How I (Mis)managed my Bipolar Disorder During my Pregnancies

Photo by Anna Hecker 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.

—

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

Pregnancy.

It’s a time of joy for some, a time of horror for others, and a time of anxiety for most.

Becoming pregnant, regardless of the outcome, changes your life forever. And if you have a mismanaged mental illness that’s affected by maternal hormones like bipolar disorder, irrevocable damage can be done.

May is National Maternal Depression month in the U.S., a time to reflect and raise awareness for mothers who face challenges such as postpartum depression.

According to WebMD, “Pregnant women or new mothers with bipolar disorder have seven times the risk of hospital admissions compared to pregnant women who do not have bipolar disorder.” 

And I was one of them.

Here are my completely different experiences with my two pregnancies and how I managed and mismanaged my bipolar disorder–and what a difference that made.

During my first pregnancy, warning signs of an undiagnosed, worsening bipolar disorder were missed or ignored by my obstetrician. As I wasn’t aware that I had a mental illness, my anxiety, depression, and mania–a mixed mood episode–quickly grew out of control and ravaged my mind and body.

Because of lingering issues centered around going hungry as a child, my manic fear that my new family would go hungry forced me to build a balcony garden with recycled tin cans and bulk soil purchased for pennies. I was terrified that my husband and I would run out of money despite his stable, high-paying job.

The garden never took off, and due to my burgeoning depression, I quickly became suicidal. I became obsessed with a show I saw once a week on television, Avatar: The Last Airbender, living only for new episodes. I forced my husband to watch the show, saying I identified with the sociopathic character who has a psychotic break in the end because I was so numb and messed up.

Faced with decorating a nursery on what I perceived to be a shoe-string budget, I dove in our apartment’s huge dumpster for mismatched, broken lamps, bassinets, and other baby items. I crammed our guest room/nursery so full of filthy items, we couldn’t even walk through the room.

I could not bond with my baby, instead concentrating on how awful I felt. I was jittery, depressed, irritable, lonely, and physically sick–I suffered from a condition called hyperemesis, which means I threw up several times a day for nine months straight.

Rather than gaining weight like I was supposed to, I lost thirty pounds and only gained back ten, and was placed on bedrest four months in. I lost even more weight after the baby was born. I started out the pregnancy at 148 pounds and ended it at approximately 100–not exactly a healthy weight for a 5’7” woman.

Throughout the pregnancy, I faced challenges such as social isolation (my husband and I had just moved 1500 miles away from friends and family for his job), limited mobility (I sprained my ankle and couldn’t drive), and completely wild hormones. It’s no wonder that I suffered a psychotic break after giving birth!

Fortunately, I committed myself to a mental hospital with the help of my therapist, whom I’d started seeing at the beginning of the pregnancy. The doctors there gave me an official diagnosis–bipolar I–as well as medication that saved my life.

Following the pregnancy, I suffered from a crippling postpartum depression that rewired me completely. I went from a bold, confident, intelligent young woman to someone fearful and constantly seeking validation from others.

It took me three long years and several medication changes to recover–and even now, 13 years later, I’m not quite 100% back to my former self.

However, three years after recovering from postpartum depression, when my first child was six, I was ready to try for another baby. My husband had always encouraged me to be in control of our reproductive choices, so he willingly agreed to a second pregnancy.

For the second pregnancy, I insisted on taking medication. I didn’t want to go back into the depths of suicidal depression. And I faithfully attended therapy once a week, discussing coping strategies I could use.

During the second pregnancy, I once again suffered from hyperemesis. I threw up 6-8 times per day from the moment I conceived until the day I gave birth.

Despite that, I my spirits were high and I didn’t suffer a massive depressive or manic episode. I was no longer depending on a television show to emotionally sustain me.

My routine of medication, therapy, and self-care kept the awful mood episodes at bay. I was sane, stable, and dare I say, happy. I was able to bond with my baby and suffered no ill effects after giving birth.

All things considered, except for the hyperemesis and bedrest, the second pregnancy was much closer to “normal” and expected for a healthy pregnancy. I certainly didn’t suffer as much emotional pain!

My bipolar disorder diagnosis–and appropriate approaches to treatment–made such a difference in my two pregnancies. After the first one, I was terrified to have more children; after the second, I considered having a third.

If you have bipolar disorder or even think you do, carefully consider the risks of getting pregnant before you embark on that journey. It may take you somewhere you don’t wish to be.

But there are steps you can take to sustain a safe and healthy pregnancy. Low-risk psychotropic medications are available to you. Talk therapy poses no risk to the baby. And a self-care routine prioritizing sleep can do nothing but good for you.

I wish you well on your journey.

Related posts:

• National Maternal Depression Month: 9 Tips for Coping with Postpartum Depression
• National Maternal Depression Awareness Month: My Experience, and How to Get Support
• Pregnant While Bipolar

Advertisement

My Experiences with Mixed Mood States and How I Handle Them

This post appeared on the International Bipolar Foundation’s (IBPF) website, here. Graphics from the International Bipolar Foundation.

[Id: A blue graphic with two men in blue shirts high fiving over a woman in a blue shirt. The graphic says “3 Ways to Manage Mixed Mood States.”]

If you have bipolar disorder, it’s likely you’ve experienced some symptoms of mania while you’ve suffered depression, or vice versa, and believe me: it’s miserable.

This awful set of feelings is colloquially called a mixed episode or a mixed mood state, and they are common in people with bipolar disorder. Half or more of people with bipolar disorder deal with mixed episodes, and I am one of them.

Just because I suffer mixed episodes, however, doesn’t mean I don’t have “pure” episodes of depression or mania–I have those, too, and they are also detrimental to my mental, physical, and emotional health.

But there’s something about a mixed episode that’s just doubly bad.

Six days after the birth of my first child at 22, I suffered an intense mixed episode with psychotic features and committed myself to a mental hospital, where I earned a diagnosis of Bipolar Disorder I.

I was constantly on the move, hadn’t slept in a week, and ate very little food or drink other than chocolate milk. I made to-do lists of over 100 items each and filled up brand new journal in a few days. I spoke so rapidly that no one could understand me, and flitted from topic to topic like a hummingbird, frustrated and irritable.

These are all symptoms of–and in the case of the lack of sleep, precursors to–mania. But I also suffered symptoms of depression: I cried constantly, felt an overwhelming dread that awful things were happening to my newborn, and vacillated between absolute euphoria and crushing despair.

Any setback destroyed me. Something as simple as not being able to eat my condiment of choice on my meal was a cause for sobbing dejection. And I fixated on my feelings of guilt, anxiety, and low self-worth.

My mixed mood state nearly got the best of me. When I wasn’t bursting with energy, I was exhausted. Angry outbursts from me were common, and my mind raced so much, I couldn’t get to sleep easily.

Fortunately, I was given proper medication in the hospital that stabilized me. Since then, I’ve faithfully taken my meds at morning and night, and I haven’t yet experienced a mood episode that terrible again.

I have, however, suffered less intense mixed episodes since my stay in the hospital. The symptoms–irritability, inability to focus, vacillation between euphoria and despair–are similar.

But I don’t allow them to control me anymore.

3 Ways I Handle Mixed Mood States

I handle mixed mood states in the same way I handle “pure” manic episodes: once I realize what’s going on, I ensure I’m taking steps to get out of the mood state.

Here are three ways I do that:

[Id: A graphic of a man lying down with words that say, “I prioritize sleep. With mania, I frequently don’t need sleep–or, at least, that’s the lie that my brain tells my body. When I’m in a manic or mixed mood episode, I need sleep even more so than when I’m not, so I practice good sleep hygiene and force myself to lie down with my eyes closed until I’m out. Taking a hot bath right before bed also helps. Sometimes medication is involved in my sleep, which brings me to my next point…”]

[Id: A woman in a blue hijab speaking with a man and another woman with the words, “I inform my treatment team about my current struggles. My treatment team–my therapist, psychiatrist, and yes, even my husband–needs to know I’m experiencing a mood episode before they can help me. First, I tell my husband, as he’s the closest to me and is most likely to be adversely affected by my mood episode. Next, if the mood episode is truly terrible and I need to adjust my medication, I phone my psychiatrist and take his advice. After that, I make an appointment with my therapist to process the issues that cropped up during the episode.”]

[Id: A man and a woman standing next to a woman seated at a desk with a computer monitor with the words, “I pare down my to-do list. One of my manifestations of mania is to be insanely productive. But the more I accomplish, the more wound up I get, and therefore I accomplish even more, getting more wound up… It’s a vicious cycle. So when I recognize that I’m manic, rather than riding the high and getting a ton done, I scale back on my to-do list. I force myself to slow down and only get done what is absolutely vital. Slowing my brain down and deliberately paying attention to detail helps me conquer a manic or mixed mood episode.”]

Final Thoughts

My experience with mixed mood states has been awful. They’re like a manic episode turned up to eleven with all the worst parts of depression bogging me down.

When I’m suffering a mixed mood episode, I’m irritable, euphoric, and despairing. I can’t focus and I can’t sleep easily.

But the way I handle those states is similar to the way I handle manic episodes: I prioritize sleep, let my treatment team know and take their advice, and pare down my to-do list.

If you find yourself in a mixed state, prioritize sleep. Force yourself to lie down and close your eyes; try to slow your brain down as much as you can so your thoughts don’t run away with you. And don’t forget to take your medication!

You can survive a mixed mood state and even thrive afterwards. I wish you well in your journey.

Related Posts:

• My Manifestations of Bipolar Mania: Crafting and Frugality
• How and Why to Learn Impulse Control
• What My Experience Being Suicidal Taught Me — and What It Can Teach You, Too

World Bipolar Day – Time to Take Charge of Your Mental Health

Photo by Nick Fewings on Unsplash

Bipolar disorder.

To those newly diagnosed or with a loved one who has been recently diagnosed, those two words may sound like a prison sentence. You mean I’ll be ravaged by out-of-control moods for the rest of my life?

I am Cassandra Stout, and I have managed my bipolar I disorder, the most intense type, for 13 years–and managed it well. And I am here to say you absolutely do not have to live in chaos.

This World Bipolar Day (WBD), traditionally observed on March 30, take charge of your mental health. There are steps you can embark on to reign the illness in and make it manageable.

As I told my newly diagnosed relative, what a bipolar diagnosis really means is work. It’s an extra layer of work that a person living a mental illness must face and embrace in order to tame the chaos of the mood disorder.

But have no fear. The work becomes easier and easier to handle. For example, I am so in the habit of taking my meds in the morning that I don’t even give my pills a second thought.

I treat my evening dose the same way–every night at 6pm, I down my pills with a glass of water.

Done. Easy. Habitual. And you can get to this point, too.

Here’s what to do to take charge of your mental health this WBD.

Take Your Medications

No one likes admitting they need help, especially in the form of mind-altering drugs.

But if you have medications, you must have realized at one point that your brain chemistry needs them to be stable.

I certainly do. I thank God for my pills; without my antidepressant, I would be a disheveled mess in the throes of depression. Without my antipsychotic med, I would be completely out of control during a psychotic manic episode, which I’ve suffered before, endangering myself and my family.

I need my meds. I cannot function without them. And it took me a few years being ravaged by postpartum depression and bipolar I disorder to realize just what kind of effect my medications would have on my life.

Thirteen years after my breakdown, I am stable and happy. I haven’t suffered a debilitating mood episode in years. I am going back to school for my counseling degree and making a difference in the world as a good parent.

I don’t owe everything to my current medication cocktail, but it is a large part of why I am so high-functioning today.

Bipolar disorder is one of the most treatable and and therefore controllable disorders. Even if your illness is medication-resistant, there are electroconvulsive therapies available.

If you’re taking your pills regularly and they don’t work, don’t give up. Go back to your psychiatrist and ask for an adjustment. For a post on how to get a psychiatric evaluation, click here.

Figuring out the right cocktail of antipsychotics, mood stabilizers, antidepressants, and anti-anxiety meds–as well as electroconvulsive therapy–requires a lot of patience, as the testing process takes time and a toll on your body.

The first step in taking charge of your mental illness this WBD is taking the medication you’ve been given on a regular basis. Set an alarm for each dose and don’t ignore this. Taking your meds is crucial to managing your brain’s non-typical brain chemistry.

You deserve stability. You deserve a happy life.

Take your meds.

Attend Therapy

Some people are reluctant to see a therapist even when they’re drowning in unstable feelings like anger, sadness, guilt, and other painful emotions.

I’ve been attending therapy for 14 years, and my therapists have changed my life for the better. With their help, I’ve been able to identify my mood episodes, develop coping strategies for them, and bounce back from crippling depressions.

As she was the one who encouraged me to commit myself to the mental hospital during my postpartum psychotic breakdown, I owe my therapist my life.

I would have been unable to recover so well from my horrendous postpartum depression without (at the time) weekly therapy sessions in which my newborn was allowed to attend.

Talk therapy, especially cognitive behavioral therapy, is one of the best ways to learn how to manage the challenges of daily life. An unbiased, sympathetic therapist can help you understand patterns of your behaviors and help you correct said patterns.

Attending therapy is essential for daily functioning when you have bipolar disorder.

If you’ve been putting off the search for a therapist, please consider starting anew now. I know how much work it is to find one, especially given that many therapists are overburdened by new patients due to the COVID-19 pandemic, but a good therapist is worth the effort.

You may end up waiting for a while, especially when insurance is involved, but don’t give up your search. A worthwhile therapist can make a world of difference.

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

Practice Self-care

Self-care is not limited to bubble baths and painting your nails. It’s taking responsibility for your physical and mental well-being.

The basics of self-care is just as it sounds on the tin: taking care of yourself. Self-care involves:

• sleeping enough (but not too much)
• eating a healthy diet
• spending time outside and with other people
• exercising
• and drinking plenty of water.

Practicing these tenants of self-care on a day-to-day basis is crucial for you to feel better. Even if you can’t do all five everyday, try to eat, sleep, and drink enough water. Your energy levels and mood may improve immensely.

When I don’t perform self-care, I feel the lack in my life, and I feel it fast and hard. I’m usually clued in by my lapse in self-care by my tense shoulders, a huge amount of anxiety, and finding myself snapping at my kids.

Realizing I haven’t performed self-care in a few hours is just the first step. The next step I do is always check on my hunger levels; as a Highly Sensitive Person (HSP), I am easily hangered.

Once I’ve had a snack, I drink at least 24oz of water. Then I check whether I’m needed for something from my kids or other duties, or whether I can do something relaxing, like take a hot bath or work on my writing.

The entire self-care process of snacking, drinking water, and checking takes all of five minutes for me (I eat fast), and often improves my mood by leaps and bounds. If I can relax, I generally relax for about thirty minutes at a time, and I have free time scheduled into my routine every evening.

For a post on how to make time for self-care as a parent stuck inside during the COVID-19 pandemic, click here,

Final Thoughts

World Bipolar Day, celebrated every year on March 30th, is a great time to take stock of the strategies you’ve used to cope with your mental illness. If you have bipolar, taking your medication, attending therapy, and practicing self-care will go a long way towards improving your ability to handle your condition.

There is no shame in having bipolar disorder. It just means your brain functions differently and you have an extra layer of work that neurotypical people just don’t have.

But you can control your illness. You can stabilize.

Take charge of your mental health on World Bipolar Day.

I wish you well in your journey.

Related:

• New Year, New Me, New Ways to Manage My Bipolar Disorder
• 11 Lessons I Learned from 11 Years of Managing Bipolar Disorder
• 5 Ways to Cope with a Diagnosis of Mental Illness

Why Hyperfocus Can be a Form of Self-Harm

Photo by Solen Feyissa on Unsplash

Brains function in weird ways sometimes.

Because bipolar disorder runs along similar pathways to ADHD, people with either mental health challenge tend to have difficulties with focusing on tasks in front of them.

When faced with a task our brains deem “boring,” we get distracted and do anything else to avoid the task.

However, sometimes, when enraptured with a project that engages our brains in just the right way, we can enter a zen state of hyperfocus, or “flow.”

In a flow state, everything but the task fades away. I myself have taken advantage of flow states many, many times, having written fanfiction in a blitz of 2200 words per hour or cross-stitched massive projects for hours on end without noticing my hands getting sore.

The neurochemistry of a flow state is super interesting. During a flow state, your brain is flooded with endorphins–nature’s heroin–and all tension in your body disappears, only to be replaced with pleasure.

I usually listen to music with noise-canceling headphones when I’m trying to concentrate a task. One way I can tell I’ve entered a flow state–aside from the massive amount of productivity–is that I completely tune out my music.

You don’t have to have a mental disorder to take advantage of a flow state, though they are common in people with bipolar disorder and ADHD, especially during times of bipolar hypomania and mania.

And trust me, flow states feel good. I love knocking my tasks off my to-do list and producing hundreds of words per hour. I love the endorphin rush I get from conquering my tasks. And I love how I feel afterwards, loose and relaxed and accomplished.

But how can this be a bad thing?

March is Self-Harm Awareness Month, celebrated in the US, Canada, and most of Western Europe. During the awareness month, mental health organizations around the world concentrate on informing the general public about non-suicidal self-harm, especially in youth.

Which why it’s a good time to explain how a hyperfocused, uber-productive state can be a form of self-harm.

Self-harm? Really?

But hyperfocus can be a good thing! You might be thinking. How can such a productive state be a form of self-harm?

It’s true that hyperfocus can be an excellent state to be in for productivity reasons. But hyperfocus can absolutely end up doing more harm than good.

Let me explain. When I’m laser-focused on a desirable activity, I narrow my attention down to what I’m doing in the moment to the exclusion of all else. I neglect to eat, drink, or even use the bathroom. I can’t recognize the flow of time, so it passes without my recognition.

And I get wired from the creativity and endorphin rush, making sleep difficult, which is dangerous for a person with bipolar disorder. Especially bipolar I, where manic episodes are more intense. If I don’t sleep, I quickly trip into mania, which helps me hyperfocus, which makes me manic… It’s a cycle.

When I’m hyperfocused, I not only neglect my own physical and mental needs, I also neglect the needs of my children. I get so wrapped up in projects, I forget to feed my kids until they not-so-gently remind me to do so.

I also hate people interrupting my flow states. When I’m jerked out of a groove, I get irritable and snappish. I have trouble pulling away. Changing gears to do things like “feed the five-year-old” is extremely difficult for me.

So flow states, though they feel great, are often sources of dysfunction for me–precisely because they feel so wonderful.

How to Manage Flow State Dysfunction

Even though I acknowledge these serious consequences from my dysfunctional patterns, I am reluctant to give up my flow states. They are addictive and a lot of my self-worth is wrapped up in my productivity, something I’m working on.

So while I’m keeping the flow states (when I can enter them), I’m setting limits on how long I produce in one.

Someone else watches my daughter from 1pm to 3pm on weekdays so I can study. This means I have a hard deadline to stop. I must stop working at 3pm.

And I am practicing patience by reordering my priorities. My children are more important than the studying, blogging, painting, sewing, or writing fanfiction–the sources of work or pleasure that sometimes trigger a flow state for me.

So I keep my children’s needs at the forefront of my mind and pull away from my screens thirty minutes before set meal times (8am, 12pm, and 5:30pm), so I can properly feed my kids.

We aim to eat at the same times each day. This regular schedule of cooking and eating meals means I have prescribed times to work on other things and maybe enter a flow state.

And I try not to work on fun, creative things–where I’m more likely to enter a flow state–until all my work is done first. I hold myself accountable and keep myself honest about what I accomplish on a daily basis, which helps with self-worth.

Limiting myself works for me. It may work for you, too. Try setting up a regular schedule of work, pleasure, and attending to your physical needs and the needs of others you’re responsible for. And set alarms if you need them–several if you’re in the habit of ignoring them.

Final Thoughts

Flow states–or hyperfocused states–feel wonderful.

They’re an endorphin rush for sure. While everyone can get into a groove, flow states are especially tempting for people with bipolar disorder and ADHD, who usually have trouble concentrating on and motivating themselves to perform day-to-day activities.

People with mental disorders need to be careful that flow states don’t become dysfunctional, which is more common than you might think. What’s more, if you find yourself entering flow states more and more often lately, track your other symptoms, as you may be entering a manic episode.

But you don’t have to give up flow states entirely. Just limit yourself.

Set alarms. Work on a regular schedule with hard stops. Hold yourself accountable for finishing work first before embarking on fun activities that are more likely to trigger a flow state.

I know it’s hard. If you’re anything like me, you’d prefer to be in a hyperfocused state all the time. I get it.

But you deserve better than your own neglect. And if you have kids, they do, too.

You can do this.

Related Posts:

• How Depression Interferes with Getting Things Done (GTD)
• New Year, New Me, New Ways to Manage My Bipolar Disorder
• My Top 8 Personal Needs During a Bipolar Depressive Episode

A Thank You Letter to My Husband for Helping me Manage my Bipolar Disorder

Photo by Annie Spratt on Unsplash

Dear Greeneyes,

Thank you for being patient.

Thank you for being patient with me as my moods ravaged me and stressed our relationship. Thank you for being patient with me as I suffered that postpartum breakdown and scared you. Thank you for being patient with me as I learned how to survive and even thrive afterwards.

I’m sorry I’m not the person you expected to marry. I wish I were her, and I’m trying to get back to that person again. Thank you for being patient with me while I relearn who I was and try to capture her essence.

I appreciate so much the fact that you stuck by my all this time through my various trials and tribulations, challenges that made you suffer as well as me. I am so grateful to you for being my first and most stalwart supporter.

Thank you for supporting me financially for so many years and allowing me to afford and use the mental health professionals and medications I needed to stabilize. That’s such a great boon to me; I know many people who are desperate to find a therapist but cannot afford one. Your working for over a decade at a job you don’t like helped me more than I can even conceptualize.

Thank you for encouraging me to follow my dreams of getting my counseling degree and becoming a therapist to help people manage their mental illnesses. I want to support you in your dreams, so thank you for letting me follow mine first so I can do that.

Thank you for listening to me gush about subjects that you have no interest in. You’re a fantastic listener, and I’ve often made your eyes glaze over by discussing my psychology courses or various friendship dramas. I will learn how to reign myself in for your sake.

Thank you for being a solid parent to our children. As you know, I often lose my temper and you are the patient one who steps in and smooths things over. Your presence as a father to our kids is so important in their lives, modeling to them appropriate behavior for every area of their lives, especially how to treat other people.

Thank you for teaching me so much. I’ve learned a range of subjects including computer science, math, baking, video games, things of a spiritual nature, how to be reliable, how to be patient, and how to love.

Finally, thank you for loving me. Thank you for always acting in my best interest even when it pained you or made you uncomfortable. Thank you for teaching me what love really means. Thank you for protecting me from the evils of the world and enabling me to blossom.

I love you. You are my rock, my love, and I would not be as happy as I am without you.

Cass

Related Posts:

• Self-Discovery Month: Looking Back on My Diagnosis with Bipolar Disorder
• When to Disclose Your Mental Illness to Your Dates
• How to Handle This Thanksgiving with Bipolar Disorder by Setting Healthy Boundaries

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:

• 5 Tips to Make (and Keep!) New Year’s Resolutions with a Mental Illness
• Mental Wellness Month: How to Look After Yourself in the New Year
• Ring in the New Year By Writing Yourself a Mental Health Vision Statement

Bipolar Mania and My Need to Craft

Photo by Aneta Pawlik on Unsplash

When I’m suffering from a manic episode, I need to craft and I cannot prioritize.

Every task that my brain comes up with must be done right then. And, like most people suffering from a manic or hypomanic episode, I come up with a lot of tasks.

Many times, my brain thinks I should start new craft projects for friends. “The holidays are right around the corner!” my manic brain screams in November. “I must cross stitch something that’ll normally take me 30 hours to complete, but right now it’ll only take 5!”

Basically, my manic brain is too ambitious for its britches. When I’ve started new projects in a hypomanic state, where I feel euphoric and superhuman, I rarely finish them, leaving them–and their accoutrements like needles–around the house for anyone to step on.

During hypomanic phases, I’ve made oodles of poorly-sewed plushies (including a whole sushi tray); painted multiple canvases and glass pictures; and cross stitched coasters, QR codes, and a multitude of other fabric projects. I don’t properly prepare for these projects, and I also usually don’t clean up until the hypomanic phase is over.

I also feel a sense of urgency with the projects. They end up rushed: I pull the stitches too tightly, warping the fabric, or splash paint on the trim when painting awkward-looking trees on the walls–permanent fixtures in our dining room that my husband absolutely hates, haha!

Like many people dealing with mania, I’ve also purchased hundreds of dollars of supplies. I’ve cluttered up my garage and ended up buying so many duplicates, I ran out of space and ended up throwing them out in a moment when I was more stable and clearheaded.

I’ve even left my fabrics and embroidery threads on the floor for the cat to pee on, eventually tossing more than half of my massive collection.

One hypomanic Christmas, I thought my father-in-law and his wife didn’t have enough presents, so I stayed up on Christmas Eve making them pink and purple hats with spare fabric and hot glue–without measuring.

The hats turned out too small, were scratchy, and fell apart almost immediately after being opened. I still remember my father-in-law trying the hat on and having it not even cover the top of his head.

After we finished opening presents, the hats were unceremoniously placed in the trash. Christmas Day, I felt ashamed and embarrassed, my face hot and tears welling in my eyes.

Recognizing that almost all of the presents I’d made for family members were of poor quality and thus rightfully unappreciated, I stopped making presents and really participating in the holidays for years.

Years later, when my daughter was four months old, I entered a similar hypomanic state and decided to paint a cherry blossom branch on a huge canvas.

Putting her in my Ergo front-pack baby carrier, I hunched over the kitchen table and painted for 4 hours, losing track of time while she slept. The project felt so urgent, I didn’t stop to eat lunch, feed my child, or even go to the bathroom.

Cassandra Stout’s cherry blossom painting. Copyrighted under a Creative Commons license.

Realizing that I was only creating when my brain was sick, that was the last craft project–or art of any kind–I produced for four years.

Thankfully, I am now much more stable. Once I was on an more even keel and not in danger of going manic, I started writing fanfiction and enjoying creating again, writing quick short stories that I can produce and publish online for my fans in a few hours.

Since then, one year after I began writing for fun again, I’ve embarked on other art projects. I’ve painted small ceramics: tiny projects–fridge magnets and paperweights–things I can get done in small increments, and things that won’t trigger that sense of urgency again.

This past holiday season, I took up cross-stitching presents for Christmas gifts again, this time for fun, and the biggest project–which really did take me 30 hours–turned out beautifully. My stitches are straight and just tight enough to make the project look nice.

I earned this stability through hard work–taking and rebalancing my medication cocktail on a regular basis, checking in with my treatment team whenever I feel like I’m slipping into a mood episode, and engaging in psychotherapy.

I am happy to say that I am now creating again, thoroughly enjoying myself and taking my time rather than feeling pressured to complete things on an unreasonable timetable.

And when I do feel that invisible pull, that pressure, that sense of urgency that I feel sometimes even when stable because that’s what my sick brain associates with crafting, I set the project down and do something else.

I am much, much happier now.

Have you ever felt like this? What does your brain force you to do when you’re manic?

Related Posts:

• When and Why to Seek Out Professional Help
• 10 Self-Care Ideas for People Suffering from Bipolar Disorder
• What is the Link Between Stress and Bipolar Disorder?

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:

• How to Communicate with Family During the Holidays When You Have a Mental Illness
• 10 Frugal Gifts for People Who Suffer from Anxiety
• Do You Have Bipolar Disorder? You Can Still Thrive This Holiday Season

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:

• National Recovery Month – A Guide to Depression Recovery Through Self-Care, part 1
• What My Experience Being Suicidal Taught Me — and What It Can Teach You, Too
• Self-Discovery Month: Looking Back on My Diagnosis with Bipolar Disorder

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.

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.

Related:

• Substance Abuse and Bipolar Disorder
• Why Should You Chart Your Moods if You Have Bipolar Disorder?
• Bipolar Disorder is Toxic–-Literally