You Call it Bipolar-I Call it MSD
She’s a Pretty Good Cook
Comorbid, as in comorbidity, is an ominous enough sounding word, meaning simply that a person has two different mental issues, existing at the same time. Annie used this phrase last week when I was writing about sorting out the different contentions with which I deal. I was speaking of being able to distinguish between anxiety and agitation, for instance, or anxiety and irritability.
Some sufferers of MSD, do not have multiple mental problems, but that is not the norm. Just as panic attack syndrome was a part of me for 48 years, anxiety remains with me still. My point in mentioning comorbidity, is that MSD sufferers, on the average, demonstrate characteristics of their illness 54% of the time, which means the other 46% of the time they do not manifest symptoms of their illness.
Unfortunately, there is no manual that tells me which are good days, and which are days that I must watch out for. I now employ the mood chart, which allows me to see when one or more red flags appear in any given day. A red flag may mean inadequate sleep, or the presence of lethargy in my legs, or any of the other identifiable components, with which I must contend.
So, when I spiraled downward on Wednesday, after leaving the psychiatrist’s office, did it mean that I was suffering from mood spectrum disorder, and that the visit was a trigger? Or did it mean that, “Life is a bitch: deal with it?” This is what I am trying to sort out, with Annie as my coach. In yesterday’s piece, I alluded to Interpersonal Social Rhythm Therapy (ISRT), a therapeutic approach which incorporates the belief that MSD patients can control their symptoms just as effectively with management, as they can with medication.
This last statement represents the essence of my therapeutic goals and objectives. In choosing management over medication, I accept the fact that I need a good coach, a good mentor (psychiatrist) and a flexible environment, so as to allow for the foibles of day-to-day existence to crop up upon occasion, without serious complications. By that I mean that being retired allows me to work when I choose, and even if that is every day, it need not be if I am encountering technical difficulties. When I was working in the school district, I did not have the luxury of deciding when I wanted to work and when I didn’t.
Obviously, it’s very helpful to not have to go to work (even if I enjoyed my job) if I am “under the weather.” I liken it to having the flu. No one wants a coworker who is sick to show up at work and share the goodness. It’s one of those damned if you do (come to work-sick), damned if you don’t (don’t come to work-slacker) situations. I, however, have made the decision that I will no longer be working on a crew. I do not feel as though that is going to benefit anyone, partly because I can not guarantee I will be there, and also because I can not be certain that I will be acceptably disposed to getting along with my coworkers, at any given moment in time.
In addition to ISRT as a therapeutic tool in my recovery program, is Cognitive Behavioral Therapy, which according to Dr. Phelps, “has been shown in several large studies to be as effective as antidepressant medications for the treatment of mild to moderate depression.” He goes on to say that “most people do not know that therapy works as well as antidepressant medications.”
And that represents the foundation upon which I will build my therapeutic recovery program. I have prattled on sufficiently about my willingness to obtain and record the necessary data on my mood chart, my enthusiasm for regulating sleep, diet and exercise, and my already-proven ability to utilize Cognitive Behavioral Therapy, so that I do not have to justify my decision. All I need to do is find a psychiatrist/psychologist who is well-versed in IRST and CBT, so we can get together and make alphabet soup. With Annie as part of the process, and a soup being contemplated, I am guaranteed of success, because Annie is a pretty good cook.