On Manic-Depression

Last month, while I was on Facebook, I got a message from the very first person who invited me to FB, and who eventually became my very first contact in this colossal social networking site that is Facebook.  In the course of our conversation, I gathered that he was at that time in the US for some kind of training. So, he was not there for good and he intimated his desire to go back to Dubai. It seemed to me that he was not really happy being there and perhaps, he had to be there as he had to do something important in his career plan. When I asked him how he has been, his reply quite knocked me off.  He said that he is still the same sick guy I tried to cure before. In effect, he was saying that I failed to help him. But before I could ask if he continues taking medication and explain to him his predicament, he got offline.

Anyway, this man in his late 20’s was referred to me for counseling and eventual therapy. The presenting problem was that he would stay in his room for days and abstain from the usual routine of normal life as a student and part time worker for the same period and then followed this by short periods of hyperactivity, i.e., staying out of the house doing anything and everything he wanted to do, even without sleep.  He had suicidal ideations as well when too depressed.  I diagnosed him to be suffering from severe manic-depressive or bi-polar personality disorder.  Due to the severity of his case and the fact that his mood swings, in particular his depression, is more physiologically triggered (caused by the chemical imbalance in his brain), I advised him to seek a psychiatrist’s assistance for medication. He needed medication to be able to bring normalcy to his daily functioning. At the same time, we proceeded with the therapeutic relationship. We collaborated on a self-management plan for him that included proper diet and regular exercise. We also had to work together on helping him do proper time management and manage his daily chores with efficiency.  I made him come up with his personal mission statement as part of the requirements in the time management coaching I did for him. Having the sense of control in his life would be of help. In short, I empowered him to be able to manage his predicament.  I noticed significant progress after the 3^rd session and based on my positive prognosis, I terminated the helping relationship after the 8^th session.

As it is of immense help in therapy and counseling that the client understands the nature of his/her condition, I remember educating him about the nature of his disorder, telling him that there is no permanent cure for his affective disorder and that he has to continue putting the same amount of efforts to all those mutually-agreed upon tasks in order for him to be able to function as a normal person.  

As demonstrated in previous researches, Bipolar Disorder is a chronic recurrent illness and in over 90% of those afflicted, it requires lifelong observation and treatment after diagnosis. It was also shown by research that patients with untreated or inadequately treated bipolar disorder have a suicide rate of 15-25% and a nine-year decrease in life expectancy. With proper treatment, the life expectancy of the bipolar patient will increase by nearly seven years and work productivity increases by ten years.

With this in mind, I could not more than stress that it is very important that he takes active part in the treatment program that we agreed upon. Hence, it came as a surprise to me that he seemed to be expecting me to ‘cure him’.  Hence, as an afterthought, I surmised that may be, partly the reason why he was not as successful in managing his case is that he did not take full responsibility for his own concern.