I need a hug.

I understand better how difficult it is for you. It is a lot on the line. Hopefully the hours you are not working you can be resting and taking extra special care of yourself. Hopefully the medication will help.

I will be pulling for you.

Medicated, Work and school will always be there. Your health is more important. I have had the same black and white thinking, but it truly isn't reality. You do have a choice. It's your life.

At this point I understand your p-doc just wants to get you stabilized, but once you have gotten past the emergency you can ask for a different combo of meds if you feel the clonaz knocks you out too much.

I have invested two years and $100,000 in debt into getting this degree. If I drop out now, I'll have to start over from square one. Maybe I'm being black-and-white, but I don't think I could ever recover (financially) from that kind of a decision. I'd have all the debt, and nothing to show for it. I really do feel quite trapped.

The clonazepam has me calm enough that I'm okay not being in the hospital... unless things get worse. I'm going to try to tough it out as best I can...

Oh Medicated, I do hope and wish only the best for you. I am sending you hugs and good energy that you can get through school and work in one piece. I'm pulling for you!

Take a lot of HUGGGGGSSSSSSSSS and use them as needed! No one hear thinks the worst of you, dear. It's part of learning what this is all about.

I'm terribly impressed at your accomplishments in spite of your illness. Just wanted to send you words of encouragement. It's a crisis, but it too will pass, and if you can pull through this, you will be very proud of what you were able to do. I think you deserve 2 degrees, one for making it through bipolar episodes while you were earning a medical degree and one for the medical degree itself. You're awesome!

((((( medicated ))))) Hope all is well for you!!!! We're all here for you!!!!

Aw, thanks.

The school certainly hasn't been helpful or tried to make this any easier for me. I was hospitalized last fall and took a leave of absence. They stopped communicating with me. When I met with them to discuss my return, they encouraged me to quit. When I came back, they promptly expelled me (for very weak reasons). Since I've gotten back in again, they continue to make my life hell. Basically, they've done everything in their power to get me out of the program. Because of that, I try to be the model student so that they'll leave me alone, but I'm still bipolar and still having episodes... and that's hard (if not impossible) to hide. I tried going to the clinic today, but between a certain degree of emotional exhaustion and the klonopin, I was useless and had to go home at lunch.

My psychiatrist friend (a former preceptor who is himself bipolar - not my doc) gave me the following advice in an email tonight:

Control is nothing more than a illusion; if not delusion. Management is key -- an excellent surfer does not control the wave AT ALL, right?

Delusion of Control: OK, I am having a rough time, but I can control this - I can go into work, do what I need to do, and no one will know...

Good Management: I am not as healthy as I would like - it is obvious to my friends and family. I want to think I am healthy and can do my routine... But if I try, I won't accomplish much, and likely will look 'not well' to everyone. I think I will stay home and do some laundry, and rest up and get better...

Less fighting the illness, more working WITH it. Not an easy task.

Take a few days easy.

This is something I'm still struggling to learn and work out in life. It's hard when you feel so much pressure to meet various demands. I need to learn to take it easy without feeling too guilty about it... and I have to stand up for myself if my faculty (or whoever) questions my poor attendance this week.

It's 3am. I should really go to bed...

What great advice! Management vs control. Great stuff.

I am so sorry they give you such a hard time. They really should be modelling accommodation for your condition. Not only are you having to battle through the symptoms of the condition but you are having to do battle with discrimination. So not fair.

I agree with Thinker. You are amazing. You will get to your destination. One day at a time. Hopefully you will get the meds worked out and resist any future temptation to mess with them yourself.

Get some sleep hun. Sweet dreams.

[quote=Medicated;1466370]Aw, thanks.

Control is nothing more than a illusion; if not delusion. Management is key -- an excellent surfer does not control the wave AT ALL, right?

quote]

Wow! what a fantastic way to think.. im going to copy this quote into my mood diary to think on today!

Sending you more . That's terrible that they're making your life hell, as if you needed any more fuel for the fire. I was always a model student too, in spite of my depression, anxiety, hypomania and mania. I missed a few classes or had to leave early when in the midst of bad episodes, but I kept up my grades. Only had to go to the hospital once and got the admin on my back for a while, but they left me alone when they saw I was making straight As in spite of my suicidal thoughts. It's really hard when the meds are not controlling your symptoms and you have so much pressure from school. Why I admire your courage: I'm on my fourth college after having started in 1998 and still no undergrad degree. It's been 12 years and will be 3 more before I have a degree at my 2 classes per quarter rate. I can't handle any more than that. You are a superstar for how far you've gotten.

Get plenty of rest and take care of your needs.

Thinker,

It took me six years to finish my bachelor's degree, and I went to school year-round. Why so long? Because I withdrew from so many classes. Every semester, the stress would overtake me, and I would have to reduce my course load or risk a crash of monumental proportions. In my graduate program, withdrawing from courses is not an option. I'm no superhero, and I don't get straight A's, but [most of the time] I pass the exams, and at this point, that's all that really matters. Bipolar is the real reason I chose to go to PA school instead of medical school - a decision that will forever break my heart. Although I've done remarkably well for myself (all things considered), I still feel like my illness has really held me back and crushed some of my dreams.

As per my evil faculty, there is a law suit pending against them under the Americans with Disabilities Act. Their actions toward me were clearly discriminatory, and they need to really understand how much pain and emotional anguish they've caused me... and perhaps hurt a little themselves in retribution. I'm sure it only makes them hate me more, but what they have done to me is wrong and illegal and it's time they pay the price... whether it ruins the school's reputation or gets some of the faculty fired or results in a financial settlement, I want them to suffer like I did.

My warmest encouragement goes out to you and all of the others on here who are still pursuing an education or career at whatever pace they can manage, and who haven't given up on themselves and on life. That is my worst fear - that one day I will decide to call it quits and give up on my hopes and dreams entirely. Sometimes it's so tempting, but I know I would regret it immensely, so no matter how many times I stumble or fall, I keep getting back up, brushing myself off, and pushing forward. I am probably pushing myself too hard right now, but there is a light at the end of the tunnel... in four months I'll be done with school and free to work as much or as little as I choose. I really look forward to that.

I really appreciate everyone's support. It has made a big difference for me in the past few days as I have struggled to cope with and make sense of things that I have never experienced before (such as the hallucinations/illusions/mania). I think I'm getting better, but it's hard to tell since I'm taking so much klonopin. I'm still not sleeping much at night, and I'm still... um... hypersexual, but the klonopin basically wipes out most of the other (freakier) symptoms. I think I'll try going to the clinic tomorrow afternoon and see how I do. If I can't do it, I can't do it.

Thanks again for all of the hugs. I realllllly need(ed) them.

((((((((medicated))))))))))))

One can never get enough hugs so here are a few more just for you....

Awww... You're too sweet.

I'm thinking about taking a 2-week leave of absence from school. It would delay my graduation by another couple of months, but it might be necessary/worth it. Thoughts?

I think you are being very wise my friend. I know how hard this decision has been for you to reach but a couple of months delay is easier to swollow then what you might risk if you pushed too much too soon. The two weeks leave will give you time to stabilize your meds and rest up to get back into it in better form.

I am proud of you for even thinking about it. It takes real courage to put yourself first. You are doing it and I have no doubt you will reep major benefits.

All the best - I hope you feel better soon. I've tried to go off my meds I think 2 times so far.
Right now I'm making friends with the Lamictin, and cannot imagine giving that up.
But I really do know the feeling of just wanting to stop it all.
No-one will judge you - just be honest to your pdoc and listen to his advise. Anything you are concerned about - feel free to challenge him

Why is it that some people are so provoked by us? I have to be careful about who I tell about my disorder and when, althouh I try to come clean to a supervisor or boss fairly soon. here, the attitudes are taking a while t change, but they are changing.

I hear you about the school programs and the costs. Story of my life for ten years or more. The more i try to pace myself, the more it costs. I feel that i am facing a system built to take me down. Don't let them do that to you. If the mdical system fired all it's bipolars, it would collapse in a day, dear. You just happened to be the one they could see.

Huggs, get some sleep. You are an impressive, tough person dear. don't forget that, but don't take it for granted.

Thanks, Sanityseeker.

I emailed my psychologist about it. He is in favor of the idea. I have yet to contact the psychiatrist, but I'm sure he would be supportive.
I emailed my mother about it. She is ambivalent - she thinks it would be wise, but is worried that my faculty will use it against me.
I talked it over with a friend last night, he thought it might be a good decision.
I emailed a church friend about it - he thinks I should push through... but I also get the impression that he really doesn't understand how disabled I am right now.
I am waiting to hear back from another church friend (the bishop/pastor).

My personal feeling: I want to take the time off and repeat the pediatrics rotation later, but I need to talk it over with my faculty to be sure of what would happen. Namely, I want to be sure that they would let me repeat my pediatrics rotation at a site in Utah (home) and not NY where the school is located.

I am so depressed by this right now. It is sooooo hard when people don't understand how crippling this can be. I know my church friend was only trying to be supportive and encouraging, but it can really hurt when people basically tell you to "suck it up and keep trying," even if they say it in a supportive way. I actually cried when I responded to his email. ....aaaaand I'm going to start crying again now just thinking about it.

I think what it comes down to is that I would have to discuss this with the school and figure out what would happen. I really don't want to tell them that I had a manic episode and am in the middle of medication adjustments, but how else can I explain the necessity for the brief leave of absence?

*sigh* what can I dooooooooo?? :'(

My psychiatrist friend (not my psychiatrist) was in support of the leave of absence idea... so I've made my decision. I'm going to take the short LOA. Unfortunately, I have to approach it from the medical standpoint because that's how these things work with my school, so I HAVE to tell them what is going on. Here's how it works:

K. Leaves of absence may be requested as follows:

1. The student is to write a letter to the Program Chair, specifying the reason, and the period of time requested, for the leave of absence. A doctor’s note and/or review by the director of the Student Health Service may be requested for medical leave requests.

2. The Program Chair makes a recommendation for approval or disapproval to the Dean of the School of Health Technology and Management.

3. The student is notified of the Dean’s decision.

So, it's possible that they will deny my request, but they really shouldn't. I called the psychiatrist's office and I'm waiting for a call back regarding a note from him stating that I need to take some time off. Hopefully I can get that today. I have already drafted my letter to the program chair, and I'd like to send everything in this morning.

Here's the draft - any recommendations?

Xxxxx,

I am writing to request a brief medical LOA from the program, approximately 2 weeks' duration. Although I hesitate to share this, the reason for this request is that I experienced a frightening manic episode over the weekend, and I am now recuperating and undergoing medication changes which are causing me to be very sedated. Although the option was encouraged, I declined hospitalization and am handling this at home with close supervision. Attached is a note from my physician stating the necessity of the LOA.

My goal is to create as little educational interruption as possible while still taking care of my needs. The requested LOA would begin immediately and end on September 2nd. This timing will both allow me the recovery time I need, and permit me to take the overdue orthopedics exam and make-up CSPs with the current second year students on September 3rd, then resume my future clinical rotations as presently scheduled.

I understand that taking this LOA will mean that I will have to repeat my pediatrics rotation in January/February, and I accept this as a natural consequence of taking the leave. At present, my recovery must take priority, or I will be risking further decompensation and complete disaster. I will look into pediatrics clinics in Utah which may be willing to accommodate me.

Please let me know the status of my LOA request as soon as possible.

Thank you,

Christine

Does that sound diplomatic and reasonable enough? Keep in mind that my faculty really don't like me... will it be enough to sway them?

Medicated; school, work, etc. doesn't need to know why you are taking the leave of absence. You just require a note from a md and your p-doc will not go into details in the note. Only you can make the decision if you want to disclose or not and I'm not telling you should or shouldn't, but I would suggest you seak to a t-doc about it, write out a pros and cons list of telling/not telling.

In the book that is in my signature there is a section on it.

School already knows that I'm bipolar. I was hospitalized at the school's hospital for a depressive episode last fall, so the diagnosis is out in the open. I'm pretty sure it's most of the reason they hate me and want me out of the program. Plus, when they see the note on the psychiatrist's letterhead, it's going to be pretty clear what is going on. Also, as the quoted policies and procedures state, I MUST explain the reason for requesting the leave of absence... but then again, maybe leaving it with an ambiguous "for mental health reasons" would be good enough.... hmmmmmmm.... why does everything have to be so complicated???? :'(

I hear ya Medicated, I went through the same thing when I went back to work. I am open about my diagnosis, but I struggled with whether to disclose or not.

Hi Medicated,
My 'lost' career was that of being the Dean of Student Services for a college. On the job and now as an independant contractor I have written a lot of policy manuals for colleges and universities among others.

Generally 'for medical reasons' backed up by a doctor's note is all that is required. They don't need to know the specifics. Make your request short and sweet. I wouldn't even talk about scheduling accommodation. That will be something you will discuss in person.

Keep it short and simple.
'I am currently a 4th year student in the ....... program. As per the Leave of Absence policy number.... I am writing to request a 2 week medical leave of absence to begin immediately and end September 2, 2010. A letter from my doctor is attached. I look forward to hearing from you at your earliest convenience. Please contact me if you require any further information. Thank you for your time and attention to my request.'

Less is more in these kinds of initial communications. Put too much in the letter and it can work against you sometimes.

Meanwhile become familiar with the Appeals process should you be refused on first request. It is very unlikely you will be refused but if you are there will be policy for an appeal.

I don't know, but if it were me, I wouldn't put anything about having a manic episode. It's none of their business what kind of episode you're in. Let your p-doc explain that you are undergoing a meds change (and why if necessary) and leave it at that. I agree with the others to be as brief as possible and let the professionals sort it out. Your psychiatrist's word will mean much more than your own to an administration...especially if they already have it out for you. Sorry you're in this situation.

Thanks for the advice everyone. Here is the letter I sent:

Dear Program Director,

I am writing to request a brief medical leave of absence from the program, approximately 2 weeks' duration. Attached is a note from my physician stating his recommendation for the LOA.

My goal is to create as little educational interruption as possible while still taking care of my needs. The requested LOA would begin immediately and end on September 2nd. This timing will both allow me the recovery time I need, and permit me to take the overdue orthopedics exam and make-up CSPs with the current second year students on September 3rd, then resume my future clinical rotations as presently scheduled.

I understand that taking this LOA will mean that I will have to repeat my pediatrics rotation in January/February, and I accept this as a natural consequence of taking the leave. At present, my recovery must take priority, or I will be risking further decompensation and complete disaster. I will take it upon myself to look into pediatrics clinics in Utah which may be willing to accommodate me for my pediatrics rotation in January.

Please let me know the status of my LOA request as soon as possible.

Thank you,

Medicated

I felt it necessary to include the stuff about repeating the rotation and taking exams because I want them to know that I am thinking and planning ahead this time. My last LOA happened on an emergency basis and it created a lot of trouble in the program. I want it to be easier for everyone this time.

Unfortunately, my program director is out of town until the 30th, and he's the one who is supposed to make the recommendation to the dean regarding whether or not I should be granted the leave of absence, but I copied half the faculty AND the dean on this email, so hopefully it won't be too much of a problem.

I think I've about expended all of my energy for one day getting the doctor's note and composing emails and such. I'm tired.

Cross your fingers for me that this all works out.

And again, I sincerely thank all of you for the wonderful support that you have given me since I first started this thread. It really does mean a lot to me. You all have so much wisdom to offer... I only hope that some day I can be as supportive and encouraging as you. Thanks.