Hi, Elsa. How are you doing currently?

I have chronic pain in my back and neck. I had surgeries in my thirties, but I have advanced disk degeneration and I know I had six bulging discs after my neck and back surgeries (I had two herniated discs replaced). Gosh, it’s been so long since I had my surgeries and I’m definitely getting worse. I’m in pain 24/7. I’m level 7 out of 10 right now.

I have some days where I am in less pain then others, but I won’t get better physically, no. I’m not giving up, however. I tweaked my back last week and I immediately started implementing all the things I knew to help...it all adds up.

I also have IBS, sinusitis and migraines. They are painful, too. But my back and neck problems are the worst. It is depressing and if I’m in a depressive episode...it makes my depression worse.

On the mental illness front, I need to preface that I have an excellent psychiatrist. I am treatment-resistant, unfortunately. I have never had anything close to a remission. My pdoc cares about me (he told me so) and I receive excellent care, he’s one of the best psychiatrists in my area.

It’s been several years, but two years after he diagnosed me he brought up perhaps he should refer me out. To another psychiatrist and not be his patient anymore. I was shocked and scared. He said he wanted me to get better and we’ve tried so many med combos....he said, “I’m by no means perfect, there might be another doctor out there that has treatment ideas that I don’t.”

I was in tears. I asked him to please let me stay on with him as a patient. Actually, I pleaded with him because I did not and do not think I can get better care. (I have other diagnoses in my signature, but the bipolar has always been the arch nemesis, by far.)

I asked him not to give up on me. He was very empathetic and said I could stay on. He did have me get extensive testing at a neuropsychologist and the testing and evaluation were the same diagnoses, including very severe bipolar disorder.

I’ve never had remission. I have never had the word remission uttered to me. My boyfriend hasn’t ever had remission for his bipolar 1, either. Actually, the other day he asked me, “is it true that some people truly get better and their bipolar goes into remission”? I said yes.

There was a guy at my support group who went to my bipolar support group and he was a patient of my psychiatrist. He only takes Lithium and has been completely symptom-free for ten years. Super nice guy.

My psychiatrist testified that I will require medication for the rest of my life for my bipolar disorder. He also stated that I could not work, would not be able to work for the foreseeable future....and that I was likely permanently disabled. (He’d never told me this and this was during my divorce.)

I’ve been inpatient many times and I’ve never been given a med combo that worked. He and I would/do tinker with gradual med adjustments afterwards.

I’ve been on the best med combo we’ve come up with for several years (but still no remission)....and it’s failed and I have to start a new med today. I’m not doing well at all. I didn’t sleep one minute last night, either, mixed episode.

We NEVER give up hope. I’ve just always figured I’d be managing my bipolar and it has gotten worse, definitely. That seems to be the trajectory for me, unless one day there is a cure.

Now, my PTSD....I am in therapy for that right now, it’s very severe. I have a good therapist and I am optimistic I can get a lot better. I think that will greatly lower my anxiety and especially my agoraphobia.

My anxiety is a disaster and I have had therapy for it, DBT the most helpful.

Perhaps my bipolar might get better if the other conditions are under control? That would be awesome! Remission, though? I doubt it, but I do my best every day.

I am going to be moving and will have a new psychiatrist. I’m .... trying to not think about it. Hopefully, I’ll find someone good.

Hope, Elsa. Cope and Hope, that’s what I do. And Radical Acceptance (DBT thing).