Thursday, November 8, 2007

The PHFBP

The Professional, High-Functioning, Bipolar Patient

There exists what I’d like to call the PHFBP, or the professional, high-functioning bipolar patient.
When looking at the PHFBP, it would appear that he faces few problems. He is compliant in his treatment. He is successful in his job; he may be married and have children; he has friends, and in essence, he is happy. For the therapist, this patient might be called "the model patient." In reality, although this patient is seen as a "model" patient, he still must cope with several, important life issues. I know because I’m a PHFBP and have been one for several years.
The issues are as follows:
1. Do I really need to take my meds?
Medication is a sticky subject. It’s usually visible, either sitting out or in a cabinet. Just sitting there for any nosey guest to come along. Medication also can put on the pounds. Like around 50 pounds. It’s a hassle to take it every day. A nuisance. Life would be much easier without it. Wouldn’t it?
2. Should I "come out" in my family, the neighborhood or at work?
I really want to tell people, but I’m afraid of the after effects. Will they lose trust in me? I feel like an imposter, like I can’t truly be myself. Who am I, really?
3. Can I take (normal and not-so-normal) risks?
I know that if I go to New York city, it might set me off. But I love New York city. There’s no other city like it. Should I go?
4. How do I cope if I start to get ill?
Who will watch my child? Can I work if I’m delusional? I’m in remission now, but there’s no cure to this thing. What will happen if I get sick?
5. Should I marry?
Who would want to marry me? I don’t trust my own brother. How can I trust a total stranger?
6. Should I have/raise children?
Will I pass the illness to my child? Will children be too much stress? Will anyone let me adopt?
7. How much responsibility can I handle at work?
I love what I’m doing, but I feel like I’m on a tightrope, like I might fall off at any minute. Should I ask for a promotion or stay where I am? Does more work make me sick?
8. How does my illness relate to my spirituality?
I once thought I was Jesus. Does this make me closer or farther from God? If I can’t get out of bed to go to church, will I be pardoned?
9. Will I become seriously ill again?
I can’t go back in the hospital. Someone will find out. I hate how in the hospital you can’t lock your door. Will I survive another hospitalization?
10. Should I be proud of myself?
Does my sickness make me stronger than the average person? If I show the world how well I am, will the sickness come back and bite me in the butt?

Yes, I know what you’re saying. "Life isn’t perfect." This is true. And this is my message for today. Life isn’t perfect. You can be a model (i.e. perfect) patient, but you can still live precariously amidst numerous difficult issues.

All we can do is our best with what we are given.

I'm a PHFBP. Are you?

1 comment:

Unknown said...

Oh my goodness. I just came across your blog (after reading your latest articles in bp mag.) and I love so many of the posts you've added, especially the recent 2008 ones. But I love love LOVE this post about the PHFBP. While I was reading it you gave me that unique feeling like you sometimes get at the psychiatrist's office of "wow! somebody else can describe how I'm feeling and what I worry about. Wow!"

-H