My Advice to a Relative Facing a Bipolar Disorder Diagnosis — And What This Diagnosis Really Means

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Trigger Warning: Mentions of intrusive thoughts that tell me to self-harm.

A dear relative came to me via Facebook messenger, telling me they’d been diagnosed with bipolar disorder and asking for my advice. They told me that they were scared of their diagnosis and they hoped I’d be able to understand.

Here is what I said to them, over an hours-long text conversation:

Oh, [name], I totally understand being scared of a diagnosis, especially one for a lifelong condition that can be dangerous under some circumstances. The best thing you can do to reduce your fear is to educate yourself on what this diagnosis really means.

What a bipolar diagnosis really means is different for everyone. But what it means to me is that I have an extra layer of work on top of my normal affairs to manage my moods.

I have to make sure I take my meds on time twice a day, monitor my moods so that I’m sure that the meds are working, monitor my actions to make sure they’re not wildly off base and within the range of societal norms, get enough sleep (this is especially important to avoid manic episodes), monitor my spending, avoid alcohol, and so on and so forth.

It sounds like a lot, and it is, but it’s just part and parcel with living with a mental illness. If I don’t put the work in, I become miserable and a danger to myself and others. Thankfully, the work gets easier as you get used to it.

I also used to think a bipolar diagnosis made me fragile. And to a certain extent, that’s true. There’s certain things I can’t do that other people can, like live without medication and drink and stay up all night.

But fragile is the wrong impression; if you go through life thinking you’re fragile, you’ll damage your confidence and make yourself believe you’re made of glass.

So while fragile is the wrong word, try delicate instead. With bipolar disorder, you have a delicate constitutional makeup. You need to be careful with yourself and treat yourself right. If you don’t, you won’t thrive or even survive well, and that’s no way to live a life.

I highly recommend educating yourself on what you have to do to treat yourself right. That’s the first step, and will help resolve your fears. Once you’re armed with knowledge about what the diagnosis really means to you and what you need to do to manage it, then you’ll be able to tackle it head on.

Do you have meds? Do they work? I would highly recommend finding a therapist that you feel comfortable with who can work with you through your diagnosis. A psychiatrist doesn’t have to be warm and friendly to know their stuff, but a therapist should be someone you feel you can talk to and basically share your struggles, challenges, and triumphs.

If you’re not on meds yet, go back to the psychiatrist and ask for some, especially a mood stabilizer to avoid endangering  yourself or others with manic episodes.

Finding a med cocktail that actually works will take some time and a lot of wading through side effects, so don’t give up! You can find something that works for you, and even if your specific diagnosis is medication resistant, there are other things you can try like electroconvulsive therapy (ECT), but that’s mostly good for depressive episodes.

Still, there are therapies out there and you can treat this disease with a combination of medication, psychotherapy, and self-care. 

But you do have to respect that this is a disease. It’s a brain disease, sure, but it’s a real and valid threat to your happiness and the happiness of those around you.

Give the disorder the respect it deserves and don’t underestimate how quickly things can fall apart. It’s a balancing act, but the more scaffolding you have in place, the less difficult it will be to balance your life.

What I mean by scaffolding is medication, a treatment team, therapy, and good habits like getting enough sleep every night. Once you have these things in place, you will find it easier to keep your mood on an even keel.

As someone who has been managing my bipolar disorder for years, I’ve realized that my brain lies to me. It does not have my best interests at heart.

I have intrusive thoughts that tell me to hurt myself, and I have to acknowledge that I had the thought and let it go. I often say to myself, “well, that was a thought! How interesting!”

And in this way I can look at those sorts of thoughts with a neutral mindset, as if I’m some sort of outside observer just looking at my brain and all its idiosyncrasies. 

I know it’s hard to believe right now, but trust me: you are a human being with inherent value. Do you think your friends deserve pain? Treat yourself as a friend. That’s what you deserve, not this brain that lies to you.

You’ve got a lot of work ahead of you. But I am confident you can manage this illness and I’ll be here for you, too.


Like most people facing a bipolar diagnosis, my relative was scared and stressed. They didn’t know where to turn to start educating themselves about their diagnosis.

But there are resources out there. My blog, The Bipolar Parent, for one, as well as the National Institutes of Mental Health website. WebMD is good for an overview of the disorder, and your doctors are excellent touchstones for you who can provide even more resources.

If you can find someone in your life who has successfully managed their bipolar disorder for years, like I have, even better.

If you’re facing a bipolar disorder diagnosis, there is hope for you to have a successful, well-adjusted life. Make no mistake, it’ll take work, and sometimes there will be situations outside your control, but that work gets easier with time.

My relative asked me to check in on them periodically and offer them advice, which I plan to do. I’ve already set a repeating event in my calendar with a notification on my phone to remind me to do so.

Like I said, I’ll be here for them–and I’m here for you, too.

I wish you well in your journey.

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Top Tips for Surviving the Holidays with Bipolar Disorder

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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.

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

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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.

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The Link Between Bipolar Disorder and Highly Sensitive People (HSPs)

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Are you sensitive to temperature, textures, or noises? Are you easily frightened, especially when people come up behind you? Do you absorb the emotions of everyone else in the room and find it difficult to regulate your own in the face of all the chaos?

Then, like me, you might be a highly sensitive person (HSP).

In her 1997 book, The Highly Sensitive Person, psychologist Elaine Aron coined the term HSP to describe the 15-20% of people whose brains are markedly different from others. Highly sensitive people have something called “the sensory sensitivity processing trait,” which basically means their brains let in more information from their environment and they process things faster and more deeply, even subconsciously.

People with this trait often live their lives being bothered by experiences that others don’t even notice. Things like the pressure of sitting on a chair that’s not too hard for anyone else, shivering in a room said to be temperate for others, or deeply feeling someone else’s anger or distress.

And research has proven that being an HSP is a genetic trait, like eye color or hair. You feel things more deeply because your brain is wired differently.

Who else feels things more deeply because their brains are wired differently? Why, people with bipolar disorder, of course.

The Link Between HSPs and Bipolar Disorder

Not all HSPs have bipolar disorder and not all people with bipolar disorder are HSPs. Being highly sensitive is not a mental illness like bipolar disorder is, and cannot be treated by any current class of medication. Nor does being an HSP cause mental illness.

But if you are a highly sensitive person, overstimulation from your environment can trigger a bipolar mood episode.

Because their brains let in more information, both people with bipolar disorder and HSPs are extremely vulnerable to stress. The brains of both types of people–and especially if you are a HSP with bipolar disorder–have difficulties filtering out stimuli. Researchers call this “leaky sensory gating,” which means that HSPs and people with bipolar disorder can easily become overwhelmed by loud noises, temperature, or other people’s emotions.

This is a huge source of stress, which is a known trigger for depression, mania, and anxiety.

I should know. Being an empathic HSP with bipolar disorder, I frequently suck up the emotions of other people in the room and have difficulty separating my own feelings from everyone else’s.

For example, when my son is upset, I experience the distress with him in not only emotional symptoms, but physical. My chest constricts, my throat closes, and my shoulders and back with pain. And I feel an intense amount of pain and anxiety in my brain. I can’t concentrate on anything else, and I spiral down deep into negative thoughts.

And these symptoms last for hours. Once, my son and I got into a fight. He grew upset with me, and I was upset with him but also upset because he was upset. We talked out the problem, solved it, and ten minutes later, he had forgiven me and came back to show me a meme that he had laughed at.

But I was still upset–not because of my own anger, but because of his–for four hours afterwards. It wasn’t until I’d done some self-care that I was able to calm down and separate myself from his emotions.

Due to thinning gray matter in certain brain regions, people with bipolar disorder have difficulty regulating their emotions and inhibitions. An HSP with bipolar disorder who absorbs emotion and has difficulty separating other people’s feelings from mine own, I have found it very difficult to calm down after conflicts.

According to the International Bipolar Foundation, people with bipolar disorder also have more difficulty recovering from events and situations that cause stress. So as a person with bipolar disorder, is it any surprise that my fight with my son bothered me so much?

Experiencing other people’s emotions in this way has caused untold amounts of anxiety for me, and I have only just identified this as a trigger for my depressive and manic episodes. Realizing there was a link between bipolar disorder and highly sensitive people was a lightbulb moment.

Highly sensitive people tend to be called to helping professions, and I am no different. In August of 2022, I plan to earn a graduate degree in counseling with the aim of becoming a licensed mental health counselor (LMHC). I am hoping that my professors will be able to train me to manage my own emotions separate from other people’s.

And it’s not just others’ emotions that hurt me. As an HSP with bipolar disorder, I also find myself distressed by physical experiences that others have no problem with. For example, I feel freezing cold at temperatures like 65 degrees F (18 degrees C) and sweat at 75 degrees F (28 degrees C). My husband thinks I’m too sensitive–which, surprise! I am!

3 Tips to Help You Handle Being an HSP with Bipolar Disorder

Do you believe you are a HSP with bipolar disorder? Then read on for three tips on how to handle the stress of being one.

1. Take Responsibility

If you are an HSP with bipolar disorder, you may think that your emotions are out of control and the world around you must help you manage them.

Don’t think that. While your friends and family might be willing to accommodate your sensitivities if you communicate effectively with them, the only person who can manage your emotions is you.

You need to take responsibility for your own wellbeing. You make your own happiness. While you may feel more deeply than everyone else, you are also capable of managing those feelings through a regime of self-care and self-love. Think about including talk therapy and/or medication in your regime as well, as those are things you can do to take care of yourself that only you can do.

Owning my own feelings will be difficult, but I believe that with the help of my therapist and my practicing self-care, I will be able to finally separate myself from others and manage my brain. Identifying where the problems are is half the battle, so I’m well on my way!

I hope that this tip empowers you rather than daunts you. I don’t mean to say that your overstimulation is in any way your fault. But you have a quirk of the brain that other people just do not have, and you are capable of managing it.

2. Learn Your Triggers

Learning what bothers you or sends you into a self-destructive spiral will help you avoid or manage those triggers. Whether it’s a TV that’s on too loudly or negative self-talk, figure out what bothers you the most and try to fix the problem or distract yourself from it.

One of my triggers is loud noises. As a result, I constantly wear noise-cancelling headphones streaming music of my choice from my phone. Research shows that music lights up the reward centers of the brains of HSPs in extreme ways, so as long as I have my soothing music on, I can ride the high.

3. Communicate Your Needs

Speaking up about your needs is one of the best ways to cope with stress as an HSP. If you ask your friends and family to stop doing that one thing that irritates you, and they do, that’s one less thing to stress out your already-overwhelmed brain.

I plan to ask my son not to wear headphones when he’s watching YouTube videos. The distraction is so great that I can’t focus on anything else. I hope that he will be willing to accommodate me, and I believe that the request is reasonable enough that he will.

Conclusion

If you are an HSP with bipolar disorder, you must take care of yourself. I am only just learning how to deal with the stress of being one of the 20% of people in the world who are highly sensitive.

Start by taking responsibility for your own care. Be proactive about managing your triggers. And communicate your needs effectively.

The more you recognize what stresses you out and why and take steps to solve those problems, the healthier you will be.

I wish you well.

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6 Easy, Frugal Self-Care Strategies for Busy Parents

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When tiny people suck up all of your available time, energy, and mental headspace or when your teenager butts heads with you and you’re just exhausted afterwards, then that is the time for self-care.

Every parent should know the importance of self-care, defined as, “the practice of taking action to improve one’s health.” Without filling your own tanks, there’s no way you can be a present parent and fill the tanks of your children. If you allow your kids to drain your batteries day after day, you’ll end up collapsing. You’ll be burnt out, unable to meet even the most basic needs of your children—or yourself.

I know that you might not think that you have time for self-care. But you need to make time, if not for yourself, then for the sake of your children. I know that when I don’t prioritize taking care of myself, I end up snapping at my kids and damaging their emotional health. I don’t want to be that parent, so I put my own oxygen on mask first, to use the metaphor.

Here are a few self-care ideas specifically tailored to parents with busy lives.

1. Go on a Nature Walk

Spending time in nature has been proven to reduce anxiety and improve your well-being. Take a walk around a forest, go to a park and step barefoot on the grass, or visit the coast, if you can. The best part is that you can bring your kids with you. They’ll benefit from a walk around greenery as much as you, which will mean they’ll be a lot calmer in the afternoons if you go in the morning. I know an outing requires a bit of advanced planning, but you can handle this.

I like taking to my 4-year-old daughter to the park as often as I can, both so she can run around with other kids and I can soak up some sunshine. We go in the mornings and return home before lunch. Spending time in nature is easier when your kids are in the sweet spot between infant (when going out is difficult) and pre-teen (when they’re not interested). But even if your kids aren’t 4-6, when they like parks the best, try to go out anyways. Your kids deserve a happier parent and walking around in nature is one of the best ways to buoy your mood.

2. Play Your Favorite Song

One way to improve your mental state almost immediately is to play your favorite song. If you have a bumpin’ playlist, even better. Crank up the speakers and have a dance party with your kids. They’ll enjoy wiggling around with you and you’ll all get some exercise in, which means naptime may be easier.

My husband gifted me a pair of Bluetooth headphones, on which I listen to music all day long. I keep one ear uncovered so I can play pretend games with my preschooler and discuss more advanced topics with my preteen son. I listen to Pandora radio, a streaming service, on my phone, and I have stations I’ve curated to match my mood and activities—fast, electronica music for cleaning, classic rock for everyday listening, and soft acoustic guitar when I’m anxious and need to calm down.

3. Engage Your Sense of Smell

Your sense of smell is tied to mood; if you smell rotten eggs or cat urine, that can ruin your day, whereas smelling sandalwood, the favored scent of your beloved aunt, can help improve your outlook. To engage your sense of smell, light a scented candle (after the kids have gone to bed), rub some perfume on your wrists, or open a bottle of vanilla extract and take a whiff. Smelling something good can help you recenter yourself during or after a busy day of child-rearing.

I love smells. My sniffer is super, so I love inhaling good scents as much as I can. When my son bakes bread, I love spending time in the kitchen with him just to get a blast of the aroma of yeasty goodness. I absolutely crack open a vanilla bottle on occasion.

4. Grab Some ZZZs

If you can, try to get some extra sleep. Studies have shown that the benefits of sleep are legion. Every parent understands the importance of sleep, especially parents of newborns and small children. Researchers recommend sleeping at least seven hours a night so your body and brain have time to reset themselves.

If your kids still take naps, nap with them. And even though it’s tempting to burn the midnight oil to get some alone time, try to snuggle under the covers before 11pm, as according to studies sleep before 12am is the most restorative. If you have a trusted family friend, ask them to watch your children for you for a couple of hours so you can grab some ZZZs.

I was actually falling asleep at the breakfast table today, and my husband happened to be home to take care of the kids. He told me to go take a nap, which I did, and I felt loads better afterwards.

As a woman with bipolar disorder, sleep hygiene is key to my mental health. Without sleep, I trip into mania, after which there’s always a crash, and that’s no good for anyone, especially me. I guard my sleep with the fierceness of Cerberus. If I’m too busy to sleep before 12am one night, I absolutely try to crash at 9-10pm the next few days. And when my daughter did nap, I slept with her.

Good sleep is essential.

5. Practice Good Hygiene

Most parents understand the appeal of a hot shower. (Those who don’t, you don’t know what you’re missing!) There’s just something relaxing about standing under the spray and letting your cares wash down the drain along with any grime you’ve gathered during a hard day of childcare. But what if you don’t have time to take a shower? What if your “shift” isn’t over for a few hours?

Well, the answer, my friend, is sponge baths. Rinse a washcloth in the sink and wipe down your face and arms. Scrub your kiddos’ face while you’re at it, and you’ll both feel better. If you find yourself with an abundance of time, brush your teeth. A clean mouth will help you feel like you can take on the world.

In the heat of the summer, nothing feels better than a bit of cool water on my face. I love dragging a cold, wet rag over my cheeks and forearms and even applying some extra deodorant, all of which takes less than five minutes. Even in fall and winter, when temperatures plummet, a warm, damp washcloth can heat up my face and make me feel great.

6. Eat a Snack

Snacking benefits more than just your kids; eating a small amount of food between lunch and dinner can sustain your energy levels. A snack can keep you from the 3 o’clock grogginess that’s so common in afternoons of child wrangling. A snack can provide more nutrients in your diet. And a snack can even help prevent binge eating. If you don’t have allergies, try eating some nuts, a piece of fruit, a piece of cheese, some sugar snap peas, or even a 1oz piece of dark chocolate.

Earlier today, I was feeling lower than low. I was tired and snappish and mindlessly scrolling through my phone while my daughter ate her daily snack after lunch, yogurt with graham crackers. She chattered with me, perky as ever, and I realized that my energy had dipped because I’d had a light lunch and I needed a snack, too. So I pulled a yogurt of my own out from the fridge and ate with her. That bit of food was enough to perk me up and help me take on the rest of the day.

Conclusion

When you find your energy flagging, your brain slowing down, and your patience thinning, it’s time for some self-care. Self-care is not an indulgence; it’s a necessity. Without self-care, you’ll end up drained and likely not the parent you want to be.

Going on a nature walk, playing your favorite song, engaging your sense of smell, grabbing some ZZZs, practicing good hygiene, and/or eating a snack can help you feel better.

So try some of these strategies today! You don’t have anything to lose!

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

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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:

12 Frugal, Easy Self-care Ideas to Treat Depression from The Bipolar Parent

Photo by Tina Dawson on Unsplash

A lot of people think self-care is limited to bubble baths and nail-painting. But that’s just not the case.

Self-care is taking responsibility for your physical and mental wellbeing. That’s it. Through treating myself to some self-care on a daily basis (as well as engaging in therapy and taking my medication), I’ve been able to manage my bipolar disorder for the past several years. I am a stable–and happy!–woman with mental illness, so I am more than willing to share my favorite self-care strategies with you.

Here are 12 frugal, easy self-care ideas to help you treat your depression. Feel free to try as few or as many ideas on the list as you’re comfortable with.

Take a break from social media.

Social media is all-consuming. Perusing the curated feeds of your friends and family can make you think their lives are perfect and yours lacks something in comparison. Take a thirty-minute to an hour break from social media today.

Not everyone can be like me, who checks my Facebook account only once in a blue moon. I am, however, addicted to chatting on Discord, a chat service, so I do force myself to take breaks from the servers I’m a moderator of once in a while so I can refresh myself rather than being drained by constant pings. It’s a very similar strategy to putting my phone on DND, but it’s specifically tailored to Discord.

Go to your library’s website and put some books on hold.

Shopping for books gives a lot of people a thrill but can be expensive. Try perusing your local library’s website and place a few books on hold to pick up later.

I don’t read nearly as often as I’d like, but when I do read, I usually read fanfiction. The fanfic experience can be tailored to you; on archiveofourown.org, you can filter what fanfiction you’re looking for through tags.

You can do a similar search for books from your library’s website, looking up keywords and authors you’re interested in. If you

Write a short story.

Google the phrase “writing prompts” and see what you can come up with from the third prompt from the first result.

One of the best self-care strategies I ever practiced was allowing myself to write fanfiction. By disregarding the stigma and treating the activity as valuable, I was able to break through a 10-year writing dry spell where I wrote nothing at all. In a year’s time, I wrote over 500,000 words and improved my writing by leaps and bounds.

Creative writing is my special way to relax. Writing fiction, specifically fanfiction allows me to express my emotions through the characters’ actions and unpack facets of my own life, like how I starved when I was a child. I highly, highly recommend writing a story of your own.

Read one chapter of a book.

Reading is one of the best frugal activities out there. It engages your brain and promotes peace. Try reading one chapter of one of your favorite books.

Like I said earlier, I haven’t read a book in a while, but when I want to disengage after a long day and engage my brain in a different way, I read a fanfic from one of my favorite fandoms. I have specific authors that I follow, and I am good friends with some of them.

Reading is one way for you to “turn off” your working brain and “turn on” your relaxed brain.

Do something imperfectly.

The perfect is the enemy of the good, and perfectionism is a killer. Give yourself permission to do something imperfectly, like coloring outside the lines on a coloring sheet.

When I started writing fanfic, I allowed myself not to obsess over whether I was using commas correctly. This small change opened the floodgates of my writing, and I wrote over 500,000 words in a year. Earlier, when I was driven to create a “perfect” piece, that killed my enthusiasm for writing entirely.

Allow yourself to try something doing something new or old imperfectly. Let go of the bad habit of perfectionism in a small, unique way.

Buy a pet plant.

Gardening is a fun activity with numerous health benefits. Caring for something small other than yourself can give you a sense of pride and accomplishment.

Studies have shown that nurturing a plant promotes good feelings. Philodendrons are beautiful, green plants with heart-shaped leaves that are easy to keep alive. Head to the nursery section of your local grocery story and purchase a philodendron or other easy pet plant.

My front yard is full of plants that my mother put in the ground for me. I love seeing the delicate, blue flowers of my vinca plants blooming. Watching my large-leafed, heart-shaped hostas grow bigger and bigger is a treat. And when the corkscrew willow tree’s leaves unfurl for spring, it’s one of the best markers of the year.

Drink a cup of tea or coffee.

Especially on cold days, a cup of tea or coffee can be just what the doctor ordered. The caffeine kick can help you get through your day but even if you drink decaffeinated beverages, the warmth from the drinks can help soothe you.

When I read this in my post, I immediately stood up to go make tea for myself and my family. My favorite tea is Harvey & Son’s Hot Cinnamon Spice, a bracing black tea with a rich flavor of orange and cloves. Drinking a cup of tea is one of my favorite ways to warm up.

Practice gratitude.

If you concentrate on what you have and how grateful you are to have it, then you are less likely to ruminate on negative things. Practice gratitude by writing down five things you’re thankful for.

When I find myself getting spinning in circles because of how busy I am, I like to stop and count my blessings. I say a prayer to God thanking him for the big things–my health, my food, and my shelter–and then try to come up with something specific. This helps me focus on what I have rather than what I don’t have, preventing FOMO: the Fear of Missing Out.

Cross something off your to-do list.

If you have the energy, tackle something that you’ve been meaning to get done for a while. But before you do so, visualize how good it will feel to have the item done. Picture yourself having done the task, and how much more free you feel.

I love crossing items off my to-do list. One of the best ways for me to soothe myself is to pull up my sleeves and get something done, like writing this post.

Depression, unfortunately, makes getting even the smallest task done difficult. But do try. Even getting a small item done will give you a sense of accomplishment and that may be enough to get through the rest of your day.

Declutter the nearest surface to you.

If you’re stuck in bed, then spend five to ten minutes clearing off and dusting your nightstand. You don’t have to spend an hour or two decluttering to make progress. Decluttering the nearest surface to you will give you a clear space to look at and a feeling of satisfaction.

When I’m depressed, I tend to let the environment around me fall into squalor. Things surround me: pizza boxes, dirty diapers, moldy dishes–you name it. It’s not good. So when I’m deep in the depths, I try to tackle the mess one step at a time.

I usually start with the dishes, clearing off the counters, and then take a break. That sense of accomplishment enables me to move on to the next step: picking up the floor, and so on and so on.

Do a full-body check-in.

Starting with your toes and progressing upward to your shins, thighs, hips, stomach, etc., ask yourself how each of your body parts feel. Are you cramping or sore anywhere? Are you thirsty? Hungry? Address those issues. Get a drink if you’re thirsty. Eat something if you’re hungry. And stretch.

A full-body check in works in tandem for me with a meditation exercise: imagine the sun creeping up your body from your toes, spilling over your legs, warming up your hips, filling your belly, and suffusing your chest.

If I do this exercise after a full-body check-in and then address all the needs I’ve found in my body, that’s one of the best ways for me to perform physical self-care.

Take 3 deep breaths.

Breathing deeply is one of the best ways to center yourself. Try the box breathing method: Take seven seconds to breathe in through your nose, hold for six seconds, and breathe out for eight seconds through your mouth. This will help you feel calmer and detoxify your body.

I often have trouble remembering to breathe when I need to, instead getting more and more hyped up until I’m hyperventilating. When I do remember to take a breath (or when a dear friend reminds me to), I can calm myself down and take a moment to re-center myself.

Conclusion

So those are The Bipolar Parent’s easy, frugal, must-try self-care ideas for depression!

Self-care is not an indulgence. It’s caring for yourself in a way that puts your health front and center. And if you engage in self-care on a weekly or even daily basis, you’ll start to build up a reservoir of good feelings.

Feel free to try as many of these strategies as you feel like trying. There’s no pressure here.

I wish you well in your journey.

Related Posts:

National Recovery Month – A Guide to Depression Recovery Through Self-Care, part 1

Photo by Chandler Cruttenden on Unsplash

As a woman with bipolar disorder, I’m no stranger to depression. I’ve sunk to some pretty low points just because I have abnormal brain chemistry. Fortunately, due to a combination of medication, talk therapy, and coping strategies, I’ve been stable—and happy!—for the past seven years. So I am willing and able to give you some tips and tricks that may help you recover from the dark pit of depression.

Self-care, defined as actions you take to improve your physical and/or mental outlook, is crucial for recovery from depression. Medication can only help if you take it (which is part of self-care!), and talk therapy is useful, too, but without your meeting your physical and emotional needs on a basic level, there’s only so much the treatments can do.

Self-care is more than just bubble baths and painting your nails. Let me outline some self-care practices below that you can do today to help you recover from depression.

Physical Self-care

First, there’s the physical side of self-care. Taking care of your body can help you feel loads better and enable you to take on the day—or at least knock some small tasks off your to-do list, like getting the mail.

Physical self-care is an easy and basic way to meet the lowest tier of Maslov’s hierarchy of needs: the physiological section. Without meeting those needs (food, water, warmth, rest), you cannot move on to meeting the next levels of needs on the pyramid.

There are any number of things you can do to take care of your physical body. Hygiene is a big one. I love applying deodorant and brushing my (short) hair when I’m feeling rotten, which takes about 45 seconds.

I’ll outline some hygiene steps below, but please remember that you don’t have to do all or any of these things at first. One step at a time.

Shower

The best thing you can do for yourself if you’re at home and safe is take a shower. I know you don’t want to take a shower. I know you don’t want to get out of bed. But if you just can’t bring yourself to endure a full-on shower, at least wash your face.

Maybe from there, you’ll feel good enough that you’ll want to brush your hair. Stop there; if you’re truly in the pits of depression, then you don’t want to overload yourself.

I try to take a shower every night so I feel good when I go to sleep and am ready to wake up refreshed the next morning. It’s easy when I’m stable but a mountain to climb when I’m depressed.

But that mountain is worth climbing. I always feel a little better after a shower, and I’d be surprised if you didn’t, too.

Lotion

On occasion my legs are itchy because of dry skin, so one of my self-care rituals is to quickly apply lotion to my legs and arms from a pump bottle. My four-year-old daughter enjoys having me apply lotion to her little arms and legs as well! There’s a lot of laughter involved because the lotion tickles her.

You can try to apply lotion, too. A bottle with a pump spigot makes squirting the right amount in your hands easy, so I’d recommend buying one of those. If you take a shower at night, set the lotion on a flat surface near your bed so finding it when you need to apply it before bed is easy.

Brushing Your Teeth

Brushing your teeth takes two minutes. And you can do anything for two minutes. I have full faith in your ability to handle this task. If you want, brush your teeth and go back to bed until you feel you can manage another aspect of self-care.

Physical self-care doesn’t have to take a lot of time, and it doesn’t have to cost too much, either. It means taking care of your body, which is linked to your mind and helps you re-center yourself.

Conclusion

Physical self-care is not an indulgence. It’s a necessity; without taking steps to take care of yourself, you’ll get to the point where someone else has to take care of you.

I’ve been there. My mom drove two hours to my university apartment and washed my hair once because I could no longer function. But after that, I soon started performing self-care and taking my own showers.

I recovered from that depression through a combination of talk therapy, medication, and self-care. Without the building blocks of self-care, I never would have found myself a therapist, which was the beginning of my recovery journey.

You are worth self-care. You are a valuable person who has worth beyond what you produce. And you deserve someone who loves you, even and especially if that person is yourself.

I wish you well.

Stay tuned for part 2 of this post: Emotional Self-care.

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What My Experience Being Suicidal Taught Me — and What It Can Teach You, Too

Photo by Dev Asangbam on Unsplash

Note from the Editor: Please welcome the Bipolar Parent back from my hiatus! I will be posting weekly personal, informative pieces on how to manage your bipolar disorder on Friday mornings. I hope that these posts will help you deal with depressive or manic episodes, and that you’ll be able to stabilize soon. 

I wish you well!

***

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.

What My Experience Being Suicidal Taught Me — and What It Can Teach You, Too

During my pregnancy with my son, I was so miserable, I not only almost ended my life, but his, too.

I was lonely and isolated, having moved 1500 miles away from my family and friends. I endured morning sickness for nine months straight and vomited so much, I lost 30 pounds rather than gaining any weight, putting me on a forced bed rest for six months.

And I was suffering from an undiagnosed bipolar depressive episode. At that time, I couldn’t handle just drifting from day to day in an interminable fog. I wasn’t able to make basic decisions, like what to eat or whether to shower. And it wasn’t like I wanted to die, I just couldn’t live anymore.

After I made an attempt on my life, trying to drown myself in the bath immediately after my son was born, things got better. I committed myself to a mental hospital where I was stabilized on medication and asked to create a Suicide Prevention Safety Plan.

If you’ve faced suicidal thoughts and have no desire to return to that place or even if you suffer from depression and think you might be suicidal, one powerful preventative action you can take is to create one of these plans.

The plan is a written set of steps to follow if you start to think of harming yourself. The benefit to making a suicide prevention plan is simple: following pre-determined steps is much, much easier than trying to figure out your next moves when you’re actively suicidal.

September 5th-11th is National Suicide Prevention Week, an annual campaign in the United States to raise awareness about suicide prevention techniques and the triggers of suicide. The week also tries to reduce the stigma surrounding suicide and normalize steps to prevent suicide and improve mental health. What better time to make a Suicide Prevention Safety Plan?

Are you ready to develop your plan? Find a template of the Brown Stanley Safety Plan, a plan recommended by the Suicide Prevention Lifeline website, here.

Have you printed your plan? Great. Here’s some information to include.

Warning Signs

Familiarize yourself with the warning signs of suicide, both in general and specifically how they manifest to you. The first step in making a plan is to write down your warning signs. During what sorts of moods and situations do you find yourself thinking about self-harm? List three to five experiences that lead you down dark paths.

Being a woman with bipolar disorder, I have a few warning signs for when I’m sliding into a depressive episodes and may end up facing suicidal thoughts that I added to my plan. The first and most obvious one is a total lack of self-care. I usually drink up to 144 ounces of water a day, shower daily, and eat three meals. When I stop doing any of those, it’s time for me to take a look at whether I’m sliding into a depression.

Other warning signs are more subtle. I may feel tired all the time and can’t get out of bed, or I may feel weepy and more emotional than usual. One notable sign that’s very specific to me is that I’m no longer creative. Writing flows through my blood; I adore informing my readers or tugging on their heartstrings or both, and when writing becomes a chore and I start dreading it, that sends off klaxons in my brain that let me know I need to take action to get on a more even keel.

Think hard about specific triggers that you may have for depression or suicidal thoughts. List them here.

Self-Care Techniques

Next, write down three to five self-care techniques. What can you do for yourself that will help you re-center? List out physical activities that calm you down, like taking a nap, getting a snack, or even something as simple as brushing your teeth. For a long list of self-care techniques, click here.

My personal plan from the hospital didn’t have this section, but because I love self-care, I think it’s a great one. One of the quickest and easiest ways for me to feel better about myself is to take a brief, hot shower. If I can’t do that because I’m too busy with my four-year-old, then I wash my face and arms, brush my hair, and apply deodorant, all of which takes less than five minutes.

Another self-care tactic I use is to eat a healthy snack, like a yogurt or a piece of cheese or, if I have time, some sautéed zucchini squash. Yet another self-care tactic I like is to go outside and breathe in some fresh air, which helps me re-center and realize that life isn’t all about my problems.

Think about what helps you the most in the moment. List your specific self-care techniques here.

Distractions

Step three is to write down three to five names and numbers of people who are good distractions for you. Who can you rely on to cheer you up with something other than focusing on yourself? If you have no one, write down social situations or place where you feel calm instead, such as in a library.

I wrote down my sister’s number. When my brain is screaming at me that I’m worthless, she can always acknowledge my pain and cheer me up by reminding me that I am valuable as a person to her specifically.

I also tap my online friends. I can message them with something like, “My brain is being mean to me and here’s why,” and they can respond whenever they’re available with virtual hugs and advice on the challenges I may be facing.

Think hard about trusted people in your life that you can rely on. If you do not have any, think about places with people that you can go to instead, like a park.

People You Can Ask for Help

After you write down distractions, write down three to five names and numbers of people you can ask for help. I know it’s hard to think of people who are genuinely interested in your problems and can help you. You may feel as if you have no friends. But think hard. There are likely people out there who want to help you.

This is where I wrote down my husband’s number, as he’s the person closest to me. It’s saved in my phone and I have it memorized, but he is the one who needs to know that I’m thinking of these things so he can tailor his approach, and possibly call in the big guns for me, such as:

Professionals or Agencies

Step five is to list out the names and numbers of doctors and addresses of crisis centers that you can go to in times of trouble. If you have a therapist, list him or her here. (If you need help finding a therapist, click here.) If you have a psychiatrist, this is where he or she needs to be. (For help getting a psychiatric evaluation, click here.) Write down the crisis center numbers and addresses as well. Then write down a suicide hotline for your country.

At the time of my hospitalization, I did not have a psychiatrist, but I did have a therapist. I wrote her number down, and then I wrote down the information for the psychiatrist that the hospital referred me to.

I filled this plan out at a discharge appointment with a doctor, so they were there to help me figure out what numbers to write down. But the crisis centers in your area are only a simple Google search away.

Making the Environment Safe

If you’ve followed all the steps in your plan up to this point, having called the professionals to help you with your suicidal thoughts, you need to make your environment safe until they can help you. What this means is that when making your plan, you need to joy down the two most effective ways to ensure your safety.

Be it withdrawing from other people or putting yourself among them, make sure these instructions resonate with you. You need to be able to take these steps, and if you’re on step six already and you’ve already called your doctors or an emergency number, then keep yourself from acting rashly. Take away anything that will help you enact your suicide plan to the best of your ability. Call a friend to help (step four) and ask them to remove temptations from your home, like knives or pills.

For my plan, I wrote down that I needed to secure child care for my infant son. I didn’t want to do anything to hurt him or even leave him behind in a place where he could get hurt, so making my environment safe was all about making the environment safe for him, too.

Reason

Finally, write down the most important positive aspect of your life. What is the one thing worth living for? What is your reason not to give up? What’s the driving force of your life that you would hate to leave behind? Hopefully the reason comes to you quickly, but if not, take some time to think hard and figure something out.

At the time of my hospitalization, my clear reason for living was to take care of my newborn. I printed a picture of him from the hospital’s computer, writing on the bottom, “The Reason I Am Here!” in bold, black and red markers.

Focusing on the care of my son helped me survive through suicidal thoughts.

Find your reason.

Conclusion

My experience with suicidal thoughts gave me the tools to use if I ever found myself in a situation again, such as if my medication ever stopped working or external or internal factors sent me back into a deep depression. The Suicide Prevention Safety Plan is one of those tools.

Now I am a happy, stable woman who happens to have a mental illness, one which I treat with a combination of medication, talk therapy, and self-care. While I’ve had hypomanic and depressive episodes in the interim years since my son’s birth, they’ve been nothing like my deep, debilitating depression during my pregnancy.

I’ve been fortunate enough to have learned how to manage my mental illness, but I still follow my plan when I need it.

I would highly recommend filling out a Suicide Prevention Safety Plan to use as one of the tools to help yourself. It will not only benefit you, but it’ll also benefit your loved ones as well. No one wants you to hurt yourself. And filling out a plan when you’re not in a time of crisis will help you know what to do when a problem hits.

Fill out the plan and place it in a spot where you and your loved ones can find it in times of trouble. You may not be able to prevent thoughts of self-harm but you can take steps to prevent yourself from leaving your life behind.

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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.

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