It seemed life could not get any lower for Melanie. Her depression was dragging her down. At times, she didn’t think she could go on.
Today, at age 50, Melanie is a happy, successful technical writer who enjoys spending time with her friends – going to the opera, art galleries and museums – and who loves to play with her Bedlington Terrier, Toby. Despite having bipolar disorder, Melanie is not only surviving, but is thriving.
How did she get to this point? She had a determined, courageous resolve and, just as importantly, she received skilled, effective help from a collaborative mental health care team.
Melanie started seeing Dr. Patricia Rockman in 2002 and began receiving the benefits of collaborative mental health care. This type of care involves mental health and primary health care providers, consumers and families working together – each with different knowledge, expertise and experience to provide seamless and integrated mental health services.
In Melanie’s case, Dr. Rockman offered collaborative care by maintaining contact with a psychiatrist while treating Melanie. Rather than passing through a series of referrals, Melanie was able to access services directly through her family physician. This was a pleasant change for Melanie who, in her search for a solution, has spent the last 20 years in and out of therapy.
“In 1982 I first realized I was sick,” Melanie said. “I knew something was very wrong. I was severely depressed and suicidal and it was not related to anything going on in my life.”
Her family physician referred her to a downtown Toronto psychiatric facility where she was evaluated and sent home. A few months later, after a depression-related crisis, she went to a psychiatrist, who eventually found a medication combination that worked for her. “The psychiatrist said I was probably mildly bipolar and could stay on medication for the rest of my life, or I could take my chances and go off them. He said that I didn’t have to see him any more, and weaned me off the medication”. Approximately ten years later, Melanie’s symptoms returned with full force.
“I felt anger and anxiety and depression all combined,” Melanie recalled. “It was worse than anything I had experienced before.”
Melanie’s family and friends became worried. She started seeing a new doctor/therapist, who treated her for six years. “I couldn’t remember what medications had worked for me before, but I knew I may have bipolar disorder. Her doctor referred her to the same psychiatric facility periodically for assessment and medication recommendations. She saw a different specialist each time and each recommended different medication.
“I was not getting better.”
There was little communication between Melanie’s doctor and the facility, and her sessions were limited in time and frequency. The medications prescribed for her also took a toll – she lost all her hair and was having problems with her balance and coordination. She had many accidents, resulting in a broken arm, a broken leg and injuries to her back. She rarely left her house and stayed home from work on long-term disability. She wanted to give up but felt she had to push on.
As her disability payments ended, Melanie decided to go back to school. In a technical writing program, Melanie shone, but it was a difficult struggle. The daily grind left her exhausted. “I couldn’t deal with the stress at all, but I couldn’t give up.”
After finishing school, Melanie began seeing Dr. Pat Rockman. Pat told her about a new collaborative care program called the Collaborative Mental Health Care Network sponsored by the Ontario College of Family Physicians. Dr. Rockman would meet regularly with Melanie, working with cognitive therapy techniques while consulting with a psychiatrist who would provide advice via phone and e-mail, sometimes while Melanie was sitting in Dr. Rockman’s office. Dr. Rockman seemed to understand her needs and was genuinely interested in working with her.
With the help of the psychiatrist, Dr. Rockman was not only able to correct Melanie’s medications, but encouraged Melanie to identify some recovery goals and have hope in the future. The effects of the right drug combination were immediate.
“It was like turning on a light switch. It was unbelievable,” Melanie said with a smile. “Instead of sending me to a psychiatric facility, my doctor was able to consult with the same psychiatrist on an ongoing basis and was also often able to get an immediate answer.”
The success of the collaborative care program has made Melanie a believer.
“I would recommend the collaborative approach to mental health care. It isn’t like fixing a broken leg,” she said. “Each case is different. You need ongoing assessment and individually unique treatment and, most of all, consistency. In addition, there is much less of a stigma than there is going to a psychiatric facility. It’s not as scary for people to admit their mental illness to their own family doctor.”
The change is something special for Melanie. Her family and close friends are thrilled. So is she. Melanie knows she could have given up, but with the help and encouragement of Dr. Rockman, she persevered. Now, Melanie has goals for the future. She is looking forward to buying a house and furthering her career.
“I never thought I’d be this healthy. I’m happier than I’ve ever been before,” she said. “Feeling okay was the best I hoped for. I now feel like a normal healthy productive person. I’ve been set free.” |
