The first and possibly hardest step in dealing with bipolar disorder is admitting that you need help.

by John McManamy
McMan's Depression and Bipolar Web

The toughest challenge on the road to recovery is probably the first - that of admitting you need help. If you’re depressed, the guilt that may be a part of your illness may tell you that you don’t want to burden your loved ones, or that you don’t have a real illness worthy of medical attention. If you're hypomanic, the problem lies in the rest of the world and not you, and in mania you are beyond reason.

Then there’s the old denial factor. Who, after all, wants to admit they’re crazy? Who wants to own up to the stigma and the shame? Typically, it is only when we run out of options (and excuses) that we seek help. The best authorities on this are my own readers:

“What caused me to seek help?” writes Bill. “Almost losing my job and my wife.”

Tricia reports:

"Recently, I was forced to get help after experiencing two mania episodes. The first one I reasoned away that I was not ill. The second one I could not reason away and I had to look in the mirror and accept that I was bipolar and would be on medications for the rest of my life. Because of my resistance to deal with my illness, I lost a job and my apartment. I have also learned a tremendous lesson - things can always be worse and they can also be better. My illness is now something I live with in a healthy way. Taking care of it so I stay well. I am no longer hiding from my shadow self. Me and my shadow are working on becoming one."

Says Christine:

"When my depression started two years ago, I blamed it on everything around me: work, being a single mother with three kids, being lonely, although in a relationship with a man recovering from alcoholism."

It took Christine at least a year to be correctly diagnosed for bipolar disorder and put on the right meds. She concludes:

"I ended up losing my job, my boyfriend, making my kids feel confused and afraid. I am still trying to recover of all of it and unsure about the future. I only hope the road of my life will have less curves from now on."

Finally, this observation from Ginti, following several suicide attempts: “Probably the most bravest thing I'll ever do - I GOT HELP!!!”

Your Next Step

For most people, their default first port of call is their primary care physician. By far more prescriptions for antidepressants are written by this branch of the medical profession than by psychiatrists, often to people who insist on going to specialists and get expert lab work done for every other aspect of their health. Unfortunately, in a routine physical exam there is no time for more than a few cursory questions.

A 2001 UCLA study found that only 19 percent of a sample of depressed or anxious people they surveyed received appropriate treatment from their primary care physician. By contrast, 90 percent of those who saw a mental health specialist got proper care.

Unfortunately, for suicidally-depressed patients and floridly manic or psychotic patients, one's first contact with a psychiatrist is usually via the emergency room and a locked ward. Don’t be frightened by the prospect of being a prisoner. In all US jurisdictions, there are strict limits on involuntary commitment (generally only if you pose a risk to yourself or others), and it’s frightening how fast you’re no longer considered a danger when your insurance runs out after two days.

Those with premium health coverage are often encouraged to remain as inpatients for 30 days before they, too, find themselves miraculously recovered and sent out the door.

Hospital day programs may take up the slack, but again patients receive a clean bill of health the day their insurance runs out. Thereafter, psychiatric and talking therapy treatment is on an outpatient basis - that is until the next life-threatening crisis occurs.

continue: Where to Get Help for Bipolar Disorder

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Reviewed: 03/2006