In bipolar disorder, as well as with many other things in life, until we acknowledge that there is in fact something wrong, there’s not much chance of moving forward in an effective way.
Admitting that “I have bipolar disorder” or “My son/daughter/husband/wife has bipolar disorder” is critical if one wants to move forward. Yet for many, coming to a place of acceptance is difficult and, some might argue, impossible. Denial of the illness in both people with bipolar disorder and their families can be hard to overcome. It’s what often fuels stopping treatment and entering a revolving door situation of frequent inpatient hospitalizations followed by rapid destabilization once back in the community.
Acceptance of the illness does not mean you have to buy into all of the theory and treatments being offered. As you’ve noticed in reading this book, there is no perfect treatment for bipolar disorder. What acceptance does is move you out of the quagmire of “This can’t be true” and “I can’t stand this” or “There’s nothing wrong with him/her” to “Okay, I don’t like this, but what are my options, how do I move forward?”
It’s no coincidence that acceptance of an illness or problem is the first step in many therapeutic programs where change is desired. This includes twelve-step groups, such as AA, and is central to therapeutic techniques such as mindfulness training and cognitive behavioral therapy.
All of that said, there’s another dimension to acceptance of illness, and that is: for many people with bipolar disorder, especially bipolar I, the inability to accept may be more a symptom of the illness (actual brain dysfunction) and less a psychological function, such as denial. As we’ve discussed earlier, this is anosognosia, and where it exists the notion of acceptance of an illness or disorder will need to be modified in a manner that is meaningful to the individual.
Statements such as “I don’t believe I have an illness, but I am able to keep a job and stay out of the hospital when I take these medications,” may be the kinds of things that will work.
Finally, insight into the illness and the possibility for acceptance can be influenced by the individual’s current mood. Insight is frequently lost or seriously distorted when people are manic, psychotic, or depressed. Yet between mood episodes, insight into the illness can be intact.