Here’s the core of the issue, articulated by Tabby in response to a recent post, Talking About Bipolar Treatment:
I have always been told, by family and by the medical profession to "be a good little girl and do what the doctor tells you to do cause they know better than you do."
The discussion continued in a follow-up post, Our Meds - Should We or Shouldn't We? In a comment, Terri observed:
The "be a good girl" theory is very dangerous ...
Knock me over with a feather. I always knew “be a good girl” was bad medicine, along with variations such as “just take your meds and shut up” and “I’m far more interested in listening to the hottie drug reps who walk through the door than in hearing from you.” But dangerous?
We are told it’s the other way around, that NOT being a good little girl is dangerous. That NOT taking your meds is how you end up in the hospital. Here’s where Terri is coming from:
I tried [being a good girl] for a few years when I first found out I was bipolar. They - the Drs. and my family, who were not knowledgeable about the disease - kept me doped up, on multiple drugs, to where I could not function or even think.
In theory, you could describe Terri’s chemical lobotomy as “safe.” You can also justify the treatment in the short term, equivalent to having your leg in a cast after a severe fracture. But, sooner or later, the cast has to come off. Maybe you walk with a limp, perhaps with the aid of a cane, but you are walking.
If I interpret Terri correctly - the equivalent of keeping us in a cast the rest of our lives is not only dangerous, it is very dangerous. As dangerous as refusing treatment.
Terri, who is now 45, reports that she stopped taking meds more than 20 years ago. She learned her stressors and how to stay in the “safe” zone. She exercises, keeps to a very strict sleep-wake routine, and learned a zillion-and-one techniques for working through her bipolar. For instance, when she goes shopping, “it's when traffic is sparse and people are few.”
She acknowledges that her illness poses a constant challenge, but “I just deal with it in a way that makes it easier on me and my family.”
“Please, educate yourself on the disease,” she advises. “Know yourself - good, bad or indifferent.”
Obviously, Terri has a life. She has grown kids, things to look forward to. We can only speculate on how her life might have turned out had she remained a “good girl,” unable to think, unable to function, but there are obviously no happy endings in this scenario.
The short-term risks of refusing treatment are very obvious. The long-term risks of being a good girl are decidedly less obvious. But if you’re not able to think and function over a period of years, as Terri was, clearly you are going to become alienated from friends, family, and work. Clearly you are going to lose your sense of self-worth. Clearly, all your social skills will atrophy and may never come back. Clearly, as you become increasingly isolated and alone, clearly you will slide into despair and lose all interest in life. Clearly, you will enter a high risk category for something we dare not think about.
Dangerous, very dangerous. Terri is absolutely correct.
Please do not interpret this post as a reason to go off your meds. In a previous post, I cited the tragedy of someone who did go off his meds. What is important is that we continue to discuss this issue drawing from the wisdom and insight from people like yourself - patients and loved ones.
Please feel free to jump into the conversation. Comments below ...
Published On: February 05, 2011
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