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Hello again, Habr.

Two weeks ago, I wrote a post with a cuming out that I work in IT with a severe mental disorder and suggested asking questions. And the answer form just exploded! For the first time in the time I’ve been on the site, I saw the human part of our community so close.

Therefore, before publishing the transcript, I want to say thank you for your support and trust. I tried to answer all the questions during the broadcast - it was long, so the transcript will come out in two parts: in general, about life with BAR and practical questions, such as finding a doctor.

Under the cut, part one is about life with the BAR.

My name is Sania Galimova, I want to talk about mental disorders, about stigma, and how to live with a diagnosis and at the same time work and stay in line. There will be many triggers and the story will be cruel, so it’s better to keep the children away from the screens.

The reflection that tries to break the mirror and kill you is tin, did you have this regularly? Do you remember this clearly? If so, why didn’t you go to the doctor for a long time?

I think it's good to start the story from this. I did not go to the doctor for a very long time, because I did not realize that there was something wrong in my condition. The first 25 years of my life were pretty hardcore, a lot of things happened to my life that made me feel miserable - that is, I had objective reasons to be miserable and be stressed, and I attributed it all to it.

It all started when I left for school with a boarding house. Then I was 11 years old. We studied a lot, it was 12 hours each of two languages ​​a week, many tasks, poorly fed. Although I am grateful to the school for the knowledge and opportunities, but it was hard. Plus, the stress of learning was added that (as it turned out) the school was sponsored by an extremist religious organization - and I got into a religious sect. I read namaz and walked in closed dresses. It was not a “madrassah”, but simply for gifted children from villages with a boarding house, which was quite difficult to get into.

In the 9th grade, I read about sects in a social science textbook and began to think: this secret organizational structure, which our teachers support and on which everything is built, somehow strongly resembled a sect. I was terribly chatty and starting to think about it, I began to discuss it: I began to talk about doubts with my friends - despite the fact that six months ago I almost pulled them into this organization.

The peculiarity of the sect is that while you are in it, you feel good. As soon as you try to break out, oxygen is shut off to you. Imagine a teenager living without parents in a school in which there are beloved and respected teachers (and I really respected my teachers, they were people who raised me, educated and cared for) - and suddenly he realizes that these people are manipulating him. This is a difficult internal conflict even for an adult.

Plus, when I started these conversations, the teachers began to put pressure on me. At some point, the classroom called me into a conversation and said that “if you don’t stop doing this, I will turn your life into hell.” And then my life turned into hell for the first time.

Then the disease debuted and the first depressive episode happened. After school, I quickly became pregnant at 17 and decided to leave the baby - I really wanted to give birth and raise him, it was a wonderful experience, but physically difficult. Then there were years when I could hardly earn a living for myself and my child - imagine an 18-year-old girl with a child in her arms in Moscow. Need to work without stopping. In the afternoon I sat with the child, at night coded bad sites on php - this allowed me to hold on somehow.

Then there was the following stress: in the wake of mania, I decided to leave for St. Petersburg and open a business related to the production of desserts. I succeeded, but then again there was 2 years of continuous work. Again I slept a little and worked hard: I either walked towards the goal, either crawled or lay in her direction. In general, it was hardcore, and I always had a reason to feel tired and not completely happy. There were no discrepancies with reality and my inner state.

But at some point I turned 23 and I decided that was enough. She made a list of things in my life that make me unhappy: not enough money, no time to relax, no good relationships, uncomfortable housing, and so on. I closed my business and went into IT, and somehow I managed to close the list. I lived in St. Petersburg, I liked the city and the new job, there was enough money, a cool guy appeared. But my depression started again. Then I made a logical conclusion that something was wrong with me - not with the circumstances, but inside me. So I went to a psychotherapist and honestly told everything: about suicidal thoughts, that it hurts in my chest, that I sleep for a long time. She referred me to a psychiatrist.

As for hallucinations and delusional states: I always found an explanation: stress, fatigue, lack of sleep, vivid imagination, dreamed. Therefore, I did not go to the doctor. To my justification, it’s worth saying that I once tried to ask for help at school, when the depression started for the first time and for the first time I had the feeling that I had a knife stuck in the solar plexus: it was hard to breathe, sleep, eat, walk. I told my mother that I was not well and asked me to be taken to a psychologist.

And since then I do not trust psychologists. This woman did not even realize that something was wrong with me. I still cannot understand how it is - I recognize teenagers who are clearly in borderline situations, even when I meet them in the subway: they have cut hands, a desperate, bad look. Such a person clearly needs help, and it is easy to identify him, especially if he himself came to see you. But this psychologist did not say anything to mom, she did not say "your child has depression, your child cuts his hands, you need to do something," but only "yes, come again for a session." I don’t go to psychotherapy because I don’t trust psychologists, and if I come, I don’t say anything important. Here I have such a trauma from psychotherapy.

When a disease is caused by an imbalance at the chemistry level, psychotherapy may not be needed?

For example, if a person’s reuptake of serotonin is broken and the joy of life is lost, then normalization of the level of serotonin will return a sense of happiness, and the therapist will have nothing to do.

When you are diagnosed with a chemical imbalance in the brain, with a biological cause, psychotherapy is necessary in order to go through the stage of making a diagnosis and a new lifestyle. It’s very hard to believe that you are crazy, it’s even harder to accept it. You need to take medications regularly and not jump off them - therefore, a person is offered support in the form of psychotherapy. Therefore, you do not need to score on it, especially if you have problems with making a diagnosis.

Are you all about problems at work, but what about your personal life? In addition to travel and career,

It used to be bad. Bipolar people are super-emotional people who often cannot control these emotions. A man in mania can behave irresponsibly - for example, withdraw all money from the account and lose, enter into random relationships, just behave ugly: from the outside it may seem that he is some kind of freak, although he simply can not control himself because of disease and does not see himself from the side.

Previously, in relationships and in life, I was not very. When I started getting treatment and went into relative remission, it became much easier to maintain relationships with friends. Previously, life simply rushed, there was no time even to write an SMS, and only those people who somehow maintained relations with me remained with me. There were many of them, and I am grateful to them.

But when remission began, I realized that not all problems are due to illness. It all depends on whether you respect other people, whether you recognize their right to think differently, have other interests, act differently from what you want.To grow into an adult, with whom it’s normal to live, to study, to work, and spend time, I needed not only pills, but also work on myself.

What about productivity or creativity? Are complex projects and ideas that are uplifting during the manic phase generally feasible?

Yes. In general, all the worthwhile projects that I did were not done in one click; the implementation of the project may require 2-3 months of included work, when you pay attention to both contractors and colleagues, resolve issues. I am a manager, it is important for me to be included in all tasks.

Mania can speed you up to some point, say, for 7 days, but after that you will be depressed for 2 months, projects will be ruined, everyone will run away and they will fire you. Mania is not the key to anything at all, it seems only in theory.

What tests need to be done; if the problem is with biochemistry, tests are a clear indicator?

Unfortunately, there is no analysis that could accurately prove and show whether there is a “biochemical” diagnosis. The diagnosis is made by a psychiatrist on the basis of lengthy conversations with you, my first appointment lasted 4 hours, they asked very specific things: when I felt bad for the first time, then I felt whether there were any thoughts, whether it hurt in different places, how many months lasted. All this must be remembered; I was lucky because I kept diaries all my life - I tried to talk, understand what was wrong with me.

When I was at school, I somehow jokingly drew a “schedule of my suffering” - and when I got the diagnosis, I opened a Wikipedia article, saw an almost identical schedule and laughed. Bring all your notes to the reception. Analyzes can be done on the thyroid gland - sometimes hormonal imbalance causes emotional outbursts. If you have to take lithium preparations, first check the liver and kidneys - they suffer from it; then, when there will be a reception, you will need to regularly check the level of lithium in the blood. It has a very small therapeutic window - it needs to have no more and no less than certain values, and if the concentration is exceeded, there can be bad consequences for the central nervous system.

How to overcome yourself and make an appointment with a psychiatrist?

I can tell you how I overcame myself. In that conversation with the therapist, in which I honestly told everything, she said: you now have a borderline state, perhaps a borderline personality disorder.

I asked: that is, do I need a psychiatrist?
She said: yes, you need to check.

I came home and realized that he was the knife in his chest that hurt me, and I could not be happy. It may just be in my head that I am sick and therefore I feel bad, and the only chance to do something about it is to go to a psychiatrist now, find out how everything is, and if everything is bad, start treatment. I had no other choice. I have already done so much to get a good job, I grew a child up to 4 years old - these were 4 years of struggle, and I found a guy with whom I wanted to build a relationship - and all this I could lose. And I had to go to the doctor so that there was a chance to win the battle and save all this. Therefore, I immediately, on the same day, made an appointment. I was very scared, I could not force myself to go myself, so I asked a friend to come with me - we just left the office in the middle of the working day, got in a taxi and drove off. He sat for 4 hours and was waiting for me, and when I left, in complete prostration, with a diagnosis that seemed fatal then, he just took me home.

That is, you need to understand what you want from life. If you want to win, you have to go to the reception, it is inevitable.

What does your colleagues work with you? Diagnosis involves sudden mood swings and communication problems

This is a question for my colleagues. But in the last two works, colleagues have never seen me during the episodes, because I have been in remission for 3 years. If I again fell into one of the conditions, I would take a vacation, and they would still not see me.

Colleagues (not management) knew in advance which person comes to the team, or did they learn ex post from the article?

I did not tell any of my colleagues. Of course, they could google and find out everything - I do not hide anything, but I do not tell specifically.Why load and upset people? A special bow to my boss: before I posted the article, he carefully warned my colleagues, so after that the PM didn’t start to tear from questions.

I see my wife’s characteristic signs of BAD, how can I help her to realize the condition and begin sequential treatment? In part, she understands that something is wrong with her unstable mood, but categorically refuses to recognize herself as “psychic” (this is a quote)

I see denial, a negative perception of the very idea of ​​mental problems. I understand that it is impossible to treat another person without her desire and without understanding the situation, but it is also impossible to live like that. Extremely exhausting the nervous "swing", storms in a glass, endless grievances out of the blue, but I do not want to part with it.

That's a very difficult question. But I have an answer to him, and he is cruel: NO. If a person denies and does not want to be treated, does not realize that he needs to be treated, then you will not do anything. I will say why: I talked a lot with other bipolar people and generally people with diagnoses; when I found out my diagnosis, subscribed to all telegram channels about it, I was interested to know how it is.

And it turns out that almost no one goes into remission, although I got out pretty quickly. I came to the next appointment with a psychiatrist and asked: why do people not work with pills?

He replied that while a person does not want to be treated, while he has bonuses from having a diagnosis, they feel sorry for him, love him, subscribe to him on the Internet - he will not be cured. I did not believe it, I thought I was just lucky, and the psychiatrist wants to warm up my ChSV. But now experience tells me that he told the truth.

Therefore, as long as your wife is in denial, you cannot do anything. Even if she believes, but will doubt the diagnosis and will, for example, take pills, then do not take - nothing will be achieved without a stable desire to recover.

If bipolar people like mania, why not move there? Why be normal? It is unlikely that such a Joker will last long, but will die happy

And here is the cruel answer: either to act as a Christian and remain in this marriage, or - if you do not want to live like this all your life - leave. I think that if I had such a partner, I would leave. I'm not so strong.
No, you will not die happy. You will die in suffering and fruitless attempts to regain control of your body and mind. Madness is one of the most terrible things I've met in my life. This is worse than death. I would rather die, but not lose my mind completely.

In general, I want to give a comment from KivApple to the previous post, with which I completely agree

Here is this comment
Although a manic phrase, even drug intoxication is “happiness on credit”. Sooner or later, the body’s reserves are depleted (and the amount of dopamine and serotonin possible to release is limited, even drugs do not generate these hormones, but simply provide an unnaturally sharp release of them, well, the majority, in any case, I have theoretical knowledge, I won’t say anything) and is inevitable Depression and apathy (drug users also call this “scum”). This is just a year to collect loans for the maximum amount and poison for a month on a trip around the world. and then eat doshiraki all year and live under the bridge, working on 3 jobs, paying a loan. At first glance, it sounds cool, but in practice, most will not like it. And if drug users can theoretically still control the time of taking a “loan” and its “amount” (and indeed it’s their choice and they are a safety net), then in the case of mental illness this is much less predictable and controllable, and it is also not a conscious choice.

Thus, theoretically, it is possible to leave the manic phase a little earlier or a little later, but to “go into it forever” an unsolvable task in psychiatry is the same as creating a perpetual motion machine in physics. Well, the cherry on the cake - the manic phase is characterized by reduced caution, dulling the instinct of self-preservation, etc.In practice, this translates into minor violations of laws (the same SDA), promiscuous sexual intercourse, uncontrolled use of drugs and alcohol, acquaintance with marginalized individuals... Again, Russian roulette. “This motorcycle will serve you for the rest of your life if you drive fast enough” (c)

How to help a loved one in this state, especially if he is locked in and does not try to help himself? How to behave like a family in this case, if a person listens to anyone, but not close ones?

If a person is depressed, all you can do now is take care of him as a patient. That is, do not load heavily, make sure that a person does not harm himself and does not commit suicide, provide assistance and support. Offer to go to the doctor together, offer help in treatment (let's get you out of this state, go to the doctor, I’ll go with you, I’ll remind you that it’s time to drink a pill), remind you to eat and sleep.

When a person is very ill and is going to go out the window, you need to call an ambulance. This is very important. If a person has already attempted suicide, then he is in extreme condition; especially if he is in mania - then he should not be left alone for even a minute. I saw such conditions in people, it is very scary and we called the orderlies. An ambulance arrives very quickly if you say that you have a suicide.

I can’t sleep without sleeping pills. Before depression, sleep was normal.

In my experience, insomnia is the fastest killer. Getting help as soon as possible.

I had clinical depression once. After I moved to St. Petersburg - I worked for 12-16 hours seven days a week for starting a business, paying for an apartment and a nanny for a two-year-old child. It was very difficult, at first I had hypomania, then mania, then depression, and then I started insomnia.

I did not sleep for about 3-4 days, and during this time I specifically went to the roof. It was very bad. At the end of the third day I had a confused consciousness, and I realized that I had to sleep one way or another - and either fall asleep or die, but I would sleep anyway

I calmly, without any anxiety, compiled a list of tasks to be done before evening, and I did everything, then I put the child to bed... and went to the roof. Calm, balanced and happy that now I will sleep. At that moment, a friend called me who realized that something was wrong with me. He came and looked after me all night; I was able to fall asleep for about an hour. He then said that it was probably necessary to call an ambulance, but he did not call, because he thought that I was “just emotional.”
After this night, I fell into clinical depression, and it was tin. I lay two months in a row, every day it got worse. I could not fall asleep neither night nor day; sometimes she forgot herself in an alarming sleep for an hour, and when she woke up she regretted falling asleep (“maybe if I hadn’t fallen asleep, I would have already died and it was all over”). I no longer had the strength to commit suicide. It got to the point that she simply lay and didn’t even get into the toilet (she endured to the very last, got up, holding on to furniture and walls, got to the toilet, then fell again).

Every day I thought that today should be better; I didn’t even realize that depression looked exactly like that, I thought “I just overworked, tired, sick, I’m young and strong, I’ll get better - tomorrow will be better.” But tomorrow it didn’t get any better. At one point, my one hour of sleep turned into 20-30 minutes.

Every day I was sure that it would get better - on one of these days my eyesight suddenly fell and everything became cloudy. I still believed that it would get better - but after a couple of days the food ceased to be absorbed.

This was probably the moment when I first met death: not when I buried friends, but when I decided two months later how many days I’m already lying, that day I think, “today will be better”, but it didn’t get any better. Then I suddenly realized that if the dynamics go down all the time, maybe it won’t go up - that’s probably all and I’m leaving this way. And I realized that I’m not afraid, I’m glad that everything was fun, interesting, not boring.

And after that I went on the mend - the next day my vision returned and gradually everything else.

Why am I saying this: insomnia is creepy, it can kill quickly. If you have insomnia, solve this problem before it resolves you.

What do you specialize in by profession?

I lead the marketing department. That is, I am responsible for ensuring that everything works well and stably. I come up with stocks, come up with their implementation, I think who needs to be attracted, how much it will cost, whether it will burn out, whether we will earn from it. Including I supervise our blog on Habré, I search for authors, topics interesting to them and so on.

Did BAR affect Sanya's habits and lifestyle? The work of a marketer requires manic creativity, perhaps this is due to

I have my own theory about how creativity and BAR are related. Indeed, there are many indications that people with bipolar disorder are more creative.

I think that people with BAD, especially in hypomanic and manic states, have a more efficient brain function. They can keep in mind the power of things and the connections between them, build complex systems, notice and remember everything. Works of art - such as when you enter an art gallery and just freeze - these are infinitely harmonious systems, they have a huge number of small details that are perfectly and harmoniously folded. The more harmonious, the more monumental and more beautiful the work.

I think that it is consciously impossible to do this, but talented people do it intuitively - and people with BAD have better intuition during the period of mania - and therefore they are more able to intuitively create works of art. Everything is being completed in their head.

I think this is also connected with the fact that bipolar people have a higher sensitivity to works of art - we understand them more deeply. There is also such a funny symptom - a complex speech apparatus: a person can, love and practice speaking a complex, more expressive language with a large number of original turns; I think my theory explains it.

But this is just my theory, which is not supported by anything.

I look at the prices for a consultation with a psychiatrist in different organizations - they are impressive. Consultation, necessary examination, observation - everything costs quite a lot of money. If I go to a cheaper organization - will the assistance provided be worse? Where to go if the budget is not very good?

It is really expensive. When I found out the diagnosis, I realized that I was cornered: I need to be treated in order to work, and to work in order to be treated - and when you start to be treated, performance decreases while the medication is being selected.

I do not think that cheaper psychiatrists are always worse; I heard that people roll off 20 pieces at a time, when I paid only 2.5. Somehow I did something stupid: I came to a regular appointment (just to show myself to a psychiatrist and make sure that everything was going well);

I am like this: class, I have a new job, now the salary is better, and the doctor in response: oh, then now the appointment is 3500 :)

In general, look. Many doctors give discounts because they want to help people, and really help us, and it doesn't have to be expensive. Look at his qualifications, as I wrote above: he must go to conferences and look for new materials and methods.

For example, there are relatively new 2nd generation antipsychotics, and I accept just them. But, if I got to the ossified doctor of the "old school" - I would sit on a haloperidol, maybe I would not have a good life. If the budget is not very good, you can contact the IPA - just carefully look at the reviews. Both in PND, and in a free clinic can provide high-quality help, but how lucky.

Insomnia for 3-4 days. There is crazy fatigue, vivid pictures appear when you close your eyes, you can’t fall asleep

3-4 days it is already dangerous, it is better to immediately see a doctor. Let at least prescribe haloperidol, but not insomnia.

Drugs and mental illness. Why not?

Because hallucinations and other special effects caused by drugs are the same psychosis as with an illness. This condition can begin on its own with the disease: at the peak of mania or depression, or with schizophrenia.

And exactly the same condition is caused, for example, by mushrooms.When people buy all sorts of substances in order to deliberately cause psychosis, and believe that they somehow “know themselves”...

Psychosis is not the discovery of the secrets of the universe, but digging in the crap tank of your brain. If you want revelations - go to work, meet real people, talk with your father. I have been struggling with psychoses for many years, I'm afraid of them, I want to get rid of them - I am amazed by people who are specifically looking for them.

Do you tell your partner about BAR? Psychiatrist advises not to speak

This is not a psychiatrist's business, but your personal one.

I told my partner right away, because I decided that he had the right to know, and to leave if he wanted. But he did not leave. We have been together for 4 years; when I found out the diagnosis, we were together for only 2 months. When I told him, he lay on the sofa facing the wall and thought all that evening, and then said that he would help me, and we will go through it. And we have passed.

He supported me during the treatment, when I could not get up, and when I wore hypomanic - now he can notice the phase approaching earlier than anyone, in the speed of my speech and some kind of micromimic. And I go to the doctor at the very early stage, probably this is one of the secrets of remission - I don’t even have time to enter the phase.

So decide for yourself whether or not to speak, the psychiatrist is not an adviser here.

How can a partner help her soul mate, living 200 km/h, stay in sight and not forget about three children? If something - they hired a nanny, parents help, but it does not save. The partner does not want to be treated - “everything is fine.”

I sympathize with you very much because I understand that a nanny, a grandmother and grandfather are not mom and dad. It should be very difficult - you want your child to have everything super. But, if a person does not want to heal himself, nothing can be done about it. It is up to you to decide whether you will continue to live this way - the partner has already made his decision.

Do you think it is dangerous to drink alcohol with medication?

It all depends on the medicine. Some cannot be disturbed at all - you can simply poison yourself. In my case, it’s just not recommended, I take the medicine even after a meeting with friends with wine and khachapuri.

Tell me, if you had the opportunity, would you return 10 years ago and live life anew - without mental disorders, in the body of an ordinary person?

If I had the opportunity to return 10 years ago, I would not have changed anything - even this dumb tattoo, which I did during mania. As I already wrote on Habré - life was hard, but life was beautiful. There was so much good! Yes, there are moments for which I am ashamed (for example, when I was running after the boys), but it’s even kind of nice - there is something to regret, something to laugh about. Moreover, even in mania I made good decisions. I was lucky that I gave birth to a child before I sat on pills - he will go to school soon and is generally wonderful. Or my business - I learned a lot, met amazing people. It's all worth it.

Does mania equalize depression?

Not. Mania is also suffering. I said that it was “pleasure,” but it is still seasoned with suffering. In mania, dangerous behavior is often present - you can harm yourself, other people, for example, if you drive.

When it accelerates greatly, the sensations are very unpleasant - the head seems to be torn. When psychosis begins, hallucinations and delirium are generally a nightmare. This does not equalize depression, it’s not what you want to return to.

How is it possible in your right mind to abandon the initial phase of mania, because it is so beautiful. Brilliant plans, simple solutions to complex problems, easy acquaintances, sex 12 times a night

12 times a night in the club’s toilet with different people - this is not wonderful, it is “you will die from shame (and, possibly, from HIV infection)”. And simple solutions to complex problems for verification turn out to be fake. And brilliant plans are unattainable.

What is the threshold dividing the normal change of phases of activity and depression of an ordinary person in this world, with all its nuances, and the diagnosis of bipolar disorder? What are the “bells” of the diagnosis?

Clear psychotic symptoms when there are hallucinations, delusions, the urge to commit suicide or self-harm. These are “calls”, it means that you have a diagnosis, and you need to urgently go to be checked.

In mania, it is clearly visible that the person is not in himself; he speaks faster, sleeps less - there are obvious quantitative indicators by which one can understand that a person has gone into mania. And for depression, too: severe depression, and then destructive things begin, like the inability to read, sleep, something can hurt. That is, there are specific symptoms by which it can be distinguished from the phases of an ordinary person.

How do I find a job if you get fired, you haven’t the most popular specialization, but also schizotypal disorder plus recurrent depression?

Start small: take medicine regularly, and try to take control of this thing. If you are interested in your work, most likely you will always work, from this your level will grow, you will be paid more, employers will outbid you. If it is not interesting - I advise you to find what is interesting. This is the only way to become a cool specialist who can provide for himself - including providing treatment.

Tell us more about the somatic manifestation of the disease. You wrote that food ceases to be absorbed - how did it happen?

From what I have not talked about, I can mention this: I once felt, in an instant, how depression was slowly disappearing. It was a mall. I went there for work, I had to buy something, and I felt very bad; there was no strength for anything. I was lost in this center - I could not understand in which part I am located, where is the desired store. In depression, cognitive abilities decrease. I remember that I stood and looked at the floor, trying to gather my strength, and at some point the sound quality sharply increased, as if the headphones were put on somehow, and they were stuck in my ears as it should.

Then I suddenly noticed that music was playing in the background and my vision suddenly became clearer - I noticed a pattern on the floor with sneakers. That is, there really are somatic manifestations, they are very obvious, and it’s very sad - you turn from an adult able-bodied person into an old man.

How to behave if a loved one has a BAR? What can and should be done, what can’t be done?

As I said - to heal, support, help. Promise that you will always support if you are really going to do it, if you are ready for this difficult path. You should not treat a person with BAR as a child. His decisions must be respected. I often receive letters with similar questions: a person met a girl (guy), started dating, and then the other side says that he has a BAR and is not ready for a relationship, and then - “you can’t take it out yet.”

More often women write such letters about men, and explain: “I am ready to come to him, to move, to be near, a wall for him, to heal, to help, to experience the phases - how to convince him to let him go to his apartment and treat him? " You must understand that the main phrase from the partner "I am not ready for a relationship with you" .

“I have a BAR” - this is often just a polite excuse. If a person has bipolar, you should not consider him as some kind of child, unreasonable, whom you will save now. Many people with bipolar can do a lot - both for themselves and for others, and if they don’t do something, maybe they just don’t want to.

Advise how to find a good and affordable doctor in Moscow to treat this disease.

My friend Andrei Breslav makes the service Alter , and for him he selects proven psychotherapists with a diploma and consisting in associations. If I were looking for a psychiatrist now, I would register there, select one or two psychotherapists, go to them, and ask them to refer me to their psychiatrists who are known to go to conferences and learn about new medicines and methods.

If the therapist works with your illnesses, then he must have a pool of psychiatrists with whom he has already cured people and to whom he can refer you. So I would be looking.

How and when to recognize such a feature in a child? How to behave if you recognize?

A very difficult topic. I am very afraid that my child will have my problem, although this is absolutely not guaranteed - for example, my parents do not have bipolar, and my brother does not, only I have. I think if you notice something like this in a child, if he really has symptoms, and it’s hard for him, you need to talk to him. It is necessary to enter from this side: “Tell me, is it hard for you? If it's hard, let's do something about it? I know a thing that can help. ” Do not bully him. If it is small, you can submit it as it is: "it's hard for you, but there are doctors who can help." If he is an adult, then everything is more complicated, and stigma works, and that’s all. I think that we need to love and respect our children, and they will answer the same, and then such conversations will be easier.

And, as I said, if your loved one has a BAR, the most important thing is not to let him kill himself. We have a very high suicide rate, above 25%, it seems, and this should be monitored.

Hello, how did you achieve remission? I also have a BAR

Health to you. I achieved remission in a rather simple way to explain, but difficult to complete. I found a good psychiatrist, and I decided for myself that I would and would like to be treated. That is, I didn’t see a single “plus” in the BAR, I didn’t want mania and hypomania, I just wanted to get back to normal, live to old age with a big bank account, a cool husband and a lot of children in a house on the sea. I realized that this goal would be unattainable if I did not give up these short narcotic attacks of pleasure from mania, so I did not want mania at all.

I have many friends, I do not suffer from a lack of attention, and I did not need additional popularity, so I also did not receive and did not see such a plus as increased attention to my person. I made a list of things for myself for which I want to be cured, and I did not have a single vote against. After that, as an obedient girl, I took everything that my psychiatrist prescribed with side effects, of course. I went to receptions, to psychotherapy - although she did not help me, after two months I just asked the doctor if it was already possible to stop, and he replied that my problems with making a diagnosis seemed to be resolved. That's how I went into remission while everything is holding out.

Did BAR affect habits? How to keep a remission?

Yes of course. Maybe you watched the movie “Beautiful Mind”, about John Nash, who, when new people come up to him, asks: “do you see him too?” and makes sure that this is not a hallucination. Sometimes I also ask my husband if he sees something, if he hears something, if something unusual. Thank God for the last 4 years it has always been something real. I monitor my condition, I sleep well, I call the doctor if something goes wrong. If it seems to me that something is wrong, I immediately go to the reception.

I was several times increased the dose, and this helped to maintain remission.

Is it possible in this state and with such a diagnosis to find oneself, to determine one's profession, how to do it? Thank you.

Yes you can. When I was diagnosed with borderline personality disorder, I began to read a lot about it. Many symptoms converged, they really overlap; but I read to the point where it says that borderline personality disorder is a disease that in the core has a person’s lack of understanding who he is. That is, the root cause is that he does not seem to have his own personality, interests, aspirations, desires, and therefore he finds a partner, clings to him, takes over all this, and when the partner throws him away, it seems to him that from him pulled out a piece.

I realized that I didn’t have a borderline disorder because I always knew who I was, what I was, what I wanted. I think for sure you have intermissions, or stages with not the most severe depression or mania. What is in there is most likely what you are.

How do you know where you are and where the diagnosis is?

I also wanted to say something important.I can talk about how a person feels after being told the diagnosis, and how to accept it. That is, how to accept that you will need to be constantly treated.

When I was informed of my diagnosis, it was very, very, very difficult. For two reasons. I was afraid that I would never go into remission and would never be happy, as in childhood; that this alternation will never end and that I will have to suffer all my life like that, and also because of treatment and side effects.

As I already said, my life was a struggle to make me feel normal, to make it easier - I fought for money, a career, to raise a child and not go crazy myself; and I thought that the struggle should someday end, because the world is fair, and everything should work out because I tried.

And then it turns out that I can try as I please - the problem is in my head, and perhaps it will never be solved. It was a hard blow. It turned out that not everything depends on my efforts and skills.
The second difficult thing is to differentiate yourself and your diagnosis. This disease affects the personality of a person, changes him.

When they told me the diagnosis, I returned home and began to read about how bipolar people behave, how they think, how they build their lives. I had the feeling of an ominous valley: everything that I considered my own character, what I was proud of, what I considered the strengths of myself, turned out to be symptoms of the disease.

70% of my character turned out to be symptoms. Am I a disease? Or vice versa? What would I be without a disease? Without a disease, I do not exist?

There is such a series - "The World of the Wild West" about robots that are programmed to live a certain life and play their scripts. In the second season there is a scene: a whore from the park sees another robot that lives on her script.

The heroine’s phrase: “I like you, you have no callousness. I will give you a discount, ”which she repeats every time a new man enters the bar.

And now she herself enters the bar as a visitor, sees another robot who turns in the same way and repeats her phrase - and the heroine has such a pain on her face. And I experienced the same thing - I sat and read my scripts. Due to the fact that when I was diagnosed, I was deeply depressed, these thoughts constantly gnawed at me, I thought about it every day.

But, although I felt bad, and I thought about all this and thought about why all this, I continued to drink medicine. And you go on. Bad thoughts should not distract from the main thing. Eat your pills while you suffer.

But I went into remission and got used to these thoughts, and now I do not care where I am or where this disease is. I am the way I am. Yes, my experience has significantly shaped what I am now, how I act and how I speak, but this is my experience, although it looks like other bipolar people.

I always had a will, my own, I always made the choices myself - no matter in mania, depression, hypomania. These choices make my path unique, they make me me.

I think this also answers such an important question: how to relate to people with diseases in general. I believe that you are not determined by what kind of crap you come across. Many terrible things can happen: you can get sick, be crazy, be robbed, be at war, get captured by terrorists. The fact that you are not lucky does not characterize you in any way. You are characterized by how you deal with this, how you behave in this situation and what decisions you make.

Therefore, I’m not afraid to tell the employer that I have a bipolar - I think that I can cope with this with honor. It warms me. And I understand that my people, whom I respect, also see and understand this.

Instead of conclusions: 5 most important points, not all of which I mentioned on the air

1. My friend strongly advises in Moscow this place for treatment. His quote:
Citizens with permanent registration in Moscow and an insurance policy, they accept for free. And most importantly, do not start specialized cards. In other words, no one except your doctor knows the diagnosis.
No stamp is placed anywhere. In mild forms of the disease, you can come only during the day, and sleep at home.

2. Electroshock is one of the most effective and safe methods of treatment for depression .People avoid it because it is a classic element of the horror movie about a psychiatric clinic - however, it has been proven that it is safer for the brain than prolonged use of antipsychotics, antidepressants and antipsychotics. The electroshock helped Carrie Fisher in the fight against bipolar disorder - Princess Leia, whom we dreamed about all our childhood. I haven’t tried electroshock therapy myself, but if I have to, I’ll go.

3. One of the most useful books on bipolar disorder is " Restless My mind win over bipolar " Kay Jamison. This is a psychiatrist specializing in bipolar and she suffers from BAD. This is the same book that dotted all the i's for my mother - she said that after reading it, it became much easier for her to live, because she understood all my breakdowns, the tendency to fatality and rigidity in some situations.

4. If your friend speaks about thoughts of suicide - take this with all seriousness. A healthy person never thinks about suicide, unless, of course, he is a samurai. One of my friends wrote to me about his suicidal thoughts and I did not react to him with sufficient warmth due to internal conflicts in our ACM party - and it was doubly difficult for me to help his mother organize a funeral.

5. If you feel that you are losing control - seek emergency help. Feel that you will go out the window - call an ambulance. It’s better to lie for a week in the clinic and then tear everyone at the competitions in Topcoder, than to leave so ingloriously. If your friend is trying to get out, also call an ambulance. When you calm him down and go home - with great probability he will try to do it again and it doesn’t matter that this person was the soul of the company and collected all the diplomas in the race. Better to ruin a relationship than to say goodbye forever with a heavy heart.

Continuing tomorrow at the same time.

ITKarma picture.