Last week, on a bright sunny day, I was sitting in the shade of a maple tree. As the sun slowly arced across the sky, the shadows cast by the tree moved across the ground. Were I to reach out and try to touch those darkened areas, all I would feel would be the earth beneath my finger tips. Touching the shadows that lay in front of me would always be elusive, though they existed right before my eyes.
A week ago, a woman asked me for advice about her son who had bipolar disorder. She explained that for the past ten years, he would be adherent to treatment for periods of time and then he’d refuse to take his medications, denying that he needed them. She witnessed him cycle through periods of wellness and illness, impotent to do anything helpful at all, she felt. She wanted to know what advice I had for her and my answer was two words: have faith. How naive I must have sounded, suggesting something that could be construed as nothing more than a trite sound bite. After all, having faith is easy to suggest, but seems near impossible to feel at times of great distress.
I explained to her that her faith would be well placed because of all those working every day to find cures for the many psychiatric disorders that continue to afflict too many of us. Her faith would be well placed in the many treatments that already exist that can work wonders to stabilize moods for those with bipolar disorder. Her faith would be well placed because so many people with mood disorders find their way toward mental health and lead wonderful, rich lives. Her faith would be well placed because her son had periods of time when he was adherent to recommended care, an excellent prognostic sign. Her faith would be well placed because her son knew that he had a mother who supported him fully in becoming and staying well. Her faith would be well placed because she loved him. Her faith would be well placed because she was part of a worldwide community of those whose hearts are in the right place, supporting their loved ones as they walk down the challenging road of life. Her faith would be well placed because she was not alone.
It’s so hard to retain faith during the difficult times that we face in our lives. But when we are caught in distress, somehow we journey on believing that tomorrow will be a better day. Even though we can’t know what our future holds for us, we take a step forward during those dark times. But darkness can be no more than a space on the ground that is cast by a tree on a sunny day. It’s not something that we can physically touch but we see it right in front of us. The shadow exists without any doubt. And here’s the thing: that shadow is there only because of the light cast down from sunshine on a bright day.
Of all my blog posts, this is far and away the most difficult one I’ve ever written. It is commonly believed that those with psychiatric disorders are frequent perpetrators of violence. This is a myth. Actually, the reverse is true. The fact is that those with mental health conditions are much more likely to be on the receiving end of assault, not the other way around. Sexual violence against those with bipolar disorder is far too common.
A frequent symptom of bipolar disorder is hypersexuality. Those who are manic or hypomanic can be flirtatious, seductive, overly erotic and have increased libidos. Given that these symptoms occur in the context of disinhibition and impaired judgement, it’s easy to see why those in elevated mood states can inadvertently place themselves in dangerous situations. Sexual assault is something that I, unfortunately, understand.
Shame and guilt
The guilt and shame that too frequently follow assault can be crushing. Self-blame erupts from within: a relentless, obsessive question circles though the mind. “Did I do something to cause this?” The answer, of course, is “no”, but it can be a tough hill to climb to convince oneself of this. When we fall into this ruminative hole, we can remember that there’s no reason for self-condemnation just because another has perpetrated violence against us. True, but as I said, a tough hill to climb.
Survival and a brighter day
I believe that shame only survives in the dark. When we keep secrets, our self worth is eroded. What is unspoken can, after some time, feel like it is unspeakable. Sometimes, like right now as I write this, I have to take a deep breath and remind myself that there is nothing more powerful and freeing than honesty and authenticity. Our truths matter. There are those who have been on the receiving end of assault and remain caught in a voiceless silence. I understand them. Perhaps sharing my story will make it just a little bit easier for them to feel unburdened and escape from the weight that bears down upon them. Perhaps they can begin to feel like survivors. I do. Somehow, I found a light to lead me on a pathway out of the shadows into a brighter and healthier day.
Yesterday, I had the pleasure of being interviewed by the International Bipolar Foundation (ibpf.org). It was a wonderful conversation, with a listening audience, about living with Bipolar Disorder and how to best maintain wellness. It was broadcast live on You Tube, Facebook and their website.
The listeners asked lots of great questions about their own journeys. I shared my story of what it has been like to be a physician living with Bipolar Disorder, touching on issues of stigma in the clinician community, faith and treatment. We discussed how best to ensure emotional and mental health, the value of being authentic and faith.
What impressed me about the audience was their commitment to remaining well. They struggle mightily against great odds, at times, and make impressive efforts to take care of themselves in impressive ways. As I spoke, I realized once again that we are a community of kindred spirits traveling the pathway of a mood-challenged life together. I received so much more from them than I gave. It once again confirmed to me that we are in this together. None of us are alone.