March 30-the birthday of the artist Vincent Van Gogh, who, with his dramatic biography and surprisingly contrasting paintings, researchers consider the classic embodiment of a manic-depressive genius. On this day, people with bipolar disorder are celebrated in the world. It was founded by the international community on the study of bipolar disorders (ISBD) to draw attention to the difficulties that people are faced with this diagnosis in our society. On this day, open lectures are held, educational programs are issued, and sometimes even organize promotions dedicated to life with a bar. Samizdat publishes an excerpt from the new book by Masha Pushkina - one of the creators of our text about the bar , the translator of Kay Jamison's Book “The Restless Mind” and the curator of the Bipolar Association group with the author’s preface.
I decided to contribute to the education and struggle with Stigma and publish a book on how people with bipolar disorder in the post -Soviet space live. Since I began to engage in enlightenment on the topic of bipolar disorder, I have learned a lot of wonderful people who live with this diagnosis. Some wrote to me when I collected stories for the article “Bipolar World”, I met others in the support group. There were so many stories that they would not fit into any article. Inspired by the hit “You are not a stranger here,” I decided that it should be a book. Just because there is no such book, but it should be. I wanted it to be a frank, honest book, and, moreover, instilling hope - because her heroes have found their ways to cope with the disease, tame it and even find positive aspects in it. People often trust the same as they, than doctors, and I hope that these survival strategies will help someone avoid pain and mistakes.
The support group is what you need
Anya, thirty -five years old, accountant:
“The first signs that something was wrong with me, I began to notice at twelve years, after the divorce of my parents. At first, these were light depressive episodes. But over the years, they became stronger and longer. At twenty -five, they could no longer be ignored. It became hard for me to work the full day, I poorly tolerated stress. I did not understand what was happening to me, and I was looking for simple explanations. I thought that the matter is surrounded: that the profession of an accountant does not suit me. I have a beautiful dream - to move to Europe. I was sure that the change of scenery would solve all the problems at once. And by the age of thirty, this dream was fulfilled. I received a highly paid job in a large company in Switzerland. I was very appreciated there.
Around beauty, mountains, I have my own apartment. But I did not become happier from it. Life in a new country without knowledge of language turned out to be serious stress. I felt torn from the usual world and experienced a huge cultural shock. At the same time, I had a clear feeling that there was no way back. The relations with my parents were bad, and I did not want to return to live with my mother. I was sure that I had to fight and provide for myself, at all costs, at any cost. I tried to cope for almost two years. Fatigue accumulated. The work became very stressful, difficulties in personal life were imposed on this. I even decided to turn to my parents for help, but they did not understand my problems, did not support, but, on the contrary, advised me to stay in Switzerland.
At first, against the backdrop of stress, my mania appeared.
I ran like a meteor, conducted conversations with God and received instructions from him. Once I decided to sacrifice all my completely solid savings in the charity fund. The rise quickly replaced with a decline. At some point, I was simply not able to go to work. In a zombie state, I went to the office for another four months, returned home and was cut down. I was in deep depression, but I could not understand it. Then I began to lose adequacy, I could no longer control myself. This condition brought me to the suicide attempt. So I ended up in the hospital with a diagnosis of depression. There I spent a month and a half, then I still went to the day hospital. And, returning from the sick leave, she found that she was fired. For good money, they expected productive work from me, but they could not allow long -term sick leave.
Returning to Russia was not easy. The standard of living has fallen noticeably. I no longer had entertainment, interesting events, companies that I got used to in Switzerland. I realized that I was not able to work in the office and get tired to death even in a seven -hour day. It turned out to be very difficult to work on the schedule, and to portray a smile on your face when you are terrible, even worse. I was constantly asked that
It happened to me, and I did not know how to answer. In the end, I realized that I could work normally only at home. Separate stress was the search for rented housing, frequent crossings. So soon I was in the hospital again, in the neurosis clinic.
At first I had a wild fear of the psychiatric hospital, especially the Soviet ones. I imagined that I would be immediately tied and tormented by an electric shock. If in Europe I did not see that this is just an ordinary hospital, and you are treated in the same way as in any other medical institution, I would never risk it. The clinic in which I lay in Switzerland was very comfortable. We were engaged in art therapy, psychotherapy, taught relaxations, there was a large beautiful park for walking. There was no gate at all, you could calmly go to the city, having scanned at the doctor. They gave me a training manual "how to support myself in depression." I learned it by heart and still use it. These are simple, but effective rules: observe the regime, to be in the fresh air, especially in the sun, do not sleep extra hours. In the hospital we were not allowed to sleep for the end, early in the morning we woke up and sent for a walk. And this really helps to cheer up. During life with bipolar disorder, it is important to use self -discipline. Russian hospitals, of course, are noticeably worse for the living conditions and the level of comfort. But these are, in general, ordinary hospitals. They may have hard beds and tasteless food, but the attitude to patients is quite human. And patients are not violently obsessed, but the most ordinary people. In addition to pills, psychotherapy helps me in treatment.
Here I am guided by the principle that you should try all available methods, but with great caution. You need to carefully study your reactions and track changes. For myself, I compiled a list of those things that help with depression, and those that, on the contrary, worsen the condition. For example, after several bodies of bodily therapy, I got worse. The psychologist began to ask me about children's injuries, severe experiences. After that, nightmares began to torment me. I had an experiment with Chinese acupuncture. She relieved menstrual pains, but did not affect depression. Everything is very individual, and different phases of the disease are different. When my health is quite cheerful, then for me the best is yoga.
And when depression is just approaching, you can return yourself to a normal life with the help of osteopathy, it acts on the body as “passive sport”. Massage is also useful. Meditation of awareness saves me very much, this is a Buddhist practice, which is often used in yoga. She teaches to feel her body. In depression, the connection with your physical shell is often lost, you stop feeling discomfort and even pleasant sensations. You need to return to yourself. In severe depression, when I can only lie, I meditate. Suitable meditation manuals can be found for free on several sites. For ten years of illness, I learned to listen to myself and feel the approach of episodes. Once I was able to slow down myself in the way of rolling into depression. Then it came to my mind that people like me are able to support each other.
The experience of life in Europe helped me a lot. Due to specific education, I used to live quite passively, to think that life is full of difficulties and obstacles. But in Europe, I realized that much is possible, and this understanding gave me new strength and creative energy. I began to act more actively to my life. Without this experience, it would not even occur to me to start something myself, I would sit at home and suffer like hundreds of other people who complain about the lack of support groups in their cities. I thought what was needed to create a group?
It turned out quite a bit: five to ten people with my diagnosis and a room for meetings. Having stumbled upon an article about bipolar disorder, I turned to people in the comments. Ten people responded. It was not difficult to find a room in one of the psychological centers. I used American developments. At first I was afraid that I would make an unimportant presenter. It turned out to be a matter of practice. First, you should prepare, study available information. At the meetings, one cannot allow yourself to relax. You have to be concentrated, listen carefully to others. The first meeting was serious stress, I even had a trembling voice. But the people who came were nervous no less, because on support groups frankly talk about very personal things that many of us do not even tell loved ones. People were wary of everything, but with interest and curiosity. The additional difficulty is that people are not just different. They come to meetings in different conditions. And if someone barely got out of bed because of depression and cannot tie two words, then the other has hypomania, he is loud and sociable. Some people need to slow down a little so that they start talking. Others, on the contrary, slow down. So the leader should always have a desire to learn from his mistakes.
Nevertheless, I very quickly realized that the group is exactly what is needed, what I didn’t have enough for me. Participants enthusiastically gathered every week, although many had a difficult condition, a lot of work, children. In the vacation season, there are fewer people, but I did not give up and searched for new people on social networks. Although initially I wanted a permanent team to form, in which you can relax and communicate confidentially. Many problems were solved. For example, when I felt bad, other participants replaced me as a leader.
I continue to lead the group for almost a year in the first place because I myself need it myself. This is a crutch, without which it is very difficult to walk in life. I am comfortable to be among my own, in an environment where they listen and understand you. After all, we all, no matter how different, are faced with the same problems, and everyone learns to cope with them in their own way. In each I see something familiar. And this understanding helps to experience crisis moments, gives self -confidence and its abilities. I am sure that many can cope with the group.
How to create a support group
Step -by -step instruction
Knowing that you are not the only one helps to cope with a mental disorder. That there are people nearby who overcome the same difficulties, and they can turn to them for advice and support. For this, there are groups of mutual support. These are voluntary and amateur meetings designed to combine collective experience, psychological adaptation skills, ideas and knowledge of people who were "already there." This widespread and successful international practice is gradually developing in Russia. I was often asked if there are support groups for people with bipolar disorder or depression in certain cities of Russia. While their units. But in order for such a group to gather, nothing is needed but your initiative - neither money, no permits, nor leadership.
On what principles is the work of the support group based on?
Self -help . We proceed from the fact that the patient is configured for recovery and is ready to make his own efforts to this. Each person has useful knowledge and skills for this, but together we know more than each of us.
Safety. Participants should feel that they can express any of their experiences, without risk to get criticism and moralizing in response.
Confidentiality. No discussions, facts, names should go beyond the group.
Equality. Each member of the group has the right to his opinion and his own path to recovery.
What can a support group give?
Communication. It is invaluable for people prone to depression. The support group can become the main incentive to get out of voluntary imprisonment in the apartment and talk to new people.
Acceptance and support. Here, your difficulties, which for many people around them seem whims and oddities, will be treated with understanding. Some people in general for the first time in their lives talk about their experience of the disease in the support group, because neither relatives nor friends are able to perceive this adequately.
Value knowledge about the disease. Unfortunately, doctors do not always consider it necessary to explain something to the patient, but without understanding it is very difficult to take the disease and the need for treatment.
An important life experience. How to cope with everyday work in depression? How to control the outbreaks of irritability? It is great to discuss this with people who understand what you are talking about.
Actually, support. The atmosphere of understanding and words of sympathy are already able to do a lot. But besides this, it is in the group that you can find people who will help you in a critical situation. For a person with suicidal thoughts, this can be vital. There is a common American practice of proxies, or, as they are also called, "baddy." This is a person who, by mutual agreement, regularly gives you feedback. For example, if you have a mania, and you cannot evaluate your condition adequately. He can also take measures if you are in danger. Ideally, a powerful person can transfer detailed instructions on how to act in an emergency - for example, if you get to the hospital.
Self -esteem. If you have a long depression, you feel lost and worthless, creating a group will not only give you a comfortable circle of communication, but also pull out your self -esteem out of the abyss. When you overcome resistance and join in the conversation, you finally feel useful.
What can't support group?
Cure you. There are professional doctors for this. At the meetings of the group, it is strictly forbidden to “treat” comrades, make them diagnoses and share their recipes. The treatment regimen that came up to one person can cause the strongest side effects in another. I know cases when, after the human drug accepted on the advice of a friend, they took away to an ambulance. If a person who is close to critical came to the meeting, the only thing you can help him is immediately directed to the doctor.
It is very important that each member of the group has a attending physician and an officially diagnosis. If someone only suspects the problem of himself, he may well be mistaken, and in case of exacerbation you will not help him.
It should be understood that the support group is not the same as group psychotherapy. For the latter, you will need a professional who leads and coordinates the interaction. The organizers of the support groups are the most ordinary people. They cannot give you a ready -made recipe for solving the problem or prescribe a medicine. But they can share valuable life experience, sympathy and understanding.
Who to gather in the support group?
Remember, according to world statistics, one of the forty people is sick with bipolar disorder. This means that even in the smallest city you are not alone. To calculate them, of course, is not very simple, because most people hide their diagnosis or do not suspect its existence at all. But you can.
If you regularly visit a psychiatrist in the PND or hospital, you probably know someone personally. Or ask the doctor to transmit your contacts to a person with the same diagnosis.
In addition to the patients themselves, their close relatives often participate in support groups who want to understand how best to help them.
Then look in groups in social networks and on forums dedicated to mental health and psychology. You can give in one of them a small announcement with an appeal to unite to create a group. In the end, you can give an ad to the newspaper- online or the most ordinary.
The comfortable size of the group is five to ten people. If it is gaining more, not scary. Usually some people are lost after several meetings.
How to organize a support group?
Find the coordinator and facilitator of the group.
If you have free time and you are a well -organized person, feel free to take up the role of the coordinator yourself. It will require systematic, but little effort: to agree on the rental of the premises and to invite participants in a timely manner. The easiest way to do this is using the closed VKontakte group or on Facebook.
For a productive conversation, a facilitator is needed. This is a person who makes sure that the participants fulfill the rules of the group, adhere to the chosen topic and let everyone speak out without interrupting.
The situation is ideal when people who are ready to take on the function of the coordinator and facilitator of the group, two or more. Это спасёт группу от развала, если, к примеру, её основатель заболеет или просто забросит инициативу, погрузившись в депрессию.
Где собирать группу поддержки?
Распространённая ошибка — начинать собираться в кафе или у кого-то дома. Часто этот план проваливается, потому что при посторонних людях практически невозможно расслабиться и поговорить на трудные темы. Не стоит путать формат группы поддержки с посиделками с друзьями за кофе. Второе тоже полезно, но не заменит первого. Нужно, чтобы продолжалась серьёзная работа над проблемами каждого. Важно помочь человеку с трудностями докопаться до сути, поддержать его, дать совет, дать обратную связь.
Идеальный вариант — небольшое съёмное помещение. Их множество в разнообразных бизнес-, досуговых, культурных, психологических центрах. В нашем случае (в психологическом центре в самом центре Москвы) расходы составляют 100 рублей с человека за одно занятие.
Как часто нужно собираться?
Наш опыт показал, что оптимальная частота собраний — раз в две недели на полтора-два часа.
Есть ли юридические трудности в организации группы?
Нет, группа поддержки — это просто личное общение людей. В законах, к счастью, на этот счёт нет никаких ограничений. В этом её отличие от групповой психотерапии, которая требует квалификации психолога и отчётности о доходах. И на этом принципе и основана популярность групп поддержки во всём мире.
Что должны делать участники группы?
Главное условие участия в группе поддержки — признание, что у тебя есть проблема и над ней нужно работать.
В правилах общения в группе нет ничего необычного — нужно просто соблюдать правила уважительного конструктивного общения. Главное, не забывать благодарить людей за их участие и советы.
Ещё нужно учитывать, что обсуждение личных проблем возможно только в атмосфере доверия, а участники — психологически ранимые люди, и потому нужно всегда быть максимально вежливым и тактичным.
Стоит следить, чтобы обсуждения сосредотачивались на том, как можно решить возникшую проблему и справиться с трудностями, а не на том, как тяжела и безнадёжна жизнь вокруг.
Что не должны делать участники группы?
Не делиться рецептами лекарств.
Не критиковать и не оценивать людей.
Не предлагать деструктивные и непроверенные методы лечения (вроде лёгких наркотиков или сыроедения вместо таблеток).
Если человеку в прошлый раз было плохо, а сейчас он просто сияет и пританцовывает — не стоит его хвалить и поздравлять с выздоровлением, а также поощрять его стремление заниматься новым мегапроектом. Есть риск, что это начало мании, и лучше посоветовать ему быть осторожным и не забывать о лекарствах.
Если человек уже в мании, лучше ему, конечно, не ходить на группу поддержки (да и сам он вряд ли захочет это делать), а обращаться немедленно к врачу.
Не стоит приходить и людям с деструктивным поведением, которые бросают принимать лекарства и советуют это другим, заменяют лечение алкоголем и считают, что такое поведение нормально и не требует корректировки.
С чего стоит начать общение в группе поддержки?
Для начала нужно попросить, чтобы люди представились и каждый рассказал, что считает нужным, о своей истории болезни и борьбе с ней, о том, какие проблемы они хотели бы решить. Про себя рассказывать любят все. Well, almost everything. Всегда в моменты длинных пауз спасает тема «какие трудности и успехи у вас были на прошлой неделе». Из тем, которые оказались многим близки — как справляться с работой и бытом в депрессию, контролирование эмоций, общение с родными на тему БАР.
Каждый участник может предложить тему для встречи. Обычно мы разбираем в первую очередь историю того человека, которому сейчас плохо и трудно. Можно заранее договориться, какие темы мы разберём в будущем. Перед каждой встречей стоит подумать, что вас волнует и о чём бы вы хотели услышать мнение или совет.
Какие проблемы могут быть у группы поддержки?
Часто приходят люди, которые не справляются со своими эмоциями (это нормально, при БАР это сложная задача). Они перебивают других, начинают отвлекаться на посторонние темы и так далее. Ведущему нужно с ними договориться заранее, что когда их начинает заносить, он будет напоминать им об этом.
Что ещё можно почитать о создании группы поддержки?
Проблема, которую не решить с помощью группы — стигматизация психически больных в нашем обществе.
Многие считают это чем-то постыдным, так же, как, например, СПИД или гомосексуальность. Вы не можете говорить о своих проблемах так же спокойно, как, например, о диабете или аппендиците. То есть, если вы очень смелый, вы можете говорить об этом открыто, но реакция даже близких людей непредсказуема. Потому тысячи людей страдают в тишине, в одиночестве. Но ведь биполярное расстройство — это вполне обычное заболевание, довольно распространённое, хорошо изученное. Оно лечится. Очень мало кто в России понимает, чем опасно биполярное расстройство, как поддержать человека.
Даже специалисты не всегда понимают. У нас вообще нет экспертов — врачей или психотерапевтов — именно по аффективным расстройствам. Психиатры лечат всё понемногу и, как правило, не вдаются в детали. Так что вам, скорее всего, выпишут стандартный набор таблеток, и на этом лечение будет закончено. Это не значит, что ходить к врачам не нужно — но придётся приложить очень много сил, чтобы найти «своего» врача.
Если вы решили создать свою группу поддержки и у вас ещё остались вопросы, можете обращаться к нам [email protected] . Вступление и интервью Маша Пушкина Москва Иллюстрации Таня Сафонова Санкт-Петербург
Вступление и интервью Маша Пушкина Москва 
Иллюстрации Таня Сафонова Санкт-Петербург 