Bipolar Weekly

Author: Allan Cooper (Page 3 of 7)

Allan Moves for Movember

November 1, 2021 /

The rate of suicide among people who have bipolar disorder is approximately 10 -30 times higher than the general population. Researchers estimate that between 25% and 60% of individuals with bipolar disorder will attempt suicide at least once in their lives and between 20% (of mostly untreated) people who have bipolar disorder will die by suicide. The reasons why this occurs can be complex but I will try to explain it from the perspective of someone who has the illness.

Most of these deaths occur during depressive episodes. When you understand the symptoms of depressive episodes it is easier to understand why these deaths occur. The first problematic symptom is that depressive episodes give you suicidal ideation. Our illness impacts our thoughts and behaviour when we are acutely ill. This is a physical response caused by the illness. In my experience, pep talks and trying to have a positive attitude will have little impact in improving these thoughts when our symptoms are severe. In fact, people may conclude that they are to blame for their symptoms because they are not trying hard enough to have a positive attitude which reaffirms any negative thoughts they are having about themselves.

There are other symptoms of depressive episodes that can contribute to suicidal ideation. You have thoughts that you are worthless, no one likes you, and every aspect of life appears dark. Depressive episodes create concentration problems which make conversations impossible. During acute depressive episodes it is very difficult to enjoy anything. This means eating, entertainment, family gatherings, music, Netflix do nothing for you. It feels like you are a shell of a human being, and it is easy to conclude that there is no purpose to staying alive.

Often people who have depressive episodes think their episode will continue for the rest of their lives which is rarely the case. We generally go back to baseline, and we may even head into hypomania or mania. It’s a journey to get the right mix of medication, therapy and a positive routine to create a positive life long term. There are many people who have bipolar disorder who are able to do this, one need only attend a peer support group to meet some of them.

This year, I will be participating in Move for Movember. For this campaign, I will be walking 60 km this month for the 60 men we lose every hour around the world to suicide. There is simply not enough support for men to receive the treatment they need to prevent these deaths so I am going to participate in the walk so that in my small way I can contribute to a solution to this problem. If you would like to make a donation in my name please click here.

If you are suffering from suicidal ideation, please know you are not alone. There are many people who have suffered just like you are. It is possible to have a better life. You may not be able to think of a solution to your problems but that does not mean that a solution does not exist.

Below are a few links to resources for support for people who are struggling with suicidal ideation.

Peer Support

OBAD (Organization for Bipolar Affective Disorder)

DBSA (Depression and Bipolar Support Alliance DBSA)

Distress Centre Lines

Crisis Services Canada 1-833-456-4566

Lifeline (US) 1-800-273-TALK (8255)

Befriends Worldwide (International)

Lifeline (Australia) 13-11-14

The “I Am Ok” Costume

October 25, 2021 /

In my experience, most people who have bipolar disorder put a lot of effort into acting like they are fine despite the fact they are really struggling. This problem is not unique to bipolar disorder, but since it is the illness I have, I will focus on it for this blog.  

Many of the symptoms of bipolar disconnect us from people. At times, the illness prevents us from physically experiencing enjoyment. When this happens conversations are extremely difficult. People generally like to talk about positive experiences they’ve had or are having. When depressive episodes rob you from physically experiencing joy then that changes how you interact with people.

For example, depressive episodes prevent you from finding anything entertaining. You could go to a movie with a friend and when they ask you if you liked it you cannot say, “Normally, I would love it George, but right now I am experiencing a depressive episode which messes with neurotransmitters in my body, and as a result I cannot experience enjoyment right now.” I suppose you could say that, but it would probably be hard to maintain friendships if you did this on a regular basis and it is unlikely that your friend would understand what you mean. It is simpler and better for us if we just put the ” I am Ok” costume on and say we liked the movie.

It’s not just depressive episodes that are problematic. Hypomanic symptoms also require a lot of energy to make one appear “Ok.” During one of these episodes, you might notice that people keep asking you to stop interrupting them because you are talking too much or your brain is screaming at you to buy a bunch of stuff you do not need. You cannot say, “Please ignore me for awhile I’m hypomanic. Can I buy your shoes? I love this song. Do you love this song? Let’s dance on the escalator.” Instead of saying or doing these types of things you have to grit your teeth, put the costume on, smile and try not to say anything.

All of this may not seem like a big deal but it’s exhausting. Bipolar disorder is a chronic illness, so our medication helps a lot, but we still have to deal with our symptoms to varying degrees on a regular basis. When we are not well enough to get the costume over our shoulders the consequences can be harsh. A parent may be at a graduation or wedding and be unable to experience the joy of the moment and can be accused of being uncaring or cold. Someone who is hypomanic can lose a lot of money, relationships, and employment.

For me, the only relief I got from wearing the heavy, “I am ok” costume was attending peer support groups at OBAD. The format is simple. You show up at a meeting and just exist without any judgement or expectation. My first meeting was such a relief. My depressive episode was so severe I could barely manage to keep my eyes open and get a word out of my mouth. It didn’t matter. Listening to other people who had bipolar disorder talk about their experience made me feel connected and not alone. I could just be ill, and everyone understood, and they were comfortable with it.

What can people who do not have bipolar disorder do to help us when they notice we are struggling to get the costume on? Unfortunately, there is not much anyone can do. My neurotransmitters do not speak English so pep talks, advice or punitive judgement will not pop me back into wellness. I just need people to be patient and compassionate with me and, in time, I will feel better.

Fall and the Winter Months When You Have Bipolar Disorder

September 27, 2021 /

Over the years of facilitating peer support groups for people who have bipolar disorder, I have noticed that some individuals have their symptoms change in the Fall and Winter. In Calgary, during these months the days become shorter, and it can be uncomfortable to go outside in the cold weather. People tend to become less active and more isolated. All of these factors can lead to depressive episodes. There are some people who struggle with symptoms of mania or hypomania during the winter but most people I have encountered generally see their mood dip.

I used to really struggle during the Winter. My mood would become so low that I would have a hard time functioning. My psychiatrist had to make tweaks to my medication every year to help me get through it. For me, taking Vitamin D everyday has helped and doing fun activities like badminton and winter hiking have contributed to improving my quality of life in the winter.

Some people who have bipolar disorder sit in front of a light box every morning in the Winter. These lamps that are used to treat Season Affective Disorder, an illness that causes depressive symptoms in the winter, can also help people who have bipolar disorder. If you have bipolar, using these lamps can trigger manic episodes so it is important to work with a psychiatrist to determine the best way to use them.  

Having bipolar and leading a positive life is a lot of work. You have to be aware of your symptoms but not focus on them so much that it brings you down. You have to watch your stress level and use any tool available to you like exercise, meditation or counselling to keep it in check. You have to look for patterns like your bipolar disorder reacting to a change in season, negative relationships or the nature of the work you do. Once you learn how your own particular bipolar works and you find the right medication and coping mechanisms you can have a positive life that brings you moments of joy despite the suffering.

I hope you found todays blog interesting. I would be interested in hearing stories of other people who have issues with the change in season. I am a very curious about people who do not live in Calgary and what the winters are like where you live and if there any challenges during the winter months where you live.

Back To Stress

September 13, 2021 /

In Canada, life takes on a more serious tone in September. This is the month that children go back to school after their two-month summer holiday, students of post secondary institutions return to classes and many people’s jobs get busier after our brief warm summer months. This transition can cause a considerable amount of stress for everyone. High levels of stress are not good for people with bipolar disorder.

 My bipolar disorder is highly sensitive to stress. Elevated stress levels played a significant roll in my first and subsequent full blown manic episodes and all my severe depressive episodes. If I am not mindful of the amount of stress I have in my life the consequences can be devastating. Every acute episode I have had has resulted in a loss of employment, relationships, and all my money. There are many things you cannot control when you have bipolar disorder but if you can decrease your stress level this can help lower the likelihood of acute episodes and help manage chronic symptoms.

The first thing to consider is to take an objective view of your bipolar disorder to figure out how much activity you can do. Bipolar disorder is not like a broken leg where the symptoms and treatment are the same for everyone. Everyone’s bipolar disorder is different. Some people can be so reactive to stress that employment would cause them to have a severe manic episode that could include psychosis or depressive episodes that have the possibility of death by suicide. Reflecting on the events that led to previous episodes can give you a sense of what you are capable of doing.

Regardless of whether you are working or not, stress needs to be managed. In Canada, since many activities start in September it is often the time of year we choose to make commitments. It is important to keep in mind the limitations of your illness when you agree to add an activity to your life. It is easy to agree to do more than you are capable of doing when your symptoms are in remission.

There are other wellness practices that can help reduce stress. Mindfulness, a life practice that grounds people in the present moment through activities like meditation and yoga can make a dramatic change in stress levels. Any form of exercise, peer support groups and incorporating recreational opportunities or volunteer work into your routine are all excellent ways to reduce stress.

Despite our best efforts, life will surprise us and we will end up having to deal with intense moments of stress. The best we can do to mitigate the damage these events cause on our lives is create a healthy routine and use as many tools as possible to decrease our stress level. This will not guarantee that we will not become acutely ill, but it gives us a better chance of maintaining wellness.

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.  

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