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Recovery is Responsibility

By John McManamy

Within the recovery movement, people tend to talk disparagingly about “the medical model,” as if doctors and psychiatrists are somehow inimical to the concept of us getting well and staying well.  The medical model theorizes that bipolar disorder and other mental illnesses are biologically-based.  In essence, this model implies that bipolar disorder is a no-fault illness. It’s not your fault for having it, and it’s not your fault if your psychiatrist is an idiot and the meds don’t work. Moreover, it’s not your fault that your loved one has left you, your friends have abandoned you, your family has disowned you, and employers treat you as radioactive.

Maybe your next prescription will fix everything.

Patients are partly correct in interpreting this model to mean that chemical imbalances of the brain should be countered with prescription chemicals, but it is clear that the medical model does not go far enough. In my book, “Living Well with Depression and Bipolar Disorder,” I write:

When I walked into my first support group meeting not long after I was diagnosed, Moe, who ran the group, told me that meds are only one part of the equation. Getting well and staying well, he said, also involves eating right and sleeping right, diet and exercise, as well as a wide range of intangibles, which may include getting out of the house, volunteer work, spiritual practice, developing a support network, and a whole bag of survival tricks one starts to pick up.

To this day, this is the best advice I have ever received.

But eating right and sleeping right and exercise and all the rest involves a lot of hard work. Not long ago, I had the good fortune to interview Frederick Goodwin MD, former head of the NIMH, who many regard as the leading authority on bipolar disorder. Dr Goodwin has an engaging bedside manner, but in our interview he was also blunt. He told me that people with bipolar disorder need to lead more disciplined lives than the general population.

Seriously, I thought, who wants to practice more discipline?

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