How to Handle This Thanksgiving with Bipolar Disorder by Setting Healthy Boundaries

Photo by krakenimages on Unsplash

When my father pressured me at the last minute to host a family Thanksgiving two days before I was slated to drive 1500 miles last year, I refused.

At first I agreed. Why not cook a feast for my extended family, at least seven people in addition to my own husband and two children (11 people total)? I would have loved to have my family over and fete them with all the trappings of the Thanksgiving holiday, all of which I would be cooking by myself because my husband was finishing up tasks at work in order to prepare for our road trip.

This made sense to me at the time. I could do laundry and pack for the massive, month-long road trip after the Thanksgiving holiday was done, right?

But I realized that as a woman with bipolar I, that much stress would immediately spin me out into a dangerous manic episode. Because of my very serious psychiatric condition, I wouldn’t have been able to even enjoy the holiday or the road trip because I would be too busy preparing for both. If I had hosted Thanksgiving like my father wanted, I may have even ended up in a mental hospital.

Once I recognized that hosting a holiday was not only overwhelming but unhealthy, I then had to set a boundary, something that has been very difficult for me in the past. Girding up my strength, I texted my father back and told him my immediate family would be skipping the Thanksgiving holiday entirely that year in order to preserve my mental health.

His disappointment rang clear to me through his emoji-filled text, but he thankfully understood my reasoning, and ended up enjoying Thanksgiving with my sister. My immediate family ended up baking a small turkey breast we bought at Costco and making mashed potatoes, a very low-key holiday of our own for just the four of us.

Thanksgiving, an American feast holiday including traditional dishes like turkey and pumpkin pie typically eaten with friends and family, can be tricky when bipolar disorder is an uninvited guest.

The stress of the holiday, especially when taking on tasks like all the cooking for a large group, may tip a person you over into mania or hypomania, after which there is almost always a depressive crash.

I am here to tell you that your holidays do not have to be unhealthy.

You can stick to your guns and set healthy boundaries with your friends and family.

If you are an adult, your family absolutely cannot force you into any uncomfortable position unless you let them. Will there be consequences for asserting yourself? Yes, definitely. But those consequences may not be as awful for your and those surrounding you as damaging yourself with a manic episode.

Why Setting Boundaries is Important

When you first start to set boundaries, you will be uncomfortable, especially if you’ve never set them before. But doing so is incredibly important. If you do not express your preferences and stick to your guns about them, you invite people to ignore your needs and set them up to fail.

Set them up to fail? What? How does that make sense? It’s simple, really.

People aren’t mind readers. But how can they be good to you if you don’t tell them what your preferences are? If you don’t tell people if you’re angry or even annoyed, they can’t respond in a proper way and they’ll continue responding in the way they feel is right based on limited information, possibly angering you or annoying you further.

If you don’t tell people the truth about what you like or what your preferences are, and if you just go along with what they say or don’t say no to them about something that feels violating to you, you are setting them up to fail.

That doesn’t lead to a productive conversation or to someone knowing the real you. This is not your fault, but it doesn’t have to be this way. You can express your needs and get them met.

Here’s how.

How to Set Boundaries This Holiday Season

Telling my father that my family wasn’t going to enjoy Thanksgiving with him was extremely difficult for me, someone who doesn’t set boundaries often, and especially not with him.

But having done my own research on how to set boundaries and having talked with my therapist about techniques, I was prepared.

Here are my steps to setting boundaries:

1. Find a supportive friend or partner to vent your feelings to before and after setting your boundary.

When I set boundaries with my father, I expressed my feelings of being overwhelmed to my husband, who helped me realize I could not take on the task of hosting Thanksgiving that year. My husband gave me the perspective and the courage I needed to stand up to my dad.

If you cannot find a friend or partner in your personal life offline to vent to, you may have more success online. You can also use a therapist for this. (For a post on how to start seeing a therapist, click here.)

2. Use clear, easy-to-understand language.

When expressing your needs, you do not want to be misunderstood or give anyone any leeway or wiggle room to interpret your words differently. Write down what you want to say ahead of time and read from your notes if necessary.

One of the best ways to express your feelings to others is to use “I” statements. When you say, “you made me feel…” that shifts blame onto the other person and puts them on the defensive. Plus, framing the sentence that way doesn’t allow you to take responsibility for your own feelings. Try “I feel,” instead.

Last Thanksgiving, I communicated with my own father via phone text, the medium he chose, so I was fortunate that I could tweak my words before sending him the message until they were the most effective I could come up with.

3. Modulate your tone.

Setting boundaries with an angry tone doesn’t work. People dismiss other angry people, and may end up getting defensive themselves. Try to speak as neutrally as possible. This will be difficult, but having your needs listened to and respected is worth it.

I always try to remain calm when setting boundaries. If I find myself getting worked up, I tell the person that I’m setting the boundary with that I need to walk away momentarily and will be back when I’m calm.

4. Do not over-explain yourself, or explain yourself at all if you so choose.

When you set a boundary, expect to be listened to. If you find that people are unable or unwilling to understand what you’ve said, repeat your clear, easy-to-understand statement until they get it. There is no need to over-explain your reasonings.

When I’ve over-explained in the past, I’ve found that people do not believe that I the boundary I am trying to set is firm. Having solid reasons–which I do not have to explain at all if I so choose, and neither do you–requires me to think about them ahead of time to determine if I’m comfortable with those reasons. In the Thanksgiving example, my mental health and the health of my immediate family had to come first.

5. Set consequences if your boundaries are crossed.

The most effective boundaries have consequences. You can always, always stop speaking to your family. It’s uncomfortable, but you might find that it’s freeing as well. If they’re not going to treat you in the way you deserve, with respect and kindness, then they do not in turn deserve your attention.

When setting boundaries with my father during Thanksgiving, I was fully prepared to stop speaking to him. Thankfully he understood my set boundary and I didn’t have to, but if he hadn’t and I’d stopped speaking to him, then he wouldn’t have seen us for Thanksgiving anyway, and possibly longer, depending on how long I was willing to stick to my guns. It was a win-win for me.

Specific Examples of Boundaries You can Set

Here are some specific examples of boundaries you can set and the language you can use to set them:

  • To set a boundary with an angry family member, say something like, “You will not treat me [in the specific way they’re treating you]. If you continue, I will leave the room (or hang up the phone call).”
  • To set a boundary with someone who criticizes you, say something like, “It is not okay with me that you comment on my [specific example, like eating patterns]. Please stop.”
  • To set a boundary with someone who asks too much of you, say something like, “Although you are important to me, I must say no to your [specific request] to take care of myself and my family.”
  • To back out of a commitment, say something like, “I know I agreed to [specific task], but after looking over my schedule, I recognize that I will not be able to give [the task] my all. I want to help you find a replacement by [specific date].”

Conclusion

Setting boundaries with your family will be difficult, but the personal power you gain will be worth it. Get some perspective from a trusted friend, use clear, easy-to-understand language, modulate your tone, do not over-explain yourself, and set consequences.

When I set my own boundary, I was fortunate that my father respected me enough to understand why I set it. But I was fully prepared to stop speaking to him. I set my boundary and stuck to it, and I had a peaceful holiday with my immediate family that I wouldn’t have traded for anything.

You can handle this Thanksgiving. Remember, you get to decide what your holiday season looks like. You family cannot force you into anything you do not choose to do. Your mental health is paramount, and if you do not protect yourself, no one else will.

I wish you well.

Related Posts:

Getting Support During a Bipolar Depression Episode

Trigger Warning: This post contains a brief mention of suicidal ideation. If you are suffering from suicidal thoughts, please talk with someone from the Suicide Prevention LifeLine at 1-800-273-8255 or www.suicidepreventionlifeline.org.

Anyone who suffers from bipolar disorder also suffers from depression. That’s just the nature of the beast. Sometimes depressive episodes can be debilitating. I’d like to share what my friends and family around me can do to help support me during an episode, and inspire you to make your own list to present to your family and friends. If you can’t bring yourself to make a list, then please feel free to print this article out and hand it to them.

Let’s dig in.

depression
A picture of a white woman holding her head. Credit to flickr.com user Amy Messere. Used with permission under a Creative Commons license.

1. Help Me Keep my Environment Clean

One of the major problems I have when I am suffering from depression is keeping my environment clean. During an episode, my house usually looks like a tornado hit it.

The depression-messy house cycle has been anecdotally supported for a long time. In short, the low energy and overwhelming feelings common to depressive episodes contribute to the inability to keep the house clean, and the resulting mess contributes to depression–specifically to shame. It’s a nasty cycle, one which is difficult to break.

At one point, during a very severe depressive episode years ago, I allowed dirty diapers to pile up on the floor of my living room. My mood–and subsequently my ability to keep the house clean–has improved immensely since the time my son was in diapers, largely due to appropriate medication and therapy.

One way my family and friends can support me–or any of their loved ones suffering from depression–is to encourage me to keep my environment clean. When I’m in the throes of depression, I need external motivation to pick up my space. This is best conveyed through praise and validation for my accomplishments. Please, I tell them, notice if I’ve done the dishes twice in a row, and thank me for doing so.

But if I’m in the midst of a completely soul-sucking depressive episode, I may need more help than just encouragement. When I’m that low, I need to be in a clean environment no matter how it happens. I may need my family and friends to step in and actually do the dishes rather than just thank me for them. There is a time and place for that level of help, and it’s okay to ask for that kind of support. Even hiring someone for me is useful.

I encourage you in turn to tell your family and friends what you need, be it reminders to do however much work you can handle or help tidying your space.

2. Encourage Self-Care

When I’m in the belly of the beast, I sometimes need help taking care of myself, including personal grooming. Brushing my teeth is a struggle. During my senior year of college, I suffered a suicidal depressive episode so bad and so lengthy that I didn’t eat or shower for weeks. My mom drove to my college town two hours away from her home and washed my hair for me. Then she took me to a crisis center, which helped me get back on an even keel. Neglecting myself made my depression worse.

If you are neglecting yourself, I encourage you to reach out to those around you. If you feel you have no one and are suicidal, immediately go to a crisis center. Do not wait.

3. Watch My Kids

This is a tip for the parents among us, but one of the best ways to support a parent in the midst of a depressive episode should be obvious: watch the kids. If I don’t get time to rest and recover from 24-hour parenting duty, I start to tune out my children and am not the present parent I would like to be. This is even worse when dealing with depression. I try not to neglect my children while depressed, but parenting while suffering from a depressive episode is incredibly difficult. Being able to briefly hand them off to my husband or a babysitter to recharge my batteries is crucial for my recovery during depression.

If you have children and are suffering from depression, try to arrange alternative supervision for them so that you won’t have to take on all their care by yourself. The best time to plan this is when you’re well, but if you didn’t, then call on your friends and family as much as possible during your depressive episode. If you don’t have friends and family around, google drop-in daycares in your city, or ask members of your church if they’d be willing to babysit. I know internet research and making calls is the last thing you want to do during an episode, but getting some time to yourself is crucial for healing.

4. Listen While Maintaining Healthy Boundaries

One of the stressors on me when I’m depressed is the fear that I’m overburdening my friends and family with my negative feelings. Thankfully, my sister is very good at taking care of herself by letting me know when she needs a break from my negativity. She is a great listener, and often provides me a space to feel vulnerable without being judged.

If you can find people who can listen to you while taking care of themselves, they can be an invaluable resource to you. There’s a certain give and take between a person suffering depression and his or her supporters, and the ultimate goal is for everyone to be healthy.

Final Thoughts

The best ways to support me while I’m in a depressive episode is to help me take care of my environment and myself, watch my kids for me, and to listen while maintaining healthy boundaries. This is what works for me. I encourage you to figure out what you need from your loved ones and don’t be afraid to ask for those things. Certain people will better be able to support you than others, and in different ways. Identify these people and lean on them for support.

I wish you well.

Related:

 

How to Communicate with Family During the Holidays When You Have a Mental Illness

family photo2
A picture of a mother, father, and their three children peeking out between white frames, as a family photo. Credit to flickr.com user Louish Pixel. Used with permission under a Creative Commons license.

The holidays can be a source of great joy for many people. But the season of celebrations can also be fraught with tension, especially when families get together. But if you have a mental illness like bipolar disorder, then navigating the heated conversations at the dinner table can be triggering and difficult. Read on to find out how to communicate effectively with family during the holidays when you have a mental illness.

1. Know Your Limits

One of the most effective ways to communicate with difficult family members starts with you knowing yourself. Before you find yourself pushed to your limits, advocate for breaks for yourself. Excusing yourself for a brief walk or a breath of fresh air will do wonders for your disposition. There’s no shame in seeking time away to ground yourself. If you suffer from bipolar disorder, check out this post on common bipolar triggers and how to manage them to avoid falling into a depressive or manic episode.

2. Redirect the Conversation with Humor

When you find yourself facing people asking probing questions about anxiety-producing topics like your reproductive plans, try gently redirecting the conversation using humor. Don’t answer the question if you don’t feel like doing so, but do try to give the asker a witty (and possibly self-depricating) comment. This is easier said than done, of course, and if this puts more pressure on you, use the next tip instead.

3. Firmly Establish Conversational Boundaries

Some family members may have the unfortunate tendency to expound on their offensive political opinions to others, especially captive audiences around the dinner table. Don’t take the bait and argue with them. Instead, firmly establish conversational boundaries. Try saying something like, “Aunt Mildred, I understand that you feel that way. But I don’t want to talk about X, Y, or Z tonight. Let’s just enjoy the party, please.” If Aunt Mildred continues, then use tip one and gently extricate yourself from the conversation to take a break.

4. Enlist the Help of a Trusted Family Member

If you have a loving spouse or partner, or even a beloved family member you are close to, enlist his or her help in managing other more divisive people. Check in with your partner and ask them to check in with you every half hour or so during parties or other family gatherings. If needed, develop a signal between the two of you so he or she can rescue you from unpleasant conversations.

5. Lean on Existing Support Systems

If you are traveling and won’t be able to meet with your usual therapist or psychiatrist, then make sure to have crisis hotlines or warmlines programmed into your phone. If you’re bipolar, one national warmline provided by Nami Orange County can be called at 877-910-9276. Online support groups can help as well; try HealthfulChat’s room focused on bipolar disorder.

6. Avoid Alcohol

This isn’t a fun tip, but alcohol can add fuel to the fires of family conflict. Staying sober will reduce the chances of your saying something you regret. If you do choose to imbibe, then know your limits, and drink plenty of water to avoid having a hangover the next day.

7. Eat Properly and Get Plenty of Sleep

This tip is similar to tip 1: take care of yourself. Try to avoid sugar as much as possible, stick to your normal, healthy diet, and go to bed at reasonable hours. If you take care of your body, then you will be better equipped to handle family members who talk your ear off. Also, take your meds.

Final Thoughts

Communicating with your family during the holidays when you have a mental illness isn’t an insurmountable task. Just make sure to take care of yourself–removing yourself from conversations if necessary–avoid alcohol, get support, and establish firm boundaries.

You can do this.

Related:

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

Family Study Emphasizes Distinct Origins for Bipolar Disorder Subtypes

family
Credit to flickr.com user Kat Grigg. Used with permission under a Creative Commons license.

The most common subtypes of bipolar disorder, bipolar I and bipolar II, stem—at least in part—from different biological causes, according to a new study published in Biological Psychiatry. Despite genetic overlap between the two subtypes, each subtype tended to cluster within families, suggesting a distinction between bipolar disorders I and II.

The study, by Dr. Jie Song of the Department of Clinical Neuroscience, Karolinska Institutet, Sweden, and colleagues helps settle controversy over the relationship between bipolar I and bipolar II disorders. Although genetic similarities indicate overlap between the subtypes, the new findings emphasize different origins. According to Song, this is contrary to a common notion among many clinicians that bipolar II disorder is merely a milder form.

“We have tended to view the two forms of bipolar disorder as variants of the same clinical condition. However, this new study highlights important differences in the heritable risk for these two disorders,” said Dr. John Krystal, Editor of Biological Psychiatry.

The study is the first nationwide family study to explore the difference between the two main subtypes of bipolar disorder. Dr. Song and colleagues analyzed the occurrence of the bipolar disorder subtypes in families from the Swedish national registers. Although a strong genetic correlation between bipolar I and bipolar II disorder suggests that they are not completely different, the family occurrence for each subtype was stronger than co-occurrence between the subtypes, indicating that bipolar I and bipolar II disorders tend to “run” in families separately, rather than occurring together.

“Within the context of our emerging appreciation of polygenic risk, where gene variations are implicated in several disorders, the new findings point to only partial overlap in the risk mechanisms for these two forms of bipolar disorder,” said Dr. Krystal.

The study also provided some additional clues that bipolar I and II disorders have distinct origins. Only bipolar disorder II showed gender differences—the proportion of females to males was higher in bipolar disorder II but not bipolar disorder I. And bipolar I clustered together in families with schizophrenia, which was not apparent for bipolar disorder II.

“Hopefully, our findings increase awareness of the need for refined distinctions between subtypes of mood disorder,” said Dr. Song. The distinction between the subtypes also has implications for treatment strategies for patients. Dr. Song added that future research is warranted to characterize new biomarkers to improve treatment and prognosis.

Text provided by Elsevier.