In my last post I talked about what it is to be an e-patient. These are the people who are engaged in their own healthcare - they are empowered patients. But if your relationship with your doctor is more passive, how do you become empowered?

Have you heard of the e-patient? If not, it’s OK, I hadn’t heard of them up until about a year ago either. And quite frankly, once I did hear the term, no one really explained it to me so I figured it was an “electronic” patient – maybe one who walked around with their health records on a USB stick, or maybe a cyborg patient (in which case, I qualify). Well, it turns out that there aren’t a lot of cyborg patients and while an e-patient might walk around with their medical records, “e-patient” actually refers to patients who are equipped, enabled, empowered and engaged. And, depending on whom you ask, also educated, expressive, expert and electronic. That’s a lot of stuff. And quite frankly, way too much pressure, so let’s boil it down – an e-patient is one who’s engaged with their own healthcare, and ideally, we all should be one.

If you’ve been poking around for mental health information for a while you’ve probably seen them: The people who decry psychiatry and all associated therapies. These people come in various shapes and forms but they often call themselves “psychiatric survivors” or “antipsychiatrists.” These are people who claim that psychiatry is evil and psychiatrists are nothing but abusers. These are people that claim that psychiatric medication will cook your brain and that those who use psychiatric services have simply been duped into believing the lies of “big pharma.” It should surprise no one that I’m not a fan of these people. In my opinion, these people prevent sick people from getting the help they so badly need and they can cost someone their life. And writing off psychiatry as a field of medicine reminds of refusing to eat Chinese food.

Mental illness symptoms are as cold and generic as inhumanly possible. “Depressed mood.” “Loss of energy or fatigue.” “Psychomotor retardation or agitation.” Ah, yes, those things. They sound like a bummer. Although, actually, they don’t. They sound like characteristics of a lab animal. And one of the pesky symptoms of depression is “easy to tear.” You know, you cry a lot. But everyone cries, so how bad could that possibly be?

One day I was in a pub eavesdropping on the girls deep in conversation next to me. They were chatting about bisexuals. They were commenting that they would never date a bisexual as really bisexuals were heterosexual that were just playing around with homosexuality and eventually they would “turn back” into heterosexuals. Well, I, being bisexual was a little insulted by this. I have not “turned” into anything. I simply am bisexual like they are simply gay. I realized though that it was lucky for me that I heard these girls talking because I could cross them off my list as I have no desire to date sanctimonious, self-righteous, ignorant women. And I also realized this: it’s their loss. I’m great. I only lost sanctimonious, self-righteous, ignorant women while they lost me. And the same is true of mental illness. When someone rejects you simply because of a medical illness that you didn’t ask for and over which you have no control, you are only losing someone ignorant while they are losing the amazing person that is you.

There is an interesting, if perhaps disturbing, phenomenon in psychopharmacological drug treatment. It is the instance where a person initially has a satisfactory response to a medication, getting well, and perhaps staying well for years, only to have the illness come back at a random time in the future. The medication just “stopped” working. We have known about this for a long time with many drugs including antidepressants and anticonvulsants (mood stabilizers) and it’s sometimes referred to as antidepressant “poop-out” (I kid you not). But this phenomenon goes against even the most basic understanding of medication, so why is it happening?

Bipolar is a disease that takes over your brain – well, parts of your brain anyway – and these affected parts of your brain change your psychology right along with them. So once when you felt “normal” or let’s say, average, you now feel utterly destroyed. Your emotions are altered thanks to the attack on your brain. And what’s worse about this is that bipolar or depression fundamentally changes who you think you are at that moment. If you used to be a fun-loving, happy-go-lucky sort, in a depression, nothing could be farther from the truth. When manic, all your thoughtful, careful ways become things of the past. You can barely identify with the person you were pre-mood. And perhaps even worse than all that is that some part of you sees this dissonance. You know that who you are at that moment isn’t who you really are. It’s like someone else, a crazy person, moved right into your head and body and coopted your life. Bipolar snatched your body and brain.

As I wrote last time, I consider about 95% of the time we spend feeling guilty wasted time. I have suggested that guilt does no one any good and instead of sitting around feeling guilty, we should try to make amends for whatever it is about which we feel guilty. But how does one make amends?

Guilt – noun – a feeling of responsibility or remorse for some offense, crime, wrong, etc., whether real or imagined. And people with a mental illness feel guilt over a lot of things. I hear from people every day who feel guilty about their illness, what they’ve done, what they haven’t done and how their mental illness and their behaviors due to it affect others (Feeling Guilty Because You Have a Mental Illness). But mostly I consider guilt a waste of time in mental illness recovery.

Recently, I was talking with someone on Twitter and she was concerned about the side effects of psychiatric medication X. I asked her what her starting dose was for the psych medication and she said 15 mg. Now, I’m not a doctor, but I can tell you two things: That is ridiculous. That will certainly make the patient stop the medication early due to side effects and never even find out if it works.