Dealing with a diagnosis of mental illness, and learning to accept it, is ironically enough, like dealing with the 5 stages of grief. It is tough to accept the reality of your situation, just as much as it is to accept the reality of your illness. My life became a whole lot easier once I accepted a diagnosis of Bi-Polar and found the proper medication that worked for me. I went through a slew of different meds and 2 different psychiatrists before I finally found a lifestyle and ONE medication that worked for me. As I draw this parallel with the five stages of grief, I think it is best to start out this conversation with a description of those stages.
The Kubler-Ross model, named after the physician who developed it, shows five distinct phases that people experience when dealing with a loss. The five stages of grief are listed as:
1) Denial
2)Anger
3)Bargaining
4)Depression
5)Acceptance
In a grief experience, this generally means the loss of a loved one. As applied to coping with mental illness, this can also mean dealing with a loss--the loss of a lifestyle and/or your perception of who you are as a person. It was hard for me to accept the fact that perhaps I was not processing things the way most people do and perhaps I needed some chemical assistance to do so. I remember my psychiatrist telling me once that there is no shame in having to take medication for your brain to work properly. A diabetic takes insulin, you just need a supplement of lithium for your brain. That explanation helped put things in perspective.
Roy Scheider as Gideon in All That Jazz
My first exposure to the 5 stages of Grief were depicted in the movie All that Jazz by Bob Fosse. Yet, at the time, I did not realize the concept applied to grief. In the movie the same concepts were applied rather to one's own impending death. That is the way it is portrayed in the movie as the main character, Gideon, grapples with his own life situation. It's a great movie with an intriguing storyline and phenomenal dance sequences. Roy Scheider stars in the semi-autobiographical story of a self-destructive director/choreographer. In the movie the incredibly beautiful "Angel of Death" visits him on a regular basis in his dreams and sometimes his drug induced visions. All the time he discusses with the angel, and sometimes his reflection in the mirror, the 5 stages of his impending death. Yes, it is a dark comedy, but one with an interesting message about how some of us cope with what life throws our way.
So when I think about how the stages apply to a diagnosis of mental illness, each and every stage fits perfectly when I think about dealing with my diagnosis of Bi-Polar. First and foremost, I do think that society's pre-conceived notions of mental illness have definitely changed for the better. Knowledge is power and the more people understand about different mental illnesses, the more they will be able to be empathetic. Just like this poster here, we need to stop the Stigma.
With the stigma of mental illness that is still sometimes perpetuated, that easily leads to the first stage: Denial. Nobody wants to be thought of as "crazy", it must be something else. I remember when I was first diagnosed as Bi-Polar. Initially it was thought of as Post-Partum Depression and "this too shall pass", but years later I had difficulties again: post-menopausal. So, it must be hormonal. Well, that may be true, but I have come to accept that the brain chemicals and the body chemicals do work together (or fight each other). Having the brain and the body in harmony is obviously essential for complete wellness.
The next stage: Anger is a complicated stage that I definitely went through but found it really hard to cope with. My anger was focused on the illness and not the people I love, it made it hard to demonstrate that to my family. Especially when I was initially dealing with Post-Partum Depression. It was so frustrating for me to demonstrate that I loved my baby boy and would not hurt him for the world. In many ways he helped my healing because I wanted to be there to care for him. Another aspect of Anger that I found so frustrating to deal with is the sexist notion that women shouldn't get angry. Outdating notions of this still exist. When a man gets angry, he is just being strong and assertive. But when a woman gets angry, well... she's just being a bitch. It's hard to fight these stereotypes, some of them are so ingrained in our psyche, but maybe we can try to rise above them.
The third stage: Bargaining to me seems to be bargaining with God. If you are perplexed as to how you got this way in life, then perhaps you would bargain to change this or that. If only I could give up a certain behavior, then perhaps the rest of my life would be smoother. Maybe some of my symptoms would disappear? Vowing to yourself to change something might actually help improve your situation. Yet, finding a medical professional that you trust is probably the most important thing to help you.
The fourth stage: Depression is probably the stage that is the hardest to define. We have all had days when we just had incredible sadness and frustration, but usually those days pass. Yet, sometimes it's more than that. The Mayo Clinic defines clinical depression in this way:
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living. More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychotherapy or both.
So, finding out if you are just feeling blue or clinically depressed is incredibly important. My diagnosis of Bi-Polar depression had "depression" in the title so for me it was a package deal. Lucky Me. Yet, the hardest thing for me to accept has been that my depression has not necessarily been "situational" depression, but rather a chemical characteristic of my body that I just have to treat and learn to live with. I have dealt with it over the years, but as you can imagine, EVERY medication has side effects, some worse than others.
The fifth and final stage: Acceptance is a tough one to swallow and there are days when you can bounce back up to the #1 stage: Denial. These stages, as they apply to Grief and also to Mental Health, helps one to understand that you are not alone. It is important to remember that some people skip stages, while others get stuck in other stages for what can be an unhealthy amount of time. The process is different for everyone, depending on their circumstances.
Several factors have helped me with my challenge of learning to stay afloat with a Bi -Polar diagnosis. First, my Faith has helped me immensely to help me feel loved no matter what. Second, my family provided support and love in spite of some of my more "difficult" moments. Last, but certainly not least, I educated myself on my illness, various medications and utilized my strength and power to have a say in my OWN THERAPY and Healing. Keeping your autonomy, does wonders for your self-esteem and in turn healing. Of course you need good doctors, friends and family to assist, but remember you are the one that knows what is best for YOU. It can be a long hard climb, but worth the effort.
