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Bipolar Disorder

Does God Have a Place in Psychiatric Treatment Plans?

One's identity is unraveled by psychiatric diagnosis and often, so too is faith.

In 1992, my father drove (more like sped) me to the emergency of Lion's Gate Hospital. I was floridly psychotic. I ran from one end of the parkade to the other, shouting ‘I am one with God'. Neither of us knew what was happening. My dad describes it as one of the most terrifying experiences of his life, for me one of the most devastating yet liberating.

My diagnosis: rapid-cycling, mixed stated bipolar disorder with mild temporal lobe epilepsy and generalized anxiety disorder. Yeah, say that five times fast!

Over the next five years I had four further psychotic episodes, innumerable manias and suicidal depressions and five visits to the psych ward.

I feel lucky, for the most part I had incredible health care providers - from the psychiatrist I saw weekly, to the nurses and orderlies who helped me regroup in the hospital to the case worker I met with.

My treatment was fairly straightforward: medication, psychotherapy, group work, occupational therapy and vocational rehab. Accepting the diagnosis and treatment however, was a whole other bucket of fish.

And unfortunately the one discharge plan element, which could have helped me accept treatment more readily, was overlooked. My spiritual beliefs were not only ignored, but more accurately actively avoided. To some degree it was understandable. My psychosis involved images of God, the devil, allusions to birth and death and an intense focus on the nature of reality. Care providers were reluctant to discuss spiritual topics for fear of destabilizing my mood.

But this was a most heartfelt dilemma and conflict I needed to reconcile in order to start the healing process. I originally shot into psychosis while meditating deeply and within that altered state had my most profound spiritual experiences; ones that I still hold dear and affect how I am in the world today.

This doesn't mean all things that happened in the psychosis were significant or even remotely relevant. But my health care team only saw the psychoses as negative, never exploring with me what happened during them or what parts, if any, felt meaningful to me and why.

Because facets of my psychoses felt life changing, I was at odds with the medical profession. How could I label something of such significance as only pathological?

This is one of the most important points I wish to convey. I refused treatment and remained ‘non-compliant' largely because no one told me these two things were not mutually exclusive.

It was not until years after my initial diagnosis and visit to ‘Club Medication' that I met an exquisitely talented psychiatrist who helped me hold an apparent paradox. He explained what I went through could be spiritual as well as psychiatric, each profoundly affecting my life.

I can't emphasize this enough: if someone within the healthcare system had taken me aside earlier, told me that just because I have a mental illness doesn't negate the importance of what I experienced, I can guarantee I would have had less visits to the psych ward.

Ideally a doctor or nurse would have acknowledged the spiritual meaning and shifts I felt I had in the psychoses, asking what they were, how they were positive and why they were important to me. And explaining to me I would be able to look at them more closely when I my illness had stabilized.

Dialogues like these would have given me much needed validation, helping me see I could accept having a mental illness without abandoning my new life perspectives and realize the illness needed to be stabilized for me to effectively and safely integrate these insights and experiences.

Eventually my psychiatrist and I agreed we'd meet to monitor my medication and for psychotherapy sessions (often CBT with interpersonal therapy) and I would also meet with a spiritual counselor who could help me put the spiritual aspects I experienced into context. This created a beautifully effective blend of very traditional psychiatry and counseling with gentle yet very vital spiritual exploration.

When a discharge plan is being drafted for you, get involved. Say your piece. Or ‘peace' as it were. Don't underestimate your own power in the building of a rehab plan. And if it is important to you, make room for your spiritual life. Self-identity is unraveled by psychiatric diagnosis and so too is faith, a sense of order and place in the world.

A ‘spiritual action plan' is a map to help affirm purpose from something that appears to have none and establishes, for us as patients, reasons to recover; reasons to continue even while the going gets tough.

My trust in reality, in myself and in the Divine was deeply wounded when I was thrust through those emergency doors. Mental illness and in particular, psychosis, shakes the strongest of faiths. Whether that faith is religious in nature, or as in my case, a ‘life perspective', in order for the whole person to heal, spirituality must be addressed.

Without indulging my irrational thinking nor dismissing ideas I valued, a gifted nurse helped me start accepting treatment. I sat on the edge of my hospital bed, despondent and unclear as to how to reconcile accepting that I had a mental illness without abandoning my spiritual insights by calling them delusional. The nurse, who had been on shifts throughout my four weeks on A2, sat beside me, listening as I explained what had brought me there. Silence. And then with quiet confidence she said: ‘when you touch that limitless part of yourself, it can be overwhelming.' That's all I needed to know: someone in the medical field had heard how powerful and not completely negative my journey with bipolar disorder and psychosis had been.

I then realized that perhaps I could find others in healthcare who shared her same caring and inclusive view. I enlisted her help and she gave me the name of the psychiatrist who I credit with coaching me back to health.

© 2009 Victoria Maxwell

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