John had a psychiatrist appointment on Monday morning. He goes about once every three months, and I pretty much always go with him.
We like his psychiatrist, Dr. Wilson, a lot. The first psychiatrist John saw after coming out of the hospital misdiagnosed him, immediately started taking him off Risperdal (substituting Pristiq), and pretty much ignored me when I tried to tell her that John was psychotic again.
After John’s second hospitalization, Dr. Wilson met with the two of us for an hour, listened to me when I told him about John’s symptoms (because he was delusional, John didn’t perceive a lot of manic behavior as symptomatic), and diagnosed John with bipolar disorder. Over time, he tapered John off the Risperdal, relying solely on the mood stabilizer Depakote. When John continued to experience residual depression months after his psychotic break, Dr. Wilson gradually switched him from Depakote onto Lamictal, which has been working great for about 15 months now. No depression. No trouble concentrating. No manic swings.
On Monday, Dr. Wilson confirmed that John’s been very stable. He cautioned us, though, that sometimes when people are stable on the meds, they begin to question whether they really need them. He explained that due to the severely disruptive nature of any mood episodes (John was on disability for 3 months, and he was lucky that he didn’t lose his job), he doesn’t recommend playing with a medication that’s working unless a patient has been stable for ten years.
John didn’t have a problem with this recommendation. With the Lamictal, he doesn’t experience any side effects, so taking a pill every night is no big deal. Now, if he were still on the Risperdal, which left him lethargic and messed with his ability to focus and do complex math (he’s an engineer), I think it would be a different story. Fortunately for John, Risperdal isn’t part of the equation right now.
Destructive Thought Patterns
I found the whole “ten years” concept kind of interesting. As an addict in recovery, I’ve come to terms with the fact that I’ll never be cured. I can make the choice to maintain my recovery by abstaining from addictive eating one day at a time, but that’s a choice I’ll have to make every day for the rest of my life.
I didn’t graduate from my Twelve Step program after ten years. I know that trying to “go it on my own” would bring my symptoms–55 extra pounds, binging until I can’t stand up straight, purging four times a day, constantly thinking about food–crashing back down.
In the 11 years I’ve been in FA, I haven’t seen a whole lot of people with 10+ years in the program decide to walk out the door. The time when this tends to happen is around a year or two of recovery. You’ve lost the weight, you’re feeling good, you start to wonder if you really need to go to all these Twelve Step meetings, make all these phone calls, be so precise in weighing and measuring your food.
You think, “I’m doing great! I’ve conquered this problem! I don’t need this program anymore!” You forget that it’s only because you are following the program that you’re doing well at all.
So maybe that’s why Dr. Wilson told us about the “10 year” thing at Monday’s appointment. John’s been symptom free for close to a year and a half–prime time for those sneaky little “Do I really need these pills? Am I really still sick?” thoughts to start creeping in.
God only knows what course John’s illness will take over the next decade, but I pray that John will continue to accept whatever course of treatment is necessary. Based on our experiences over the last year and a half, I believe he will.