I came to the next appointment with a psychiatrist and asked: why pills do not work for people?



He replied that as long as a person does not want to be treated, as long as he has bonuses from having a diagnosis, they feel sorry for him, they love him, they subscribe to him on the Internet - he will not be cured. I didnā€™t believe it, I thought I was just lucky, and the psychiatrist wanted to warm up my PSI. But now experience tells me that he told the truth.



Therefore, while your wife is in denial, there is nothing you can do. Even if she believes, but will doubt the diagnosis and will, for example, take pills, then do not take - nothing will be achieved without a stable desire to recover.



If bipolar people love mania, why not move there? Why be normal? It is unlikely that such a Joker will last long, but he will die happy



And here is the cruel answer: either act like a Christian and stay in this marriage, or - if you don't want to live like this all your life - leave. I think that if I had such a partner, I would have left. I'm not that strong.

No, you will not die happy. You will die in misery and fruitless attempts to regain control of your body and mind. Insanity is one of the scariest things I've come across in my life. This is scarier than death. I'd rather die, but not go completely insane.



In general, I want to quote a comment fromKivApple to the previous post, with which I completely agree



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How to help a loved one in such a state, especially if he is closed in himself and does not try to help himself? How should relatives behave in this case, if a person listens to anyone, but not loved ones?



If the person is depressed, all you can do now is take care of them as if they were sick. That is, do not load heavily, make sure that the person does not harm himself or commit suicide attempts, provide help and support. Offer to go to the doctor together, offer help in treatment (let's get you out of this state, go to the doctor, I'll go with you, I will remind you that it's time to take a pill), remind you to eat and sleep.



When a person is really bad and is going to go out the window, you need to call an ambulance.It is very important. If a person has already attempted suicide, it means that he is in an extreme state; especially if he is in a mania - then he cannot be left alone for a minute. I saw such states in people, it is very scary and we called the orderlies. An ambulance arrives very quickly if you say you are suicidal.



Can't sleep without sleeping pills. Before the depression, sleep was normal.



In my experience, insomnia is the fastest killer. It is very important to get help as soon as possible.



I had clinical depression once. After I moved to St. Petersburg, I worked for two years seven days a week for 12-16 hours to start a business, pay for an apartment and a nanny for a two-year-old child. It was very difficult, at first I had hypomania, then mania, then depression, and then I started having insomnia.



I didnā€™t sleep for about 3-4 days, and during this time my roof went off. It was very bad. At the end of the third day, I had a confused mind, and I realized that I had to sleep in one way or another - and either I would fall asleep or I would die, but I will sleep anyway



I calmly, without any anxiety, made a list of things to do before the evening, and did everything, then put the child to bed ... and went to the roof. Calm, balanced and happy that now I will sleep. At that moment, a friend called me, who realized that something was wrong with me. He came and looked after me all night; I was able to fall asleep for about an hour. He then said that, probably, it was necessary to call an ambulance, but he did not call, because he thought that I was "just emotional."



After that night, I fell into clinical depression, and it was hard. I lay for two months in a row, every day it got worse. I could not sleep at night or during the day; sometimes I was forgotten with anxious sleep for an hour, and when I woke up, I regretted that I fell asleep (ā€œmaybe if I hadn't fallen asleep, I would have died and it was all overā€). I no longer had the strength to commit suicide. It got to the point that I just lay and did not even get up in the toilet (endured until the very last, got up, holding onto furniture and walls, got to the toilet, then fell again).



Every day I thought that today should be better; I had no idea that depression looks exactly like this, I thought "I just worked it over, I'm tired, I got sick, I am young and strong, I will get better - tomorrow it will be better." But it didn't get any better tomorrow. At some point, my one hour of sleep turned into 20-30 minutes.



Every day I was sure that it would get better - on one of these days my eyesight suddenly dropped and everything became cloudy. I still believed that it would get better - but after a couple of days the food stopped digesting.



Probably, this was the moment when I first met death: not when I was burying my friends, but when, two months later, I counted how many days I was already lying, what day I thought, ā€œtoday will be better,ā€ but it didnā€™t get better. Then I suddenly realized that if the dynamics are going down all the time, perhaps it will not go up - this is probably all and I am leaving in this way. And I realized that I was not afraid, I am glad that everything was fun, interesting, not boring.



And after that I went on the mend - the next day my eyesight returned and gradually everything else.



Why am I saying this: insomnia is terrible, it can kill quickly. If you have insomnia - solve this problem until it resolves you.



What do you specialize in by profession?



I run the marketing department. That is, I am responsible for ensuring that everything works well and stably. I come up with promotions, come up with their implementation, think about who should be attracted, how much it will cost, whether it will work out, whether we will make money from it. Including I am supervising our blog on HabrƩ, looking for authors, topics of interest to them, and so on.



Has BAR influenced Sania's habits and lifestyle? The job of a marketer requires a manic creativity, perhaps this is due to



I have my own theory about how creativity and BPD are related. Indeed, there are many indications that people with bipolar disorder are more creative.



I think that people with bipolar disorder, especially those in hypomanic and manic states, have a more efficient brain. They can keep in mind a lot of things and the connections between them, build complex systems, notice and remember everything. Works of art - such as when you enter an art gallery and just freeze - these are infinitely harmonious systems, they have a huge number of small details, ideally and harmoniously folded. The more harmonious, the more monumental and beautiful the work.



I think it's impossible to do this consciously, but talented people do it intuitively - and people with BPD have better intuition during periods of mania - and therefore they are more adapted to intuitively create works of art. Everything is completed in their heads.



I think this is also related to the fact that bipolar patients have a proven higher sensitivity to works of art - we understand them deeper. There is also such a funny symptom - a complex speech apparatus: a person knows how, loves and practices to speak in a complex, more expressive language with a large number of original turns; I think my theory explains it.



But this is just my theory, which is not supported by anything.



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It's really expensive. When I found out the diagnosis, I realized that I was driven into a corner: I need to be treated in order to work, and to work in order to be treated - and when you start to be treated, your capacity for work drops while the selection of drugs is underway.



I don't think cheaper psychiatrists are always worse; I heard people dump 20 at a time when I only paid 2.5. Somehow I did something stupid: I came to a regular appointment (just see a psychiatrist and make sure everything is going well);



I'm like this: class, I have a new job, now the salary is better, and the doctor replies: oh, then now the reception is 3500 :)



In general, look. Many doctors give discounts because they want to help people, and they really help us, and it doesn't have to be expensive. Look at his qualifications, as I described above: he must go to conferences and look for new materials and methods.



For example, there are relatively new 2nd generation antipsychotics, and that's what I take. But if I got to the ossified doctor of the "old school" - I would sit on haloperidol, maybe I would not have a good life. If the budget is not very good, you can contact the PND - just look carefully at the reviews. Both in the PND, and in the free clinic, they may well provide quality assistance, but how lucky.



Insomnia for 3-4 days. There is insane fatigue, bright pictures appear when you close your eyes, you can't sleep



3-4 days it is already dangerous, it is better immediately to the doctor. Even if haloperidol is prescribed, not insomnia.



Drugs and mental illness. Why not?



Because hallucinations and other special effects caused by drugs are the same psychosis as with an illness. This condition can begin on its own with an illness: at the peak of mania or depression, or with schizophrenia.



And the exact same condition is caused, for example, by mushrooms. When people buy all sorts of substances in order to deliberately induce psychosis, and believe that at the same time they somehow "know themselves" ...



Psychosis is not the discovery of the secrets of the universe, but digging in a shitty sump of your brain. If you want revelations, go to work, meet real people, talk to your father. I have been fighting psychoses for many years, I am afraid of them, I want to get rid of them - I am amazed by the people who are specifically looking for them.



Do you tell your partner about BAR? Psychiatrist advises not to speak



This is not a psychiatrist's business, but yours.



I told my partner right away, because I decided that he had the right to know and leave if he wanted to. But he didn't go away. We have been together for 4 years; when I found out the diagnosis, we were together for only 2 months. When I told him, he lay down on the sofa with his face to the wall and thought so the whole evening, and then said that he would help me and we would get through it. And we passed.



He supported me during treatment, when I could not get up, and when I was running hypomanic - now he can notice the approach of phases before anyone else, by the speed of my speech and some kind of micromimics. And I go to the doctor at a very early stage, probably, this is one of the secrets of remission - I don't even have time to enter the phase.



So decide for yourself whether to speak or not, the psychiatrist is not an advisor here.



How can a partner help his soul mate, who is burning life at 200 km / h, stay in sight and not forget about three children? If anything, a nanny was hired, the parents help, but it doesn't help. The partner does not want to be treated - "everything is fine."



I really sympathize with you, because I understand that the nanny, grandparents are not mom and dad. It must be very difficult - because you want your child to have everything super. But if a person does not want to heal himself, nothing can be done about it. It's up to you whether you will continue to live like this - the partner has already made his decision.



Do you think it is dangerous to drink alcohol with drugs?



It all depends on the medicine. Some should not be disturbed at all - you can simply poison yourself. In my case, it is simply not recommended, I take the medicine even after sitting with friends with wine and khachapuri.



Tell me, if there was an opportunity, would you go back 10 years and live life anew - without mental disorders, in the body of an ordinary person?



If I had the opportunity to go back 10 years, I would not change anything - not even this dumb tattoo that I got during the mania. As I already wrote on HabrƩ, life was hard, but life was wonderful. There were so many good things! Yes, there are moments for which I am ashamed (for example, when I ran after the boys), but this is even somehow sweet - there is something to regret, something to laugh about. Moreover, even in mania I made good decisions. I was lucky that I gave birth to a child before I sat down on the pills - he will soon go to school and generally wonderful. Or my business - I learned a lot, met amazing people. It's all worth it.



Mania equalizes depression, doesn't it?



Not. Mania is also suffering. I said it was "pleasure," but it is still seasoned with suffering. In mania, dangerous behavior is often present - you can harm yourself, other people, for example, if you get behind the wheel.



When it accelerates strongly, the sensations are very unpleasant - the head seems to burst. When psychosis begins, hallucinations and delusions are generally a nightmare. It doesnā€™t equalize depression, itā€™s not something to return to.



How can you in your right mind abandon the initial phase of mania, it's so wonderful. Ingenious plans, simple solutions to complex problems, easy dating, sex 12 times a night



Twelve times a night in a club toilet with different people is not great, itā€™s "then you will die of shame (and possibly HIV infection)." And simple solutions to complex problems turn out to be fake. And ingenious plans turn out to be unattainable.



What is the threshold that separates the normal change in the phases of activity and depression of an ordinary person in this world, with all its nuances, and the diagnosis of "bipolar disorder"? What are the ā€œbellsā€ of the diagnosis?



Explicit psychotic symptoms when there are hallucinations, delusions, suicidal or self-harming urges. These are ā€œbellsā€, it means that you have a diagnosis and you need to urgently go to be checked.



In mania it is clearly noticeable that a person is not himself; he speaks faster, sleeps less - there are clear quantitative indicators by which one can understand that a person has entered a mania. And for depression too: strong depression, and then destructive things begin like inability to read, sleep, something can hurt. That is, there are specific symptoms by which you can distinguish it from the phases of an ordinary person.



How to find a job if you have been fired, your specialization is not the most popular, while schizotypal disorder plus recurrent depression?



Start small: take your medication regularly, and try to get this thing under control. If you are interested in your job, most likely you will always work, your level will grow from this, you will be paid more, employers will outbid you. If she is not interesting, I advise you to find something that is interesting. This is the only way to become a cool professional who can support himself - including providing treatment.



Tell us more about the physical manifestation of the disease. You wrote that food stops being digested - how did this happen?



From what I did not talk about, I can mention the following: I once felt, in an instant, how depression is slowly disappearing. It was in the mall. I went there for work, I had to buy something, and I felt very bad; there was no strength for anything. I was lost in this center - I could not understand in which part I was, where the right store was. Cognitive abilities are reduced in depression. I remember that I stood and looked at the floor, trying to gather my strength, and, at some point, the sound quality increased sharply, as if the headphones were worn somehow, and they were stuck in my ears as it should.



Then I suddenly noticed that music was playing in the background and my vision suddenly became clearer - I noticed a pattern on the floor over my sneakers. That is, there are indeed somatic manifestations, they are very obvious, and this is very sad - from an adult, able-bodied person, you turn into an old man.



How to behave if a loved one has a bipolar disorder? What can and should be done, what is not?



As I said, heal, support, help. Promise that you will always support if you are really going to do it, if you are ready for this difficult path. A person with bipolar disorder should not be treated like a child. His decisions must be respected. I often receive letters with similar questions: a man met a girl (boyfriend), started dating, and then the other side says that he has a BAR, and he is not ready for a relationship, and then - "you won't take it out, yet."



More often, such letters are written by women about men, and they explain: ā€œI am ready to come to him, move, be near, a wall for him, treat, help, go through the phases - how to convince him to let him come to his apartment and treat him? " You need to understand that the main phrase from your partner is "I'm not ready for a relationship with you . "



ā€œI have a barā€ is often just a polite excuse. If a person has bipolar, you should not consider him as some kind of child, unreasonable, whom you will now save. Many people with bipolar can do a lot - for themselves and for others, and if they don't do something, they may simply not want to.



Advise on how to find a good and affordable doctor in Moscow to treat this disease.



My friend Andrei Breslav makes the Alter service , and he selects for him proven psychotherapists with a diploma and members of associations. If I were now looking for a psychiatrist for myself, I would register there, select one or two psychotherapists, go to them, and ask them to refer me to their friend psychiatrists, about whom it is known that they go to conferences and learn about new medicines and methods.



If the therapist works with your diseases, then he should have a pool of psychiatrists with whom he has already cured people, and to whom he can refer you. So I would look.



How and when to recognize such a feature in a child? How to behave if recognized?



It's a very difficult topic. I am very afraid that my child will have my problem, although this is not guaranteed at all - for example, my parents do not have bipolar drugs, and my brother does not, only I have. I think if you notice this in a child, if he really has symptoms, and it is hard for him, you need to talk to him. It is necessary to enter from this side: ā€œTell me, is it hard for you? If it's hard, let's do something about it? I know one thing that can help. " Don't bully him. If it is small, you can present it as it is: "It's hard for you, but there are doctors who will help." If he is an adult, then everything is more complicated, and the stigma works, and that's all. I think that you need to love and respect your children, and they will respond in kind, and then such conversations will be easier.



And, as I said, if your loved one has a BAR, the most important thing is not to let him kill you. We have a very high suicide rate, above 25%, it seems, and this should be monitored.



Hello, how did you achieve remission? I have a BAR too



Health to you. I achieved remission in a fairly simple way to explain, but difficult to accomplish. I found a good psychiatrist, and I decided for myself that I would and want to be treated. That is, I didnā€™t see a single ā€œplusā€ in the BAR, I didnā€™t want manias and hypomania, I just wanted to drive back to normal, live to old age with a large bank account, a cool husband and a large number of children in a house by the sea. I realized that this goal would be unattainable if I didn't give up those short bouts of narcotic pleasure from mania, so I didn't feel like mania at all.



I have many friends, I do not suffer from a lack of attention, and I did not need additional popularity, so I did not receive or see such a plus as increased attention to myself. I made for myself a list of things for which I want to be cured, and I did not have a single vote against. After that, as an obedient girl, I took everything that my psychiatrist prescribed, with side effects, of course. I went to appointments, to psychotherapy - although she did not help me, after two months I just asked the doctor if it was possible to stop, and he replied that I seemed to have resolved my problems with accepting the diagnosis. That's how I went into remission, while everything is going on.



Has bipolar disorder affected your habits? How to maintain remission?



Yes of course. Maybe you watched the movie "Beautiful Mind", about John Nash, who, when new people come up to him, asks: "Do you see him too?" and makes sure it's not a hallucination. Sometimes I also ask my husband if he sees something, if he hears something, if something unusual. Thank God, over the past 4 years it has always been something real. I monitor my condition, I sleep well, and I call the doctor if something goes wrong. If it seems to me that something is wrong, I go straight to the appointment.



My doses were increased several times, and this helped to maintain remission.



Is it possible in such a state and with such a diagnosis to find oneself, self-determine with the profession, how to do it? Thank.



Yes you can. When I was initially diagnosed as having borderline personality disorder, I started reading a lot about her. Many symptoms converged, they really overlap; but I read to the point where it says that borderline personality disorder is a disease that at its core has a person's lack of understanding of who he is. That is, the root cause is that he does not seem to have his own personality, interests, aspirations, desires, and therefore he finds a partner, clings to him, takes over all this, and when his partner leaves him, it seems to him that tore out a piece.



I realized that I did not have borderline disorder, because I always knew who I was, what I was, what I wanted. I think you probably have intermissions, or stages with less severe depression or mania. What is in there is most likely what you are.



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I also wanted to say something important. I can talk about how a person feels after being told the diagnosis, and how to accept it. That is, how to accept that you will need to be constantly treated.



When I was told my diagnosis, it was very, very, very difficult. For two reasons. I was afraid that I would never go into remission and never be as happy as I was as a child; that this alternation will never end and I will have to suffer so much all my life, also additionally - because of the treatment and side effects.



As I already said, my life was a struggle to make it normal for me, to make it easier - I fought for money, a career, to raise a child and not go crazy myself; and I thought that the struggle should end one day, because the world is fair, and everything should work out, because I tried.



And then it turns out that I can try as I like - the problem is in my head, and it may never be solved. It was a hard blow. It turned out that not everything depends on my efforts and skills.

The second difficult thing is to differentiate yourself and your diagnosis. This disease affects the personality of a person, changes him.



When I was told the diagnosis, I returned home and began reading about how bipolar patients behave, how they think, how they build their lives. I had a sense of an ominous valley: everything that I considered my own character, which I was proud of, which I considered my strengths, turned out to be symptoms of the disease.



70% of my character turned out to be symptoms. Am I a disease? Or vice versa? What would I be without illness? I don't exist without illness?



There is such a series - "The World of the Wild West" about robots, which are programmed to live a certain life and play their scripts. There is a scene in the second season: the whore from the park sees another robot who lives her script.



The heroine has a phrase: ā€œI like you, there is no callousness in you. I'll give you a discount, ā€which she repeats every time a new man walks into the bar.



And so she herself enters the bar as a visitor, sees another robot that turns in the same way and repeats her phrase - and the heroine has such pain on her face. And I experienced the same thing - I sat and read my scripts. Due to the fact that when I was diagnosed, I was deeply depressed, these thoughts constantly gnawed at me, I thought about it every day.



But, although I felt bad, and I thought about all this and thought, why all this, I continued to drink medicine. And you go on. Bad thoughts should not distract from the main thing. Eat your pills while you suffer.



But I went into remission and got used to these thoughts, and now I don't care where I am and where this disease is. I am the way I am. Yes, my experience has significantly shaped the way I am now, how I act and how I speak, but this is my experience, although it is similar to other bipolar people.



I always had a will, my own, I always made the choices myself - no matter, in mania, depression, hypomania. These choices make my path unique, they make me me.



I think this also answers such an important question: how to treat people with diseases in general. I believe that you are not determined by what kind of shit you faced. Many terrible things can happen: you can get sick, turn out to be a nutcase, be robbed, be in a war, be captured by terrorists. The fact that you are out of luck does not characterize you in any way. You are characterized by how you cope with it, how you behave in this situation and what decisions you make.



Therefore, I am not afraid to tell the employer that I have bipolar - I think that I do it with honor. It keeps me warm. And I understand that my people, whom I respect, also see and understand this.



Instead of conclusions: 5 most important points, not all of which I mentioned on the air



1. My friend highly recommends this place for treatment in Moscow . His quote:

Citizens who have permanent registration in Moscow and an insurance policy are accepted free of charge. And most importantly, they DO NOT get specialized cards. In other words, no one except your attending physician knows the diagnosis.

No stamp is placed anywhere. In mild forms of the disease, you can come only during the day, and sleep at home.


2. Electroshock is one of the most effective and safest treatments for depression. People avoid it because it is a classic element of the psychiatric horror film - however, it has been shown to be safer for the brain than long-term use of antipsychotics, antidepressants and antipsychotics. Electroshock helped Carrie Fisher in her fight against bipolar disorder - Princess Leia, whom we dreamed of all childhood. I haven't tried electroconvulsive therapy myself, but if I have to, I'll go.



3. One of the most helpful books on bipolar disorder is Troubled Mind. My Victory Over Bipolar Disorder"Kay Jamison. This is a psychiatrist specializing in bipolar and she suffers from bipolar disorder. This is the book that dotted all the i's for my mother - according to her, after reading it, it became much easier for her to live because she understood all my breakdowns, tendency to fatality and rigidity in some situations



4. If your friend talks about thoughts of suicide - take it seriously. A healthy person never thinks about suicide, unless he is, of course, a samurai. One of my friends wrote me about my suicidal thoughts and I did not treat him with sufficient warmth due to internal conflicts in our ACM-party - and it was doubly difficult for me to help his mother organize the funeral.



5. If you feel that you are losing control - seek urgent help. You feel that you will go out the window - call an ambulance. Better to lie in the clinic for a week and then vomit everyone at the Topcoder than to leave so ingloriously. If your friend is trying to get out, call the ambulance too. When you calm him down and go home, it is highly likely that he will try to do it again and it does not matter that this person was the soul of the company and collected all the diplomas in all-Russia. It is better to ruin the relationship than to say goodbye with a heavy heart.



Continuation tomorrow at the same time ...






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