Living with Bipolar Disorder: Self-Determination

16th October 2023

Towards developing personal responsibility, with the goals of
recovery and remission.

In the book, Recovery in Mental Health: Reshaping scientific and clinical responsibilities, by Michaela Amering and Margit Schmolke, the work of Mary Ellen Copeland is cited, under the subheading, "Wellness Recovery Action Plan (WRAP)". Amering and Schmolke’s book take a positive look at mental health disorders and outline success paths towards mental health recovery.

Copeland, who witnessed a close family member being crushed by a severe mental health disorder, with inadequate "status quo" treatment, developed a program to better facilitate mental health recovery through action. That is, not simply resigning oneself to a label, and laying oneself on the doctor’s table to delegate the job of recovery to someone with better qualifications than yourself.

Every individual needs to take personal responsibility for health decisions and actions. Self-determination and personal responsibility are crucial elements of mental health recovery and remission.

Of course, the status quo for the past few decades has increasingly shifted in a direction that greater facilitates economic benefit for all professional parties involved, that is, psychiatric labeling, identifying the mental health disorder, and prescribed medicine, perhaps with a bit of therapy in the mix. This sometimes works the opposite way, and better facilitates regression rather than recovery.

Copeland’s model is based on "hope, empowerment, self-determination, recovery and wellness". Some of the key factors in recovery considered by Copeland are:

  • Hope.
  • Self-determination - taking personal responsibility – that it is up to each individual to take responsibility for his own wellness.
  • Education.
  • All people grow by taking positive risks.
  • The point we want to get from Copeland’s work, along with the many examples of success stories associated with her work, is, to keep a positive hopeful attitude towards recovery, you can recover if you work hard at it from various fronts. Take personal responsibility for your life. The doctor at the end of the day, goes home to his own family, and that is where your relationship with him or her ends, in most cases. You can’t call your doctor in the middle of the night if you are having a crisis or perplexing question, it is generally a professional relationship.

    In the end, you are accountable for yourself, not your doctor, whether or not your doctor’s advice and method of treatment is good or lacking. We need to avoid, then, the tendency to blame or write everything off to the disorder. You can make positive incremental progress, even if you have setbacks, but progress, including recovery and remission, is, to a large extent, up to you.

    Self-Determination Contributes to Empowerment Towards Positive Steps for Recovery and Remission

    Self-determination, then, contributes to empowerment. Realizing that you have power over your own decisions, and can affect positive change within your own life, will help get us off the couch and shake us out of complacency and resignation. The tragedy of modern psychiatry, that is post-Freudian medical model based psychiatry, is the hopeless resignation it inspires, with the exception of exalting the benefits of psychiatric drugs.

    In Blaming the Brain, by Michigan State University professor emeritus Elliot Valenstein. Ph.D., a very well-documented treatise against the medical model and towards a more realistic approach towards understanding mental heath disorders, by an impartial and unbiased researcher. It presents the facts in a convincing argument, providing a useful foundation against the mainstream approach to labeling and medicating, and empowers the one suffering with a serious mental health disorder such as bipolar disorder, to take whatever positive steps are necessary towards his or her own recovery.

    Self-determination, then, does not inspire guilt, as much as it inspires hope and contributes to a sense of empowerment. Take the horse by the reigns, even if the horse is still bucking. If you fall off the horse, by all means get back on!