The Bipolar Bum

Backpacking and Bipolar II. Taking Manic Depression on tour.

Managing expectations and passive therapy pt.2

#bipolar #treatment #mentalhealth #selfdetermination #therapy

YOU'RE at the helm! No one else.

YOU’RE at the helm! No one else.


So to cap off the last post I just felt like I should make one more point.  If you’re really lucky, dear reader, it may even prove cogent!  The point being that, ultimately, it is the responsibility of the ill party to make themselves well.


This may sound rather obvious but it is so often the case that I read about someone’s TOTAL dependency on a therapist or medication.  The dependency alone isn’t the biggest issue.  Rather it is the fact that having a ‘qualified professional’ on the case seems to make the patient pass the baton forward and wind down their efforts completely.  Like a well-practised drunk collapsing into the waiting arms of a friend, a lot of us assume that once a professional healer is involved that we no longer have a part to play in the healing process.  This could not be more wrong.


In the U.K doctors of every denomination are seen not only as healers, but authority figures.  There is the widespread assumption (correct in I’d guess the vast majority of situations) that because of their training they know more about illness and healing than we laymen.  We assume that this knowledge empowers them and that the lack of it renders us spectators to the treatment process.  The wheels fall off of this assumption when it comes to mental health.


 No matter how depressed and confused you are, you are still the only person living with your brain.  You have by far the strongest incentive to make yourself well, and regardless of whether you WANT to be in charge of your therapy or not – you are.  This isn’t a variable.  It is fact. The only variables are the levels of efficacy and how much effort you make.


The widely held belief that therapists “make patients well” is bogus.  If your expectation is for a therapist to say some kind of password unlocking your chances at good health – you will either be disappointed or just kept on the treadmill, waiting for a eureka moment that isn’t ever going to arrive.  Therapists help you tailor your life’s parameters to create the best possible situation for you to make and keep yourself well.  Using their experience they can help you decide which medication to try.  They can feed back to you when your thinking is obviously wrong and present the opportunity for you to change your thought processes.  They can’t do it for you.  It is impossible.


Doctors and therapists are there to try and help you along the way to wellness.  They can only work from information you give them and even then, mental health treatment is still a very blunt tool to be used for such a precise job.  Imagine that you’re walking to a destination, the doctors are the cars that will pull up to give you a lift.  You are still in charge of where you go, and to get there quickly you need to make your directions very clear.


It is empowering to know that your involvement is the most important element to making yourself well.  GREAT!


The part that you actually CAN control is the most important element to the whole treatment equation.


The issues of social stigma and absolute dependency on medication and medical professionals are inextricably linked.


Social stigma means that people rarely seek a diagnosis of any mental health issues until they are at the absolute apex of human suffering, or until they’ve attempted to self-destruct.  This then means that the patient is utterly overwhelmed and at their LEAST capable to take charge of anything.  When a patient bounces off of the bottom, all they want to do is hand over responsibility to someone else.  They have run out of energy.  One problem creates and reinforces the other.


When overwhelmed then, it makes sense to let someone support you.  Let them take over and drive to the destination of YOUR choice for a while until you’ve recuperated enough to take control again.  Abandoning all authorship of your mental health will only do one thing though in the long run.  It will make you feel helpless and useless.  It will lend weight to your negative self talk.  It will deny you the chance of becoming well as you enter the treatment stasis I described in the last post.


I won’t tell you to take control of your healing, because it is impossible for you to ever have lost it.  You are always in control, even if you try not to be.  Choosing not to help yourself is still a choice.  All I will say is that you have the option of making a better or worse job of it.  I hope you do the former.


Is there anyone who feels that they actually ARE NOT in control of their treatment?  Do your therapists and doctors enable this subordinate mindset or do they challenge it?  Have any of you only recently begun to really work consciously at making yourself well?  Do you have anything to add here that will aid your mentally ill brethren?  I’d like to hear from you.


All the best,

5 comments on “Managing expectations and passive therapy pt.2

  1. stockdalewolfe

    Excellent post and excellent question. I have worked with my therapist telling him what drugs I absolutely cannot tolerate, what work, and what drugs are abysmal. But I have had helpful feedback from my husband. It is a hard job, taking care of yourself even in a therapist’s care. Even with feedback from a spouse. I still am unhappy with the loss of religious feelings and creativity but my husband often reminds me that I am better able to produce something creative and that I can deal with the loss of religious feelings by meditation and other practices. Which is all to say that it is damn difficult to care for yourself even with the best of help. The medical establishment throws drugs at you that have been shown to help some and then waits to see how you react. But you have to have a say as to what you will accept.


  2. robin1967

    I agree that being passive, choosing not to help yourself, is a choice. It’s crucial that the client remain active in their treatment, doing research on meds independently of their doctor if necessary and getting second opinions if they disagree with what the doctor is doing. The deeply depressed may not be capable of this, that’s why it’s important to have someone who can advocate for you when you’re at your worst.


    • drheckleandmrjibe

      Agreed. Solid support is something that is sorely lacking for most people. I am becoming more and more of the belief that unless a person has personal experience with depression they can’t really offer the right kind of support for someone who is completely overwhelmed. They just don’t speak the same language.

      All the best,

      Liked by 1 person

  3. DysthymiaBree

    I’m very much in control of my treatment 🙂 I’ve devised a many-pronged approach and am assertive in working towards healing. Unfortunately, just making that assertion doesn’t mean the process is quick or easy!


    • drheckleandmrjibe

      Absolutely true. In the case of ‘quickness’ if not efficacy, expecting someone else to be able to do the legwork with what is happening in your mind would just be folly. Actively engaging your illness and taking charge of the treatment is the only way that things will ever happen in my opinion. It is the only way I got to where I am (Alive).

      All the best,


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