Source: Pete Linforth from Pixabay
My intention in writing these posts is to share the experiences that I went through with my son, starting with the first manifestation of his illness and our journey through numerous subsequent episodes. It’s also to provide commentary as a parent and psychiatrist on issues that these experiences bring up, such as how the diagnostic process works in mental health, and how to work with treatment providers and medication issues. My hope is that reading this may be helpful for people with mental health issues and also their families and friends.
Moving to the Dorms
Bill continued to live at home taking two courses at Washington University. He had a very regimented life, self- imposed. In the morning he first meditated for an hour, then had tea, then performed martial arts exercises and then ate a large breakfast. He became more interested in having a healthy balance of foods. He read extensively about nutrition, especially according to Taoist concepts of energy. He had very specific food requests, such as fresh beets, which he boiled, pureed, and made into a health drink. He also started to eat “Manna” bread made out of densely packed whole grain. With every meal he ate fresh vegetables, fruits, and nuts. He also took vitamin supplements and began to experiment with various other supplements, such as barley grass, alfalfa, ginseng and a variety of other plant nutrients. As he explained, these were not to replace a deficit but to create maximal health.
Right before Christmas I had to go on a business trip and Bill stayed home. Late one night I received a phone call asking me what to do about medication. Bill had run out of his medicine and was worried that he wouldn’t have enough to last until I returned home. I decided to call in a new prescription for him at the pharmacy even though I was not his treating psychiatrist. Bill was very relieved and seemed at that time to feel that medicine had been useful for him. He was doing so much better then that I felt very comfortable with his moving into the dormitories over Christmas break. He had spoken to the housing office about obtaining a roommate. On the first day of the new term we packed up all of his belongings in the back of the station wagon and moved him in to his new dormitory room. However, he soon found it difficult with that roommate because of the noise and mess. His roommate often stayed awake until 2 or 3 am playing guitar. With Bill’s requirement for regular sleep this was a large problem. A return visit to the housing office produced another potential roommate, this one a quiet engineering student. We moved all of Bill’s belongings again and I crossed my fingers. Within a week he reported that he really liked this guy and that they got along well. Bill stopped by the house frequently to eat and talk with me. Meeting girls was high on the agenda. During this time he stated that he was taking his medication and his grades reflected that.
Fooled Aain
He started the school year with enthusiasm and self-confidence, taking three courses. He actually received credit for four, counting the credit earned from a summer independent study course assisting with neuropsychological research—testing fellow college students on making optimum decisions given a limited amount of time to decide. His fall courses were child development, social psychology, and statistics. He was proud that he was finally taking a full load, but as always, he insisted that his real focus was his “training,” the term Bill used to describe meditation, yoga, swimming, posture control, and breathing exercises. He seemed to be doing so well for the first couple of months but then, around Thanksgiving, he began to seem more preoccupied and self-absorbed. At that time we visited his cousin and family. During an evening performance of The Nutcracker Suite, Bill was constantly up and down in his seat, leaving during the performance and returning late from intermission after the dancing had resumed. He paced throughout the vacation and continued afterward. Sometimes it was whole walks, sometimes just walking back and forth in the driveway or in the street. The beginning of December, during exams, he was very quiet and kept insisting “I’m fine.”
“Don’t you realize it’s time for me to be a man of victory not a man of defeat? I have spent enough time schooled in the ways of defeat, now it is the hour of victory. I will train my body to the utmost. Now is not the time to hone my mental gifts although I know I have them.”
Bill didn’t seem to care whether he made sense. He enjoyed hearing himself talk. At the same time, though, it became harder for him to be around other people. On Christmas eve, when the rest of us had a wonderful dinner with friends he stayed home by himself. He said it was too much effort to make “ordinary” conversation. The spring term never really got underway for Bill. He antagonized his professors with loud disruptive behavior in class, interrupting lectures with long-winded questions only loosely related and jumping up to do stretches. This behavior resulted in his suspension from college and an involuntary leave of absence: “By authority granted by the University Student Judicial Code and delegated by the Chancellor, I must, notify you that you are temporarily suspended.” Bill was prohibited from being on university property, subject to immediate arrest, until his case was heard. He used the time to volunteer at Midland House, a psychiatric rehabilitation center, and also started therapy visits in conjunction with his psychiatrist. As the following letter shows he was intent on recovering his health, perhaps especially to prove himself to those who doubted.
To the Dean:
I left school due to my bipolar affective disorder. I have been very determined to recover full health during this leave. My activities, thus, have focused not so much upon the goals of earning money, studies, or service (though I have done a little bit of each) but have focused upon developing a routine designed to re-center and stabilize myself.
My central activity during this spring semester has been to work at Midland House, a unit of Independence Center, which is a psychiatric rehabilitation center. All work there is voluntary; the idea being that work is therapeutic. I work in the kitchen unit five days a week from 9:30 to 3:00. I have also found it therapeutic to talk to other members there who have been through similar experiences.
As part of my psychiatric rehabilitation I have also been seeing my psychiatrist frequently and have been working with a therapist. An important part of my stability is that I am now on a better combination of medications for me and I have a new understanding of how to work with my psychiatrist to titrate the dosages up or down in response to my bipolar disorder symptoms. Working with my therapist has been a source of support and has given me valuable insight about how to live with a serious illness.
Other activities include socializing, both rebuilding old friendships and establishing new ones, and the support from these friends has been extremely important. Other aspects of stability have been developing a daily fitness routine, including swimming and aerobics at the Center of Clayton. For the first time since my illness was diagnosed three years ago I have finally accepted my illness, made peace with it, taken the necessary steps to cope with it and am ready to get on with my life.
I am very excited at the opportunity to return to the University. I miss the inspiring lectures of my professors and the opportunity to study with and talk to fellow students about new ideas. I am close to finishing my psychology degree and hope to continue my studies in graduate school. I plan to study physical therapy and hope to apply the knowledge I have gained in psychology to understanding more about the mind-body connection as applied to physical rehabilitation.
Please see the attached letters from my psychiatrist and therapist.
If only he could have persevered with this degree of hopefulness and commitment, he might have been able to stay stable.
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