Author Topic: psd or esa for bipolar?  (Read 498 times)

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Offline johnbltz

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psd or esa for bipolar?
« on: July 10, 2017, 07:12:49 PM »
Hey all! New here and have a question. Actually, a pretty long one, so sorry in advanced... Also, trigger warnings, I think? I'm never sure when I should include one, but I'll be talking about abuse and severe depression, so heads up.


TL;DR: I was diagnosed with Bipolar about a year ago, taking meds and trying to make lifestyle changes. As I've been looking into PSDs and ESAs I find myself obsessing over whether I'm 'disabled enough' for a PSD. I know I would benefit from routine maintenance, being woken up and encouraged to go to bed at normal hours, and just help remembering and doing general everyday things I struggle with. While I can go outside without having a severe panic attack, it is also not uncommon for me to isolate myself at home because of anxiety and depression. I don't want to be the guy who goes task shopping so he can justify a PSD because he wants his dog with him everywhere (although now that I think about it, as much as I've loved the dogs in my life, I don't think I've ever thought it would be super nifty to take them with me everywhere, 24/7...). I'm trying to think really hard about whether a PSD is right for me, or whether an ESA is a better route, and could use some experienced, outside perspectives and advice.


I was diagnosed with Bipolar just over a year ago. My diagnosis came after a lifetime of struggling with mental health. I am a childhood sexual abuse survivor, a survivor of damaging ex-gay "therapy", and a suicide survivor. My illness really began affecting my life when I left home. I attempted suicide about two months into my freshmen year of college. Then I came back and failed my first semester because I was so overwhelmed and anxious about going to classes and being around new people that I skipped, which of course made me more anxious, which of course led to more class skipping, which lead to... well you get it. I spent most of my time in my dorm room that semester. A few semesters latter I officially failed out.

After that I spent several years on an emotional rollercoaster, made some terrible decisions, put myself in really dangerous situations, and generally did the kind of self-destructive stuff that us Bipolar folks seem to love so much. I tried going back to a community college, but couldn't cut it. Couldn't hold down a job, and was generally just a mess.

About five years ago I was pretty much at rock bottom, got myself dumped, kicked out of my apartment and cut off by most of my friends. Luckily for me I also met my partner at that time. He has been a hugely stabilizing influence for me. He got me to go back to school and eventually I went back on anti-depressants. Unfortunately right before my last year of undergrad he had to take a job out of state and move away. It didn't take long for the emotional rollercoaster to kick back in again. I made stupid decisions, my grades took a hit, and I hurt the friends around me. Finally my pdoc diagnosed me with Bipolar and put me on a mood stabilizer.

The diagnosis came just months before I was supposed to start graduate school in a new state, still away from my partner. I'm working with a therapist and a pdoc, and their great, and the meds certainly have helped. But I still really struggle. I feel like I just barely made it through this past year. I know that feeling out of place or inadequate is a common experience for grad students, but I objectively have not performed up to my ability. I spend enough time with my cohort to know how they are doing versus how I am doing. We are all struggling, grad school is hard, but I'm definitely struggling more and in different ways than they are. I really feel like if I don't figure out something I'm not going to make it through my program, and that would be devastating for me.

SO, with all that long, depressing background out of the way... I stumbled in here because I am exploring a PSD as a treatment option. However, I'm feeling really uncertain about the necessity of one, and whether an ESA would be a better fit. I often feel like, because I've made it to grad school and functioned reasonably well for the past several years, I don't really *need* a PSD. I don't want to be one of those people who goes task shopping so that they can justify a PSD. But I also feel so much of what I read is subjective. What does a severe mental disability look like? What counts as a significant impairment in a life activity? I keep thinking that unless I'm totally housebound, or have meds that cause significant mobility issues (dizziness, etc), then I'm not really disabled enough for a PSD, and should instead look into an ESA.

To top it all off, I still struggle with the stigma and stereotypes of my disability. All those days I didn't go into the office, and thus got nothing done? I was just being lazy. My seeming inability to go to sleep and get up at normal times? I just lack discipline. Dodging out of social events? I'm just an introvert. So I don't need a PSD, I just need to get my 'stuff' together! I guess I'm just constantly second guessing myself, and this is just another thing to second guess about.

As far as what barriers I would want a PSD to help me with, the first thing that jumped out at me when doing research was routine maintenance. Getting me out of bed in the morning and making sure I go to bed at the same time every night. Forcing me to get out of the house and exercise through walking the dog. And frankly help with any of the other daily tasks that I often struggle with doing.

I don't know how I feel about taking a PSD with me everywhere when I'm out. I keep telling myself that I obviously don't need that because I go out now without having severe panic attacks. But then I remember all of those days, even weeks, when I isolated myself at home because I felt too anxious or depressed to go out. Or the social events I skipped because I knew I would be too anxious around other people. And then I also worry about the stigma and outing myself as disabled and bipolar. I study in a pretty progressive field so I would like to think it wouldn't be an issue, but you never know. I just have this dread of my colleagues and professors looking at me all side eye if I show up one day with a PSD, having to explain it to them, and of course fielding questions about whether I can actually succeed in my field as someone with a mental disability and PSD.

I don't know. I'm super confused, in case you couldn't tell  :tongue2:, and could really use some outside perspective. Thanks!

Offline Kirsten

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Re: psd or esa for bipolar?
« Reply #1 on: July 10, 2017, 10:59:57 PM »
John, I have a traumatic brain injury that affects my ability to read print.  I'm not able to read your post and remember what it is about by the time I reach the end because of processing difficulties I have.  I understand you're trying to choose between an ESA and a PSD, but is it possible for you to give a shorter summary of your concerns, maybe a list of what you need from the animal?  I'm good at answering questions and have a lot of information crammed into my head, I'm just not very good at reading more than about a paragraph because of memory processing issues.

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Offline EverConfused

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Re: psd or esa for bipolar?
« Reply #2 on: July 10, 2017, 11:39:22 PM »
people who have ESAs aren't 'less' disabled. you need to be disabled to have either an ESA or a service dog.

the difference is ESAs are used for treatment, service dogs are used to compensate for what isn't treatable.

if you had a dog with you, is it possible that just having it around and taking care of its needs would add structure and motivation to your day that's missing right now? i know you and your partner have lots of animals, so you might have some sense of this.

if you think the dog's mere presence wouldn't be enough, what about having a home only service dog? it could be trained to wake you up and remind you to go to bed, if alarms don't work, and so on. and you wouldn't have to figure out having the dog at school.

i'm not recommending one particular course of action. just, from your post it sounds like you don't really want to have a dog with you all the time. i hadn't heard of home only service dogs until just a few years ago, so i thought i would mention it.
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Offline johnbltz

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Re: psd or esa for bipolar?
« Reply #3 on: July 11, 2017, 10:08:29 AM »
@EverConfused Thanks for the reply! I didn't know that home only service dogs were a thing, I'll have to look into that.

As far as going out, I think I probably need to talk to my therapist about it. I feel like I tend to underplay my illness, and attribute the ways it disrupts my life to some kind of character flaw, and of course you just need more discipline and hard work to overcome those! Last semester I missed an entire week of class because of depression and apathy, and missed a few other classes throughout the semester for similar reasons, plus anxiety. I try to downplay it to myself, but in reality missing even one class in grad school can be pretty disruptive, to the point that sick students are often encouraged to skype in if at all possible. Not to mention I didn't stay home at least one day because of anxiety.

I also frequently skip social events because of anxiety. I used to be a bit better before I quit drinking, alcohol was a great anti-anxiety drug for me, unfortunately also a very destructive one  :tongue:. Big social events, which I'm often required to attend, can really fill me with dread. I'm always finding excuses to duck out early as my anxiety becomes more and more overwhelming. Basically, the more people and the more crowded a social event, the more overwhelmed I get. I also end up wasting a lot of money on take out in order to avoid going to the grocery store.

I never thought of any of these issues as "that serious" because I don't have full blown panic attacks when I'm out. Thankfully I haven't had a full blown panic attack in years. But anything that would enable me to get to work and class every day, on a regular basis, would - I think - significantly improve my ability to function.

I guess I'm verging on asking for a diagnosis of some kind, which obviously you all can't do. But I really appreciate your comment about 'less' or 'more' disabled. That's probably not a way of thinking that's particularly helpful, and I really need to try to get out of that frame of mind.

Thanks again for the reply!

Offline johnbltz

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Re: psd or esa for bipolar?
« Reply #4 on: July 11, 2017, 03:28:26 PM »
@Kirsten Thanks for the reply! I think in part I need to talk to my treatment team, because I have trouble recognizing things as part of an illness rather than a character flaw. That said, here's a quick list of things I think I would want to train any dog, ESA or PSD, to do...

  • Disrupt self harm, mostly head banging and scalp picking
  • Waking me and putting me to sleep, alarms only work about 50/50 for me, at best
  • Suicide prevention, basically using a K9 phone in case I ever attempt again
  • Going out when I'm depressed/anxious. This is the one I have the most problem thinking through. I haven't had a full blown panic attack in years. I can often go out without much of a problem. But I also often miss out on things because I'm depressed/anxious. I guess I feel like if I can go out alone 50+ percent of the time, I don't really need a PSD?
  • Disrupting psycho-motor agitation. I don't know if this is something a PSD can do, but I get it really bad, sometimes tapping my feet so hard that I'm basically stomping.
  • Grounding in case of depersonalization/psychosis. I've only ever experienced mild, brief psychosis, but it still worries me.