- Do you ever feel like, when you've been doing well,
you've been faking your illness the whole time?
That's what I'm gonna talk about today.
I'm Dr. Tracey Marks, a psychiatrist,
and this channel is about mental health education
and self improvement.
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This question is based on a viewer question from Claire,
and she says, "When I have a stable episode,
"it makes me feel like a fraud,
"like what if I'm living a lie?
"What if I've wasted everyone's time
"like my GP fighting for me to get seen?
"It makes me feel guilty, but deep down in my heart
"I know I'm not well.
"I keep a journal with all my episodes and such,
"to hand to my psych but yeah, I don't know.
"Sometimes, this is more painful than my low episodes.
"Do you think you could make this a topic?
"Thank you."
Thank you, Claire.
I love this question because it was enlightening to me,
I've never had a patient tell me that they felt like a fraud
or they wasted my time, but of course,
why would someone tell me this?
This could explain why I see so many people
with bipolar disorder stop their medications
when they're feeling well.
They usually feel that they don't need
the medication anymore,
even though they've had many episodes
or multiple episodes and even been in the hospital.
There's not much written in the scientific literature
about this impostor reaction but it makes sense
that there wouldn't be much information about it
if people are too afraid to talk about it.
Here's my thoughts about why I think this happens.
Real impostor syndrome is when someone fails
to internalize their accomplishments and their skills
and they think that they don't deserve
their current position.
Likewise, with bipolar disorder,
there's a lack of internalization or taking ownership
of the illness, and this isn't simple denial,
like saying to yourself, there's nothing wrong with me.
It's a deeper sense of this isn't me,
it's a defense mechanism that you can use to deal
with the insult the illness brings to you,
and like with impostor syndrome, you may feel,
at some level, that you don't deserve this,
and therefore, you're a fraud for going through the motions
as if you had something really wrong with you.
If you're in between episodes, you can look back
on your episodes and think, how could I not get out of bed
for three days?
What normal person stares into space for two hours?
I can't believe I did that.
It's such a foreign feeling, it feels removed
from who you are today.
And so what's the logical conclusion?
That maybe you just made that stuff up.
And even if you remember trading in your six month old car
for a new Jaguar, now you may think,
hmm, was I just doing that to get attention?
Because who does that?
Not me!
So I think, in this scenario, the behavior you had
when you were ill or the thoughts that you had
are so foreign to you, there's a huge disconnect
but when you try and match up who you believe you are
and who that person was, and we call this ego dystonic.
It's when your thoughts and behaviors don't match
your current emotional state.
Another thing that can contribute to this
is depersonalization and derealization.
I did a video on this that I'll link in the corner,
and you can watch more on this, but in short,
derealization happens when you feel unreal
and detached from your surroundings and your environment.
Your environment doesn't seem real, like you're in a dream.
Depersonalization is defined as feeling unreal
and detached from your body's thoughts,
sensations and actions so it's like
you're observing yourself and your thoughts.
Derealization and depersonalization can happen
with bipolar disorder.
You can experience it during the depressed state
or the manic state, but it can linger
in between episodes, as well.
Sometimes, depersonalization can be very extreme,
but perhaps, it's a subtle form of depersonalization
when you have this feeling that you just can't seem
to shake, that the past several months of symptoms
that you had were not real.
Think about it.
It is the experience of feeling disconnected
from your thoughts and behaviors,
so the whole, I was faking I thing can be another way
of saying, I can't relate to this person
who was going through the motions and doing all those things
but the only way I can make sense of how
I could've been that way is that I must've made it up.
So that conclusion is a way
to piece together the disconnect.
One more factor that can contribute to this
is if you become psychotic, and this is an altered state
where you don't perceive things as they really are,
and so when the psychosis resolves,
you really can't relate or connect to those thoughts
that you had, you can just think that you were playing
a role or exaggerating things.
What can you do about this?
Well, you can keep a record of your episodes.
I did a video on strategies to manage bipolar disorder
and I talked about recognizing early signs of an episode,
and I'll put a link to this video in the description,
but you wanna get the pattern of your symptoms,
as well as the timing of your symptoms,
and one good reason to do this is so you can see
an episode coming and maybe even prevent it.
But another reason that is to remind yourself
of the scope of your illness and recognize
that it's something that comes and goes,
so that when you're feeling good, you can see on paper
what it looks like when you're not feeling so good.
Now this isn't a perfect solution.
Claire, who asked the question, said she still struggles
with this feeling, even though she journals her episodes.
I do think, though, it may get easier to shake
this fraud feeling the longer you have the illness,
and the longer you live out the pattern.
Another help is grounding exercise.
If you think what you're experiencing
has a depersonalization feel to it,
you can try some grounding techniques.
Grounding techniques help you manage overwhelming feelings
by reorienting you to the present,
and there's many ways to do this.
One way is to wear a rubber band on your wrist,
and it helps you pull yourself out of your head
and into the present.
Another approach is to do a sensory awareness example.
It's called the five, four, three, two, one exercise.
You name five things that you can see in the room with you,
you name four things that you can feel,
and this would be real things like the leather
that you're sitting or the carpet under your feet,
you name three things that you can hear right now,
like fingers tapping, or the tick-tock of a clock,
and then you name two things that you can smell at the time
and if you can't smell anything, then name two things
that you'd like to smell,
and then you name one good thing about yourself.
I hope this was helpful for you.
Share this video, and spread the knowledge,
and give me your thoughts in the comments, too,
I really like hearing from you.
Take care, see you next time.
(upbeat music)
♪ I am what I am today ♪
♪ 'Cause I did it my way ♪
♪ Nothing y'all can say ♪
♪ In this life or the next one ♪