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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by SLS on April 2, 2009, at 12:22:38
I recently experimented with a change in drug treatment for my bipolar depression. I had not been feeling horrible. However, the drugs I was on for many months brought me so far and no more. I reached a plateau in treatment response that I found unacceptable. I was still missing over half of my mental energy and intellectual capability. The experiment failed, and I can't think of anything better to do than to go back to what I was taking before.
My psychotherapist keeps trying to impress upon me that she has seen a large improvement in me. Well, duh. 35% of an improvement yields significant observable differences. It might be enough for her, but it is certainly not enough for me. She did not agree that I should try to enhance the results of treatment by making changes. If not now, when?
My therapist says that I might have to learn how to live with what I have. I have. I am. I always have been, even when confined to a couch, mute and staring into space.
So, I should accept and live with what I am now?
Is this as good as it gets?
- Scott
Posted by SLS on April 2, 2009, at 12:23:38
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
Posted by seldomseen on April 2, 2009, at 13:06:36
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
Now THAT'S a question for the ages.
Is the desire to have more keeping us from contentment with what we have? I know it's hard for you it seems as though you are trying to regain something you lost.
On one hand, you could look at your drug therapy like medical professions outside of psychiatry would. Is a 35% response to chemotherapy sufficient for a cancer patient? Is a 35% response to antibiotics acceptable for a patient with pneumonia? Would a 35% removal of the gall bladder be sufficient for a patient with acute cholecystitis? Is a 35% reduction in pain sufficient?
On the other hand, if you decide that the answer is "yes, this is as good as it gets", I think that answer could be very freeing. At the bare minimum it would provide a very clear framework from which to live your life, accept yourself, and mobilize what is available to you. At the maximum, it would provide peace.
Personally, I would never ever be so presumptuous as to tell someone "this is a good as your life is going to get".
But there maybe some merit in considering that this may be the best treatment for your illness that is to be had.
Seldom
Posted by raisinb on April 2, 2009, at 13:17:54
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
This is a tough one. I think you have to figure out where your desire to achieve a better response comes from.
Does it come from feelings of not being good enough in general? If so, you could productively work on accepting yourself as you are. As Seldom says, that can be an incredible source of peace and well-being.
Or, does it come from genuinely feeling bad and wanting a better quality of life? If so, I don't think anybody has the right to tell you "this is as good as it gets." That's a heck of a recipe for bitterness for the rest of your life.
A related question is, how much of feeling bad comes from feeling bad about feeling bad? (if that makes any sense whatsoever). Are you having a lot of negative thought patterns about your symptom that make your emotional state worse?
Those are just some thoughts and questions that have helped me in dealing with my depression.
I wish you the best in dealing with this.
Posted by antigua3 on April 2, 2009, at 14:07:55
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
I'm struggling with this right now, as in "Is this as good as it's going to get?" If so, I have to find a way to live with it, to make peace with my demons and accept that there won't ever be a "healing" as I always expected there might be.
I don't know. What's more, is this a life worth living? I didn't expect to have to accept less than what I had hoped for. But maybe that's what life really is all about: accepting the limitations and finding a way to live with them. I didn't expect to be perfect, but I expected better than this.
How are we supposed to know?
antigua
Posted by backseatdriver on April 2, 2009, at 15:02:59
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
Scott, your post gave me an idea. Maybe there is only so far we can expect to go with drug treatment; no matter what, it is still an individual thing, to take a drug or not take, and see what happens. Maybe the next step is not pharmaceutical but something else.
For me the post-pharm changes have been interpersonal and intrapersonal. Being myself with no reservations (as Anthony Bourdain might put it) has been the curriculum.
Doing this creates intrapersonal anxiety for me because it is unfamiliar behavior and I make mistakes. As I struggle to manage the internal conflict, this in turn provokes interpersonal conflict, as my inner anxiety makes me either withdrawn or clingy, depending.
Coming out of my intrapsychic closet also creates anxiety for the people in my life, who are used to dealing with a soothing and reassuring person who is usually very present and not asking for much. If I am not careful about boundaries, their anxiety can spark mine, making the spiral even worse.
Change is hard. :( I take small steps.
BSD
Posted by Dinah on April 2, 2009, at 17:29:25
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
I love seldomseen's answer.
No, this is not as good as it gets.
Whether this is physically as good as it gets, I don't know.
I'm not the person I was when this journey started. Whether it's the years of medication, or the years of anxiety/depression, or just simple age, I don't have the energy, the brains, the concentration, oh so many things I used to have. But it's ever so much better now than it was when I started asking the question you're asking. It can get better. It's just that the path to better than this might not be the one you expect.
If that makes sense. One thing I've lost is my ability to make sense after a long day. But I've gained the ability not to be as upset by that as I might have been at one time.
Posted by Garnet71 on April 2, 2009, at 17:54:17
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
The search for serenity might defeat the purpose. You can be self destructive to yourself being so caught up with trying to feel better, rather than trying to do the best you can with what you got...that it defeats the purpose. At what point do you stop? I think it might depend upon faith or acceptance.
Remember, happiness is not an ultimate destination - rather, its accepting, feeling content, and making the best of the journey. It's the ultimate self-acceptance that allows the ultimate inner peace. At least this is what I keep telling myself.
Like you and others, I'm driven to get back to myself-my baseline-my version of my best. Some people on another support forum, well I'd say some wise people, have told me I will never get "myself back" after PTSD and my experiences.
Like you though (maybe), I have trouble accepting that for an answer.
Posted by TherapyGirl on April 2, 2009, at 18:51:34
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
I hope not, Scott. You have been such a gift to me on this Board. I hope there is some treatment regiment that will help you control symptoms AND live your life the way you want to.
I wish I could wave a wand for all of us.
Posted by Sigismund on April 2, 2009, at 19:50:36
In reply to Re: Is this as good as it gets?, posted by Dinah on April 2, 2009, at 17:29:25
I don't know that in my life I have ever seen quick and dramatic improvement. I have seen improvement too slow for me to notice but observable in retrospect.
I certainly believe for me this is as good as it gets.
Is it acceptable?
Only bloody just.
Like, I try to do all the right things and hope they will pay off.
Posted by Sigismund on April 2, 2009, at 19:59:14
In reply to Re: Is this as good as it gets?, posted by Sigismund on April 2, 2009, at 19:50:36
And I forgot to say, when agomelatine works, when I can sleep, and when I feel more resilient, it really helps to see other people's suffering and try to be of help.
That is good enough for me, but then I think (or part of me does) that the whole shebang is a big mistake, and that's not something I wish to change particularly.Just resilience...I'd like more of that, and sometimes agomelatine gives it to me.
Posted by Sigismund on April 2, 2009, at 20:06:15
In reply to Re: Is this as good as it gets? » Sigismund, posted by Sigismund on April 2, 2009, at 19:59:14
Why, after all, is the Crucifixion so resonant an image, or those visions of hell from Buddhist Thankas?
Religion has so much more to tell us about suffering than psychology does (especially the DSM), IMO.
Posted by Phillipa on April 3, 2009, at 13:07:49
In reply to Re: Is this as good as it gets? » Sigismund, posted by Sigismund on April 2, 2009, at 20:06:15
We all love Scott and care deeply for him there is a thread on Social his Grandmother died last night. Please leave condolences if not triggered. He is such an asset he needs our support through this difficult time. Thanks. And Love Phillipa
Posted by HyperFocus on April 3, 2009, at 16:24:55
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
No it's not. I understand what everyone says about trying to be at peace and accepting your current limitations. But I think it will be impossible for you personally to do something like that and just stop trying to get any better. You shouldn't even worry about it - it's not in your DNA. You must have glimpsed, however briefly, how good life could be if you were free from illness. Those visions propel you forward - you're not going to settle for less.
I don't have an answer as to when you will be able to stop fighting and get to that place. You told me once that the journey itself is its own meaning. I guess looking back at what you've covered you might wonder how on earth you've managed to come so far. But I get the feeling you're much closer to your goal.
Posted by 10derHeart on April 3, 2009, at 20:26:06
In reply to Re: Is this as good as it gets? » SLS, posted by HyperFocus on April 3, 2009, at 16:24:55
I think I agree with how HF has expressed this, Scott. You are an inspiration.
Keep going, keep striving, looking, wondering. Anything could be around that next corner.....
Posted by Sigismund on April 3, 2009, at 23:02:39
In reply to Re: Is this as good as it gets? » SLS, posted by HyperFocus on April 3, 2009, at 16:24:55
>But I think it will be impossible for you personally to do something like that and just stop trying to get any better. You shouldn't even worry about it - it's not in your DNA. You must have glimpsed, however briefly, how good life could be if you were free from illness. Those visions propel you forward - you're not going to settle for less.
You are right. That is very much how I think of Scott. Given himself an education in psychopharmacology that amazes me. These are the approaches to life that make us who we are, and the response each has to his or her own suffering is very much to be valued, oddly enough, I find myself thinking. I had not expected to think so highly of humankind.
Posted by SLS on April 4, 2009, at 8:38:28
In reply to Re: Is this as good as it gets?, posted by Sigismund on April 3, 2009, at 23:02:39
I can't help but to cry at the notion that I should finally "accept" my illness and live in the moment without acknowledging why my moments are so frustrating, painful, and unrewarding. One of the things I most hate about this illness is that it separates me from the people around me. It separates me from human experience. I can't see going the rest of my life without continuing to want more connectedness. I will always miss the fullness and brightness of the experience I had when I was in remission for several months.
All I know is that, for now, it is against my nature to accept depression and resolve to make it a lifestyle. This might be a wast of time and energy. However, I cannot just "let it go". Maybe I can make some adjustments. I don't know.
I am not in a good place right now. I am filled with anger, sadness, and fear.
- Scott
Posted by Dinah on April 4, 2009, at 15:07:44
In reply to Re: Is this as good as it gets?, posted by SLS on April 4, 2009, at 8:38:28
Note that I am pragmatic to my toes. Which works fine for me, but maybe not so well for others.
In tenth grade, for probably less than a year, and twelfth grade, for a probably a bit more than a year, I was taken over by an alien that my therapist and I call "Happy Dinah". I loved being Happy Dinah. It was the best days of my life by a long shot. Every once in a blue moon, Happy Dinah returns. But the other closer to fifty years of my life that I'd like to recall where lived by regular old Dinah. Who is not by nature particularly happy.
If I were told that it was possible to get Happy Dinah back, I'd jump at the chance. I was smart and funny and a bit popular, and my husband and a friend I've kept in touch with from that time freely admit I was prettier those two years too. But not eleventh grade. Go figure. I was enormously efficient. My concentration was great. I wasn't manic, and I wasn't depressed.
But I can't wait to live my life until Happy Dinah returns. I can't put my life on hold. I have to make the best of the me I am. I may never see Happy Dinah again, or I might. I hope I will. But in order to make the most of my life on this day in this time with regular old Dinah in charge, I can't look back at Happy Dinah. I can't even look back on superdepressed postpartum Dinah or slightly nuts adolescent Dinah. I am who I am today. It may not be "good enough". Goodness knows I could certainly aim for more. But it's what I have. At this moment. For this day. It's what I have. I need to make the most of who I am today.
I might try to be better than who I am today. But that needs to remain separate.
For me.
For you it might be different. But that's how it works for me.
Posted by SLS on April 4, 2009, at 15:33:18
In reply to Re: Is this as good as it gets? » SLS, posted by Dinah on April 4, 2009, at 15:07:44
> But I can't wait to live my life until Happy Dinah returns. I can't put my life on hold.
Through psychotherapy, I am doing my best to live that way. Fortunately, or unfortunately, I have been blessed with a fierceness that will not let go of certain things easily.
> I have to make the best of the me I am.
I think I have learned to do this to a great extent. I always try to use ALL of what LITTLE God gives me to work with in the moment.
I am very happy with who I am, even when severely depressed. I am just not happy with the depression itself. All in all, I am actually a very happy person with an inescapable drive to remain optimistic, positive, and constructive. I really do love life. I do wish I could be more like you. It is sensible and would help provide me with a greater balance with which to experience life.
I am always looking to improve myself for my own sake. I thank you for helping me to do exactly that.
Love,
Scott
Posted by Phillipa on April 4, 2009, at 20:48:11
In reply to Re: Is this as good as it gets? » Dinah, posted by SLS on April 4, 2009, at 15:33:18
Scott I know you will find to answer. You did it once you will do it again. Your're fantastic!!!! Love Phillipa
Posted by Bobby on April 5, 2009, at 0:37:35
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
I believe in the ebb and flow of life. Some times are better---some are not. I remember an old coach I used to have who always preached, "Winners never quit--and quitters never win." Well, I'll bet he was never BP---but that is a good quote to model life by. If you've ever been fishing----you probably know how the size of the fish caught last year grows with each passing year. Sometimes I remember how beautiful the teacher was in grade school---when , in fact, there was nothing extraordinary about her in hindsight. I guess the point I'd like to make is that your worth is not based on your intellectual prowess----dear God I hope not. People , well some people, say that some races are not as smart as others. Well what's that got to do with anything? You're smarter than a child or a pet ----yet does that mean that you s\don't love them with every fiber of your being? That you'd give your life in exchange for their's? You have made lot's of friends here on Babble and I see no reason you can't make them in real life. Life will not end if you don't wind up being the president of Harvard or Yale---and anyone who judges you by that measuring stick is not worthy to be a real friend anyway. Man---believe me when I tell you that I know the feeling well. I hope that things improve and that , at the very least, you become satisfied one day----whatever that requires. Cling to hope and self preservation----and I trust you will---that's why we're all still here posting---I think. I know you're dealing with a host of emotions right now---but lot's of folks are pulling for you---I know I am. That's all...
Posted by Kath on April 6, 2009, at 10:51:30
In reply to Is this as good as it gets?, posted by SLS on April 2, 2009, at 12:22:38
So sorry.
I haven't the mental or emotional energy or something, to read all the posts. I have to keep reminding myself that I'm sick right now, so am not my usual self.
I just want you to know I'm thinking of you & care.
xoxo Kath
This is the end of the thread.
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