Carrie Fisher, known for her role as Princess Leia, has been battling bipolar disorder all her life - no medication helped her, only electric shock. She is my favorite bipolar person, therefore she illustrates this article.This
is the second part of the ether decoding about life and work in IT with bipolar disorder, the first and zero parts about my story, how I learned this from my mistakes, you can read in the announcement and the first part of the decryption ...
In this part of the transcript, all the practical questions about mental disorders that were asked by the readers of Habr during the broadcast: how to find a doctor, how to help a loved one with a disease, and whether you can be forcibly hospitalized and registered in modern Russia.
How to find psychiatrist standards? Should you follow the standard path through budgetary institutions?
Judging by the reviews, they can only do worse there, in my region
I'll tell you how I found a psychiatrist. I had a good acquaintance, a woman psychotherapist, and through her friends she referred me to my doctor. He was a man in his 40s with great experience, and he was distinguished from others by the fact that he did not get stuck in the knowledge that was invested in him at the university 25 years ago. He goes to conferences all the time, reads about new drugs, communicates with other doctors, reads studies in English, speaks himself - that is, he is actively involved in his work. And he specializes in bipolar medicine: look for a doctor who has a specialization in which he understands. The head and the brain are very difficult.
As for the neuropsychiatric dispensaries that you can go to for free: I know that in St. Petersburg there is a good PND in the Petrogradsky district. Unfortunately, my friend, who went there, was not cured - I don't know what exactly this was connected with. I've read bad reviews, but I think it all depends on the specific doctor you go to. Of course, the easy way is to look for a private doctor and go to him for money, and not have any problems.
Have you had any problems at work due to bipolar?
Yes they were. I was fired from my first IT job because I sat for two months, looked at the monitor and could not do anything. This prompted me to go to a psychiatrist and get a diagnosis. Conflicts were only due to the fact that I behaved badly. Everything will be fine.
How to distinguish between depression and bipolar disorder?
With BD of the first and second types, there is mania or hypomania. That is, if a saw-like mood graph and emotionality are twisted towards being in a good mood beyond what people feel for no reason, then it's probably bipolar. The psychiatrist will accurately determine.
Do lithium preparations help?
Yes, they help many people. They have been helping for two thousand years, by the way - even the ancient Greeks noticed that people with heightened emotionality, when they go to springs with mineral waters, where there is a lot of lithium, get better. Now lithium is prescribed first of all, I also took it, but it did not help, so I no longer take it.
I wonder if the condition can get worse or better with age? How does the disease develop in relation to aging?
With age, it gets worse, the disease progresses. Both mania and depression gradually became deeper in me.
I would like to know how many episodes are on average and maximum?
The phases last from a few weeks to two years. Light intervals are intermissions, when there is neither mania nor depression, they are rather short, and they may not be at all.
Can maternal instinct and feelings for family be lost due to the disorder? How to fix it?
Yes maybe. During depression, sometimes there is a state where there are no emotions at all. I had this, I broke off the relationship. Then the world is like through cotton wool. How to fix - just get treatment, engage in psychotherapy, take prescribed drugs.
Can your back and trigger points hurt with bipolar disorder?
Yes, absolutely everything can get sick, especially during depression. You may feel sick, your temperature may rise - whatever.
How did you get out of obsessive-compulsive disorder and behavior patterns? Type of overeating, loss of interest in appearance, excessive cleanliness
I just lived with it; and when I started to be treated, it all passed.
Can you light a BAR of the second type, please?
In short, there are two types of BAR. Bipolar patients of the first type have full-fledged, pronounced manias - they are blown away not only during depression, but also during mania. I have already said that in such cases speech accelerates, sleep time decreases, psychotic symptoms appear. Bipolar patients of the second type have hypomania, with increased mood and performance, which does not develop into full-fledged mania. Type II bipolar disorder is often confused with recurrent depression.
How to interest a person to return to life again?
No way. Interest in life will return if he can recover.
How to motivate a person to fight for himself and for his happiness? Self-pity leads to past inaction and resentment
By the age of 26, I realized that resentment and being stuck in the past is childish and it is better to throw it away as unnecessary trash. It is not related to psychiatry, it is related to growing up.
How to understand that the problem is not from the disease, but from the pattern of behavior? How not to lose your job and still get out of procrastination?
If your relationship with people does not consistently fit, and this is not due to the fact that you break off or shout at them, but simply does not communicate, then most likely you do not know how to listen to other people or do not respect their decisions.
This was the case for me, and it was very difficult for bosses and colleagues to communicate with me. It was not related to illness. Relationship problems persisted after I went into remission. I just started learning to behave differently.
What if I constantly feel resentment - it is not clear why?
This sensation exists independently of my desire, with the presence of a lump in the throat. I can be happy, but the resentment remains. There is an elated mood, and then again a cruel despondency. Sometimes I stretch myself, because I don't want to stay in this state.
Perhaps you are wrongly reflecting this state as an offense. Maybe it’s a condition like mental pain; if it stays stable, even when you are happy, then it is depression. You need to go to a psychiatrist and talk to him. This does not mean that you will definitely become a regular customer: perhaps this is due to something that is passing away, that you can be cured forever and not return to drugs. Be sure to go.
What to do if a person becomes lethargic from the medications prescribed by a psychotherapist, does not want anything, constantly lies and does nothing and there are constant side effects?
Various things happen during the drug selection period. They do have a lot of side effects. When I first started taking medication, I was depressed - I slept 14 hours a day; I read a kilometer-long list of side effects and there was drowsiness. I thought: now it will be 20 o'clock, or what? I fell asleep at a meeting, during a Skype conversation, once - during a personal conversation. In general, while the medicines are being selected, there will be many side effects, and they will be severe. It is difficult to pass, but necessary.
I have endogenous depression, now I have to drink medicine all my life? I recently started treatment
The psychiatrist will tell you this. Depends on the cause of the depression.
Problem: I feel bad when I leave the house. Difficulty breathing, dizziness, imbalance, sometimes increased blood pressure and palpitations
If I'm going somewhere, it's a nightmare. I constantly think about how bad it will be if I leave; and so it happens. At first it was gradual, now it is already unbearable.
It is impossible to live a normal life. Who to contact?
See a psychiatrist. This sounds like severe panic attacks. Sometimes psychiatry - with pills, all that kind of thing - is only needed to give you a resource in order to understand psychotherapy. While you are in deep depression, you do not have the strength to go to a psychotherapist and disassemble something, change your life, so sometimes pharma is needed as a supporting thing. When you figure it out, you can remove it, and everything will be fine. Most likely, your path is supportive pharma -> psychotherapy -> problem solving.
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Who will the security service of future employers have access to? Or should you visit private clinics to remain anonymous? Depression with suicidal thoughts lasting 2 years, with periods of incomplete remission and worsening, without mania.
If you have depression with suicidal thoughts, you definitely need to see a doctor. This is a disgusting thing, why live with it? It needs to be thrown into the trash, and for this a doctor is needed. Officially in Russia there has long been no such thing as accounting; all your data is protected by medical secrecy. Of course, the strictness of the laws is compensated by the non-binding nature of implementation, and I cannot guarantee that this will not come up anywhere, so if you are worried about anonymity, it is better to go to private doctors. When I went to my doctor, I did not show any documents - you can even walk under a fictitious name.
Please give advice. The son is 9 years old, he was diagnosed with OCD because obsessive thoughts appeared, he had ADHD before
The doctor prescribed antidepressants, although there is no depression, he is active. We began to drink medicines, now they always drink? There is little effect so far. How in the future life with a diagnosis of OCD, he can get a license, a job?
He can have all this, everything will be fine. I cannot give advice about pharmaceuticals - what to take can only be advised by a doctor who sees your child, takes tests from him, monitors the dynamics and knows the medical history. All I can say is hold on.
How did you get out of the manic phase the first time and how do you get out now?
Now, if I get into a manic phase, I call the doctor. He increases the dose. This is the only way and you should not deceive yourself that it can be controlled. If you are bipolar, you have to farm.
What advice can you give to a relative of a person with this diagnosis?
As I said: to take care, help, support, persuade to go to the doctor.
My relative is now in a manic phase. He thinks that everything is fine with him, does not want to do anything about it. Persuasions and beliefs that later depression will be bad do not help. Doesn't want to take medicine.
I already answered this question: unfortunately, all you can do is to make sure that he does not kill himself and does not run into someone in a car.
My therapist is my psychiatrist. I was looking for a qualified person for a long time
Super. I also have a psychiatrist-psychotherapist. If this is not the same person, it would be good to arrange so that they work in conjunction to exchange data about you and adjust treatment.
A psychologist is not a psychotherapist. At least by education: a therapist (in Russia) is a doctor, and a psychologist's diploma can be obtained after the course or even self-named
Yes. The word "psychologist" does not mean anything, do not go to psychologists. If you want to learn (how to behave, react, track emotional outbursts) - go to psychotherapists, if you need help, treatment - to psychiatrists.
All these concepts should not be confused. If you have serious problems: depression, insomnia, suicidal thoughts - you should immediately go to a psychiatrist. If there are less serious problems (I am offended by my mother), you can go to a psychotherapist.
Is bipolar disorder caused by a genetic deficiency of lithium ions?
This is a lie, lithium does not help all bipolar patients. Nobody knows where the BAR comes from. There is some evidence for genetic backgrounds, but, for example, not all identical twins develop bipolar disorder. Rather, there are many different factors: genetics, condition, environment, stress, but no one knows for sure yet.
Which specialist is the best to start with? Please answer
It all depends on the symptoms. If you have psychotic symptoms, immediately contact a psychiatrist (that is, hallucinations, delusions, obsessive states - a desire to kill yourself, harm yourself, etc.).
Drink pills all your life?
In my case, yes. I have a chemical imbalance that triggers the states of happiness and deep grief on their own, and in order to regulate serotonin reuptake and other things, I have to take medications all my life. But this is not the case for everyone.
Most depressive disorders are not visible on MRI?
Yes it's true.
Can bipolar disorder have psychosomatic headaches, numbness, nape pressure? Especially during emotional outbursts and fatigue. There is nothing on the MRI.
Yes, maybe. I had a similar one.
It is impossible to treat a loved one from persecution mania, he believes that doctors are in cahoots with "them". Any advice?
I dont know. A very difficult situation. Probably, I would try - I don't know how legal it is at all - to ask a psychiatrist if it is possible to somehow add a medicine, because there is clearly a need for pharma. Don't take this as advice, I don't know the answer to your question.
There are similar ups and downs, but they are weak, there were no hallucinations, is it worth worrying?
You may have cyclothymia, a milder version of bipolar without extreme symptoms or psychotic symptoms. If you are concerned about this, go to the doctor, get checked.
What examinations and tests did you take to confirm the diagnosis?
BAR is not detected by any tests.
Luck doesn't exist, hug your friends tight
Thank.
Can I drive a car with this diagnosis while in therapy?
Better not. Many medications cause drowsiness and decrease attention, depression also decreases attention, and many things can be overlooked in mania. In other countries, bipolar patients are forbidden to drive a car and have a weapon, but here - remember the strictness of the laws and the non-binding nature of the implementation? When asked about driving, my psychiatrist replied: "as you know, someone drives just fine after three haloperidol tablets." I was ... a little surprised. In general, cross the road carefully. I think driving with a BAR is irresponsible. If you have these symptoms or are on pills, it is best not to drive.
How do I trigger a phase inversion?
It’s unmanageable.
Briefly about my ex: a couple of years ago, a manic phase gradually arises, which ends in the hospital - at the stage when devils are already crawling from everywhere. There is no depressive phase.
Until about the middle of development, she is aware of what is happening, she may ask to take her to a doctor, but towards the end she does not realize, "you are all sick." Sleep disturbances, fussiness, energy is directed towards home economics. The question that worries me is the following: the attitude towards the person with whom you live and, in the period of remission, sincerely love, can it change to the stable opposite?
I think no. I know that during depression there can be a feeling that inside you there is emptiness and there are no feelings. But such that there was a diametrical change - no. We don't take episodic rage into account.
If you allow the phase to develop, then to what extent can your (hopefully) beloved husband become a devil in your perception?
I didn't have that. Even when I was very depressed, I knew that I love him. It was this love and desire to maintain a relationship that helped me get out and take all the medications with complex side effects.
How to distinguish long-term physical disorders from mental disorders? Can somatic disorders develop into mental disorders?
I dont know.
All my conscious life I struggle with two states:
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Yes, it sounds a lot like depression. I'm not sure if you have manias. I know that there is a weak type of bipolar disorder called cyclothymia, then a person has a depressive and hypomanic phase. They are not so pronounced as to reach psychosis, but this feeling “everything is shit and me too” will be, and the feeling “oh, I'm flying” will also be.
It is worth mentioning that mania does not immediately become mania. Hypomania happens - productive, cool, pleasant, which gradually develops into mania.
I am glad that there is an opportunity to ask a question to a person with experience on the other side of psychiatry. I am sure that your efforts will help many people solve problems.
I have periods of low productivity, after which I start to worry that I'm not working well enough, because of which productivity drops more, depression begins, it becomes very difficult to force myself to work - and so on in a chain. How do you learn to avoid it? Is this a reason to go to the doctor? It will not upset me if I am diagnosed, I am afraid only to upset my relatives with the diagnosis. This is normal?
I think it's normal that you love your family and worry about them. It is worth going to the doctor to rule out the worst - the endogenous cause of depression (that is, when there are not enough screws in the head). Perhaps your problem is solved by psychotherapy with a good psychotherapist, but I can only advise, I am not a doctor.
Does a large neuropsychic load provoke the development of bipolar disorder?
Probably yes. I heard that yes. As I said before, I had a hardcore life, and maybe it influenced.
I got hooked on drugs, I can't do it without them. Have you had an addiction, and if so, how did you get rid of it? Or do you constantly drink pills?
As I said, I always drink pills, and I will always take them.
Panic fear of escalators, can't ride at all. Is it a psychiatrist or a psychotherapist?
I recommend starting with a therapist. You are not saying that you have hallucinations or something else scary - so go to a therapist, talk to him about it.
What is more serious - bipolar or schiz?
These are diseases of the same severity.
Claire Danes did a good BAR at Rodina?
I started looking, but I wasn't really hooked. Can not answer.
I understand that something is wrong with me, but I'm afraid to go to a psychiatrist. If everything turns out to be really bad, the last thing I want to do is spend a week or a couple of months in the ward. How to be Because of this fear, I can't ask for help for 5 years.
There is only one option in which you will be locked in the ward: if you try to do something bad to yourself. For example, cutting the veins. If not, no one will forcibly hospitalize you. I went to a psychiatrist because I was already so bad that I had nothing to lose, and I didn't want to go on like that. If you also do not want to continue this way, ask for help.
I am interested in the topic of depression, could you tell us more about this aspect: you seem to live and do something, but you don't want to do anything; from work sometimes - a thrill, sometimes - no; there is absolutely no desire to do any chores around the house, clean up, and so on.
Without stopping, I just want to chat with friends and read books. It seems to be called apathy, but there is a nuance: due to hearing loss, I cannot fully receive the stream, will there be a text version?
Yes, there will be a transcript. I'll put it this way: if you have the strength to communicate with friends and read books, most likely you do not have deep depression. I think that cleaning, work and other things are possible when you are in a resource state; to enter it, you need to achieve at least some success. We are like rats who push a button, have fun and push further. I want to go to work when there are some successes, progress, goals in it. When this is not the case, nothing happens. Maybe you have the opportunity to change your field of activity to one that will inspire you and in which you will get better results?
Where is it from? Is it a congenital feature of the brain, or is it acquired? It seems to me that I have such a diagnosis - in my life I am chasing an ideal image of myself, but it is unattainable, and, probably, it broke me terribly
As I said, no one knows exactly where it comes from. There are genetic prerequisites: for example, if you have had relatives with depression and mental illness, then the likelihood is higher that you too may start. The environment is also strongly influenced, stress can trigger the onset. It's impossible to say for sure. I hope that you are going back - I saw that people can collect themselves back. Everything will be fine.
I have bipolar disorder of the second type, I have been treated for about a year. Is it possible to go into remission at all and then give up medication? Can you support yourself naturally?
If you give up the pills, the disease is likely to return. Schizophrenia and bipolar disorder are severe mental illnesses that must be constantly monitored by the pharmaceutical industry.
Treating BAR with baths, massages and sports is like treating diabetes with the laying on of hands. If you are diabetic, you need insulin. If you have endogenous mental illness, you need to be supported by antipsychotics, antidepressants, and other pharmaceuticals. Moreover, if a person goes into remission, quits medication, and has mania or depression again, the same dose of the same medication may not help. Therefore, do not give up medicine. If you are in remission, light a candle, and then take the pills further.
My son also works in IT, I sent him your article, I'm not sure he will read it. Many times I asked him to go to a psychiatrist, does not want to hear, please help
Make sure he doesn't kill himself - that's all you can do. If you see that he is deeply depressed - come to him and follow him, this is very important. Maybe love, respect and support will gradually convince him to accept help.
Looks like I have uncontrollable mental problems
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You know I have the same problem. I would like to make a brilliant advertisement, but I need to earn money. I understand you. I think yes, this may be due to creative unrealization, and it sounds like a question that is being resolved with a psychotherapist. Come to him, excavate everything to the end instead of doing it alone. Perhaps it will help you - for many, psychotherapy works well.
I have a diagnosis - organic lesion of the central nervous system, depersonalization syndrome, derealization syndrome, depressive syndrome with anxiety
I am 54, I have been suffering for 20 years. We have already tried everything possible with a psychiatrist, there is almost no improvement. I have a leadership position, it's hard to work. Maybe you can advise something?
I really sympathize with you. It might be worth changing the psychiatrist. I'm not saying that you have a bad specialist, I don't know him and you, but maybe a fresh look at the problem will help. Maybe you're lucky — for example, a new drug comes out and a new doctor suggests an experimental treatment regimen. My doctor said that it was not so bad to fit into experiments: I myself was initially scared when he suggested, but then he explained that there are good results.
Alcohol and BAR - is it possible?
You can't. But I drink.
What is your treatment regimen that brought about remission?
I never talk about my treatment regimen. I understand that there is a strong temptation to go and take the same pills that helped another - but this way you can easily get yourself psychosis, collect all the side effects and go completely crazy.
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