Quality of Life

After 6 years with my doctor, who is a Treasure, I worked this equation out. I am on a rather heavy dose of anti-psychotic, and an anti depressant. It took a full year enduring side-effects like dopiness until we got the right mix, taken at the right time. Our course of therapy is called Cognitive Behaviour Therapy.

What do you think?

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Quality of Life = Excellence of Psychiatrist / Severity of Symptoms * Motivation of Patient/Client.

Quality of Life equals Excellence of Psychiatrist divided by Severity of Symptoms multiplied by Motivation of Patient/Client.

Excellence of Psychiatrist: Is the course of treatment one that will work for you? Are the meds appropriate? Is it a good fit between you both? Do you trust your doctor? Does your doctor specialize in your illness?

Severity of Symptoms: It is what it is.

Motivation of Patient: Are you committed to following a course of treatment? Will you be patient and persevere until you find the right balance of meds? (Enduring side effects until you get the right Rx) If your doctor is Not the right fit for you, will you persevere until you find one who is?

When patient becomes client.
When you pass over from a suffering person, to a person maintaining wellness.
A client exercises autonomy... is in charge of their treatment, with doctor as the specialist.

I love your equation. I hope to see it on my blackboard soon.

bhikshuni wrote:AWhen patient becomes client.
When you pass over from a suffering person, to a person maintaining wellness.
A client exercises autonomy... is in charge of their treatment, with doctor as the specialist.

Good point!

The doctor is a specialist, not a care-taker. You also hit on the "suffering" person as one who transforms to the active role rather than the passive, or victim role.

You sound like a technical person with this equation - great idea! Maybe an a more general formulation of your idea could be:

1. Initial conditions:
a) already know your life's work or purpose,
b) realize self-idenity at time = 0,

2. Variables:
Q = quality of life as determined by a sustained period of positive or constructive and stable thinking.
A = all forms of guidance including family, books, and psychiatrist.
X = motivation of patient to achieve their life's work, where X is bounded by [too little, too much] as determined by severity of symptoms.
t = time.

3. Governing equation: Q = A*X*t.

Thanks so much for your reply... this equation is FABulous!!

sorry I didn't get back to you sooner.

it almost nearly fits for me... life's purpose has been my psychiatrist's issue all along... while in my days as a suffering person my only issue was survival with some kind of quality of life that made life livable.

Yes, time is the great healer.

While not a "technical" person, I make up equations all the time.

One of my doctor's equivalences (equations) is:
Mental Health is the ability to tolerate, cope with, and work with reality.

lemme take some more time to look at yer equation : ))

thanks very much and happy christmas : )

Sounds right to me. I like it. I also had years of doctors and therapy and learned to help myself.
Doctors, therapists and meds are tools to be used to better ourselves.

bhikshuni wrote:When patient becomes client.

I really agree with this. Even the etymological root of the word patient (patience - quality of being patient in suffering) shows that there is something negative associated with identifying yourself as a patient and likewise something postive associated with being a client, a user of the system.

bhikshuni wrote:Quality of Life equals Excellence of Psychiatrist divided by Severity of Symptoms multiplied by Motivation of Patient/Client.

YOU CAN'T DIVIDE SEVERITY OF SYMPTOMS AND MULTIPLY MOTIVATION OF CLIENT! THEY'RE NOT NUMBERS!!!

Okay, *deep breaths* I got the math weenie out of me

I do think it's a good heuristic though. Perhaps it's missing the coping skills people pick up over time coping with the disorder.

Anyways, thanks for the post. It was very informative. Take care.

1. Initial conditions:
a) already know your life's work or purpose,
b) realize self-idenity at time = 0,

2. Variables:
Q = quality of life as determined by a sustained period of positive or constructive and stable thinking.
A = all forms of guidance including family, books, and psychiatrist.
X = motivation of patient to achieve their life's work, where X is bounded by [too little, too much] as determined by severity of symptoms.
t = time.

3. Governing equation: Q = A*X*t.

dear ian,

after a long time i have returned to your equation, which is excellent, stand alone.
it does not, however, include excellence of psychiatrist. the quality of life i now enjoy: mental
stability, positive outlook, the experience of peace is absolutely a direct consequence of
working with my psychiatrist who is excellent! after six years now, my meds have been
reduced: "because you don't need them," said he. (I first experienced wellness and stability after a course of Vitamin D, recommended by my doctor. wellness came very gently, i felt myself settle down.) i often say to him, "we just don't know how well i can get" since mine was the mania of
the suicidal type, i think i can say we have saved a life here. about purpose in life, that value
is still something of a blank for me. i take care of myself, i love my loved ones, i try to write..
that's about it at the moment.

in my original equation severity of symptoms should be "subject to change"
so, in my equation, as severity of symptoms decrease, excellence of psychiatrist shines forth,
becomes manifest to client. the work becomes more creative, proactive (forward moving)

the reason i left treatment so many times in the past is because i could not find a
doctor that i liked, believed in, trusted. so i wouldn't have got my "foot in the door"
towards a path of wellness had it not been for the excellence of my doctor. when i was
a suffering person with no ability to exercise positive choices and thinking
styles i had to follow his lead, and that i did. my road to wellness began with my
decision to be compliant with the treatment plan he laid out for me. yet, from the
beginning my doctor said i was in charge, i was the captain of my ship of fate.
i just couldn't do it that way when i was very sick.

another reason to avoid or flee from treatment is not wanting to let go of
the manic high. to my psychiatrist i liken this to the cocaine high. where this
is the case, the doctor and family have to negotiate with the patient to choose
wellness over getting high, and i can't see any difference here between the
bipolar in this chosen manic state and any other addict, except that the "meth lab" is
in one's own head.
i read and hear alot of this:

"Later Karen performs an ‘experiment’, purposefully stressing
over a disturbed student, keeping herself awake at night – all in order to kick-start the creative ideas she craves."
Me and Her: A Memoir of Madness Karen Tyrrell
"I work best, or at least most intensely, when I work myself into a hypomanic (just below manic) state fueled by sleep deprivation and focused excitement."
Off the Deep End: Diary of a Mathematician, Scott Axelrod

a person w bipolar disorder out of treatment or refusing treatment is tragic,
in my opinion. so, if we want to prevent tragedies the first wave has to be
with the doctors' training.

when patient becomes client

i've been reading an excellent paper, hard to get,

“As these examples from the clinical literature illustrate, the managing self of biomedical discourse is predicated on a distinct notion of authentic selfhood as something that is and must be delineated and distanced from the disease. According to this logic, there exists a subtle but actual boundary between the real person—who is characterized by coherence and stability, or continuity across time—and disease manifestations that may take the appearance of personhood and ‘‘fool’’ the untrained patient.”

The (Un)managed self: paradoxical forms of agency in self-management of bipolar disorder.
Talia Weiner; Cult Med Psychiatry. 2011 Dec ;35 (4):448-83 21874387

here we find your important concept: "coherence and stability, or continuity across time"

I like the notion of the post, but I do not quite grasp the equation concept/s. And what to do if I don't meet the initial conditions? Is waiting my only option?

1. Initial conditions:
a) already know your life's work or purpose,
b) realize self-idenity at time = 0,

i don't meet the conditions , but i get the direction he is going. my psychiatrist emphasizes life's purpose, work and identity all the time. at present my life's purpose is to take care of myself (i save my life every day), do good towards others (i focus on my loved ones, i try not to dwell on myself)... i write a bit... no grand plan here