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.