12 Steps to Bipolar Recovery?

I feel a bit better, mostly due to John Hughes and a mammoth session of puking expelling the greasy food I gorged on today. Nothing worse than that lining your tummy, erk.

If you cast your eyes to my list of links, you’ll notice a new one there called The Bipolar Foundation. Please visit this. It’s quite a new site and a very worthy inclusion to the blogroll. It’s set up by Oxford University and has extremely up to date research. More to follow.

My dad was given a serenity prayer when he joined Alcoholics Anonymous. It was this:

 

He wasn’t at all religious, rather the opposite, but he still found comfort in these words. I remember him retelling to me a frightening statistic he had been told in his group- one out of five of those present would die due to their drinking. It chilled him and he told me how young the people were there. It saddens me that he was that one.

I think I will go to a meeting sometime when I’m a little more stable. For now, though, internet heresy ahoy.

I’ve been looking at the Twelve Steps to Recovery for Alcoholics Anonymous.

1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

My problem with those twelve steps is that they are God centric, therefore not particularly useful for the vast amount of atheists and agnostics out there.

They are also rather self flagellating, focusing on shortcomings and wrongdoings, which makes it all seem like a punishment for Your Big Bad Thing rather than recovery.

For Recovery from Mental Illness?

However, I know many people have sought comfort and inspiration from the twelve steps.

Alcoholism is a physical and emotional dependance on alcohol. Mental illness is a little different, however, I can see core similarities in recovering from addiction and mental illness. Obviously, in order to apply them you need to be in an accepting state of relatively sound mind, i.e not at the time psychotic or in denial about being sick. As the cliché goes, the first step to recovery is admitting you have a problem.

I think the important part is following them in order as the last steps seem to reach for penance and absolution. But I’m going to flout that for now because I’m annoying like that.

Let’s see.

1. We admitted we were powerless over alcohol—that our lives had become unmanageable.

One of the first things we have to recognise when diagnosed with a mental illness is that the illness itself is partially responsible for our behaviour. A person without schizophrenia or any substance abuse problems won’t ordinarily be suffering from psychosis, for example.

And the manic depressive’s depressions and manias are often caused by, well, manic depression. Manic depression, by its nature, is mood swings that are far greater than those of “normal” people and which cause disruption in our lives. That doesn’t mean that Life in General has no impact- of course it does- but suffering from manic depression means you’re predisposed towards certain reactions, such as depression or hypomania.

It can sometimes be quite liberating as it frees you up from unneccessary self-examination. You can adjust your lifestyle accordingly when diagnosed with a mental illness, however, it removes that deep terror that you caused this and are somehow doing it to yourself. And there is nothing worse than feeling depressed and thinking, this will never end. When you have a diagnosis, a partial cause and you accept that diagnosis, it can help with that feeling of permanance. It’s a mood swing and you had better hold on tight. You will go through everything depression or mania entails but clench your teeth, take your medications, do whatever you can, tell the people around what is happening, and it will pass.

Also:

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

Now, this might be controversial but in my world, god doesn’t exist. I don’t believe in relinquishing control of your life to anyone or anything. But, if you have a diagnosis of mental illness that needs to be treated, one of the first decisions you are faced with is:

Medication or no medication? Therapy or no therapy?

Do you continue as you always had done or do you accept help? I’m not comparing psychiatry to god, here, but for those who suffer mental illness, they are our guardians. They are in ultimate control of our treatment. I personally think it is best to be involved as far as you can with your own treatment (or if you have a carer, for them to be very involved with your guidance). In order to do so, you’ve got to make the decision whether you will accept the treatment you’re offered. Find what works, find what doesn’t. If you have ever reached the point where you need to recover in order to save your life or sanity, it’s probably best to at least evaluate your options.

4. Made a searching and fearless moral inventory of ourselves.

I say trash this one. The last thing you need when you’re recovering from an episode in mental illness is more relentless self-criticism. If anyone, give yourself a break. That doesn’t mean you can use your mental illness as a get out of jail free card. It does mean that you don’t need to catalog your wrongs and punish yourself for them. It’s a waste of time. Life’s difficult enough as it is. With bipolar disorder, the come down from mania is a guilty and horrible whirl of blank memories, self-hatred and guilt. Depression generally encompasses those things anyway. Do you really need more reasons to hate yourself?

6. Were entirely ready to have God remove all these defects of character.

Let me tell you this right now. Mental illness is not a defect of character. There is nothing wrong with you and you did nothing wrong. You don’t “deserve” it. You’re a victim of it and you have three choices- you let it take over, you embrace it and go insane or you stand up and you fight it.

Applied to substance abuse, I can see where they’re coming from. A “defect” might be the reason you drink or some of the fallout from it- such as neglect of the family etc. Still, I’m not overly keen on asking god to “remove” these alleged defects. Good old teamwork with a therapist and your loved ones might be handy, though.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

Applied specifically to bipolar disorder, this is good, if galling, advice. When I’ve been crazily high or crazily low, I’ve been capable of great thoughtlessness, bitchiness and general odd behaviour. I’ve insulted and cracked on to friends, stolen and told crazy delusional tales. At the time, I had no idea what I was doing but in the aftermath, it all became too clear. I think if relationships are wrecked or on the brink, if you can face it, face them. Explain why you acted that why and that you weren’t really in your proper mind at the time. Shit, it’s hard. I know this because I’ve done it. But it’s good advice.

10. Continued to take personal inventory and when we were wrong promptly admitted it.

Recovery needs awareness. Part of the reason I keep this blog is to be aware of how I’m acting. I also keep a personal journal and ask Rob to observe when I’m going too far up or down. I decided to do this when I was in the state of mind to do so, but in getting other people involved, when I’m not, they are there to pick up the slack.

If you or someone else notices you’re going too far up (in a way that’s going to fuck things up, like not sleeping enough, being overzealous at work, acting a little nuts and pissing people off or when psychosis kicks in) or too far down, you can take action. Talk to your psychiatrist or friends. Take steps. A few days off work, if you can, try to rest however hard it might be and slow the hell down.

In the past, before I was formally diagnosed as suffering from bipolar I disorder, I did notice when I was going a little *makes hand gesture* but, because I thought, “Well, I’m like this”, I didn’t do anything and more often than not, I went too far and caused havoc where I went. Lost friends, jobs, dropped out of school, engaged in, ahem, antisocial behaviour or slipped into damaging self harming behaviour.

Now that I know and make an effort to document it, I know when to say, “This isn’t working for me”. My ultimate goal in life is to have a normal life. Earn money, write a million stories and be the person I know I really am.

The Problem of God

If you don’t believe in god or have spirituality, who are you getting better for?

The ideal answer is “yourself” of course, but we’re not always so dependable.

When the medication is shit, the CPN hasn’t returned your calls, you feel like a black cloud is following you and you notice that spiders are crawling up your arms, who do you say “Stop!” for?

Do you try harder for anyone else?

In my case, it’s Rob. He is my best friend and I know how hard it was for him to put me in hospital. In the immediate aftermath, he hated himself for it and wondered if it was the best thing to do. He thought he had made everything worse rather than better.

I want him to believe that what he did was for the best. If he hadn’t put me in hospital, I would have been dead by now.

So when I’m retching a little from the Depakote but planning for a future I would never have had had he not put me in hospital, I thank him and think of him.

I think of my family too who can not bear another loss. I know that in some cases, mental illness is terminal and I know I have reached points in my life where it has almost been the case for me. I don’t want my family to have to face that again.

God is infallible and constant, whereas people are inconsistant and mortal. Therefore God’s abandonment probably stings a hell of a lot more than people’s. I live in a world without god due to lack of belief but I can’t imagine the desolation of those who live without god because they feel god is living without them.

So I think it’s always a good thing to have a real life, flesh and blood person there to, if not hold your hand, occasionally flash a smile and let them know you’re there. People always feel as though they’re a burden but spread yourself thinly. Involve anyone you know who loves you a little bit.

I quite like being helpful and when people turn to me in sorrow I never feel as if they are burdening me. I feel honoured that they share with me.

Recovery

I don’t believe that mental illness has a cure but I believe, like any lifelong condition, there are Bad Times and Good Times and that there is a “recovery” of sorts. The point where you can manage your condition and live a relatively happy life.

I’m not there yet. But I will be.

I want society to recover too. From their ignorance and prejudice against the mentally ill. I want people to stop shirking from the words “mentally ill” as if its some sort of witching hex. People don’t raise an eyebrow at physical illness so why at mental illness? Mental illness is not a personal weakness. It is a real and treatable condition that requires research, advocacy and acceptance.

The treatment is not archiac self-examination. I firmly believe that mental illness has a biological basis and I believe and hope that further research will prove this. So that, once and for all, mental illness has the same acceptance and status of physical illness and that being mentally ill is not the societal equivalent of being branded with the scarlet letter.