I recently saw a patient that taught me something about seeing people living with Bipolar Disorder. Not going to elaborate what this disorder is as the link provided does a better job than how I'd simplify it (my mind can be garbled with ideas when trying to explain something simple and it's just how I operate).
Anyway, the patient came in on a regular follow up crying and I immediately just thought she was going to tell me she was noncompliant with the medications and now she's on her depressive episode again. But instead she told me she was compliant and had none of the symptoms I'd clinically check on the list to call it a major episode.
TL:DR she was sad because her father whom she was not in good terms told her mean things and even took it out on her autistic son and there was no one else in the family that could console her or feel supportive of her.
Her sadness even affected her work but she was still functional and able to control her impulses.
I did a different approach to cheer her up by listing the positive things she can take from this event:
- She didn't slap her manager when she wanted to
- She didn't argue back to her father even when she wanted to.
- She exercised greater self restrained while working in her shift as a customer service representative. Even when the client on the other side of the call was irate, she maintained her composure and only cried in between calls.
- She immediately recognized that she needed to follow up soon because she was feeling unwell.
- She kept taking her medications.
- She resisted the impulses to harm herself again or commit suicide.
And as I elaborated all the good things she did, it started to connect to her how much she's changed since she started being compliant to the treatment and how things could've gone downhill if she wasn't just from the triggered encounter with her father.
One thing family members often fail to understand or realize that there's a different person there and they come out after their manic or depressive episodes are resolved. She would've done all the opposite directions listed above had she stopped complying with medications and this calmed her down and eventually made her realize how much this trial tested her.
I didn't spice up the story, I just reiterated what she did that she probably overlooked about herself.
What's remarkable about this? I made it clear that what she felt was valid and anyone who doesn't feel bad after being told by their own family member mean things may have a problem too. She's not taking medications to feel like a robot and it's human to feel happy/sad depending on the situation.
I think it's a misconception that antidepressants make you immune to feel sadness but these are meds that keep you going over the edge and be suicidal. You can still feel sadness because that's a natural emotion and the meds help with controlling your impulses to do stuff you're going to regret.
I framed the replies under these ideas and she started smiling halfway through the interview discovering that's she's not going crazy, she's not going into relapse like her depressive state as before, she's just experiencing what normal humans do when they're sad. She felt validated.
I reflected on what happened and this post came out from it.
Thanks for your time.