Bipolar Weekly

Month: May 2021

Bipolar Disorder and Stress

May 31, 2021 /
Photo by cottonbro from Pexels

Stress management plays an integral role in maintaining a stable life when you have bipolar disorder. High levels of stress can trigger acute depressive and manic episodes. The frequency and severity of these episodes can be reduced by a lifestyle that is conducive to a lower stress level.  Having a life that is suitable for your tolerance of stress, healthy relationships, a support system, counselling, and other wellness practices can help manage the symptoms of bipolar disorder.

Finding an activity level that is congruent with someone who has bipolar disorder’s tolerance for stress comes from experience. It is only after having multiple episodes can it be determined how sensitive an individual’s bipolar disorder is to stress. Once a pattern emerges, decisions can be made on matters like the capacity to maintain employment or attend school. These decisions can be hard on one’s self esteem, but they may be necessary for long term stability.

When you have bipolar disorder, navigating personal relationships in a positive way can reduce the chances of stress induced acute symptoms. There is no black and white approach that can be used to do this. Using relationship skills is more of an art that takes into consideration the consequences of changing behaviour, one’s sense of duty, power dynamics and the nature of the relationship. Learning about healthy boundaries and other social skills an be helpful. The Canadian Mental Health Association offers free courses online on these topics in their Calgary Recovery College.

You cannot maintain stability without a support network. Psychologist Kelly McGonigal makes the argument that stress is good for us as long as we seek the support of others in her TED talk How to Make Stress Your Friend. While this view may be extreme for people who have bipolar disorder, it illustrates the value of having support. The support of family and friends is essential for people who have bipolar disorder and peer support groups like those offered by OBAD or the DBSA can be life changing.

Counseling can play a significant role in reducing stress. People who have experienced trauma from life experiences or their episodes can benefit from therapy that addresses these issues. Counselling can also help with negative thought patterns, emotional dysregulation, and relationships.  

Mindfulness, a life practice that grounds you in the present moment, and exercise are often recommended as ways to decrease stress. While it is true that incorporating these two things into your life will reduce your stress it may be a challenge to maintain a routine that includes these activities given the constant change in our symptoms. For this reason, I feel it is important to decrease stress in multiple areas of life.

Maintaining a positive life when you have bipolar disorder requires a lot of work. One must be mindful of their symptoms, be an active participant in finding the right medication, and create a life with a manageable level of stress. It takes a long time to build all of this into your life but usually the suffering decreases along the way and the frequency of consistent moments of joy increase.

This will be my last written blog until September 6, 2021. For the next three months, I will be sharing a link to my podcast, “The Bipolar Disorder Moment” where I will be reading excerpts from my book , Brain Betrayal: The Allan They Never Met, every week. My book has not been published yet but hopefully a publisher will pick it up in the near future.

Please subscribe to my site if you would like to receive a link to my blog emailed to you every week.

Bipolar Disorder and Shame

May 24, 2021 /
Photo by @felipepelaquim on Unsplash

One of the most awful aspects of having bipolar disorder is dealing with the shame that comes after having manic and depressive episodes. Our symptoms are caused by a chemical imbalance that makes us behave in ways that can be confusing, hurtful, and problematic to those around us. Because our illness causes a change in behaviour it is difficult for people to separate our symptoms from who we are as people. As a result, individuals in our life may change the way they treat us after an episode. This along with memories of the episode can all contribute to a heavy sense of shame.

After manic episodes, people who are impact by the episode may react to the person who had it with anger, resentment, and fear. It is not my place to say which of these feelings are valid or not valid, but I believe the fear is often a result of the media and entertainment industry’s love of portraying people who have mental illnesses as violent. We are no more likely to be violent than the general population. Feelings of anger and resentment are valid but a challenge to process because we would never choose to behave the way that we do when we are acutely ill. Being the brunt of this type of negativity is hard on our self esteem and it diminishes our ability to have a positive sense of self.  

The shame that comes from depressive episodes can be different. These episodes may result in friends breaking off contact from you because you are no longer pleasant to be around. You may lose a job because you are not able to perform your duties or a relationship with a spouse may end as they feel you are no longer capable of being a positive influence in their life. These episodes are not our fault, but the consequences on our lives are considerable and can be hard on our sense of self worth.

It is not just the reaction of people around us that is difficult, but the memories of our behaviour can bother us as well. I remember saying awful things to loved ones during the height of my irritability and the confused faces of people who did not understand my psychosis. These memories used to weigh heavily on me, and they made me wonder if I deserved to pursue a better life.

One of the ways I recovered from the overwhelming shame was by attending a peer support group at OBAD. It was nice to meet people who had bipolar disorder that managed to have a positive life and almost everyone could relate to my experience of dealing with shame. Attending the group and trying to focus on living in the moment rather than ruminating on the past has helped.

I have heard stories of family members repetitively reminding people who have bipolar disorder of their behaviour during acute episodes because they are angry or hurt by what happened. While it is understandable that one would want to seek comfort after being hurt by these events, constantly reminding someone of their behaviour when they were acutely ill is hurtful. It may be more helpful to seek out support from agencies like the Organization for Bipolar Affective Disorder, the Canadian Mental Health Association and the DBSA who have groups and resources for family members of people who have bipolar disorder.

Feelings of shame after acute episodes can be so debilitating that it may hinder the possibility of returning to a functional life. Even if I deserve to be punished for the pain my illness has caused people connected to my life, surely a life sentence of crippling shame would be an excessive punishment. To minimize the negative impact my illness has on those around me, all I can do is make lifestyle choices that are conducive to making my symptoms manageable. I cannot do this if I am stuck in shame.

The Value of Learning About Your Bipolar Disorder

May 17, 2021 /
Photo by Tim Samuel from Pexels

 Everyone who has bipolar disorder has their own unique version of the illness. We all understand what it is like to be stuck in the physical anguish of a depressive episode and the euphoria of hypomania but the severity of our symptoms, how they manifest and how we respond to medication is different. It is important to learn as much as possible about your bipolar disorder to have a positive life.

For example, after my last manic episode, a psychiatrist told me that taking too much pleasure in creative thinking, solutions to problems or philosophical ideas can trigger a manic episode for me. He called this, “Intellectualizing.” When I reflect on all three of my manic episodes, I realize they were all triggered by intellectualizing. This means, I am careful about what I talk about and think about. I do not push my brain to the edges of philosophical questions, and I am mindful of how excited I get about my own thoughts.

I have learned from my experience of having depressive episodes as well. When I am in my car and I notice that I keep changing the radio station I start to wonder if my mood is dipping. An inability to enjoy things is a symptom of depressive episodes and this can be the first sign that this is occurring for me. Then, I think about whether or not I am having other symptoms like poor appetite, fatigue, and lack of concentration. If I am, I add more physical activity to my routine. This does not make me feel better, but it prevents things from getting worse. I force myself to eat to prevent my appetite from dropping even further and I meet people to reduce the possibility of self isolating.

Medication plays a crucial role in managing bipolar disorder. Without it I could become acutely ill on a regular basis which could potentially be fatal. There is no imaging device or blood test that a psychiatrist can use to assess the symptoms of someone who has bipolar disorder. They rely on their observations and our report on what is happening in our life. To make this process more effective you can use mood charts that rate your mood daily to learn about patterns that may exist. Also, Crest.bd has a Quality of Life Tool that asks you a series of questions and produces a report that can help you understand how you are doing in the context of your illness.  Providing this information to your psychiatrist can improve your treatment.

When you have bipolar disorder, creating a routine that includes consistent opportunities for joy and fulfillment requires learning as much as possible about your illness. Over time, this knowledge can empower you to lead your best life. While it is not a guarantee that your symptoms will never become acute it gives us the best chance to lead a rewarding life long-term.  

Bipolar Disorder and Anxiety

May 3, 2021 /

Thinking about writing about anxiety and bipolar disorder made me feel overwhelmed. I felt like I would have to spend months compiling my experiences and knowledge and consult with several professionals to do the topic justice. Rather than attempting to do this I have chosen to focus on my own experience for this blog.

In my case, it has been a challenge to figure out the difference between the anxiety I have because of bipolar disorder and my anxiety that was borne from life experiences.

In 2010, I had a manic episode that was followed by a severe depressive episode. I felt lifeless. I did not have the energy to shower, get out of bed and I had to force myself to eat. My anxiety was so high that the thought of opening the door to leave my home made my heart race, my throat tighten, and my muscles would ache with dread like they were trying to prevent me from leaving. Once the episode subsided, my anxiety level dropped substantially and leaving my home was not an issue.

When I am not having a depressive episode, I also experience anxiety but the source of it seems to be my life experiences. I know this because I have had psychotherapy to address the issues from my past and my level of anxiety has dropped tremendously.

 A couple of years ago, I started experiencing a difficult side effect from an antipsychotic I was taking to help manage my bipolar disorder. My psychiatrist’s assessment of my bipolar disorder at the time was that we could try going off the medication. After being off the medication for about a week, I went to a grocery store and my heart began to race, the muscles in my throat tightened and I felt like I was going to throw up.  My anxiety had returned. After describing this experience to my psychiatrist, she put me on a different antipsychotic and my anxiety went back to a manageable level.

These experiences tell me that my anxiety has a bipolar disorder source and a life experiences source. I am not sure where the boundary is between the two or if they are interconnect. I believe that there is a difference because I know psychotherapy alone would not have helped me recover from the anxiety I experienced during my last severe depressive episode or when I was taken off my antipsychotic. I do not believe that medication could have helped the anxiety I suffer from because of some of the experiences I have had in my life.

There are a wide range of approaches available to deal with issues with anxiety. These include mindfulness, a life practice that grounds you in the present moment and includes meditation, Cognitive Behavioral Therapy, a form of therapy that helps you address negative thought patterns, and there are different types of therapy to address issues from the past. In terms of medication, there is a range of approaches psychiatrists can take based on their assessment of their patients’ needs.

Addressing anxiety issues for people who have bipolar disorder is complex and it takes the expertise of a psychiatrist to be able to tease out the source of the problem and the most effective way to treat it. It is one of the most debilitating aspects of having bipolar disorder for many of us but there is a range of strategies, therapies, and medications available that can facilitate a better life for people who struggle with it.  

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