11 Lessons I Learned from 11 Years of Managing Bipolar Disorder

sky is falling
A black-and-white photo of a man standing in front of a storefront, looking up at the sky. Credit to flickr.com user Neil Moralee. Used with permission under a Creative Commons license.

I have suffered from bipolar disorder I for decades, but I didn’t know that my condition had a name for a long time. It wasn’t until after a psychotic break following the birth of my son 11 years ago that I was diagnosed, and started managing the illness. Thankfully, my bipolar disorder is not the treatment-resistant type, so I have responded well to medication and therapy.

Here are 11 lessons I learned after 11 years of managing bipolar disorder:

Lesson #1: Take my Medication, Everyday

Like almost everyone who takes medication for a chronic illness, I found myself not wanting to take my pills. Could I manage my disorder without them? Do I have to take my meds everyday? The answers to those questions are: no, I can’t, and yes, I do, respectively.

I learned the hard way that I have to take my medication every day. If I don’t, I end up manic, anxious, or depressed, and sometimes all three at once. Mania and depression presenting at once is called a mixed episode, which I have on occasion. They are the most dangerous of all the episodes if left untreated, because I think awful thoughts and have the energy (and lack of impulse control) to act on them. For me, taking my medication daily is the only way to head off these episodes.

Lesson #2: Take my Medication on Time

Taking my meds on time (morning meds in the morning, night meds at night) is something I still struggle with. My psychiatrist recently told me to take a medication I was taking at night in the morning, which I am not at all used to, so I often forget to take them. But I’ve found that if I take the medication which shares a caffeine pathway in my brain at night, then I’ll be up all night, which can lead to manic episodes. It’s a balance I’ve yet to master.

Lesson #3: This Mental Illness is Lifelong

Until the past several months, I hadn’t suffered a depressive or manic episode in six or seven years. I thought, foolishly, that the mental illness had simply–poof!–disappeared. The fact that I can’t just make mental illness go away has been one that I’ve struggled to accept. I can manage my disorder, but it is always with me.

Lesson #4: Make Peace with my Diagnosis

Like many people diagnosed with a mental illness, I struggled at first with my diagnosis. I couldn’t be bipolar, I thought. I wasn’t crazy, like the people surrounding me in the mental hospital I committed myself to. But I was and am mentally ill. Making peace with my diagnosis only came in time, after I had figured out how to manage my condition. Like lesson #3, I had to realize that this mental illness is lifelong, and I needed to deal with it.

Lesson #5: Take my Bipolar Disorder Seriously

If left untreated, my bipolar disorder will wreck my life. Over the years, I have taken my medication consistently and attended therapy religiously. But when I didn’t, my carefully constructed life fell apart–and how. I have since learned that I must take my mental illness seriously. Like a diabetic, one slip up is enough to send me into a spiral of destruction. I can never stop managing bipolar disorder, ever.

Lesson #6: Honesty is the Best Policy

I’ve found that, when it comes to my moods, honesty is the best policy. When my son asks me how I’m feeling, I will tell him that I am anxious, depressed, fine, or feeling “up.” I don’t ask him to manage my emotions, but he is able to adjust his expectations of me accordingly. He is extraordinarily empathetic and mature for his age, and I have no doubts that’s because of how my mental illness has affected him. In other cases, being honest about my bipolar disorder to people other than my immediate family ends up with the same result. For more information on how to disclose your disorder to friends and family, click here.

Lesson #7: Gather a Support System

For many, many years, I was too depressed to gather a strong support system. I had moved away from all my friends and family for my husband’s job, and felt isolated. Making new friends, especially when I had an infant to care for, seemed impossible. It’s only been fairly recently that I’ve reconnected with my family (and been honest with them; see lesson #6), and made new friends who understand mental illness. This support is crucial to my wellbeing. If I had known how much not havingĀ  a system in place affected me, I would have pushed myself hard to make friends sooner.

Lesson #8: Manage my Sleep

Staying up all night for a week is what triggered my psychotic break and first real manic episode. I have learned the hard way that sleep is my best friend. When I don’t sleep, I end up firmly in the middle of a manic episode, depressive episode, or mixed episode. Sleep is crucial for anyone with bipolar disorder, but I need more sleep than the average adult (about 9-10 hours a night vs. 7-8). I cannot function without sleep.

Lesson #9: Trust my Mental Health Team

Like many people who suffer from mental illnesses, I have had upwards of seven psychiatrists, and two therapists. They keep moving on me! Building trust in a new treatment team is so difficult, but I have to advocate for myself and learn to trust every time change upsets the apple cart. The lesson that my mental health team is only acting in my best interest has been a difficult one to learn. I now rely on my current psychiatrist and therapist with my life.

Lesson #10: Know my Triggers

Learning common bipolar triggers took time, and effort. I didn’t do a lot of research about bipolar disorder when I was first diagnosed, and what a fool I was. Figuring out that I needed good sleep hygiene (see lesson #8) took a period of trial and error, during which my husband and child suffered as I wasn’t present for them. Learning what triggered my manic or depressive episodes, and how to manage those triggers, was crucial in learning how to manage my disease.

Lesson #11: Therapy is Awesome

Though I was attending therapy for nine months before my diagnosis, learning coping skills in therapy was invaluable. I have attended innumerable sessions with a therapist over the years, and doing so has helped me: be more present as a parent and wife, learn how to manage my bipolar disorder, and figure out how to deal with family situations like a tense Christmas. Therapy is awesome. I highly recommend prioritizing counseling sessions if you can afford them. Many therapists take clients on a sliding scale.

Final Thoughts

Over the years, I have learned several more lessons than just these 11. But these are likely the most important. Many of these lessons are common ones learned by people who suffer from mental illnesses. If you suffer from bipolar disorder and are newly-diagnosed, take heart. Do research on your condition, take your medications, and never stop fighting.

I wish you well in your journey.

Related:

 

Dear Younger Me: You’re Bipolar, and That’s Okay

Dear Younger Me,
If someone were to tell you that by age 33, you would have a diagnosis of bipolar I, you wouldn’t be surprised. You would be surprised, however, at the fact that you have the wherewithal to treat your mental illness, both emotionally and financially.

You wouldn’t be surprised at the soul-sucking depression you feel now. You would be surprised that you haven’t felt this way in years, and that you are a productive, usually happy, stable woman. You’d be shocked at the fact that the meds have worked so well to control your bipolar disorder up until this point, and that adjusting them isn’t a major problem in your life.

You wouldn’t be surprised that you are a writer. After all, you’ve been writing since you were four and knew how to scribble letters, and wrote your debut “novel,” The Fish. You would be surprised that you are a) married to a wonderful man who would die for you, b) have kids, and c) stay home to take care of your kids. You’d be shocked to know you’re an amazing mother, with healthy, compassionate children.

cassandra stout photo
A closeup photo of author, Cassandra Stout, facing left. Protected under a Creative Commons license.

You wouldn’t be surprised to know that you are still attending the same church you grew up in, the church of Christ. You would be surprised at how much closer to God you’ve become. You’d be shocked to recognize how much He has guided your life, and worked out all things for good.

Younger me, you will be happy someday. You’ll escape the narrow-minded bullies of your small town, and establish yourself in a big city 2000 miles away. You’ll survive college–barely. You’ll suffer a postpartum psychotic breakdown, but that won’t stop you. You’ll just write a book about it.

Younger me, you have so much life ahead of you. A good life. Thank you for not giving up. You will face so many challenges and come out on top. Your grit, determination, and prayers will see you through.

Don’t give up. Don’t give up.

Love,
Cassandra Stout

Related:

What is a Warmline, and How do You Use Them?

phone2
A picture of a red, wired telephone on a orange background. Credit to flickr.com user Ant & Carrie Coleman. Used with permission under a Creative Commons license.

When you’re struggling with depression or other mental health challenges, sometimes you just need someone to talk to. Someone who’s “been there,” someone who will carefully listen to your troubles or help you celebrate a big accomplishment. Why not call a warmline?

A warmline is a number you can call for free to discuss your current struggles with volunteers who may be in recovery themselves. Warmlines are not for people who are in crisis. They are intended to help people manage their issues before the crisis point hits.

Warmlines support people from all walks of life facing all manner of challenges, from postpartum problems to tuberculosis to gambling addiction to emotional and mental health issues, like bipolar depression. Warmlines are meant to foster a human connection.

Unlike a crisis line, the peer on the other end of the call will not call the police on you if you are in crisis or suicidal. Peers on warmlines are meant to let you vent your troubles and potentially connect you with resources in your county which can help.

How to Use a Warmline

But what can you talk about on a warmline? Well, the list includes but is not limited to:

  • Everyday challenges and activities
  • Grief and loss
  • Accomplishments you want someone to hear
  • Medication issues
  • Addictions
  • Resources
  • Relationships with a spouse, significant other, or friends and family
  • The past, present, or future

On a warmline, you can expect that the volunteer will listen to you carefully and non-judgmentally, keep your information confidential, and be willing to connect you to further resources. If you’re in the US, you can find a comprehensive list of warmlines by state at www.warmline.org.

The Challenge in Finding an Open Warmline

Unfortunately, warmlines are rare and 24-hour warmlines are even rarer. As I’m currently suffering from bipolar depression and struggling to get through the day, I called the warmline in my county, but was unable to get through to a human being. That line is only open from 5-9pm, and I called at about 8:30pm, so it’s possible that I’d have more luck calling earlier in the day.

I then searched for more warmlines on the internet, and found one dedicated to parents of children under six years old based out of Bakersfield, CA. I have a toddler who challenges me on a daily basis, so I called the line (1-888-955-9099, https://e-warmline.org), and was directed to an answering service staffed by a human being. She took my number and said the line operator will call me back the next morning, after the line opens at 8am.

After that, I called a warmline purporting to be a 24-hour nationwide service based in Oregon (1-866-771-9276). A recorded message told me that that number is no longer taking calls. After that, I called a few more warmlines with similar results–they were either not open, were county-specific, or not taking calls at all. Finally, I called a warmline run in my state which is open from 4pm-midnight everyday. I left a message at 9:15pm, but did not hear back from them before midnight.

My Experience With the Parenting Warmline

The parenting warmline did call me back at about 9am the next morning, as promised. The female line operator, who I’ll call Paula, was kind and gentle. She listened carefully to my main, current parenting struggle–letting my toddler watch too much screen time while I am depressed and unable to get out of bed–and was compassionate on me. I told Paula that I have made an appointment with my therapist, to discuss coping skills, and my psychiatrist, to adjust my meds, and Paula said that I’m doing everything I’m supposed to do.

While I was on the phone, my toddler repeatedly tried to get my attention, and my conversation with Paula was interspersed with talking to my kid. Paula remarked on that, saying that she appreciated how responsive I am to my child, and that she could tell that I’m an amazing mom. Paula also has a toddler, who spoke up in the background of our call. She is a volunteer who is clearly in the trenches of parenting, and while I didn’t ask her if she’d ever suffered from depression, she seemed in tune with my challenges.

Over all, calling the line was a good idea, as Paula helped me have a good experience. She was an empathetic listener. Paula also offered me some reading materials through the mail, which I am looking forward to receiving.

Final Thoughts

If you need a compassionate person to talk to and are not in crisis, I would highly recommend calling a warmline. Finding an open one may be challenging, but I think being listened to by someone who wants to listen is invaluable.

You might get a lot out of calling a warmline, especially if you don’t have access to a therapist. Pick up the phone today. You may find that you, too, have a good experience.

Related:

Tips and Resources for Online Support Groups

internet
A picture of a sign with yellow font on a blue background that reads “Internet Chat Room” in all caps. Credit to flickr.com user Fuzzy Gerades. Used with permission under a Creative Commons license.

If you suffer from a mental illness like bipolar disorder, then a peer support group can be a valuable asset to you. Having other people validate your experience might be liberating; being able to offer similar support to those around you may be cathartic. Support groups are not a replacement for therapy but can be a useful tool to help you feel less alone in your struggles.

However, finding a local group can sometimes be difficult, so you may turn to the internet to help facilitate a meeting between you and your peers. Read on to find out some tips to make the most of an online support group, as well as a list of resources for internet-based groups centered on people with bipolar disorder.

1. Be respectful

Do I really need to suggest that people need to be respectful of others in online support groups? Unfortunately, yes. Some people can be overly critical of others and attack them personally. Keep away from those behaviors, and your peers will respond accordingly. Correcting misinformation is okay, but be mindful of other people’s feelings while doing so.

2. Don’t release personal details

When participating in an online setting of any kind, you need to stay somewhat anonymous. Sharing your experiences is okay, as long as you don’t offer any personal details like where you live, your age, your real, full name, or anything else that identifies you. There are already documented cases of insurers denying life-saving coverage to people from based on what they’ve shared online. Employers also look at online history when determining whom to hire. If you post anything to the group that can be tied back to you, you put yourself at risk.

3. Try to remain positive

When I say “try to remain positive,” I don’t mean that you should pretend everything is hunky dory when you’re struggling. I mean that you should recognize what agency you have in the situation, and try to remain hopeful that your pain will pass eventually. One of the reasons to attend a support group is to build up the grit needed to reject despair and move forward.

4. Be mindful about what you read

You may ask for and receive advice that is applicable to your situation, or you may find that people share diverse experiences with you that don’t relate. That’s okay. Take what you need; reject everything else. Don’t expect that every word you read will be applicable or even accurate. There is a lot of misinformation about treatments floating around on the internet. Make sure to do your own research rather than just listening to the first source you hear. Support groups are mainly for the sharing and validating of experiences.

Resources

Here’s a list of resources for online support groups. Don’t give up if the first group you find isn’t a good “fit” for you. You may need an in-person support group (which I will cover in a future post) led by a facilitator instead, but give the online ones a try.

+supportgroups is a website with an easy commenting system. You simply post what you’re feeling and people respond on the site, similar to a forum.

bp Magazine Bipolar Facebook Support Group: The tagline for this Facebook support group run by bp Magazine is “Hope and Harmony for People With Bipolar Disorder.” There are over 8,000 members at the time of this writing.

The Depression and Bipolar Support Alliance (DBSA) runs several 60-minute support groups on specific dates and at specific times on the website Support Groups Central. Join the site as a member for free; you have to fill out a profile, but your attendance in meetings is confidential. You will see a video stream of the facilitator and may choose to allow your own video to stream. This is the most like an in-person support group that I’ve found.

HealthfulChat is a traditional chat room with regulars and new people at all hours of the day. You may need to install the most recent update to Flash in order to log in.

Final Thoughts

Whether you’re feeling depressed or manic, there’s a support group for you. Just remember to be respectful, don’t release personal details, try to remain positive, and be mindful of what you read.

Book Review: Balancing Act: Writing Through a Bipolar Life, by Kitt O’Malley

 

balancing act
A picture of the cover of the book Balancing Act: Writing Through a Bipolar Life, by blogger Kitt O’Malley. The cover contains a stack of black rocks which become smaller the higher the stack. The background is a gray storm cloud.

 

Everyone with mental illness knows that managing their disease is a balancing act. Kitt O’Malley, a mental health advocate with bipolar disorder and blogger at the eponymous kittomalley.com, knows this all too well.

O’Malley collected the best posts of her blog into a book titled, appropriately, Balancing Act: Writing Through a Bipolar Life. I was offered an advanced reader copy in exchange for a review, which I am glad to give.

This book is excellent. As a former Marriage and Family Therapist and fellow bipolar sufferer, O’Malley is uniquely qualified to write about the disorder and how it affects her life, as well of those of her loved ones. In the first and second sections, O’Malley clearly lays out the symptoms of her bipolar disorder (first diagnosed as bipolar II, now recently changed to bipolar I), as well as her mental health journey. The third section, Bipolar Thoughts, is an eloquent, haunting collection of posts detailing her “ramping” up in hypomania, and the debilitating dives into depression. The fourth section, Write With Purpose, describes what writing means to O’Malley and how the art fuels her activism. The fifth section, Caretake, is a description of her managing her son’s struggles with chronic illnesses, as well as helping her aging parents–both who suffer from dementia–navigate multiple care homes.

Let’s look at what does and doesn’t work.

What Does Work

  • The writing is poignant and straightforward, and at times lyrical. O’Malley includes the occasional poem as well. She is quite the wordsmith, coming up with turns of phrase I wish I would have thought of myself. The poetry is especially appreciated.
  • While O’Malley has attended a multi-denominational seminary, the book is not overly religious. This may not be some people’s preference, but for others, the approach will be fine.
  • O’Malley’s candor is refreshing. She describes every slip up she has, including the times when she was unfortunately abusive to her son and husband. Holding nothing back is incredibly hard, and O’Malley’s bravery is commendable.
  • One of Balancing Act’s great strengths is that it is, indeed, a collection of blog posts. We are able to travel along O’Malley’s journey with her in real time, reading first, for example, about her brother-in-law’s lung cancer, and then that he passed. O’Malley often addresses her readers with rhetorical questions, as well as thanking them for their support.

What Doesn’t Work

  • While reading Balancing Act, I had to take breaks every 40 pages. O’Malley’s struggles with managing her bipolar disorder, caring for her son’s migraines and digestive issues, and looking after her aging parents are relentless. I couldn’t help but sympathize with her constant difficulties, but I did feel overwhelmed at times, like she does. However, O’Malley often expresses her gratitude to her readers, her husband, and to her parents’ caretakers. I really appreciated that.
  • This is a small nitpick. Very rarely, O’Malley uses multiple sentences together without subjects, starting with a verb. This is fine; it’s a stylistic thing, and it’s a great demonstration of O’Malley’s anxiety and hypomanic symptoms. But the transitions were occasionally jarring. The writing is still excellent.
  • While the book being a collection of blog posts is one of its greatest strengths, that is also its greatest weakness. O’Malley sometimes includes transcripts of videos, which may have been more effective in video form. The posts can also be a bit repetitive, as some of it is rehashing information we’ve learned before in different words. These are tiny nitpicks, though, and all in all, the blog does translate well to book form, as long as readers keep in mind that the writing was once in blog form.

So that’s a glimpse of Balancing Act: Writing Through a Bipolar Life. The book will be on the market, published by Eliezer Tristan Publishing, starting September 19, 2019. I recommend this book and encourage you to pick up a copy today. Thank you, Kitt.

Hiatus Announcement for The Bipolar Parent

It’s time for me to take a break.

cassandra stout photo
Blogger Cassandra Stout. Protected under a Creative Commons license.

I’ve been burned out with family responsibilities and dealing with some intense conversations in therapy, and my blog has suffered for it. You may have noticed a dip in quality, for which I apologize for. I’ve only written a single post in the past six weeks. In short, while I have the motivation to blog, as I don’t want to disappoint you guys, my readership, I have lost the inspiration. I don’t want to churn out low-quality posts just to have something up on Fridays, so it is with a heavy heart that I’m announcing a hiatus until the first Friday in September, 2019. I promise to start blogging again then, and to give you the level of detail and quality you expect from The Bipolar Parent.

Thanks so much for being here with me. Until September.

-Cassandra Stout

How Specific Gene Variants May Raise Bipolar Disorder Risk

cpgv level
In this data visualization, each horizontal line is an individual. Those with bipolar disorder were more likely to be on the lower end of the CPG2 protein expression scale, and more likely to have gene variants that reduced expression. Credit: Rathje, Nedivi, et. al.

A new study by researchers at The Picower Institute for Learning and Memory at MIT finds that the protein CPG2 is significantly less abundant in the brains of people with bipolar disorder (BD) and shows how specific mutations in the SYNE1 gene that encodes the protein undermine its expression and its function in neurons.

Led by Elly Nedivi, professor in MIT’s departments of Biology and Brain and Cognitive Sciences, and former postdoc Mette Rathje, the study goes beyond merely reporting associations between genetic variations and psychiatric disease. Instead, the team’s analysis and experiments show how a set of genetic differences in patients with bipolar disorder can lead to specific physiological dysfunction for neural circuit connections, or synapses, in the brain.
The mechanistic detail and specificity of the findings provide new and potentially important information for developing novel treatment strategies and for improving diagnostics, Nedivi said.

“It’s a rare situation where people have been able to link mutations genetically associated with increased risk of a mental health disorder to the underlying cellular dysfunction,” said Nedivi, senior author of the study online in Molecular Psychiatry. “For bipolar disorder this might be the one and only.”

The researchers are not suggesting that the CPG2-related variations in SYNE1 are “the cause” of bipolar disorder, but rather that they likely contribute significantly to susceptibility to the disease. Notably, they found that sometimes combinations of the variants, rather than single genetic differences, were required for significant dysfunction to become apparent in laboratory models.

“Our data fit a genetic architecture of BD, likely involving clusters of both regulatory and protein-coding variants, whose combined contribution to phenotype is an important piece of a puzzle containing other risk and protective factors influencing BD susceptibility,” the authors wrote.

CPG2 in the Bipolar Brain

During years of fundamental studies of synapses, Nedivi discovered CPG2, a protein expressed in response to neural activity, that helps regulate the number of receptors for the neurotransmitter glutamate at excitatory synapses. Regulation of glutamate receptor numbers is a key mechanism for modulating the strength of connections in brain circuits. When genetic studies identified SYNE1 as a risk gene specific to bipolar disorder, Nedivi’s team recognized the opportunity to shed light into the cellular mechanisms of this devastating neuropsychiatric disorder typified by recurring episodes of mania and depression.

For the new study, Rathje led the charge to investigate how CPG2 may be different in people with the disease. To do that, she collected samples of postmortem brain tissue from six brain banks. The samples included tissue from people who had been diagnosed with bipolar disorder, people who had neuropsychiatric disorders with comorbid symptoms such as depression or schizophrenia, and people who did not have any of those illnesses. Only in samples from people with bipolar disorder was CPG2 significantly lower. Other key synaptic proteins were not uniquely lower in bipolar patients.

“Our findings show a specific correlation between low CPG2 levels and incidence of BD that is not shared with schizophrenia or major depression patients,” the authors wrote.

From there they used deep-sequencing techniques on the same brain samples to look for genetic variations in the SYNE1 regions of BD patients with reduced CPG2 levels. They specifically looked at ones located in regions of the gene that could regulate expression of CPG2 and therefore its abundance.
Meanwhile, they also combed through genomic databases to identify genetic variants in regions of the gene that code CPG2. Those mutations could adversely affect how the protein is built and functions.

Examining Effects

The researchers then conducted a series of experiments to test the physiological consequences of both the regulatory and protein coding variants found in BD patients.

To test effects of non-coding variants on CPG2 expression, they cloned the CPG2 promoter regions from the human SYNE1 gene and attached them to a ‘reporter’ that would measure how effective they were in directing protein expression in cultured neurons. They then compared these to the same regions cloned from BD patients that contained specific variants individually or in combination. Some did not affect the neurons’ ability to express CPG2 but some did profoundly. In two cases, pairs of variants (but neither of them individually), also reduced CPG2 expression.

Previously Nedivi’s lab showed that human CPG2 can be used to replace rat CPG2 in culture neurons, and that it works the same way to regulate glutamate receptor levels. Using this assay they tested which of the coding variants might cause problems with CPG2’s cellular function. They found specific culprits that either reduced the ability of CPG2 to locate in the “spines” that house excitatory synapses or that decreased the proper cycling of glutamate receptors within synapses.

The findings show how genetic variations associated with BD disrupt the levels and function of a protein crucial to synaptic activity and therefore the health of neural connections. It remains to be shown how these cellular deficits manifest as biopolar disorder.

Nedivi’s lab plans further studies including assessing behavioral implications of difference-making variants in lab animals. Another is to take a deeper look at how variants affect glutamate receptor cycling and whether there are ways to fix it. Finally, she said, she wants to continue investigating human samples to gain a more comprehensive view of how specific combinations of CPG2-affecting variants relate to disease risk and manifestation.

Materials provided by Picower Institute at MIT.

Related:

KonMari Revisted: A Review of the Method in Tackling the Clutter Demon With Bipolar

The KonMari method, a technique for tidying by Japanese professional organizer Marie Kondo, involves grouping your stuff by category (clothes, books, papers, miscellany, and sentimental clutter). You lay your items out on the floor, hold each one, and ask yourself if it “sparks joy.” Then you decide to keep the item or let it go.

In a previous post, Taclking the Clutter Demon with Bipolar Disorder, I described my first attempts with the method. I noted that the joy of getting rid of clutter is indeed real, and addicting–and for a bipolar person, could tip him or her into hypomania.

I’ve now completed half the method, and am happy to report that I did not suffer manic or hypomanic symptoms after tidying each category. I did, however, endure a brief depressive episode after getting rid of most of my books, which I believe was unconnected to the decluttering, as I didn’t suffer depression after all categories.

During the process, I felt a great deal of overwhelm; my sister helped guide me through tidying my clothes and books, and I tackled papers and kitchen items by myself. Marie Kondo’s book, The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing claims the tidying up process takes at least six months. I stay at home with a toddler who takes up all of my attention when she’s awake, so I have to depend on people being willing and able to watch her while I declutter. This is why I’ve taken so long to go through the KonMari method, and am only halfway done at the six month cut off. I’ve made progress, though it’s less than I would have liked.

After paring down my clothes, I was tired. Same with the books. I was so sad and exhausted, I felt like crying. But after tackling out my papers, I was happy. I was somewhat tired, true, but shedding the accumulated detritus of over a decade was refreshing–which was ultimately true for all categories, but especially papers.

marie kondo
A picture of Marie Kondo, a Japanese professional organizer, wearing a headset microphone and giving a talk. Credit to flickr.com user RISE. Used with permission under a Creative Commons license.

I still have a long way to go on my house. When tidying my clothes, I found items I’d never worn. When decluttering my books, I’d found books I’d never read. When clearing out my papers, I found stories I’d written in college that I’d lost due to multiple hard drive failures (I still need to learn to back up my digital items). I’d forgotten about those items because I never looked at them. Getting rid of about 75% of my clothes, 80% of my books, and 90% of my papers has enabled me to truly enjoy my remaining possessions. I have since received more asked-for books for Christmas, and bought one, but I am planning to reduce my collection again after I have finished reading the new books.

My husband is not on board with the method, so his stuff is off limits. I’m only decluttering my things, which means we still own massive shared board game and video game collections–containing games we’ve never played–and my husband possesses enough free T-shirts to outfit an army. Still, I need to learn to respect his space, and lead by example rather than nagging. When one partner in a marriage champions minimalism and the other is a packrat, arguments can rise up easily. I’m trying to avoid that, so I keep my spaces clear and do my best to ignore his spaces.

Marie Kondo is now the star of a Netflix show, “Tidying Up with Marie Kondo.” I’ve seen the first episode, and Kondo, and her interpreter, also named Marie, are utterly charming. They don’t judge the people who have asked for their help. The first episode focuses on clothes, and on Kondo’s unique folding method (see a YouTube video of it here), which I have put to practice in my own drawers. When you’re finished folding, the clothes stand up on their ends, making seeing which outfits you have available easier. Kondo says that the clothes like to be folded in this manner and will remember how they’re folded, which is part of the touchy-feelyness of her method that turns some people off. I don’t buy into it entirely, but the method is useful to me.

In short, I’ve taken what I find helpful from the KonMari method and set aside the rest, which has enabled me to start down the path of a tidy house. I’m looking forward to doing another review once I complete the method. Keep an eye out for a future post detailing my completed tidying!

Related:

How to Talk to Someone Experiencing a Bipolar Mood Episode

Trigger Warning: This post contains a brief discussion of suicidal ideation.

Bipolar patients suffering from mood episodes often make no sense. If they are depressed, they may say things like, “I’m a failure. No one loves me. I want to die.” On the flip side, if they’re manic or hypomanic, they might say things like, “I can fly! Let’s deep clean the house at midnight! It’s all so clear now!”

Telling the depressed person that he or she is not a failure and that people love him or her may fall on deaf ears. Similarly, trying to engage with the manic person’s delusions might be futile. So how do you talk to someone suffering from these issues?

Let’s dig in.

How to Talk to a Depressed Person

In order to talk to a depressed person, you need to address the root problem: the illness. You need to offer sympathy, understanding, and possible solutions.

For example, one thing you can say in response to his or her negativity is this: “I hear you. I understand that you’re depressed. This is normal for your bipolar disorder. I know it sucks. I’ve seen you like this before. Maybe you could take a long, hot shower; we know that helps you feel better.” This response addresses the real issue and communicates that you are there for the depressed person.

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A woman with very red lips on a cell phone. Credit to flickr.com user Anders Adermark. Used with permission under a Creative Commons license.

Depressed people may also suffer suicidal thoughts, which are dangerous. If they express these thoughts, you can say something like, “Thank you for telling me. You mean a lot to me, and I am here for you.” Then suggest that the depressed person call his or her treatment team and let them know that he or she is suffering from these thoughts.

How to Talk to a Manic Person

Similar to talking to someone suffering from depression, when talking to a manic person, you need to respond with patience and understanding. He or she will try to talk over you, and will not be able to stop talking. Be careful about being swept up into the conversation, as it can be overstimulating for everyone.

If the manic person ends up overstimulated, his or her mania or hypomania might worsen and he or she may become agitated. Despite their confidence, people with hypomania or mania are very sensitive in their elevated mood, and may take offense easily. If you are overstimulated, you might not be as effective at helping them remain calm. Make sure that the manic person is in a safe place and walk away for a break.

When you return, answer questions briefly, calmly, and honestly. If the manic person proposes a project or goal, do not agree to participate. You can keep tabs on them during the project and remind them to eat, sleep, and generally take breaks.

In my own experience, I was manic shortly after giving birth. I clapped my hands repeatedly and demanded that we–myself and the woman from church visiting me–clean the house, rather than let me recover. I was focused on getting my projects done, and ended up devastated once my goal was thwarted. Prepare to deal with that devastation–or frustration.

If the manic person tries to argue, remain detached. Talk about neutral topics. If you need to postpone the discussion, say something like, “I see this means a lot to you. We definitely need to discuss this, but let’s do so in the morning after I am no longer upset and tired.” You can also try to redirect his or her behavior, saying something like, “Would you prefer to take a walk or watch a movie?”

Final Thoughts

Communicating with people suffering from a mood episode, be it mania or depression, can be difficult. They often believe things that aren’t true. So taking care of yourself in the situation is paramount. If the manic or depressive person is critical of you, tell the person that you understand that he or she is ill and upset, but that you will not tolerate being spoken to in that way. Then find a way to exit the conversation and reconvene later. Be firm, but kind.

Above all, as with so many strategies for dealing with bipolar people, be patient. They are suffering from a mental illness that they cannot control. It’s not their fault. If they must deal with the consequences of their actions, try to present those consequences after they come out of the mood episode, when they are back to their rational selves.

Good luck!

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How Sugar May Harm Your Mental Health

Sugar, especially refined white sugar which has been processed, inflates waistlines and contributes to obesity. But, while some studies have shown that sugar may have a detrimental effect on the mood, not a whole lot of research has been done on sugar’s effects on mental health.

In a past post, Good, Good, Good Nutrition, part II: Foods to Avoid When Managing Bipolar Disorder, we covered how sugar can cause wild mood swings in bipolar patients. And how obesity can make some bipolar medications ineffective, especially if the weight is gained around the middle. But there are other ways sugar harms mental health.

Let’s dig in.

Addictive Properties

The addictive properties of sugar have been studied in recent years, though the research is still controversial. But anyone who’s craving a chocolate fix can understand how additive sugar is. Sugar and actual drugs both flood the brain with dopamine, a feel-good chemical which changes the brain over time. Among people who binge eat, the sight of a milkshake activated the same reward centers of the brain as cocaine, according to a Yale University study. Speaking of cocaine, rats actually prefer sugar water to the hard drug. And according to a 2007 study, rats who were given fats and sugar to eat demonstrated symptoms of withdrawal when the foods were taken away.

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A spoonful of sugar on a black background. Credit to flickr.com user Gunilla G. Used with permission under a Creative Commons license.

Cognitive Effects

Sugar may also affect your ability to learn and remember things. Six weeks of drinking a fructose solution similar to soda caused the rats taking it to forget their way out of a maze, according to a University of California Los Angeles (UCLA) study. In the same study, rats who ate a high-fructose diet that also included omega-3 fatty acids found their way out of the maze even faster than the controls, who ate a standard diet for rats. The increased-sugar diet without omega 3s caused insulin resistance in the rats, which leads to diabetes and damaged brain cells crucial for memory.

Depression

Countries with high-sugar diets experience a high incidence of depression. Mood disorders may also be affected by the highs and lows of sugar consumption and subsequent crashes. In schizophrenic patients, a study has shown that eating a lot of sugar links to an increased risk of depression.

The researchers behind the study produced a couple of theories to explain the link. Sugar suppresses the activation of a hormone called BDNF, which is found at low levels in people with schizophrenia and clinical depression. Sugar also contributes to chronic inflammation, which impacts the immune system and brain. Studies show that inflammation can cause depression.

Anxiety

Sugar consumption doesn’t cause anxiety, but it does appear to worsen anxiety symptoms. Sugar also causes the inability to cope with stress. Rats who ate sugar and then fasted showed symptoms of anxiety, according to a 2008 study. In a study in the following year, rats who ate sugar (as opposed to honey) were more likely to suffer anxiety. While you cannot cure anxiety through a change in diet, you can help the body cope with stress and minimize symptoms if you avoid sugar.

The Bottom Line

The good news is, people are consuming less sugar now that the risks to eating it are clearer. A decade ago, Americans ate sugar for 18% of their daily calories, but today that’s dropped to 13%. The more we learn about the human body and how our choices in foods affect us, the more we can tailor our diets to maximize the benefits to our health and minimize the risks.

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