New Year, New Me, New Ways to Manage My Bipolar Disorder

Photo by Andreas Dress on Unsplash

This post appeared on the International Bipolar Foundation’s website, here.

I used to look at the new year, especially the month of January, with trepidation.

When I was but a young college student dating my then-boyfriend–and now husband of several years–I had not yet been diagnosed with bipolar I because I hadn’t suffered a major manic episode, but I still suffered crushing depressive episodes.

I didn’t notice until several years later that these depressive episodes followed a pattern: I would be up, up, up, cheerful, social, and insanely productive, totally killing it on my tests and in my friend group.

Then I would crash and burn, and spend several weeks if not months not showering, self-isolating, and unwilling to get out of bed for any reason.

This pattern almost always manifested itself around the holidays. Until I started dating my husband, I didn’t celebrate Christmas because my parents didn’t for religious reasons. So when I was encouraged to celebrate the holiday season with my husband’s family in college, I went all out for years.

One of my expressions of frugality is crafting. I bought a ridiculous amount of crafting supplies, exhausting my budget and preventing me from eating food for weeks, and hand-crafted multiple intricate individual gifts for everyone in my husband’s family in a hypomanic frenzy.

Usually starting in November, I painted, cross-stitched, sewed, sculpted, decorated, baked, and crafted Christmas presents that were ultimately unappreciated–and rightfully so. Because I was rushing to complete these gifts and make more, more, more–because more is better, after all, my sick brain told me–their quality was shoddy.

I still recall my father-in-law on Christmas day trying on a too-small felt hat I’d simply hot glued together at midnight the night before without measuring. The hat fell apart shortly afterwards and was relegated to the trash, like most of the poorly-constructed presents.

My manic brain would not allow me to slow down and complete the work right rather than fast, and I had never been taught–or taught myself–to pay attention to detail, a skill I am still learning years later now that I’m healthier.

And after the insanity of the holidays, I always, always crashed.

Coupled with the weak winter sunlight and the hypomanic episodes I’d enjoy from November 1st until December 25th, January was always a miserable month for me. I suffered a depressive episode every year like clockwork for about 15 years, until I learned how to manage my bipolar disorder–and manage it well.

Now, for the first time in over a decade, I look back on this new year with contentment and excitement. I decided to purchase Christmas gifts for my family and give myself ample time to craft some for a few of my friends. I started in October, planned out my purchases and cross-stitching carefully, and made sure not to overwhelm myself with the holiday spirit that is so easy to get caught up in.

I now monitor my sleep, medication levels, and sunlight exposure throughout the year. I have a SAD light for the winter and take vitamin D3, which I need in the cloudy Pacific Northwest, as well as iron pills and a multivitamin. I also take my psychiatric medication faithfully and check in with my therapist when there are problems I cannot solve on my own. I communicate about my moods with my husband and children and socialize with my friends on a weekly if not daily basis.

By taking measures to protect my mental health this past year, I have earned a happy January. After decades of out-of-control moods bending me to their will, I have finally learned how to work with my bipolar disorder diagnosis rather than against it.

For the first time ever, I am happy, healthy, and well-balanced in January. Rather than facing the new year with fear and trembling, I am happy to say that I welcome what challenges I will face–and eventually conquer–including going back to graduate school for my counseling degree.

Bring it on.

Related Posts:

How and Why to Create a Routine with Bipolar Disorder

Photo by Renáta-Adrienn on Unsplash

I can hear you now: Sticking to a routine is one of the most difficult things ever with bipolar disorder. Why do I have to do it?

I’ll tell you why: because your brain thrives on structure, and following a daily routine can help prevent and treat bipolar mood episodes, according to Ellen Frank, PhD, professor of psychiatry and psychology and director of the Depression and Manic Depression Prevention Program at the University of Pittsburgh School of Medicine.

In a study of interpersonal and social rhythm therapy (IPRST) and its effectiveness of managing mood episodes, Frank found that patients with bipolar disorder who followed a routine survived much longer without an episode than those who didn’t follow a rhythm, and that IPSRT was extremely effective at preventing mania and depression.

My therapist told me years ago that consistency would be the best gift I could give my children, and I despaired. How could I, being an inconsistent person based on my mental illness and habits developed in a chaotic childhood, provide them with a life with reliable “rocks,” or big activities that we did daily?

Finding–and sticking to–a pattern has been one of the most difficult things I’ve ever done. And as we’ve added to our family, I have changed the pattern. But I’ve noticed a stark difference in my own happiness and the happiness of my children when I create order in my life rather than submit myself and my family to chaos.

The importance of creating a daily routine–and following it!–can’t be stressed enough. But how do you create–and more importantly, stick to–a routine?

Read on for some tips and tricks based on my own personal experience.

Tip #1: Start Small

When I’m manic, I tend to want to organize my life. When I’m in this state, I suffer from the compulsion to make to-do lists and plan out my schedule and the schedules of my family.

So my first tip is probably obvious: don’t start planning your routine when manic. My next tip is probably less so: start small.

What I mean by that is don’t add a bunch of items to your to-do list all at once and expect to follow them daily. You’re setting yourself up for failure that way.

Start with the “rocks,” or big activities: meals, sleep, and work hours. Which leads into tip two.

Tip #2: Fix Your Sleep Hygiene

I could go on and on about how crucial sleep is for stabilizing your mental health. (In fact, I have, here and here.) Sleep hygiene is one of the easiest and most effective ways you can get yourself on an even keel and reduce the severity of mood episodes, even and especially preventing them.

Sleep is a rock in your day, so try to schedule sleep times. Schedule wake times. And try to stick to those. If you have sleep problems, talk to your doctor. You need enough sleep.

How much is enough depends on each individual person. Some adults need 7-8 hours, others need more. But if you’re not getting enough sleep, that’s a fast track to mania.

I go to sleep between 9-10pm every night. Approximately twenty minutes before bed, I shut off my phone and take a shower or bath, depending on my mood and how much time I have. I wind down at night by lying in bed by either praying or planning out my next fanfiction.

Waking up used to be much more difficult for me, but now that I’ve lowered the dose of one of my meds, I’ve been finding myself waking up with much more energy. But I still roll over and go back to sleep after turning off my alarm.

I’m telling you this tip–fix your sleep hygiene–but I’m also telling myself. I need to start waking up at 7am consistently like I used to and address the likely lingering slight depression.

Starting tomorrow, I will be waking up with my alarm at 7am and forcing myself out of bed rather than shutting it off and sleeping in. Wish me luck!

Tip #2: Schedule Meal Times

In addition to sleep, one of the quickest ways we can stabilize our moods is to keep our blood sugar levels stable. Being an Highly Sensitive Person (HSP), I know I myself am extremely susceptible to being hangry.

If you can, try to stick to regular meal times. Eating 3-4 small meals a day will help you keep an even mood, but not only that, it’ll help you lose weight or maintain a healthy one.

My meal routine is simple. I take my meds right before breakfast at 9:15am, eat a breakfast of a single egg and a glass of milk with sugar-free salted caramel syrup, and then take my daughter to the park until 12pm, at which point I eat lunch (usually last night’s leftovers). I eat a small snack at 3:30pm. Dinner, which I usually start making at 4:30opm, is between 5:30-6pm, depending on the recipe. I also drink about 144oz of water throughout the day.

This schedule works very well for me and my family, and helps keep me sane. Try scheduling your meals for regular times. You won’t regret it.

Tip #3: Schedule Your Work Hours

For most of us, work takes up most of our day. If you can schedule your own hours, do so. Whether you work in an office, attend school, or work from home, you need to set a start and end time.

According to Dr. Frank’s research, having a set work schedule will help you feel better. If you can, tap your colleagues, teachers, and family to help you meet your obligations with enough time for you to complete the day’s work at a set end time.

I’m a writer and a stay-at-home parent attending online psychology classes for my graduate degree, so my work day starts at 8am, when I wake up and make my daughter breakfast.

After that, we go to the park until 12pm, when we return home to eat lunch. My mother-in-law, who lives with us, watches my daughter and reads her stories and practices her sight words and hand writing from 1-4pm, during which I study. Then I make dinner at 4:30pm, eat at 5:30pm, and have time for relaxation with the rest of the family after the dinner dishes are done at 6:30pm.

At 8pm, the bedtime routine begins, including a bath for my daughter. She’s in bed by 9pm, and then I take my own shower and go to bed shortly afterwards on most nights.

My schedule is not very intense, and it leaves room for flexibility. But if you’re a homemaker, it’s especially important for you to schedule a set end to your workday. Without a specific time to stop and relax, you can easily work yourself to the bone.

Which leads to the next tip.

Tip #4: Schedule Time for Self-care

All work and no play makes Johnny a dull boy, or so it’s said. If you don’t schedule time for relaxation, you will burn out with stress, which is a known trigger for bipolar mood episodes.

As I said in the last tip, I have penciled in time to relax with my family from 6:30pm to 8pm. I also have a “night off” from the bedtime routine on Mondays, which I usually spend writing short stories or cross-stitching, hobbies I enjoy that chill me out.

Make time each day to do something you enjoy. Self-care is incredibly important in fighting mood episodes, especially depression.

There’s any number of things you can do for self-care. You could take a walk, indulge in a cup of tea or coffee, or do something creative, like painting or writing.

For a list of 100 Doable Ideas for Self-care When You’re Suffering from Depression, click here.

Tip #5: Forgive Yourself

If something throws you off your routine–and something always will eventually–don’t panic. Try to be flexible enough to roll with the punches.

Accept what has happened and then follow your routine as best as you’re able. Forgive yourself if you can’t quite make it one day. There’s always tomorrow.

When something interrupts my routine, I get crabby. That’s what I mean about feeling an impact to my happiness when my routine is altered, especially without my permission. But even with my permission, I struggle to remain happy with the change.

For example, Monday nights are my night off, and Tuesday is the night my husband and mother-in-law go shopping. This Monday, my mother-in-law suggested that they hit the store that night rather than Tuesday and give me a night off on Thursday, a change I agreed to because it would be better for my husband.

By the end of the night, while doing the unexpected bedtime routine with my daughter, I was cranky. She got on my nerves more than I care to admit.

But I bathed her and put her to bed, tucking her in and singing “Rock-A-Bye Baby” twice, as is her routine. Then, exhausted, I went directly to bed.

I made sure to give myself grace for being annoyed and reminded myself that this change was temporary and I agreed to it. The next day, Tuesday, my mother-in-law took over the bedtime routine and gave me that night off instead of Thursday, which I was pleased with.

Sometimes routines don’t work out, and that’s okay. As long as you forgive yourself and get right back into it as soon as you can, you’ll be alright.

Make adjustments as needed, like getting a hotel room if you’re not going to get home on time to sleep. A hotel room costs less than a hospitalization if your mood destabilizes.

Let’s Recap

If you suffer from bipolar disorder, routines are crucial to your success in treating your mental illness. They prevent and treat mood episodes, keeping you stable and happy.

Think of following one for not only yourself, but also your family and those around you.

To follow a routine, start small, fix your sleep hygiene, set meal times, schedule a start and end times to the work day using your colleagues, and forgive yourself if the routine doesn’t go as planned.

You can follow a routine. You can be consistent, despite your mental illness making that difficult. Schedule your rocks and stick to those commitments. You will benefit from doing so.

I wish you well in your journey.

Related Posts:

5 Tips to Make (and Keep!) New Year’s Resolutions with a Mental Illness

Photo by Andreas Dress on Unsplash

Have you ever failed to keep a New Year’s resolution?

You’re not alone. Studies show that 92% of Americans who set resolutions fail at keeping them, and up to 80% fail by February.

But was your mental illness to blame?

For a lot of us, setting resolutions sends a shot of dopamine straight into our brains, but it’s hard to make plans–and keep them!–when you have unpredictable brain chemistry.

As a woman with bipolar who has historically overextended myself during the holidays, I’ve started most new years of my adult life in the midst of major depressive episodes.

As you know full well if you’ve ever had depression, that sucks. It puts a damper on the whole year.

So this year will be different. I’ll not only plan my holidays effectively and with my mental health in mind, I’ll also take steps to thrive with bipolar disorder during the hustle and bustle of December.

But what does that mean for New Year’s resolutions?

Well, I can set good ones and keep them despite my mental illness putting obstacles in my way, and so can you.

Here’s how.

1. When Making Resolutions, Prioritize Your Mental Health

Celebrate the new year by taking charge of your mental health.

Fixing your sleep hygiene, taking your medications daily, seeing a therapist regularly–these are the kinds of resolutions people who struggle with their mental health need to make.

And make sure not to set resolutions that interfere with your health. If there’s a resolution that forces me to sacrifice sleep, encouraging me to sleep less than 8 hours a night, that is not one I’ll even entertain.

My resolutions in this area are twofold:

  1. Monitor myself better for signs of depression and mania, and
  2. Seek help at the very first signs of a bipolar mood episode.

I have a treatment team waiting in the wings ready for me to call on them. If you don’t, getting one in place would be a great resolution. For a post on how to start seeing a therapist, click here. For a post on how to get a psychiatric evaluation, click here.

2. Know Thyself

Not everyone knows what challenges them most, but a lot of us have a gut instinct as to what those issues are.

Before you make a resolution to hit the gym everyday that you’ll balk at when it comes time to put your nose to the grindstone, sit down and figure out why you balk.

Do you not like the gym because you’re overwhelmed by all the options? Ask one of the employees to recommend a class to you.

Do you not like the gym because you have to get up early? Try a walk after dinner instead. You can even take the kids!

Do you not like the gym because of social anxiety? Try practicing meditation and go to a therapist to conquer that problem first.

And so on.

Know what challenges you the most and work around those issues. Starting with something that makes you more comfortable and that you feel you can tackle first will give you confidence to handle the next step.

My plan in making resolutions is to list the barriers that will get in the way of me fulfilling those resolutions. Be they internal, like social anxiety, or external, like my need for childcare, I will list them out and figure out ways around or through the obstacles.

My resolution for this area is to sit down and identify trouble spots when it comes to treating myself right. To prevent myself from sinking into a depressive episode this January, I need to figure out where I’m struggling.

My resolution in this area is to start keeping a daily gratitude journal. If I can find out what I’m grateful for on a daily basis, I can hopefully also identify where my challenges are.

3. Break Resolutions Down into Steps

When I’m depressed, most of the time I’m completely overwhelmed.

I am usually unable to see past the seemingly-insurmountable mountain of dishes, and I simply cannot think my way past that into “do one dish at a time.”

On the flip side, my past resolutions have been monsters. “Lose weight.” “Be fit.” “Eat healthy.”

But “eat healthy and lose weight” are too big of resolutions for me, especially when I’m depressed. They’re not specific, measurable, or time-sensitive. “Eat one salad a day” is much, much easier.

Rather than “eat healthy and lose weight,” my resolution in this area is to eat salads or vegetables for lunches every day.

For a more extensive post on how to break things down into bite-sized pieces when you have depression, click here.

4. Start When You Feel You Can

You don’t have to start on January 1st just because you’ve made a New Year’s resolution.

For example, if you’re not ready to conquer your social anxiety–if you don’t buy into the process of learning how to do a goal and then doing it–then you’re not going to.

To stick to a resolution, you need to have the mindset that you can keep this, and you need to be ready to start making progress to goal.

If you need to wait until summer for your head and your heart to be in the right places, then wait until summer.

My resolution in this area is to start a gratitude journal as soon as I’m ready to do so.

5. Know That Quitting Isn’t Bad

If you make an impulse buy when your resolution is to spend less money, don’t be filled with self-loathing. Just recognize that you’ve made a mistake and move on.

And if you do make a mistake, take some time to reevaluate whether this resolution is worth keeping at that point in your life. Sometimes things we try fail because they no longer make sense to do.

There’s no shame in quitting something that no longer works for us, even when the action used to be objectively good. That’s true of everything in our lives: from our resolutions to social media to our jobs and even our relationships.

And just because you’ve put time/energy/money/work/resources into something that used to be objectively good doesn’t mean that you have to keep doing the same thing that doesn’t work now.

Keeping on the same path that doesn’t work now just because you’ve been walking it for a while is called the ‘sunk cost fallacy,’ and a lot of people get tripped up by this way of thinking.

Don’t fall into that trap. If a resolution used to work but isn’t working for you anymore, examine why that is and figure out if it’s still worth striving for.

My resolution for this area is to give myself grace when I mess up and try again on the things that are truly important and working for me at that point in my life.

Let’s Recap

With these tips and specific, measurable goals, you can stick to your New Year’s resolutions.

First, when setting resolutions, prioritize your mental health. Next, know what challenges you’ll be facing and work around them. After that, break resolutions down into steps. Start when you feel you can. And make sure to recognize that quitting isn’t bad.

Give yourself grace this year, and strive to make positive, wholesome changes in your life.

You can do this.

I wish you well in your journey.

Related Posts:

Top Tips for Surviving the Holidays with Bipolar Disorder

Photo by Valentin Petkov on Unsplash

So much baking, so much fuss, so much shopping to nonplus. Cute rhymes aside, surviving the holidays with bipolar disorder is no joke. But dealing with a mental illness doesn’t mean that you can’t enjoy the season.

Bipolar disorder complicates the holidays for several reasons. December is a month where we’re expected to spend a ton of money, socialize in potentially uncomfortable situations (and do this a lot), and party until all hours of the night, sometimes with alcohol involved.

But with proper planning and vigilance, you can enjoy the holiday season.

Tip #1: Know Your Limits with Alcohol

Yes, I know. Everyone else is drinking, and you want to partake. But you have to know your limits. If you’re on medication for bipolar disorder, be they antidepressants, antipsychotics, or anti-anxiety meds, drinking alcohol is a terrible idea in general. Not only will the meds stop working as well and possibly hurt you, alcohol is a proven trigger for bipolar mood episodes, too.

You are not immune to destabilizing. If you drink and you lose control, you may as well be sending all your hard work to avoid a relapse down the drain.

This is easier said than done, especially for alcoholics or former alcoholics, of which there are a startling high number that includes people with bipolar disorder. But try to find a substitute that you can rely on and stock up at home so you can bring it to parties. Soda works for some people, or tea, or seltzer water.

I know this is hard, and I might lose readers by saying that you have to limit drinks as my first tip. But this is so important because I want you to be happy and healthy, and if you’re looking to survive the holidays with bipolar disorder, know your limits.

Tip #2: Try Not to Obsess Over Gifts

Years ago, before I had my bipolar disorder under control, I would go all out for the holidays. Growing up, my family never celebrated Christmas, so when I married into a family with holiday traditions, I was ecstatic.

One of my manifestations of my hypomania is crafting. I used to sew plushies, paint gifts, make hats, cross-stitch video game characters and QR codes for the people I affectionately call nerds (including myself!), and basically stress myself out, further exacerbating my mania.

I’d spend hundreds of dollars and dozens of hours on these gifts, and because I was manic and in a hurry to make gifts for everyone, I would rush these projects and they never turned out well. Because of the shoddy quality, these gifts were the least appreciated and almost never taken home from our communal meeting place.

I later realized that I was crafting gifts for me, and not because they would be thoughtful presents for those around me. This was a painful realization to come to, but it had to be done in order for me to stop inflicting these thoughtless gifts on others.

Now I buy my gifts online and have them sent to people’s homes already wrapped. It’s less personal, but sometimes a less personal touch is good. And the gifts are much more appreciated than my rushed, botched projects I made in a manic frenzy.

Don’t be like me. I’m not saying don’t handmake any gifts. You can absolutely choose to make a few, select gifts, be it either via crafting or baking or wherever your skills lie. But do limit yourself to projects you can do well and have the time to do, and give them to people who will appreciate them.

You also have my permission to give gifts that you think aren’t perfect for the recipient, even though you don’t need me saying so. (Sometimes that helps me, when my friends give me “permission” to do self-care.) Putting thought into each gift is a good thing, but try not to obsess too much over which ones you give.

Protect your mental health. Don’t go manic just because you want every gift to be perfect.

Tip #3: Do Practice Self-Care

Self-care isn’t limited to bubble baths and painting your nails, though those can be important ways to destress if they work for you.

Self-care is taking responsibility for your physical and mental health. That’s it. It’s easier said than done, because of a lot of us (myself included) believe we don’t deserve to take time to fill our tanks.

But if we don’t, and we’re running on empty, that’s a surefire recipe for a depressive crash in the new year. I know I’ve suffered many Januarys feeling terrible because I overextended myself during the holidays and didn’t protect myself.

So a brief run-down of self-care during the holidays:

  • Prioritize sleep. If you do any of these tips, prioritize sleep. Sleep is crucial for maintaining your stable mood; there’s no better way to send a person with bipolar disorder spinning off into mania than not getting enough sleep. I know very well the awfulness that follows from not getting enough sleep, mostly from staying up working on rushed crafting projects.
  • Don’t overextend yourself socially. You do not have to attend every party, especially not huge ones where you may be uncomfortable. I know the extroverts among us (myself included!) love being surrounded by people. We get our energy from talking and enjoying the presence of others. But sometimes, we get too much energy, and end up manic. I often have. The same goes for introverts; don’t wear yourself out with people and have nothing left to give to yourself. Be selective about your time.
  • “Eat food. Not too much. And mostly plants.” -Michael Pollan Overeating during the holidays is a terrible idea. We all do it, especially Americans, with our Thanksgiving feasts. But do try to avoid fatty foods; a 2015 study published in The Journal of Psychiatric Research showed that certain fatty foods increased dysfunction in bipolar disorder. And weight gain is a common problem with bipolar disorder, and if you’re on medication it’s even easier to gain weight and harder to take it off. Indulge in one cookie per gathering. You can make a game of which cookie you’ll take!

Conclusion

If you have bipolar disorder, you can still enjoy the holiday season. I know this list seems like a whole lot of “don’t do this, don’t do that.”

But think of it this way: you deserve to be healthy. You deserve to protect yourself and your hard-won stability. You don’t deserve to suffer from a manic spiral or a pit of depression.

Treat yourself in the way you deserve to be treated. Don’t drink to excess (or at all, if you can manage), try not to obsess over gifts, and practice self-care. With these tools in your belt, you can survive and even thrive this holiday season.

I wish you well in your journey.

Related Posts:

5 Things I Wish Someone had Told Me When I was Diagnosed with Bipolar Disorder

Photo by Priscilla Du Preez on Unsplash

When I was diagnosed with bipolar disorder thirteen years ago, I had no idea what what that meant.

I have a chronic mental illness? What does that mean for the rest of my life? I thought.

I wished that I had someone to guide me, someone who had survived and thrived with their own bipolar disorder and could help me understand what this truly meant for me and my family.

I have been stable–and happy!–for about seven years, so I am glad to share my experience with others in the hopes of helping them. Here are the 5 things I wish someone would have told me when I was diagnosed with bipolar disorder.

1. It Gets Better

This is the most important item on the list. Facing down an alarming diagnosis and a years-long recovery from my postpartum psychotic break, I desperately needed to hear “it gets better.”

After the break, I spent years nearly-dying in the black pit that is depression. I could not care for my infant son, leaving dirty diapers on the living room floor for weeks because I couldn’t summon the wherewithal to pick them up. Even when he aged into preschool, I was still fighting to survive.

If I had someone tell me that I would eventually come out whole and healed on the other side, I don’t know if I would have believed them at the time, but I would have looked back with gratitude.

Telling someone in the midst of a bad situation “it gets better” can help them, especially when you yourself have lived through a similar situation. If you can expound upon how you survived your own challenges, even better.

2. You May have Mixed Feelings About Your Diagnosis

When I was given the label of “bipolar disorder,” I was by turns both devastated and elated:

Devastated because I had no idea what being bipolar would mean for me and my family. Elated because I finally had a label that made sense.

The label explained so much about my behaviors until that point. I wanted to tell everyone I’d ever met that I had bipolar disorder–an impulse in the midst of a manic episode that my husband gently cautioned me against.

I found myself vacillating between utter despair at the fact that I had a mental illness that would never go away and happiness at the fact that I could start working towards recovery with a targeted approach.

You may feel mixed feelings about your diagnosis. Your feelings, whatever they are, are valid, and they don’t change your inherent value as a person. Feel whatever emotions you feel, accept them, and move on.

3. Your Meds are Crucial for Recovery

When I was first diagnosed, I had a difficult time remembering to take my medication. But once my psychiatrist prescribed me the right ones, I found that when I took my pills–and took them on time–I stabilized rather quickly.

Bipolar disorder is no joke. Many people, especially those of us with Bipolar I, cannot manage their condition without psychiatric care. I know I can’t; without my anti-psychotic and anti-depressant, I would be in a very dark place.

I wouldn’t wish my depression on anyone. Without my medication, I would not have recovered. Thankfully, with a combination of medication that works for me and talk therapy, I have been stable for years.

Take your meds. They’re there to help you. Taking medication doesn’t make you weak; quite the opposite. It’s the first step towards stabilization; the first step towards healing. No one looks down on a diabetic for taking insulin, and bipolar meds are the same: life-saving.

4. Be Honest with Your Family About Your Diagnosis

Being honest with your family about your diagnosis is probably one of the hardest parts of being diagnosed. You now have a label that carries with it a certain amount of stigma.

Like me, your family will be confused about what a chronic mental illness means for them. Hopefully they’ll want to support you in this new journey of yours.

If I hadn’t been honest with my husband, my biggest supporter, he would not have been able to respond in an appropriate manner to my bipolar mood episodes. Whether it was hypomania, mania, or depression, my episodes are dangerous to my family, as I can’t concentrate on anything but my moods and whims.

So communicating honestly with him, though extremely difficult at the beginning, became easier and easier as time went on.

Tell your family about your diagnosis. If you don’t let them in on what challenges you’re facing, they will never understand what your diagnosis means for you and for them.

5. Try to Find Cheerleaders

When I was diagnosed with bipolar disorder thirteen years ago, my husband and I had just graduated college and moved 1500 miles away from our friends and family. I’d also given birth to our first child six days prior.

I had no new friends in the area we lived, and I felt alone facing my diagnosis. Making friends proved extremely difficult, but I wouldn’t trade the supporters I have now, who cheer me on through my various challenges, for the world. They have helped me handle my struggles with grace and gladness.

Finding a cheerleader or two is so important when you’re facing a diagnosis, especially if they’ve been in your shoes and can understand what you’re going through.

If you have existing friends willing to help you, that’s excellent! But if you feel truly alone, immerse yourself in groups of potentially-supportive people.

You can find these people online through Discord (a chatting service) servers centered around a common interest, like a show. Or you can attend support groups online or in-person, or ask your doctor what they recommend.

Relationship building takes a ton of effort and you may be overwhelmed, especially if you’re depressed. But your friends will be so worth it.

Conclusion

Dealing with a diagnosis like bipolar disorder may feel daunting. You may feel utterly overwhelmed, especially if you’re newly-diagnosed.

I’m here to offer suggestions and reassure you that yes, it gets better. Your possibly mixed feelings about your diagnosis are valid. Take your meds, be honest with your family, and try to find cheerleaders.

Your recovery and stabilization from bipolar disorder may take years. And that’s okay. Keep fighting the good fight. You’ve got this.

I wish you well in your journey.

Related Posts:

4 Times You Should Call Your Doctor to Save Yourself from a Bipolar Depressive Episode

Photo by Nik Shuliahin on Unsplash

Trigger Warning: This post contains a discussions of suicide. If you or someone you know is at risk of suicide, please:

  • Call the U.S. National Suicide Prevention Lifeline at 800-273-8255
  • Text TALK to 741741
  • Or go to SpeakingOfSuicide.com/resources for additional resources. 

For a post with a list of domestic crisis lines, click here

For a post with a list of international crisis lines, click here.

Trigger Warning: This post has brief mentions of the 2020 covid pandemic.

4 Times You Should Call Your Doctor to Save Yourself from a Depressive Episode

People all over the world face mental health struggles, and with the 2020 covid pandemic isolating people and causing physical illness and death, the challenges have never been greater. But some people are still confused about what problems need professional help, especially when suffering a depressive illness.

Depression is a serious illness that can lead to people taking drastic actions such as committing self-harm or dying by suicide. Even when the depression “isn’t that bad,” you may still be sad, apathetic, or just tired all the time.

Your mental health might still be in the toilet, and that’s no way to live. 

If you’re living with a depressive illness, you deserve medical attention. The earlier you get treatment, the more effective it’ll be, but even if you’ve been living in the black, viscous pit of depression for years, you still have hope that therapy and/or medication can help.

But when should you, you personally, call your doctor? I’ll give you a few reasons below, as well as examples about when I’ve personally brought in my own treatment team.

A Note Before We Get Started

If you already have a psychiatrist and/or a therapist, awesome. That makes getting adequate treatment easier. But if you don’t have one available, ask for a consultation by a primary care physician (preferably yours, if you have one) to refer you to mental health services.

(For a more detailed post on how to start seeing a therapist, click here. For a more detailed post on how to get a psychiatric evaluation, click here.)

1. Call Your Doctor When… You’ve Lost Interest in Well, Everything

Anhedonia is the loss of interest in things you used to find pleasurable. It’s a deep well of apathy that’s one of the classic signs of depression. Food, hobbies, even sex don’t appeal to you anymore, and you have no desire to do anything except curl up in a blanket fort and hide for the rest of your life. 

This is no way to live. Call your doctor. They can help you.

As a person with bipolar disorder, one of the first signs of a depressive episode for me is when I’ve lost interest in writing. Writing is my lifeblood; I adore putting words to paper and either trying to inform my readers about something that can help them, or tugging at their heartstrings, or both. 

So when I find writing starting to be a chore to me, that’s a sign that I need to call my therapist and let her know that I’m sinking into a depressive episode.

2. Call Your Doctor When… Your Sleep Patterns Have Changed

Sleeping all day is not normal. Being tired constantly seemingly without reason can be a symptom of depression. Insomnia or difficulty falling asleep are also possible symptoms. If your sleep patterns have changed and you can’t pinpoint why, it’s time to call your doctor.

When I first put my daughter in preschool, I was suffering a massive depressive episode without realizing it. I would drop her off at 9am and then go home and collapse in bed, sleeping until 12pm, even after having slept 9 hours the night before. I was sleeping up to 12 hours a day and I was still exhausted. 

When I pulled my daughter out of preschool due to the covid pandemic, I realized I needed to wake up. She needed me to be a present parent; I couldn’t afford to sleep all day. 

So I called my doctor. He adjusted my medication, and I recovered from the depressive episode, which enabled me to be a better parent.

3. Call Your Doctor When… You Can’t Stop Crying

Crying releases endorphins and can be a release for some people. But crying during a depression isn’t usually a healthy release; it’s constant and exhausting and tends to rile people up, not help them. If you find yourself shedding tears and can’t stop, call your doctor.

I sobbed my way through my time committed to a mental hospital. I absolutely could not stop crying; everything was awful and my face was constantly wet. The sobfest may have been due to postpartum hormones; I had just given birth to my first child, but my tears never stopped for a solid week.

After starting medication, I stabilized and stopped crying. Now I’m a happy, present spouse and parent who only cries for release.

4. Call Your Doctor When… You Have Thoughts of Self-Harm or Suicide

Thoughts of self-harm and suicide are serious enough that you need to call your doctor immediately. If you have more than a fleeting, intrusive thought of driving your car into oncoming traffic and it starts to become a plan you could see yourself acting on, then please absolutely seek medical attention.

During my pregnancy with my son, when I was suffering thoughts of self-harm, I did not call my doctor. I was isolated and lonely from a recent move across the country, and while I told my obstetrician I felt sad, I didn’t let her know about my thoughts. 

I ended up making a suicide attempt five days after my son was born. Committing myself to a mental hospital and earning a diagnosis of bipolar disorder saved my life. I was given a referral to a psychiatrist, who gave me stabilizing medication. Now, 13 years later, I am a happy and stable parent and writer. 

Don’t be like me. Don’t prolong your suffering from these debilitating thoughts. Call your doctor.

Conclusion

Sunday, October 10th, 2021 is World Mental Health Day, an initiative by the World Federation by Mental Health intended to bring awareness to mental health issues faced by people globally. 

What better way to celebrate World Mental Health Day than to take charge of your own psychological well-being?

From losing interest in pleasurable activities, changing sleep patterns, constant crying, to thoughts of self-harm, depression has varied symptoms that add up to a debilitating condition. 

If you are facing any of these four challenges, don’t wait. Call your doctor today.

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How Alcohol Complicates Bipolar Disorder

Alcohol, the social lubricant. Some people drink because alcohol relaxes them in social situations. The drink isn’t called “liquid courage” for nothing.

But alcohol is an addictive substance, which has great potential to be misused, especially by people who also suffer from bipolar disorder.

How Alcohol Complicates Bipolar Disorder - CassandraStout.com

The Connections Between Alcohol Use and Bipolar Disorder

Studies have shown that people who abuse alcohol are more likely to have bipolar disorder. According to a 2013 review, up to 45% of people with bipolar disorder also have alcohol use disorder (AUD).

Overwhelming feelings of sadness from bipolar depression make people more likely to self-medicate with substances like alcohol. And self-medicating makes it more likely for people with bipolar disorder to not stick to their medication regime or attend therapy sessions.

Alcohol also affects people with bipolar disorder in different ways than the neurotypical population.

A 2006 study showed that people with bipolar disorder are adversely affected by even small amounts of alcohol, which may both trigger and worsen manic and depressive symptoms.

Mania is known to increase impulsiveness. Because alcohol reduces inhibitions, consuming alcohol during a manic episode may encourage risky and irrational behaviors.

Alcohol, a central nervous system depressant, also contributes to lethargy and sadness during depressive episodes. The symptoms of depression triggered by alcohol are increased when people first stop drinking, so recovering alcoholics with a history of depression may relapse in the first few weeks of dealing with withdrawal.

People who suffer from psychosis triggered by manic episodes are also adversely affected by alcohol. Consuming alcohol during psychosis contributes to both long-term and short-term complications. Alcohol also complicates the treatment of psychosis, contributing to dangerous medication interactions.

How Alcohol Affects Medications

Medications that are part of your treatment plan are strongly affected by alcohol.

Valproic acid, known commonly as Depakote, is often prescribed to treat symptoms of bipolar disorder. Similar to alcohol, Depakote is a central nervous system depressant which affects the liver. Combining alcohol and Depakote increases the chance of  liver damage.

Similarly, consuming alcohol with lithium, which is frequently prescribed to treat symptoms of bipolar disorder, can contribute to liver disease. Lithium has side effects such as gastrointestinal problems, lethargy, and tremors, all of which alcohol can increase.

Antidepressants and antipsychotics may not work as well when combined with alcohol. Side effects can be increased, and you may feel more depressed and anxious.

You may decide to skip your medication in order to drink. This is a bad idea, as your symptoms of bipolar disorder may return quickly, triggering an episode. Stopping your dosages of medications without tapering off under the guidance of a professional is detrimental to your mental and physical health.

Alternatives to Alcohol

Alcohol can help you relax and socialize. Cutting down on alcohol can be difficult. It may be helpful to replace some of your drinking with relaxing habits.

Some alternatives to having a drink are:

  • Getting a massage
  • Attending a yoga or taekwondo class
  • Meditating
  • Exercising
  • Taking a warm bath
  • Using aromatherapy

Final Thoughts

Drinking responsibly takes on a whole new level when you suffer from bipolar disorder. You not only need to be aware that drinking, especially to excess, triggers and worsens manic and depressive episodes, but also that your medication may interact poorly with the substance.

I’m not saying to cut all alcohol out of your life if you have bipolar disorder. If you are a responsible adult, there is no reason you can’t drink. But be aware of the complications alcohol brings to your life. You may find it easier to abstain.

I wish you well in your journey.

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How Alcohol Complicates Bipolar Disorder - CassandraStout.com

Child Abuse Prevention: 4 Crucial Tips for Parenting With Depression

Child abuse comes in many forms: physical abuse, emotional abuse, medical abuse, sexual abuse, and neglect. When we’re suffering from depression and dealing with the inability to take care of ourselves, we are at risk of neglecting our children. This risk must be mitigated in order to prevent seriously harming our kids.

4 Crucial Tips for Parenting with Depression - CassandraStout.com

It’s all well and good to say so, but how does one prevent child abuse when they have depression? Here are 4 crucial tips to parenting with depression.

Tip #1: Practice Self-care

You’ve heard the analogy of the oxygen mask on the airplane. Before you tend to your children, you must put your oxygen mask on first.

Self-care is that oxygen mask.

Self-care may seem like just another item on the to-do list. But it’s actually crucial for you to function. Self-care is taking responsibility for your physical and mental well-being. If you don’t perform some self-care on a daily basis, you’ll not only neglect yourself, you may start to neglect your kids as well because you’re burnt out.

Some people think self-care is limited to bubble baths and painting your nails. That’s not true. Taking your medications and attending therapy are forms of self-care. So is getting enough sleep, eating well, and drinking enough water. Spending time outside and with other people also falls under that umbrella.

If you put your oxygen mask on and practice self-care on a daily basis, then over time you’ll be in a much better position to care for your children. Avoid burn out. Prioritize self-care.

Tip #2: Seek Professional Help for You and Your Child

When you’re a parent suffering from depression, the bond with your child may suffer. You might neglect your duties at home and spend a lot of time in bed, ignoring your babies. This is frightening and confusing to a kid, who needs you to be a consistent presence in their lives.

Before the situation gets that bad, seek professional help. Find a therapist you can trust for yourself, and talk about your feelings with him or her.

But don’t forget to find a therapist for your child as well. He or she may need help understanding why your depression affects you the way it does. Your kid needs a trusted adult to be a comforting presence. A therapist can teach your whole family coping skills.

For a post on how to start seeing a therapist, click here.

Tip #3: Communicate with Your Child

As I’ve said before, parental depression can cause unusual behaviors in you which are scary to your child. Nip that in the bud and communicate with him or her as much as possible about your depression.

Let your kid know that your mental illness, while not going away, is not his or her fault. Explain that you have a chemical imbalance in your brain, and you’re doing your best to cope with it. If you are taking medication, tell your child that you are taking steps to circumvent the depression and its effect on him or her.

Don’t be afraid to let your kid know how you’re feeling that day, be it tired, sad, or even and especially happy. Don’t make him or her responsible for your emotions, but do share them with your child.

For a post on how to communicate with your children about your mental illness, click here.

Tip #4: Forgive Yourself for Mistakes

You cannot be the super parent every day of the week when dealing with depression. Setting too high of expectations for yourself and your children can be dangerous, because if you fail, it can trigger overwhelming feelings of despair.

Recognizing that you deserve forgiveness for mistakes, especially while suffering from depression, can be one of the hardest things you’ll do. But you must forgive yourself if you mess up, because you’re setting an example to your child to forgive you and others.

Know that “good enough” parenting is really good enough. Allow your kid some leeway when it comes to screen time. Offer them a cheese and celery and tomato plate instead of a full dinner, but only occasionally, when you really can’t cook. (For a post on 22 easy meals to make while depressed, click here.) And don’t cut back on your kid’s activities; get him or her out of the house as much as possible, so he or she can be around other people.

Final Thoughts

Parenting while suffering from depression is one of the hardest things you’ll ever do. Neglecting yourself comes easily; neglecting your children is just the next logical step. Don’t get there. Practice self-care, seek professional help for you and your child, communicate with him or her, and forgive yourself for your mistakes.

These practical tips will help you foster a more positive environment for you and your kid. Eventually, if you continue taking care of yourself, your depression will lift, and you’ll be able to say that you did a good job parenting while suffering depression.

I wish you well in your journey.

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4 Crucial Tips for Parenting with Depression - CassandraStout.com

What is the Link Between Stress and Bipolar Disorder?

Are you feeling stress? Stress exacerbates your bipolar disorder. Learn how in this post on the Bipolar Parent!

The Link Between Stress and Bipolar Disorder - CassandraStout.com

Stress affects everything in your body, from your shoulders to your hormones, from your immune system to your mental illnesses. Stress is a physical issue, just like bipolar disorder, as both mess with your feel-good chemicals.

There are different types of stress. There’s good stress (also called eustress), which can motivate you to make dinner on time and meet deadlines at work. Good stress is infrequent, usually not repeated, and short-lived, leaving you better off than you were before you encountered the stress.

Bad stress, on the other hand, lingers. It lasts a long time and repeats frequently, leaving you much worse off than you were before.

But stress is even worse for people who suffer from mental illnesses, like bipolar disorder. People with mental health conditions tend to be unable to handle stress as well as neurotypical people. For people with bipolar disorder, even small, inconsequential decisions can stress us out. If we feel stress during everyday decisions, then the fact that stress exacerbates bipolar disorder symptoms makes sense.

Bipolar disorder and stress, especially bad stress, are a nasty combination. Stress is a known trigger for both hypomanic and depressive episodes–and sometimes even mixed episodes.

My Experience with Stress

Different types of stresses affect me in different ways. Before a long road trip or a flight, I get riled up and anxious without fail. I definitely have racing thoughts and other symptoms of hypomania, minus the euphoria. Sleeping becomes difficult, which only exacerbates the manic feelings.

On the flip side, feeling stressed about my messy house depresses me. The link between clutter and depression is very real, as having items on the floor focuses me to make decisions about them (specifically, whether to put them away or leave them there) every time you walk past them. After a full day of making many, many decisions and (usually) not taking any action on the items, I suffer decision fatigue, which for me leads to depression.

When I’m stress-depressed, I often berate myself for my inability to pick up the house. I know rationally that my laziness isn’t really laziness, but is a problem called executive dysfunction, which stress also makes worse.

Executive dysfunction is the inability to prioritize tasks, and determine the order of actions. Stress makes prioritizing and deciding on which actions to take very difficult, which is common for those of us who suffer mental illness.

(For a post on the link between bipolar disorder and executive functioning, click here.)

When I’m stressed, my ability to handle my responsibilities falters significantly, which only leads to more stress. I am reduced to a ruminating mess, turning in circles and chasing my own tail. Bad stress makes me completely incapable of acting like a functional adult.

Take Care of Yourself: Destress

If you want to improve your bipolar disorder symptoms, you need to manage your stress levels. Being constantly stressed, especially with bad stress, will lead to a mood episode.

Sometimes you can make big changes, like getting a new job or finding a new living situation. Diet also plays a role in how well you’re able to handle stress, so a lifestyle change like eating healthier foods may help you fill up your tank.

Even small changes can help. Starting a yoga or taekwondo class can help you relax. Deep-breathing techniques may also reduce your stress.

Talking to a therapist is also a good idea. You can learn coping techniques and tools for handling stress throughout the rest of your life.

Above all, practice self-care. Self-care is taking responsibility for your physical and mental well-being. That’s it. Don’t neglect to eat regularly, get enough sleep, go outside, socialize with people face-to-face, drink enough water, and exercise. If you do most of these big six tenants of self-care on a daily basis, you will be better off.

Final Thoughts

Bad stress affects me in a lot of negative ways. I’m not the best at handling stressful situations. So I plan ahead for them. I make massive to-do lists, outlining each tiny step that I need to take in order to conquer the issue. And I practice self-care.

Bad stress may affect you despite your best efforts. You may end up living through many, many stressful situations throughout your life, like moves, marriages, and births. You need to lean on your coping tools during these times.

Plan ahead. Take the times when life is relatively calm to assess your ability to handle stress, and plan how you’ll respond to changes. If necessary, you can get a prescription for anti-anxiety medications that you take on an as-needed basis.

Effectively managing your stress will help you suffer less from your bipolar disorder.

Related:

The Link Between Stress and Bipolar Disorder - CassandraStout.com

#BipolarBrave: How I Became Comfortable Sharing my Bipolar Diagnosis

This post appeared on the International Bipolar Foundation website, here.

After my postpartum psychotic breakdown in 2008 and my time spent in a mental hospital for it, I was diagnosed with bipolar disorder.

That explained so much. When I returned home, I was elated. I was compelled to explain to everyone who had ever touched my existence that I suffered from bipolar disorder, and that was why I had acted so erratically my entire life.

#bipolarbrave - How I became comfortable sharing my bipolar diagnosis - CassandraStout.com

Clutching my newborn tight with one hand and opening my laptop with the other, I explained to my husband–with rapid, pressured speech due to a lingering manic episode, no less–my desire to email all my old college friends, strangers I had yet to meet, and everyone at church.

“Not all of them need to know, at least not right at this moment,” he said, trying to contain my compulsion. “I understand that you want to share, but explaining your diagnosis to all your old college friends, most of whom you’re not even in touch with, would be counterproductive.”

I bristled, but he continued. “You need to educate yourself about your diagnosis before you begin to share with others, so you know what it means. And, rather than focusing on sharing that you have bipolar disorder with everyone, you need to take care of yourself and our baby.”

That made sense to me. I reluctantly closed my laptop, and looked at my beautiful, fragile infant. He needed a mother who wouldn’t bend to every compulsion that struck her. I didn’t fully understand at that moment that I was compelled to share my diagnosis due to a manic episode. I wasn’t in my right mind; only halfway there.

My husband was right.

After I recovered from the manic episode, I no longer desired to shout, “I have bipolar disorder!” from the rooftops. When it came to my diagnosis, I became closed off. I would no longer spill my darkest secret–that I’d committed myself to a mental hospital and was separated from my 7-day-old baby because I was literally insane. I grew ashamed of my bipolar disorder.

Then I began writing my memoir, Committed, detailing my days spent in the psychiatric ward. I realized the story was compelling, unique, and could help people understand what it’s like to experience a bipolar mixed episode with psychotic features. And I realized that if I ever wanted to publish my work, my dream since I was a little girl, I had to be open with sharing my diagnosis.

A few months after I started writing, I formed a critique group, the Seattle Scribblers, who encouraged me to attend the Pacific Northwest Writers’ Conference in 2012. I pitched my not-yet-completed manuscript to agents and editors.

“After the birth of my son, I suffered a postpartum psychotic episode and committed myself to a mental hospital,” I told them in my elevator pitch. “My memoir, Committed, details the time I spent there while separated from my newborn.”

I explained to the agents and editors that I was grappling with a bipolar diagnosis, and that the mental illness had upended my entire life. I was met with a warm reception by some, but others were completely turned off by the “crazy” person sitting in their midst.

I wasn’t offended. Stigma is real, and I wasn’t going to change their minds about mental illness in the brief moments I had to make an impression.

Now, I have no problem telling people I’ve known even for a few weeks that I have bipolar disorder. When people ask me how I am, I tell them honestly: “I’ve been suffering from a depressive episode lately, but I’ll be okay. I have bipolar disorder, and that’s part of the cycle.”

The diagnosis is no longer shameful for me. It’s just a label that’s a reason behind why I sometimes act unpredictably#bipolarbrave - How I became comfortable sharing my bipolar diagnosis - CassandraStout.com. The explanation comes out naturally. Bipolar disorder is just a part of my life–a big part, to be sure, but it’s not everything.

My husband was right. Not everyone needed to know right then. I had to prioritize my own well-being and that of my infant.

But he was also wrong, in a sense. I had to grow into being genuinely comfortable sharing with my diagnosis eventually. I realized that by being open, I could help other people who might be struggling. So I started my blog, The Bipolar Parent, a comprehensive resource for parents with mental illnesses.

I faced my compulsion and my subsequent shame, conquered them, and never looked back.

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