Caring for a bipolar person is complex. Despite all the years of studies and the experience acquired, it can still happen to feel helpless in the face of the distress of a patient in great difficulty.
In fact, the management of manic episodes and depressive by the psychiatrist can prove to be delicate, all the more so when the hopes and expectations of the patient and those of their loved ones rest on him.
Today, I am doing an interesting exercise, as a bipolar person, which is to write an article for practitioners. Throughout this one, I will of course adopt as best I can the point of view of the patient that I am.
As you well know, this first session is crucial. It lays the foundations for a relationship of trust and understanding. Therefore, be attentive to apprehensions And to Hopes of the patient is essential. Especially since it is necessary to anticipate that the patient will:
So the stakes are huge for the patient and all this will depend on one person, you.
In the majority of the stories we are told, the patient leaves with a treatment (which is normal), but sometimes without real in-depth explanations of its effects. And this is what bothers the people concerned the most because most patients dream of a fantasy (I have experienced it myself) in which taking medication will solve everything overnight.
But you and I both know that the reality is quite different. Far from that, even.
THEtrepidation is therefore often palpable during the first exchanges. Sweaty hands, parasitic thoughts, fear of speaking, the patient feels like a child again in a world in which he knows nothing and where he must learn new skills to tame the evil that gnaws at him.
Moreover, he is afraid of being judged, misunderstood or even made fun of. “What you are experiencing is not much, you are exaggerating a bit.”
This space of trust is fundamental. For you as well as for the patient. I'm sure you already know this, but it's always important to remember. As much as possible, the patient should feel comfortable sharing their anxieties And its fears which, in his opinion (and what society refers to) are not normal.
The problems that the patient faces are obviously not fun.
The management of human relationships, in addition to the complexity of mood changes, can then sometimes (often?) become a hell in view of the emotions experienced.
Having an airlock in which it is possible to feel safe and understood is therefore essential.
La plight of the bipolar patient is silent and can be, at times, a bit minimized. Especially since he may not clearly express his suffering, often not knowing what is happening to him or how he can welcome it.
Reading between the lines and recognizing the subtle signs of inner struggle is the most valuable skill you have and that I invite you to use at will.
La fear of treatments is real and deeply rooted in the patient and in the culture of psychiatric care. Fears of side effects, addiction or simply taking something that will “change” one's behavior, everything must be taken into consideration. So openly discussing these fears, demystifying them, and taking the time to try to understand them is essential, of course. But what is even more important is that the patient feels that you are taking this step.
Trust can only be established if there is a real exchange and I myself have changed psychiatrist several times precisely because it did not take the time necessary to establish a solid foundation.
As you know, a bipolar person's sensitivity is heightened. Showing that this is taken into account allows you to install a trust basic. And we all know that when you start off on a good footing, it's much easier to try new things like taking medication for example.
As mentioned earlier, the quality of communication And of theempathy is therefore fundamental.
The patient bipolar may fear being judged much more than one might imagine. Even more so during a depressive phase. For example, I tend to interpret the smallest gesture, the least intonation or the least look that seems different to me than usual when I am in phase (which is becoming more and more rare).
So certainly, it's something that everyone does more or less naturally after all.
But still, as bipolar, we are very good customers at this level.
Practicing theActive listening words, emotions and what is not said, that's the basis. It requires patience, attention, and a willingness to understand the patient's unique experience. Personally I am lucky to have today a psychiatrist very good at it, but that wasn't always the case. And like everything, it is something that can be worked on and that, honestly, will be largely profitable for those who practice it with a bipolar person (and even in their professional and personal life in general)
After that, it's always a question of balance. The profession of psychiatrist must be quite demanding psychologically and it is important to know how to protect yourself as well.
Involvement management emotional is then at the heart of the practice.
Les prejudicing social problems profoundly affect the patient.
It is crucial to recognize and understand how these prejudices influence one's perception of himself and his illness.
Too many people still associate people with a mental disorder as crazy. The fault of the media? to the movies? to the cliches? It doesn't matter.
The reality is that today, when you have bipolarity, discussing it, even with your friends, is taking the risk of exposing yourself to rejection and criticism. And what is man's greatest fear? Bingo, to be rejected from one's social circle since in prehistoric times, it literally meant to die.
In short, I got a bit lost.
Each patient is unique, each bipolarity is unique and each treatment is therefore logically unique. I can't imagine the complexity you had to face on a daily basis to choose which treatment will be most suitable for the person in front of you. You really have courage and, it must be said, your skills save lives every day, including mine.
And for that, a big THANK YOU.
Enough of feelings. As a psychiatrist, learn from experiments enriched practice and makes it possible to offer better support to patients, that is undeniable.
Maximizing this feedback is, in my opinion, the best way to speed up the recovery process. As I often like to say: trial, error, feed back, feed back, feed back, feed back, try, oh well, success (whew).
It is all too pleasant when the combined efforts with the psychiatrist lead to the success of the supported and allows you to achieve what every good bipolar person dreams of: recovery.
The relationship between patient and psychiatrist is a continuous journey that is constantly under construction.
La mutual understanding is the cornerstone of the exchange between the patient and the psychiatrist but let's be honest, the patient will sometimes rely more on you rather than being proactive in the process of his care journey.
The first session, if we come back to that, is then crucial since the patient quickly forms an opinion of you. And it will be difficult for him to change it later. However, this positive opinion is key to optimal care because if the patient has confidence, there is a good chance that he is confident in the prescribed treatment.
And if that is not the case, let him not follow it...
Let's talk about it quickly.
A supported patient will always feel stronger, more able to face the challenges of their condition and confident in the solutions offered to them.
For example, the only times when I did not follow the treatment that was offered to me was when I had this feeling of lack of support, understanding, listening and empathy.
And guess what...
Today I have exactly the treatment he prescribed. I just changed psychiatrists.
The ability to offer support empathetic can make all the difference in the patient's care journey. So it is something to optimize as much as possible.
In the end, accompanying a bipolar patient is a journey that is shared, it is an exchange. Each session is an opportunity to learn, grow and progress together knowing that the first session is often decisive in building trust between the two parties. By understanding the expectations And the apprehensions of the patient, by reading through his fears and by offering empathetic listening and support, an environment of growth and progress can take place.
La bipolarity, with its ups and downs, challenges and opportunities, is ultimately a profound human experience for both. As a psychiatrist, it is a privilege to support unique patients, to help them find their balance and to celebrate each step forward with them. The celebration of patient victories may also be the subject of another article.
But let's remember the most important thing: that we learn from everyone and that this can change practices and deeply enrich the understanding of human nature. It's a journey that requires courage, compassion, and constant commitment, but the rewards are priceless.
We are now at the end of this article. I must admit that it was not easy for me. Fears of judgment, lack of legitimacy (?) and a whole lot of other things came up during the writing of this one.
We would like to inform you that HopeStage offers personalized support services, designed specifically to facilitate the launch and monitoring of your activities as a practitioner. To find out more, we invite you to consult the section of our website dedicated to mental health professionals.
Thanks for reading!
