An updated version of UP FROM THE ASHES now available in ebook

Never satisfied with his work, Peter has completed an updated version of UP FROM THE ASHES in ebook format. It is now available on Amazon here.

Life is a struggle but the outcome can be a surprise

By Peter J. Dorsen, M.D., LADC

The preliminary version of Up from the Ashes: One Doc’s Struggle with Drugs and Mental Illness is available on Amazon.com. Give a read. It is a revised version of Crazy Doctor: Mixing Drugs and Mental Illness.

I owe it to those I endeavor to help with the struggle dealing with the treatable bipolar disorder.  Here’s a flash. Luckily on Lamictal (lamotrigine), I noticed as the season is morphing into Fall, I felt myself slipping into depression. I was going down just as the Maples and ash were coloring beautifully yet dropping their treasures. Suddenly, I felt my discomfort stop. I realized that a frightening mood change had stopped.

So, for me, I describe the blessing of the correct medication. My story I recount in the new Up from the Ashes is the journey culminating is stability. I am during a bountiful relationship with a beautiful (inside and out) woman, but I am not blowing it.

We both face our challenges.  We share our individual struggles. The outcome is a mutual love now possible by facing our demons but not fearing losing our creativity or how we function with other life’s stressors.

I hope Up from the Ashes: One Doc’s Struggle with Drugs and Mental Illness may afford you the wherewithal to take such a journey from inner and outer pain to an all-new freedom. My updated message is get sound advice and accept medication that can eliminate self-medicating with alcohol or drugs. Take this journey with me in my new book.

'Dr. D' at Hoigaard’s Classic Marathon in 2017

My new book: Up from the Ashes: One Doc’s Struggle with Drugs and Mental Illness

Up from the Ashes: One Doc’s Struggle with Drugs and Mental Illness

(ebook, Amazon, July 2017)

I write about the bad times in my life. But as my story confirms, there is hope for anyone struggling with bipolar disorder with chemical abuse thrown into the equation.

“Dr. Dorsen’s personal and poignant life story is a risky self-disclosure that mirrors hope to anyone, regardless of profession, who may suffer from co-occurring illnesses.” – Bill Manahan, M.D., author of Eat for Health: Fast and Simple Ways of Eliminating Disease Without Medical Assistance

I was a professional, I was over 50, had a mood disorder that my treating doctors had neglected for decades even back to my childhood. Certainly, my illness was impacted by intermittent pot smoking over all those years. Now, I had relapsed. I was not sure the Board would ever really see how my dual illnesses impacted on my deterioration as a physician, father, husband, and member of a greater community. As my 16-year-old's guardian, I was able to temporarily obtain a medical subsidized housing for me and a shared food card for her and me.
            My recovery was emerging from the shame of failure. Yet the sharp reality of my current destiny let me look clearly at the then and now. Was hard manual labor punishment for my errant ways, or was my sentence an opportunity, at 62, to take a break from my profession — the process Joseph Slater describes in Self Renewal? In every sense, I have had to think out of the box and rediscover who I really am, to find my soul. I remember that I felt a kinship with the physician in Milos Kandahar's wonderful book, The Incredible Lightness of Being. Our protagonist has been banished from medicine for political reasons but enjoys the perks of his new profession traveling from apartment to apartment washing windows. He also gets an opportunity to intimately know the women who live there.
            I now believe I have become closer to the Zen of my life. I feel once again. How did I do it? At first, I attended about three AA meetings a week. By day, as I toiled, my body became harder. I endured an existence that was a trial of hot and cold, wet and dry, clean or dirty unlike the sterility of an unexamined life. My mental health was due to my sobriety and the right medical treatment. I no longer chose to self-medicate with pot and then enter a painful world of anxiety, panic, and depression.
            I went from day-to-day appreciating a new freedom. My life had been self-imposed chaos. I no longer wore the mantle of the medical profession. Sometimes even, I felt good in a new life of honesty and acceptance. I worked trustfully with a sponsor who was a supporter and confidant. I stuck doggedly with a psychiatrist I had known since 1983 and trusted. I now worked to define myself from a different perspective. I was a worker in the earth in search of a stronger, renewed persona; as Plato spoke for Socrates, "The unexamined life is not worth living."

No matter where we are coming from, a doctor like myself, or artist, we fear we will lose creativity by taking the medications. This is my testimony how anyone with bipolar disorder can be creative and functional again. My story is about the relief from suffering from mercurial emotional fluctuations with the right meds.

Popalos and Popalos in the seminal Bipolar Child confirm that bipolar disorder may well have started in kindergarten when I was described as a “Very active little boy.” My life would continue as a seasonal depression. But no one figured it out. Society punishes behavior while paying lip service to a brain disorder like mine.

“Telling this story lays out my guts for the world to see. In so doing, I have surrendered resentments over what I had no control over. Finally, I see, through pain and denial, the devastation my own illness. I am writing about a private personal journey of pain.”

Things Are Looking Up

By Peter J. Dorsen, M.D., LADC

It is so important to take what comes your way as not necessarily bad. In my last post, I confessed I was in the poverty corner.  I told how much I appreciated my sponsor even if he was pessimistic that sometimes in recovery and working back up, we take some hits.

I suggest keeping as active as possible and--if you are about to retire--make some plans.  Retirement and too much time on your hands can be a set up for depression or just saying, "What the hell, I'm not under any stress any longer, so I'll just start dropping my dosage.

Bad move. Maybe less or no stress but our brains still just aren't wired like most of those other critters out on those mean streets.  Let me reiterate by reemphasizing that any life stress can kick off cycling either starting as depression or as hypomania/mania.

Make up a safety plan as I have attempted to do. I can never figure why anyone would just be counting the days until retirement. Another fantasy for many is imagining never ending tee off time will be like heaven.  Unless you play like a pro, forget it. I am told that golf is not for those with weak egos or low self-esteem.  Retirement is of itself often the surrender of all those hats and cloaks of fame and position that made us who we were.  My mother, a retired physician bemoaned how, in her retirement years  she became a nobody

So this is to emphasize that we must be forever on the vigil so that we do not slip back into a dangerous predisposition for feeling worthless hence depressed, angry, stop our meds and then swirl into a vortex of our illness that may be most unsettling or debilitating.

I have to confess, I am having considerable trouble retiring and a significant cause of that is..I need the money.  My bank account continually reminds me that I am not a nonprofit company. I exercise every day (sometimes too much--and risk moodiness).  Eating frequently and avoiding simple sugars, and I avoid self-medicating (pot, alcohol, too much coffee).

Just as addiction is an equal opportunity destroyer, we all have both genetic and environmental (multifactorial) reasons to know we have propensity to relapse anytime. So too, we have also a genetically and environmental reason we can slip and slide back into dysfunctional patterns especially as we age and in fact have new stressors of aging and loss.

I still want very much to get  Kay Redfield Jamison's secret. Is she like the rest of us with bipolar 1 or 2? She must always assess the state of her illness. She deserves her privacy as much as any of us. I try to not take personally that I sent her my book, Crazy Doctor, but, alas, no response. I suspect though that all of us deserve a little mystery but that should probably exclude our loved ones.  Many of them we have hurt by using illicit(pot, meth etc) or licit Vicodin, Oxycontin) drugs.   Others of us have abused our relationships with explosive anger, inconsistent behavior (cycling), infidelity, excessive spending, or failure.

I remember my bottom and don't intend to go there again.

"I'm Peter and I will always have co-occurring illnesses."

Until next time,

Peter J. Dorsen, M.D., LADC

Life With Bipolar Is Possible and Can Be Fun With Proper Treatment

Peter J. Dorsen, M.D., LADC

Hey, Everyone. As Aaaanold says, "I'm back." AS long as I'm not sounding like Clint, I'm gonna be OK.

I apologize that so much time has elapsed since my last blog. One learns to live with success and failure. As that goes, I am about to hear that my license to practice alcohol and drug counseling (LADC) no longer has Rules and Stipulations. Most of what all that was about was The Board watching me for 5 years and confirming I was stable with my bipolar disorder.

Frankly, no one but myself was ever worked up about co-occurring illness, in my case something just as simple as throwing my illness haywire with mood altering substances.

Whew! This a good thing and things just seem to be fitting into place. I am able to deal with pressures that include instances like that with the Board that I find humiliating.My sponsor, John B, tells me he was never poorer than when he entered recovery. Boy, that's great to hear.  Does that men that I have to take a vow of poverty. No. It tells me and indirectly you who will read my blog that moving forward with a stable bipolar life can still have some bumps.  My point in writing is that proper medication and sobriety, as in my case, can--as I explained some time back-- mean a level playing field.
I attribute an improved life as one in which I am constantly doing personal checks and sometimes asking my therapist or psychiatrist if they are comfortable with where I am, my moods, my behavior as they observe it.

I try as best I can to be honest. I have had to report that Trileptal made me dizzy. Heck, I kept on flying off the track last year at cross country ski races. We moved on to lamotrigine but I must confess after I went the wrong way on a course I knew I had to convince my prescriber I was on too much.  Hell, I'm 69 next month (which is very hard to believe), if my coronaries clogged 7 years ago, it doesn't come as a surprise that some of my brain blood vessels have also narrowed some.

My point: Stand up to your provider and don't just stop your meds but challenge, ask questions, and refuse until you get what you deserve.  There are actually psychiatrists I believe fear the mental illnesses that they claim to be qualified to treat. Find a new shrink or therapist who you may feel does not respect you. Hey team, we bipolars are the ones who besides being dysfunctional also are the most creative, the most driven.

I'm welcoming myself back and encourage all of you who gravitate to our blog to tell us what you think about living with a treatable condition.  We're right up there as the most likely to quit taking our meds.  I know, I need them and that my life has taken a beautiful direction with caring professional who listen, are not on the defensive, who do not fear their own mental heath issues that we mirror.

No one said this would be easy. There are plenty of those who have known us who would judge.  That is why impartial opinion and professional expertise mean so much.

Tell us your journey.  We are here to listen and respond. Blessings,

Peter J. Dorsen, M.D., LADC

Using CBT with Bipolar Disorder

Cognitive Behavioral therapy is an evidence based practice for bipolar disorder as well as for unipolar depression. One way to access the skills of CBT is to go to therapy with a CBT practitioner. It is my belief, however, that the goal of a CBT therapist is to help one's clients understand and use CBT skills on their own. Those of us experiencing episodes of depression, whether mild or severe may benefit from the same kind of cognitive restructuring that folks with unipolar depression find helpful. In low moods we need to recognize pessimistic thinking and exaggerated self-criticism.

Clients with higher levels of mania are often helped to adjust their thinking to accept the need for medications and professional help. I am thinking that a more challenging area is for those of us experiencing milder mania. Hypomania can be very seductive, because it feels so damn good. The addictive voice of hypomania tells us to disregard feedback and criticism from others. Consequences of mild mania are less severe for the short term, but have the potential to affect our careers, our relationships with partners, parents, children and friends.

In my early recovery I was fortunate to get a strong dose of challenges to my "normal" way of thinking. When one is put in a position of getting a great deal of feedback from others, including peers and counselors, one may learn to consider alternative avenues of thought seriously. Also, treatment can provide the opportunity to identify priorities in life, such as a career, a committed relationship, parenting children and positive connections with family and friends. Mania, whether mild or severe tends to be self-focused, hedonistic and isolative, interfering with many of these priority values.

With mild mania, change may require time projection. It may be easier for those of us who have already experienced destructive consequences in our lives. For example, I can ask myself if I really want to lose ANOTHER job or relationship or if I like drifting from friendship to friendship without any permanence? I can notice old patterns of thinking and behavior that have cause me problems in the past. When others challenge me, I can listen and consider options and experiment with small changes that can lead to more and more significant changes.

Some examples. Racing thoughts have had a history of interfering with sleep. I have learned that progressive muscle relaxation and imagery can help me disperse these thoughts and relax my body to promote sleep. I have also learned to change what i am doing about every 30 minutes to try different approaches to the problem. Right now, I am writing this to divert the excess mental energy into a positive form. In a minute I will try lying in bed for a while. more examples will be coming.

Remember, You CAN change the way you think and feel!

Having Bipolar Disorder versus being bipolar

Bipolar Disorder is a disease. It is not who I am. I am so much more. To say that I AM bipolar may imply that there is no hope of transcending the worst symptoms. The term bipolar itself shows attention only to the extreme moods of mania and depression. Moods do not exist only as these extremes. There is rather a continuum of moods marked by at least 6 divisions. Starting with low mood, there is not only major depression, but also minor depression. People with Bipolar Disorder can also go through long periods of euthymic , or "normal" mood. Then there is mild mania, known as hypomania and full-blown mania. Another point on the continuum would be mixed states, where symptoms of mania and depression are combined,

It may be best also to distinguish between being an addict and having addiction. I am more than my addiction. Even when I was using i had positive qualities and potential. Our self-esteem may be damaged by identifying ourselves with this scourge on humanity. We are learning that there are various markers or "stages" of abstinence and recovery. Our unifying factor is that we are all somewhere on the journey. Also, I believe that those of us with bipolar disorder can be at different places in our recovery.

So what is recovery as applied to bipolar disorder? it seems that medication compliance has been the standard of recovery for many mental illnesses, This seems to assume that the disorder has been properly diagnosed and that the optimal medication is not only currently in existence, but has been correctly prescribed, Unfortunately, it has unfolded that different people with the same disorder respond better to different medications or combinations of medications.

Research has shown that non-medicine approaches to the treatment of bipolar disorder are also effective. To be fair, the best results were achieved with pharmacotherapy (use of medication plus the therapy). One example of this is Interpersonal Social and Rhythm Therapy (IPSRT) developed by Ellen Frank and others. They developed a 5 item social metric which advocates for regularity with 5 behaviors: getting out of bed, first contact with another person, Starting work, school, volunteering or family care, dinner and bed-time. They found that clients gained more mood stability as they got closer to performing theses function about the same time every day. There is also a 17 item version of the social metric. Attention to the consistency of sleep may be another factor in mood stability. Frank and associates seem to have begun the work of helping clients to change their daily routines.

Other empirically supported psychosocial treatments include Cognitive Behavioral Therapy and Marital and Family Therapy. A specific form of family therapy, known as Family Focused Therapy has been shown to be effective for clients with bipolar disorder and their families. A growing body of evidence-based practices implies new parameters for being in recovery from bipolar disorder. My own experience is that different people are attracted to and therefor more likely to practice different behaviors that contribute to mood stability, Perhaps we can see recovery tools as a buffet. As more of the tools are selected and used we can become healthier and healthier. After all, isn't it all about balance?