I see more and more clients who have gone to their doctor complaining of "mood swings", being diagnosed with Bipolar Disorder and placed on mood stabilizers. Yet when I talk to them they do not meet the diagnostic criteria for Bipolar Disorder. When I talk to them more I get an interesting picture.
When I ask them to describe their mood swings they describe having emotions. They simply feel their emotions. How did we get to a place where this is diagnosed as being abnormal and medicated with a very serious, and often dangerous class of drugs?
Human beings have mood swings. This is normal. This is what makes us human. If I get up in the morning and I'm having a good hair day, I awake refreshed and excited about going to work, I'm wearing something I feel particularly good in and the weather is beautiful, I may be in a really good mood. I may feel happy, content, and energetic. I get in my car to drive to work and accidentally spill coffee all over myself. I am now in a quite different mood. I may experience, anger, frustration, irritation or sadness. I manage to clean up the mess and recoup what's left of my good mood. I go on to work where I hear that the funding for our program may be cut. I am now in yet another mood. I may be feeling anxiety, fear, trepidation, worry, frustration or irritation. This is all normal. This is how human beings function. We have emotional reactions to things going on around us or happening to us. This does not need to be medicated.
So what happens if we are facing some particularly difficult life challenges and feeling some particularly uncomfortable emotions as a result? Emotions like anger, fear, anxiety, frustration or sadness? If we are so sad or anxious that we cease to function, medication may be temporarily appropriate to get us throuogh this difficult time and bring us back up to a level where we can at least function. But only in extreme circumstances. If we experience something painful in our lives we need to feel it. People often ask why we need to experience such unpleasant feelings when we have medications that will numb them. There are several reasons for this.
1. Medications, like mood stabilizers, which tranquilize or damp down negative emotions also numb positive emotions. Though we may feel the pain of a recent death less, we may also be less able to enjoy happiness or pleasure either. A hug from our child, a walk on a beautiful day, our favorite music or food, a get together with friends, playing our favorite sport. The intensity and joy we feel during these events may be numbed as well.
2. Medications also prevent us from learning more natural ways of handling intense emotions. We come to rely on the medications alone to do all the work. It's important to develop the skills necessary to manage uncomfortable emotions. If you don't learn to deal with the death of a close family member or friend when you are 30, how are you going to deal with the death of your friends and family at 70, when it is going to start happening more often? Working through grief teaches us how to cope with it. It allows us to develop ways of comforting ourselves and skills for living with suffering that we will need later. It gives us a chance to look at our own lives and find what is important in them. Things we will need to hang onto later. If we don't develop these skills gradually over time, we suddenly arrive at old age. We now have to deal with a myriad of problems; our own declining health, the deaths of friends, family or spouses, the inability to work, our increasing dependence on others. How are we going to deal with all of these issues if we haven't developed strategies for coping along the way? We may find ourselves standing like a deer caught in the headlights with absolutely no way of handling it. Or we may be so doped up on medications that we no longer experience our own lives. And if you are not experiencing your life, what is the point of living it?
Suffering is part of life, but only part of it. Learning to have your emotions and be comfortable with them makes life a much richer tapestry of experiences. It's the difference between eating fat-free, sugar-free ice cream and Haagen Dazs. It's the difference between listening to your favorite music on a transistor radio and listening to it on your home stereo system or in a concert hall.
Does this mean that I think that no one has Bipolar Disorder? Absolutely not. Bipolar Disorder exists and requires medication. Though counseling may help people with Bipolar Disorder develop skills for coping with the disorder, it can only be controlled with medication. For people with a true Bipolar diagnosis, medication may be the only thing that keeps it from totally destroying their lives and I would never advocate that they go without it.
My concern is for people who are actually experiencing the normal emotions of life, labeling them "mood swings" and trying to medicate their discomfort away. My concern is for doctors who participate in this and validate it. My concern is for teaching people that emotions can be "negative" and undesirable. That they are "bad" in some way and should be eliminated, by chemical intervention or any other means. This is not a message we want to send. Emotions are what make us human. And expressing them is what keeps us sane.