Friday, August 21, 2015

Responding. . .

So a loved one has a mental illness diagnosis.  How do you respond?  What is helpful?  What response will be welcomed by those of us with a mental illness?

As one with a Bipolar II diagnosis, I wish I knew the answer to these questions.  Its not a simple matter.  At this moment, three things stand out.  Empathy, understanding, and perspective.

"I know how you are feeling."  Well, no, you probably don't.  But I'd sure like for you to try.  Empathy is the ability to understand and appreciate the feelings of another.  This is possible because we are not unique.  We have much in common.  No, in all likelihood you are not Bipolar, nor have you had those experiences and feelings.  That said, even 'normal' people experience the ups and downs of life, We've all experience times of feeling depressed, or experiencing an emotional high.  Its just that with someone who is Bipolar, those cycles are much more pronounced, uncontrollable, and frightening.  Imagine, for example, what it is like to be feeling quite normal, life is good, everything is manageable, and then to be thrown off a cliff.  All it takes is a few words, a bad experience, or nothing at all, and then over the cliff and into the abyss I go.  The frightening thing, is I never know where the bottom is.  Or imagine living each day, knowing that as evening approaches, depression will roll in like the San Francisco fog.  Or imagine what it feels like to believe that life is full of opportunities, everything is achievable, and great things are possible.  There is something exhilarating about being on the top of the mountain.  Can you imagine that?  And then imagine being locked on a roller coaster, and being subject to these ups and downs, uncontrollably, and you can't get off.  If you're normal, you won't experience to totality of life the way one who is Bipolar experiences it, and yet you do experience, at some level, the individual pieces of that.  Draw from that experience and seek on that basis to empathize with what we are experiencing.

Understanding.  It is helpful for those who deal with someone who is Bipolar to make the effort to understand the condition.  For example, the mood swings are both physiological and psychological in nature, or so my counselor says.  And the two are interrelated.  Sometimes I feel the way I feel because, and only because, of the particularities of my brain chemistry on that day.  "Is something wrong?"  Well, yes, and no.  Yes, I'm feeling deeply depressed today, but no, nothing has happened out of the ordinary.  I just feel depressed.  Another day it is quite possible that an event, a comment, a personal interaction, a positive or negative development, has resulted in the mood shift.  Understanding.  I don't feel the way I feel because of what I've done.  I do what I do because of the way I feel.  Understanding.

And then there is a wonderful gift that you can offer to someone who is Bipolar, especially during the manic phases of the disease, and that is perspective.  And yet tread lightly here, it is extremely angering to be dismissed categorically, because "its the mania talking."  Having said that though, it is often helpful to have the perspective of a normal person guiding me.  The more I understand the peculiarities of this disease, the less confidence I have in my own judgement.  "I used to really enjoy fishing.  Maybe I'd feel better if I started fishing again.  Yes, that is it.  Now I'm excited.  I think that to make the most of it, I'll buy a new fishing boat.  Yes, it's more than we can afford, but I'll make it work.  It'll be money well spent, if it makes me feel better, and I know it will, because the thought of it already is making me excited!"  At this point, perspective is indeed helpful.  It's not that a new boat is necessarily a bad thing.  But it would be a better thing if the decision is made based on something a little more grounded than the mood we are experiencing.

But tread lightly here.  The last thing I want to be told is that I'll never be able to buy a boat.  I don't want every 'great idea' I have vetoed because I'm Bipolar.  The gift of perspective though, is to offer assistance making a few judgments.  Is this a reasonable choice given the realities of our life?  Or is this just a mood driven desire?  Perspective is to assist one to make life choices with one's feet firmly grounded in reality, not mood.  This is a gift that can be given.

Thursday, August 6, 2015

Savior's a Nuisance. . .

A savior's a nuisance to live with at home,
Stars often fall, heros go unsung,
And martyrs most certainly die too young.
(Joan Baez, "Winds of the Old Days")

What's the narrative of your life?  This was the question my counselor asked yesterday.  What's the narrative?  How do you make sense of it all?  What's the story line.  I recoiled at the question.

"That somehow, through all the suffering, through all the ups and downs, there might be some redemptive value to it all."  "No matter how far down the scale we have gone, we will see how our experience can benefit others."  (AA promises)  Wounded healer.  That others might somehow be helped by my sharing my story.

There is a significant burden to the compulsion to be a 'savior'.  And the quest for meaning and purpose in a life riddled with ups and downs is illusive.  "At least there was a redemptive purpose to Jesus suffering."  Its the search for a redemptive purpose that drives the hypo-manic phases of my life.  In spite of the "nuisance", there is this desire deep within me to change the world.  Perhaps it is born out of a sense of helplessness to change myself.  At least if some good comes out of it, then I can live with it.  A star is born, headlining my own drama.  A hero arises out of life's long suffering battles.  

But stars often fall, heros go unsung.  During times of depression I find myself overwhelmed by the meaninglessness of it all.  There is no purpose.  A life wasted.  It didn't have to be like this.  "Would it spoil some vast eternal plan, if I were a wealthy healthy man!"

Ah, but contentment takes the edge off of creativity.  "Were it not for depression we would never have had a Hemingway.  Of course, were it not for depression we might have had Hemingway a bit longer."  (comments of a colleague)  Perhaps its that tension between being a savior and meaningless suffering that is the catalyst for movement and purpose.  That I suppose is the narrative of my life.


Tuesday, July 21, 2015

Heart surgery was easy. . .

It is 4 am.  I awoke this morning before 1 am.  After trying numerous times to get back to sleep, I gave up and am starting my day.  I return to my blog. . .

In 2002, on December 29th, my twenty fifth wedding anniversary, I ended up in the emergency room as a result of a major gastro-intestinal event. During the course of the examination the doctor remarked "Has anyone ever told you that you have a heart murmer."  "No."  "You better get that checked out."

Turns out I had a mitral valve prolapse, and was scheduled for surgery that spring.  I did my research and discovered that the surgery was being performed with a surgical robot, and found a doctor that was willing to do it that way.  I ended up being the first surgery in Spokane using this technique.  I checked into the hospital early Wednesday morning.  The surgery lasted a long time and it was late in the evening that I began to awake.  However, because the whole surgery was performed though a series of 1/2 inch incisions the recovery was almost instantaneous.  By morning I was walking around the floor.  I was discharged from the hospital on Friday.  My doctor asked that I remain in Spokane over the weekend.  On Saturday the kids came to visit and we spent the day walking around Riverside Park and riding a four person bicycle car.  When I got home to Sandpoint on Monday, I had a funeral for a young child who had died while I was in the hospital, and I resumed a full work schedule.  Open heart surgery had been a piece of cake.

 It is amazing to me that I could undergo heart surgery on Wednesday, be riding a bike on Saturday, and back to work on Monday.  And yet after nearly two decades of treatment, I still cannot sleep.

"I can knock you out."  my doctor said.  The problem is to find a medication that will enable a healthy sleep cycle, and that is sustainable.  At one point, fearing that I had become dependent on alcohol for sleep (I had) I asked my doctor for an alternative.  I was prescribed a sleep medication.  When I went to the pharmacy to have the prescription filled, the pharmacist took me aside to emphasize that I should only take the medication once every three days or so.  If I took it everyday, I would become habituated to it and it would no longer work (at least without increasing the dose beyond what was appropriate).  Furthermore, there was a risk of addiction.  Not to mention that it also carried a risk of liver damage.

So I was faced with two choices.  I could take the medication that was habituating, addictive, and caused liver damage, or, I could drink alcohol which is habituating, addictive, and causes liver damage.  I began taking the medication one night, and drinking two nights, which at least reduced my alcohol consumption by 1/3.  When my wife would complain about my alcohol consumption I would be quick to point out that my choice was not whether or not to use drugs to sleep -- it was simply a choice of which drugs to use.

After undergoing treatment for chemical dependency, my doctor has been very committed to prescribing only medications that are non-addictive.  This has severely limited the choices.  Basically, almost all of the sleep medications are potentially addictive and so we've been using other drugs such as anti-depressants that have a side effect of making one drowsy.  This has had the effect of enabling me to go to sleep.  Staying asleep is the problem.  We changed meds this last week to see if we could find a more effective treatment.  It is worse.

Less than a week after open heart surgery I was going full speed.
Two decades of treatment for insomnia has been ineffective.
Something just doesn't seem right about that.

The hardest thing about this whole experience is fighting off the urge the think that a full night's sleep is only a couple of drinks away.  The last time I tried that I nearly entered into "eternal rest" which is an entirely different problem than waking up too early. . .

Wednesday, July 8, 2015

Dissed Ability

At one and the same time I am extremely grateful that I have disability insurance and can be sustained by that safety net as I cope with my Bipolar diagnosis, AND am extremely resentful that I am considered disabled at all.  The most aggravating part of being on disability is to be asked the evaluative questions by my insurance company.  Can you dress yourself?  Can you care for your own personal hygiene.  Can you assist with routine household chores?  (Truth be told, I've never done well with that last one even when I was at my best.  Just ask my wife!)

My experience has been that I have been more disabled since diagnosis and treatment than I was prior to treatment, when I was still maintaining a full work schedule, though admittedly, it was getting more difficult.  But before we proceed, a bit of background on Bipolar II symptoms.  First of all, someone who is Bipolar will experience recurring bouts with depression alternating with periods of "hypo-mania", or an elevated mood, but one that is not a full blown manic episode.  Symptoms of hypo-mania are:



  • Inflated self-esteem or grandiosity
  • Decreased need for sleep
  • More talkative than usual or pressure to keep talking
  • Flight of ideas or subjective experience that thoughts are racing
  • Distractibility (e.g., attention too easily drawn to unimportant or irrelevant external stimuli)
  • Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
  • Excessive involvement in pleasurable activities that have a high potentional for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indescretions, or foolish business investments)
As I began to recognize these symptoms in my own life and that they were symptoms of a disease, two things occured:  First, I felt that some of my greatest gifts had been dissed, or devalued, and were now to be considered as liabilities, symptoms of a disease to be managed, not assets to be drawn upon; and secondly, I felt extremely vulnerable, unable to confidently trust in my own abilities.  For example, one of my most recent episodes occured when I decided to resign from my position as pastor of First Lutheran and go back into the woodworking business.  I immediately determined that to be successful I need to cash in some of my pensions and invest in a CNC router, along with upgrading some of the other woodworking equipment in my shop.  I was absolutely unable to hear and appreciate my wife's caution in this regard. In my mind my abilities to make this work and the goals so achievable if I just went "all in", that to even question them was inappropriate.  I, over and against my wife's concerns, bought the equipment, and only time will tell whether it was a wise choice or an "unrestrained buying spree" and "foolish business investment".  The jury is out.

I went on disability because of a deep depression.  Stress at work was also producing within me "partial complex seizures", where my right arm would shake uncontrollably.  This was particularly pronounced in Church, where I could not sit through a worship service, let alone lead one, without experiencing the seizures.  I was also diagnosed with PTSD at that time, which I preferred to call "Post Traumatic Church Disorder".


As I mentioned above, my decision to not return to the ministry, but rather establish a woodworking business, triggered a hypo-manic episode.  That proved to be relatively short lived, however.  Once we had the CNC Router up and running, a simple complaint about the noise by a neighbor (we were operating it with the garage door open) sent me into a tailspin into a deep depression.  My productivity went way down.  And since that time, I have struggled to maintain a full work schedule.

It's this vulnerability to external triggers that keeps me on disability.  My medical team is absolutely convinced that parish ministry is toxic for me, now.  Too many triggers.  And there is no way to predict whether a trigger, such as a simple negative comment from a parishioner, will send me into a deep depression that has previously left me feeling borderline suicidal or ignite the engines for another hypo-manic phase.  

I am fortunate that our Church has a good and generous disability program.  What I have come to appreciate is that there are two distinct advantages to having that in place.  First of all, and most obviously, it provides a safety net for me.  Through the disability program the Church has cared for me and my family and we have not suffered as a consequence of my being Bipolar.  But, I also realize now that the disability program also protects the Church from becoming a victim of my disease.  As I mentioned in a previous post, one of my most pronounced hypo-manic episodes ended up costing the Church millions of dollars.  Yes, that is no exaggeration.  Hopefully, one day, that will be recoverable.  Perhaps the greatest risk associated with a bipolar pastor would be if a hypo-manic episode manifested itself in "sexual indiscretions".  The potential damage of that would be irreversible.

And so, for my sake and for the sake of the Church, I've accepted the safety net.  I just wish I didn't have to answer questions about whether I can dress myself.

Monday, July 6, 2015

Sleep,or Not.

Sleep has been a constant problem, since my adolescence.  The irregularities concerning sleep have varied over time, but the lack of a consistent, healthy sleep pattern has remained constant.  A good night's sleep, illusive as it may be, is the end that has justified many means.

Early one in my life, transitions were the problem.  When awake, I could stay awake late into the night or even for days at a time without a noticeable problem.  But once asleep, I had a hard time waking.  During adolescence, when sleep problems first manifested themselves, I began by staying up late.  I became a Johny Carson fan and never missed an episode.  At the conclusion of the show, I would stack six or seven albums on my record player and attempt to sleep with the music providing the 'white noise' in the background.  By morning, I was finally in a deep sleep and could not wake up without difficulty.  My father rigged  up an alarm bell in the ceiling above my bed that they could activate from upstairs, and leave ringing until I got out of bed and went upstairs to turn it off.

During college and my years in seminary, I dealt with my sleep disorder by studying late into the night.  I found that I was most alert after 10 pm, and completed most of my work between 10 and 2 am.  One semester in college I purposely arranged my schedule with late afternoon classes and evening classes so that I could stay up till 2 or 3 in the morning, and then sleep past noon.  Even then, waking was extremely problematic.  I found myself dependent on roommates, or later, my wife to wake me up as devices such as alarm clocks could easily be ignored or turned off.  The irregular sleep pattern was difficult on relationships, whether a roommate or my wife, simply because some people actually wanted to be undisturbed by my 'alternative' schedule.

After I got married, in an attempt to regulate the sleep pattern I found that an excessive amount of walking late in the evening helped me get to sleep.  I would typically leave the house about 9 pm and walk until I was so exhausted that I could fall asleep.  This might involve 2 or 3 hours of walking, I suppose 8 to 10 miles of pavement pounding.  I became notorious in the communities in which I lived and well known by the police departments, who on many occasions had been called to investigate who this person was walking about the neighborhoods late at night.  There were times when I wondered about my safety as I walked late at night.  Then I realized that I was the one everyone was frightened by.  I wore my knees out in the process.

When I was first diagnosed with depression, I was put on Ativan, and anti-anxiety drug that also helps sleep.  Of all the remedies, Ativan, or lorazapam, was the most effective.  With it I could fall asleep on schedule and sleep for 8 hours or so.  After about four years, I decided that my depression had passed and that I could go off all medications, including the Ativan.  What I didn't realize was that the Ativan was addictive and worked on the same receptors in the brain as alcohol.  Upon quitting the Ativan, I immediately replaced it with alcohol, and found that a couple of "Scotch doubles" (my definition of a "double" varied greatly over time, and I would get really irritated at what a restaurant or bar considered a double).  Alcohol worked for me as well as the Ativan had, though my dependence on it brought a whole lot of other problems that would have to be addressed later.

When I went through chemical dependency treatment for the alcohol, my psychiatrist informed me that both alcohol & Ativan (which I had resumed taking prior to that time) were now off limits.  My "bottom" that had led me into treatment had involved taking Ativan and alcohol simultaneously, which is not to be recommended.  I nearly died that night.

Since then, my anti-depressant medications and the mood stabilizer all have a sedative side effect, though non-addictive.  And I have been prescribed trazodone to specificallly aid the insomnia.  One of the impacts that this has had on me is that now, going to sleep is no longer the problem.  I struggle to stay awake until bedtime, which has moved up from midnight or later to 8:30 pm.  But then I wake.  I begin waking up as early as 10:30 or 11, but more frequently at 1 to 2 am.  I am typically, after a half hour or so awake, able to get back to sleep for an additional hour or so, but then by 3 or 4 am I can no longer sleep.  I have subsequently been diagnosed with sleep apnea, requiring the use of a CPAP, but that has not changed the basic sleep pattern.  During the day I find myself overwhelmed with drowsiness, which is a problem in that my work as a woodworker involves using tools that are dangerous to operate while drowsy.  Occasionally, I can take a nap and actually feel rested afterward, but normally that is not effective.

It seems such a simple thing.  A night's sleep.  But a solution to my insomnia has been the most illusive issue I've dealt with since adolescence.  And to this day, the greatest threat to both my remaining on medications and my sobriety is this simple desire -- to have a full night's sleep.




Thursday, June 25, 2015

Mustard Seeds or "You haven't seen nothing yet"

If I had a hero it would be Eric Norelius, a Swedish Lutheran pastor who came to this country in 1856 and began by serving two congregations, in Red Wing and Vasa, MN.  I first became aware of Norelius because the education building at my internship congregation, First Lutheran Church of St. Paul, MN was named after him.  First Lutheran Church was the oldest Lutheran Church in Minnesota, and in the early years, lacking a pastor of their own, Norelius would come up from Red Wing to help them.  On one such trip the congregation approached him about a family that had just arrived from Sweden.  Shortly after arrival, both the father and mother had died, leaving four children alone.  Norelius decided to take them home with him.

The next Sunday the congregation in Red Wing decided to hire a woman to care for the children, and the congregation in Vasa opened its basement as a home for them.  Shortly after founding this orphanage, Norelius, together with other Swedish Lutherans started a home for the elderly in Chisago City.  In time these two simple acts of charity ended up becoming Lutheran Social Services of Minnesota and Ecumen (one of the countries largest providers of senior housing).

There was also a need for pastoral leadership as more and more Swedes kept arriving in Minnesota, and Norelius began taking young men into his home to train them for ordained ministry.  Thus, Gustavus Adolphus College of St. Peter was born.  Norelius was instrumental in the organization of the Augustana Synod and became its first president.

Now I would guess that when Norelius brought those four children home that night he was not thinking about establishing one of the largest social ministry organizations in the country.  Probably he was most concerned about what his wife would say.

But if he were Bipolar, it would have been all part of the plan. . .

Shortly after my arrival in Sandpoint, a member of my former congregation in Plevna, MT, who was attending seminary, was assigned an internship as a missionary in Russia, and began serving St. Nikolai Lutheran Church in Novgorod.  That connection led me to get our congregation in Sandpoint to become mission partners and support his work there.  I was able to visit Russia twice.  On the second visit we had the opportunity to meet with the Bishop of the Evangelical Lutheran Church of Russia and Other States, and also the Bishop of European Russia.  During that visit they shared that they were dependent on a 2 million dollar gift from the German Lutheran Church to fund all the salaries of the pastors in Russia, and that the money was running out.  The bells went off in my head.  Hypo-mania kicked in.  We had 4 acres of undeveloped land next to First Lutheran in Sandpoint that was worth about two million dollars.  We could sell the land, and use the endowment fund created to support all the pastors serving in Russia.  Wouldn't it be great for a modest size congregation to take over the responsibility currently being funded by the Lutheran Church in Germany.

But when I got home, I thought, lets have our cake and eat it too.  Instead of selling our land, lets develop a ministry here (senior housing) that would generate more income than an endowment, and use the income to support the pastors in Russia.  Luther Park at Sandpoint was born.

But that wasn't enough.  If we could do this in Sandpoint, why not get the Synod to do a similar project as a means, not only of providing a needed senior housing ministry, but also as a way to fund other mission work, e.g. Hispanic ministries, new congregational starts, etc..  Plans were developed for the Beacon at Southridge in Boise, which would have been about 225 units of senior housing, and was projected to generate over a million dollars a year in revenue.  A 25 acre parcel of land was purchased for 3 1/2 million dollars and we were seeking financing for the project when the economic collapse of 2008 shut it all down.  The Church still holds the land in Boise.  Which, to my way of thinking, could be sold and an endowment could be established to fund the pastors in Russia. . .

Now, the folks at the Mission Investment Fund of the ELCA probably have no clue how a simple desire to offer mission partnership support to an ELCA intern serving in Russia resulted in their owning a 3 1/2 million dollar parcel of land in Boise.  But it all was part of the plan.  There is part of me that would like, more than anything else, to follow through on that.  After all, if Norelius' bringing four kids home could result in the founding of two of the nation's largest social ministry organizations, what could come from a more robust plan with the backing of the Church?  Just give me a modest salary (not a big deal, cause I'm already on the Church's disability plan, why not pay me to do something?).  Just let go of the reins and let me run with it.  I'll get it done.  But first I'll have to go off my medications.

Monday, June 22, 2015

Wounded Eagle

Imagine, if you will, an eagle with one broken leg.  While in flight the eagle can soar with the best of them.  The problem is landing.  Left with only one good leg, every time the eagle comes in to land the result is not pretty.  And then, to avoid the rough landing, it is determined that the only reasonable choice is to keep the eagle from flying.  And so, rather than being able to soar (and crash land), the eagle now is restricted to limping along on the ground.

That pretty much describes how I feel today about being treated for Bipolar II.  

But first, a few notes on the diagnosis and treatment that I've experienced.  First of all, diagnosis of mental health issues is not an exact science.  There are no brain chemistry tests to determine what exactly is going on in there.  In my case, I was first diagnosed with dysthymia (long term, low grade depression) with major depressive episodes.  Later on, a lovely word was added to the diagnosis -- "unresponsive", meaning that in spite of treatment with many different medicines and a substantial amount of therapy the depression continued.  It was like having a viral infection as opposed to a bacterial infection.  It simply had to run its course.

After unsuccessfully trying to treat the depression with anti-depressants the decision was made to change my diagnosis to Bipolar II and use a mood stabilizer as the major therapeutic drug.  This has been more successful. There is a type of backwards diagnosis going on here.  If the depression responds to a mood stabilizer, but not to an anti-depressant, then the likelihood is that one is dealing with Bipolar depression, not 'normal' depression.

I wish that I could say that having the correct diagnosis, and treating my Bipolar II condition, has now restored me to health and everything is just fine.  What has happened for me is that the ups and downs that I was experiencing have been replaced with a consistent low grade depression.  I once told my doctor that if we were going to stabilize my mood, could we wait and stabilize it during a hypo-manic phase.  A persistent state of 'soaring with the eagles' sounds a lot better than hobbling along on the ground.

This is my experience.  During the ten years or so that I was self-medicating with alcohol I was functioning at a very high level.  I had one of my most substantial and sustained period of hypo-mania and was accomplishing much.  If that could have been sustained I would never sought treatment in the first place.  And quite frankly, if I could return to that state I would do so in a heart beat.  There were two  problems.  They both have to do with the progression, the trajectory, that I was on.  With respect to the bipolar symptoms, the highs kept getting higher, and the lows lower, and the transition between the two more pronounced and in my words, violent.  The second problem is that alcoholism is likewise progressive.  It was taking more and more alcohol to have the same effect, and with the increased consumption came an increase in the negative consequences.  Alcohol works until it doesn't and then it never will again.  What happened was that I had a rock bottom, a major crash and burn, and not treating my condition, both the alcoholism and the Bipolar disorder was simply not an option.

The disturbing thing for me is that prior to treatment I was functioning at a high level.  Though I have to acknowledge that in the year prior to treatment I was on a downward spiral.  On October 14th, 2012, I crashed and burned and entered into treatment.  But I was not in anyway prepared for what happened.  The first thing we addressed was the alcohol, and I have been clean and sober since October 15th, 2012.  Then the effort was made to treat the depression.  However, rather than it getting better, it got progressively worse.  And new conditions developed.  I started having partial complex seizures. I was diagnosed with PTSD.  The depression intensified until I was no longer able to function and went on disability.  I began to notice that I was "rapid cycling", that is, I would awake between 1 and 3 am, and have an elevated mood, be able to accomplish a lot, etc..  But then by 3 or 4 in the afternoon it was like the San Francisco fog rolled in and I would bottom out, unable to function at a most basic level.  (In the years that have passed, the violent swings in mood have been moderated, but I continue to experience a low grade depression and struggle greatly to maintain even a modest work schedule.)

Now this is the way I'm tempted to think.  Life was better, as a whole, prior to beginning treatment.  I would like to erase from my memory the last six months, or so, prior to entering treatment so that I could maintain the illusion of how good life was.  It is tempting to think that it is the treatment itself that now shackles me, leaving me disabled.  If the medication is the problem, then the solution is easy and straight forward.  Stop taking the damn pills.  I know fully well why so many people with a bipolar diagnosis decide to stop taking their meds.  They want to soar with the eagles once again.  Life on the ground doesn't feel that good.

That's the temptation.  However, ceasing meds is a cardinal sin for someone who is bipolar.  In my case I am well aware that if I were to cease meds, my periods of hypo-mania would likely progress rapidly into a full blown manic state, probably requiring further hospitalization.  Also, the depressive states would progress to dangerously intense levels.  And so I continue to remain in treatment and religiously take my meds.

But it is like that eagle being told that the dangers of landing with only one good leg are too great, and the only solution is to never fly again.  I would suppose that an eagle would not be thrilled about that.  And quite frankly, neither am I.