Treatment for mental health is hard because diagnosis is even harder

Part of the reason I write this blog is to document my particular struggles with mental health. Having to deal with some kind of challenge that’s within the range of mental health is just as common as dealing with some kind of difficulty with any kind of physical health. In other words, either category is EXTREMELY broad. Physical challenges can range from diabetes or thyroid issues to cancer or gallstones. Any disruption in mental health can lie anywhere in a big range, too. Physical illnesses can sometimes prove tough to pin down, but it seems figuring out a diagnosis of a mental illness can prove consistently more difficult. Even if a diagnosis seems mostly straightforward, finding a treatment that will help the person going through it to get to a fairly “normal” state is far more difficult.

I’m in my mid-40s, and I’ve been diagnosed with depression, bipolar, or atypical bipolar disorder variously over the past 25 years or so. I’ve gone through a number of antidepressants and some medicines that are usually prescribed to treat bipolar disorder. Some have helped for a short time, some haven’t helped at all, some have made me feel worse. Some have helped enough for me to live my life pretty normally. I’ve been seeing a very capable nurse practitioner for the past five or six years, I think, and I’ve been on an antidepressant that’s pretty much kept me mostly in “normal” mode. But I’ve still had bouts (or very, very long, standard stretches) of what I’d just call irritability. And I know that just isn’t ME. I’ve known instinctively that it’s more a quirk in my brain chemistry or something, rather than a defining characteristic of who I am. And my extremely busy life managing a household, taking care of four daughters (now one of whom is married and out of the house, so the dynamics and responsibilities have somewhat changed, but not at all taken her “off the register,” so to say), working from home part-time and volunteering and managing fairly big church responsibilities, just for a short summation, keeps me running at a high level. It’s easy to say it’s “understandable” I’m irritable. But recently I thought it was time to check in with my practitioner and address the irritability again. I’m exhausted from “managing” it. Surely there’s something out there to help me with my underlying mental health so I’m not working so hard to manage and can just live, expending a bit less energy on coping?

pill-bottle_21_G6So we visited a few weeks ago, and talked for a while. She is fantastic because she’s very thoughtful and discusses the issues with me, asks probing questions, revisits assumptions, etc. We’re partners in my care, and I really feel she’s very knowledgeable, and she’s sensitive as well. That’s a biggie. She said to me that perhaps I’m not really on the bipolar spectrum at all. All she could say was that I’m just my own thing. So there might not be either a diagnosis for whatever I present as yet, or because mental health really is so varied and unique to each of us, maybe there isn’t or won’t be, if that makes sense. All we know is there have to be some kinds of ways to help me with some kind of existing medication so I can function better. So she said she’d try something, a medication that psychiatrists sometimes use to help with that part of mood. It’s a seizure medication used off-label in this way. She tried me on a very small dose, and I actually do feel it’s helping. My life is still CRAZY BUSY!, but I feel a little less like I have to work hard to manage my mood even while I’m managing my life. So I’m feeling hopeful and a little happier, just to have an extra tool in my arsenal, and to know that my practitioner is really awesome at her job.

This just leads me to a few conclusions yet again: we still don’t know a lot about mental health and illness. We’re doing better than 30, 50, 70 years ago, but we have far to go. And we need far, far more practitioners who have the training, experience and skills to deal with this complex issue. So many people are suffering and there simply aren’t enough practitioners around to help them. I’m blessed to have found someone who can do what she does. Even that’s not perfect, but it’s really about the best I think there is. Meanwhile, I just wish, wish, wish we had more incentives for people to go into the profession and stay there, that the specialists were available in every small and underserved area.

I write this because I just want to put my voice out there. I’m mostly a “success story,” and that’s just because I’m not crippled by my lapses in mental health, and pretty well functioning, and I’m a very resilient, determined personality. I have at least enough income and resources that I have been able to find someone to really help, but that’s still taken a great deal of time and work on my part. It’s been a long and tough journey. It shouldn’t be this hard.

As we work to try to improve outreach, availability and quality of care, and genuine help for those of us with mental health challenges (again, not at all just a small portion of our population), let’s continue to just be kind, patient and understanding to those around us who struggle and need our help. It still does mean the world.

Life of the mind

lifeandlims View All →

I'm a book reviewer, editor, and writer with four daughters and tons of projects always keeping me hopping. I blog at Life and Lims and run the book review site Rated Reads.

1 Comment Leave a comment

  1. This is great Cathy! About 30 years ago, when I was forty, I got the same diagnosis. Bipolar was the buzz word then. Anyone with emotions was listed as bipolar and given lithium, an antidepressant and an antisezure medications. If that didn’t fix it, then the doses were upped! And upped until you became a Zombe.
    When I was growing up sandwiched in the middle of a large family, the only girl, I suffered much abuse. Sexual abuse from my dad, physical and emotional abuse from my mother She blamed and punished me for everything my dad did to me. It was my fault. Also my older brothers were taught to abuse me. I was considered the crazy person in our family. My mother told everyone I was crazy and that I told lies. Now I know her behavior was to protect her secrets. She was terrified that I might tell someone the truth of what was going on in our household. So, most my life I thought I was crazy. And I WAS different. I was creative, honest to a fault, always took the blame and punishment, thought outside the box, was afraid of boys. In fact I was afraid of just about everything. But, nobody knew it because I was also a good actress, and an exceedingly brave survivor.
    As I grew away from home and into a marriage I was able to balance most things even though my ex-husband reenacted my parent’s and sibling’s behavior. He, ten years my senior, was harsh and dominant. He controlled my very breath. Emotionally, I was still that very small child being ruled by my mother and siblings. On the surface, to outsiders, he was a quiet man of achievement and I was the perfect wife. I was very pleasant to look at with a perfect petit figure. I cooked, cleaned, washed & ironed and made our clothes, took care of, nursed, and tutored kids, and always conforming to his bidding. Oh, and I had a lucrative business and did lots of volunteer work in the schools, at church and in scouting.
    Eventually, when the kids were gone, instead of the quiet life I was looking for, Hell fell through the roof. My Ex became more critical and violent. Since everything that went on around me had always been my fault, I decided to fix me. If the marriage was broken, it had to be my fault. That’s when I got into therapy. Fix me, and the marriage would be fine. Valiantly, as usual, I set out to solve the problem.
    To be continued.
    It’s 1:00am and my battery is mostly dead.
    Love you much, we gotta talk,
    Jeani Mills

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