By Katherine Ponte, BA, JD, MBA, NYCPS-P, CPRP | Jan. 25, 2019
I was recently discussing coping strategies for my bipolar disorder with my psychiatrist. I was pressing him for new ways to cope. He told me that most of his other patients also tend to look for what to do—a new medication or treatment method—but it is just as important to focus on what not to do.
I was interested in learning more about the experience of his other patients. After all, one of the most effective therapies has been learning I’m not alone, that other people have similar experiences. I wanted to know what he observed as the most common behaviors and habits that interfere with recovery and coping. Indeed, I learned that the obstacles I faced for years are actually fairly common: denial, ambivalence, ignorance and fear of stigma.
I could not help feeling regret as he listed them off. I realized that I had held myself back during all the years I denied the seriousness of my condition. In hindsight errors are obvious, but as I was experiencing the illness, I lacked the insight to make the right decisions. My doctor explained that these behaviors largely result from the “blind spots” that mental illness can create in our awareness. On top of that, stigma compounds the issue by limiting our perception of ourselves and the possibilities of living with mental illness.
Achieving recovery and coping with mental illness has required improvements to both my medical treatment and my interaction with my bipolar disorder. It has required increasing my awareness and coping by not doing behaviors created in response to stigma. Here are some of those harmful behaviors to avoid.
I stubbornly refused to accept my diagnosis of bipolar even though I knew something was wrong. That blind refusal took on many forms, including refusing all types of help. My treatment was needlessly delayed, which worsened my condition. I also refused to ask for help when it was clear that I needed it. The primary reason was fear of the consequences of being labeled as “mentally ill.”
I often dismissed my family’s input. I foolishly thought, “who are they to think they know better than me.” But during many critical times they did know better. For example, my spouse has always been better than me at spotting signs of my hypomania. My refusals and dismissiveness also lessened my family’s motivation to find me help. I didn’t fully appreciate their efforts to help me, but looking back I know they had my best interest at heart.
I remained uninformed about my condition as a form of denial. I was worried that my suspicions, my health care provider’s assessment and my family’s concern would be confirmed if I became more informed about my condition. Ignorance made me a poor patient. I lacked the knowledge and impartial perspective to effectively assess and influence my treatment. I was sometimes combative when my doctor suggested a medication adjustment. I didn’t know how to effectively express my treatment objectives and ask for medication alternatives. I wasn’t self-aware enough to recognize the signs that my condition was deteriorating, and I needed to adjust to stay on track.
I was non-adherent to my treatment plan a couple of times. I convinced myself that I was well and didn’t need my medications. When my symptoms became less pronounced, I immediately thought I’d been cured. Without proper medical advice, I reduced and stopped taking my medication, which led to a serious manic episode and hospitalization. I now understand the consequences of stopping my medication without consulting my doctor.
I was impulsive and ignored my safety on a few occasions. In one instance, I was furious with the rapid weight gain, which is a side effect of the medication. I insisted my doctor either reduce my dose or complete cessation. I got what I asked for, and I also got manic along with it. On another occasion, I hid my symptoms from my spouse because I was worried I might be hospitalized. My condition worsened, and I ended up being hospitalized. I have learned to trust those closest to me and accept the help when its offered.
Even after accepting my diagnosis, I remained ambivalent about my treatment for many years. This led me to accept subpar treatment. I didn’t ask if there were options, if things could be better. Due to my apathy, my spouse had to step in and make treatment decisions for me, which I ultimately resented. I would take my medication and attend therapy, but do little else. I’d take a fistful of anti-depressants and lie in bed all day waiting for some magical transformation. I didn’t give the treatment the support that it needed to be effective.
For many, these behaviors are deeply ingrained. Addressing them may involve facing your own insecurities and hopelessness that stigma instills in us. But if we don’t, we may limit our ability to fully adopt and benefit from new treatment strategies.
I learned the hard way that I was holding my recovery back. For over 15 years, I struggled. I had convinced myself that nothing would ever change, that nothing would ever work. I denied myself and my treatment the benefit of the doubt. Maybe things would have been different if the feeling of repeatedly losing hope wasn’t so painful. The last time I reached out for help might have been my last, but I grasped hope once more and never let go. I won’t ever let go again. It finally led me towards recovery and back to my family. I realized that not having hope was my greatest blind spot of all.
“Katherine’s candid description of times when she more than once “got in her own way,” possibly undermining her own treatment goals, is far from unusual and, I suspect, will sound familiar to many readers who struggle either first- or second-hand with chronic mental health conditions. By definition, it is awfully hard, if not almost impossible, to recognize blind spots. I applaud her candor and self-reflection.” – Dr. Goldberg
Author’s note: Thank you, Dr. Joseph Goldberg for being a wonderful doctor, for showing me that recovery is possible and helping me get and stay there. I wish everyone had a doctor just like you.
Katherine Ponte is a mental health advocate and entrepreneur. She is the founder of ForLikeMinds, the first online peer-based support community dedicated to people living with or supporting someone with mental illness illness and also offers Recovery Coaching. She is in recovery from Bipolar I Disorder. She is also on the NAMI New York City Board of Directors.