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mrjones

Can you control bipolar?

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Had a question from therapist yesterday that kind of made me think, thought I'd bring it here.  She ask me: Do you feel you're at a point that you are in control of your bipolar now?  After some thought had to answer truthfully NO, I've never really felt in control of it at all.  Basically in two hours or at any time my whole mood can change like flipping a switch, and I really don't immediately notice the switch.  But it seemed a pretty profound and fair question, maybe some folks are more in control of it.  Kind of wonder if there was a right or wrong answer and by the way I've been bipolar for roughly 25 years if it matters.  well actually schizo-affective, bipolar 1 type for the last couple years, if the labels are important.

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That’s a very peculiar question. If bipolar was controllable, well, it wouldn’t be...bipolar. Do you suppose your doc meant “Do you feel as if your meds are working to a satisfactory degree?” or “Are you satisfied with the degree of insight you’ve obtained into how your bipolar affects you, and your ability to see an episode coming on?”

I could answers those questions. My insight improves all the time. And my meds are tweakable. 

But if the question is more like “Can you shut it down when you want to?” the answer is no, of course not. That’s an incredibly stupid and insulting question, reminiscent of “If you try harder you’ll get better.”

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20 hours ago, Gearhead said:

That’s a very peculiar question. If bipolar was controllable, well, it wouldn’t be...bipolar. Do you suppose your doc meant “Do you feel as if your meds are working to a satisfactory degree?” or “Are you satisfied with the degree of insight you’ve obtained into how your bipolar affects you, and your ability to see an episode coming on?”

I could answers those questions. My insight improves all the time. And my meds are tweakable. 

But if the question is more like “Can you shut it down when you want to?” the answer is no, of course not. That’s an incredibly stupid and insulting question, reminiscent of “If you try harder you’ll get better.”

I'm going to have to ask about the "insight" that you mentioned, although I am pretty sure she meant "control it" and that this question DID have a right or wrong answer. Meaning if I said I could control, that would have been wrong, now what she would have learned I'm not sure.

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Probably some intent behind the question that wasn’t clear. I wish I could control bipolar. It sounds like a trick question or maybe just didn’t convey the right meaning. Might be good to clarify. 

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Se, I would have just interpreted the question basically as, "do you feel that your bipolar disorder is well managed," kind of the way people talk about diabetes or asthma being well controlled or not well controlled. I'd say that I am in control if I have been stable for an extended period of time and feel that I have a good track record of catching and addressing episodes before they become too disruptive. Right now I'd say, for me, that I'm stable but not in control. I'm not in the middle of a mood episode, but it wasn't too long ago (a few months) when I was last episodic, and I'm still learning to identify episodes and working with my doctor on medication that will keep me stable in the long term. I wouldn't think there was a hidden motive behind the question, rather, that she was trying to get a sense of how well you feel your bipolar is managed in overall, not just at this minute. 

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I have some control over my symptomology now that I'm on Seroquel and lithium.

Prior to meds though...it truly was a ride from hell. 

Like said previously, bipolar disorder defies the ability to control your mood without chemical intervention.

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On 11/18/2017 at 1:10 PM, mrjones said:

I'm going to have to ask about the "insight" that you mentioned, although I am pretty sure she meant "control it" and that this question DID have a right or wrong answer. Meaning if I said I could control, that would have been wrong, now what she would have learned I'm not sure.

Insight means that I can recognize symptoms as I’m having them, and sometimes see episodes as they’re ramping up. 

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My last therapist had similar communications. She would ask what triggered a depression episode. Only once was there ever something, but she'd say something had to trigger it, even if I couldn't identify it. She believed that with CBT I could end an episode completely, not just get through the worst symptoms with less trauma.

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8 hours ago, Chantho said:

She would ask what triggered a depression episode. Only once was there ever something, but she'd say something had to trigger it

What a moron. The punch line of mental illness is that it’s biochemical, not situational.

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That's pretty much why I stopped focusing on coping skills for episodes. She was *brilliant* with CBT for my self-esteem. 

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On 11/18/2017 at 2:41 PM, thunder said:

Se, I would have just interpreted the question basically as, "do you feel that your bipolar disorder is well managed," kind of the way people talk about diabetes or asthma being well controlled or not well controlled. I'd say that I am in control if I have been stable for an extended period of time and feel that I have a good track record of catching and addressing episodes before they become too disruptive. Right now I'd say, for me, that I'm stable but not in control. I'm not in the middle of a mood episode, but it wasn't too long ago (a few months) when I was last episodic, and I'm still learning to identify episodes and working with my doctor on medication that will keep me stable in the long term. I wouldn't think there was a hidden motive behind the question, rather, that she was trying to get a sense of how well you feel your bipolar is managed in overall, not just at this minute. 

I think you're right.  I also think that it's not an inherently insulting question.  I know quite a few people with bipolar diagnoses.  They aren't necessarily on these boards, because they just take their meds and live normally and don't feel compelled to spend a lot of time thinking about it, (like some of us, me included, who find it's more of a constant presence)  If someone asked them "do you think you're in control of your bipolar disorder" they'd say "uh, yeah, I haven't had an episode for like five years.  I take my meds and I feel mostly good.  Sad when things are sad, happy when things are happy."  

Ultimately, I think it's a good question.  Therapists ask uncomfortable questions because your response is important.  Do you control your illness, or does your illness control you?  I couldn't answer it with "yes" or "no," personally. 

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On 11/17/2017 at 11:26 AM, mrjones said:

Basically in two hours or at any time my whole mood can change like flipping a switch, and I really don't immediately notice the switch.

This can happen to anyone, regardless of them being bipolar or not.

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