I have had some adventures finding a therapist. I had one therapist who let me cry for 45 minutes without speaking to me. Another called my spouse and told him all I really needed was someone to be firm and give me some tough love. I had a therapist who told me that he didn’t believe in bipolar, but he did believe in bad marriages. I had some therapists who I just didn’t make progress with and I felt didn’t understand. I persevered and found someone who I related with and I finally made strides. That is not to say I didn’t have time periods where I gave up and felt discouraged.
It took me decades to find the right medication combination. I have tried 64 different medications and almost that many medication combinations/dosage trials to see what would work. I have had side effects that have made me question if the medicine was worth it and side effects that I have loved. I have never stopped taking medication all together even when I have wanted.
I am sharing this because when I was going through this process of finding help in the form of therapy and medication I felt so alone. I was sure everyone was magically finding the “right” therapist. I had so many therapists that I called and that never even called back. When I did finally get in to see someone, it felt like such a let down when it didn’t work out.
It is exhausting to be ill. It’s so unfair to have an illness where the patient has to work so hard to cure themselves. In mental health, a patient has to decide if their treatment is working. No cancer patient contacts their doctor to say, “Yes, my tumor is not responding, so let’s move my treatment in this direction.” With a serious mental illness, I’d call my psychiatrist to report the medication was not working and why. I had to report if I felt this class of medication was helping vs the other types we had tried. Psychiatry is solely motivated by patient self-reporting. Someone with diabetes may take their blood sugar often, but they still have hard data to hand over to their physician.
Luckily, in my time spent searching I learned some tricks. When finding a therapist, it helps to usewww.psychologytoday.com. This site allows users to filter by their insurance, city, and issue. While the site does allow users to send a direct email message, I had better luck using the links to go to therapists individual websites. Most therapists have direct scheduling on their sites and if they don’t, then a phone call is best. A therapist's website usually gives a better idea of their vibe. Also, think big picture about what you want to discuss. My loved one is in a same sex relationship so I look for LGBTQ friendly because I know I will be discussing them. That has been an issue with a past therapist, so I want to be sure my therapist will embrace not only me, but those I love.
The right medication combination has been helped greatly by DNA testing. Every doctor now will gladly give a GeneSight test to help figure out what medications will work best. This test is super helpful, but it doesn’t make psychiatry perfect. The patient still needs to self-report. The best way for me to do that is by keeping a daily mood chart. This is raw data that allows the doctor to see a record of how the medication is working. An ideal mood chart will chart mood, but also stressors and keep a medication diary. For example, Sunday: moderate; took meds/ Monday: sad; took meds/rained all day and high credit card bill. There are also many mood chart apps available. Mood charts kept over time can help a person discover patterns, such as manic periods. When life seems so out of order, this can really help a person find a way to take back control.
Finally, if there is someone you trust, it can really help to allow them to come to appointments. My spouse would come to appointments when I was really struggling. To be transparent, I was sometimes very angry at what he would report to my psychiatrist. The only reason I did it was because I felt it was so unfair that I was in charge on my care. My ill brain was supposed to rationally report and get help? I questioned so much at that time and felt so paranoid of those around me. The paranoia included myself-I didn’t trust my own judgement when depressed and when manic I trusted myself to such a level that I often made decisions I later regretted.
At the same time I felt angry and resentful of my husband for “telling” on me. I wanted his help, but I could not stand that he saw me not being perfect. Why was I not covering up better at how badly I was struggling? I also at times felt he was talking about someone else. I had trouble recognizing some of my own behavior. It was a very odd dynamic. Yet, it worked. My medication would be adjusted and I would start to feel like me again.
That’s really all I wanted. I wanted the pain to stop and to find myself again. I spent a long time believing that was not possible, but now I feel like myself all the time. It was worth all the hard work.
I don’t know if you are ready for therapy or medication or if those paths even interest you. I do know that people find recovery in a lot of different ways. People get better every day. You can get better.
I wanted to remind you today that you are not alone. What you are going through is so hard. It feels very lonely. It feels painful. It’s ok to cry. It’s ok to hurt. You are not going to be able to just work a little harder and everything will be all right. You WILL be able to work a little and move a little closer to recovery. You can do that because you are worth it. You matter.
“Your illness does not define you. Your strength and courage does.”
By: Meghan Albright
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