Accepting bipolar
April 28, 2013 11:08 PM   Subscribe

How do you get used to yourself as bipolar (II)? Trying to understand my lows and mixed highs better, but find myself slipping into despair.

I'm starting to get depressed again. I know that this is part of my cyclical moods, and having this knowledge that I didn't have (or rather rejected) over the past several years should be helpful, right? Instead I just feel bad about myself, damaged and despairing. As a recent NYT op-ed reflected, the diagnosis doesn't help you deal with the sense of self you're losing.

Any ideas of how to take strength in this process? I'm trying not to give in to my lousy feelings, but I just want to skip work and lie in bed. I feel like I need a role model, a way to accept this, something. Thanks.
posted by elephantsvanish to Human Relations (11 answers total) 9 users marked this as a favorite
This is what having a therapist and a psychiatrist is for. One can help you with breaking thought patterns into manageable chunks so you can overcome your symptoms manually, and the other is for working through the cause chemically and medically. I would not be a functional person without either. Perhaps you would benefit from having one of each as part of your treatment process, too.
posted by These Birds of a Feather at 11:20 PM on April 28, 2013

I absolutely second These Birds in recommending both a therapist and a psychiatrist. I would not be here, much less functional, if I did not have some incredible doctors and therapists helping me at various times in my life since diagnosis. If you find the right med/cocktail of meds, things should start to get easier. I read that post earlier today as well, and found it to be so on-point. It's true, a lot of times it does feel like you're losing your self in gaining that diagnosis. but it doesn't have to end there.

One thing that helped me survive was my art -- somehow, I was able to keep creating even when I was at my lowest. "Creating" doesn't always mean "finished products," either. Hell, a lot of what I did was nothing more than "oh, that's pretty, it gives me an idea, let me write that idea down for later." And then, when I had the energy, I went through a lot of my notebooks and took out the good stuff and used it for "real" projects. Reading helps, too. If you have the energy for doing a weekly "thing," that may provide some focus. Not necessarily support groups, either, but it doesn't have to be something big like a book club... it can be something simple like "every Saturday, a group meets to have brunch, and I go for the first ten minutes."

Mostly, though, I wanted to say that I know how it is. That first little crumble of the slope under your heel, when you look down and say "oh, shit, here we go." It's terrifying, every single time it happens. You know all the tropes, you know all the platitudes, you know the little tips and tricks everyone will throw at you. But all you can feel is that depression, or that mania [yes, I know type II is hypomania, it still counts], and wonder where and when you'll make it out again. It's hard. It sucks. But it's possible to learn to live with it. It just takes time.
posted by gloraelin at 1:03 AM on April 29, 2013 [5 favorites]

You accept it by accepting it. It's no different than having skin that sunburns easily or going bald. You can't change the stormy mood-weather in your brain, but you can change how you react to it. Part of that is understanding that the hypomania is just as bad for you as the depression, and accepting that that brief good feeling is not a brief reprieve from constant depression, but a different side of the same mountain.

And, maintaining a positive outlook on treatment.

Accepting and dealing with mental disorders isn't easy, but it is better than the alternative of simply being a victim to it.
posted by gjc at 2:38 AM on April 29, 2013 [2 favorites]

(caveat, this is not my diagnosis.)

You can accept that you have bipolar without accepting that you just have to grin and bear the symptoms. If you feel yourself slding again, it is definitely a good and encouraged thing to call your mental health support team and say, "I am getting some bad symptoms." maybe there's a little extra they can do, maybe not, but they need to know it's happening. I know, you think you shouldn't bother them, they know you are sick, why tell them something they already expect, this kind of thing is just going to happen... As we said in my household, that's just yer stinkin' thinkin'.

It's a disease you have. That doesn't mean it gets to have you.
posted by Made of Star Stuff at 5:00 AM on April 29, 2013 [2 favorites]

(This is also not my diagnosis) It is really hard to accept. There will always be a part of me that wants to not have OCD. I know now that's not a reasonable goal, but I can acknowledge the desire to be symptom-free without desperately chasing it. For some reason that has been one of the biggest part of accepting.

Finding a psychiatrist/therapist/counselor who really clicks for you is absolutely priceless. My relationship with my psychiatrist is one of the deepest relationships of my life.

Good luck. Mental illness is really, really hard.
posted by Katine at 6:24 AM on April 29, 2013 [1 favorite]

In addition to the individual specialists helping you, have you considered/checked out support groups? I semi-dragged my bipolar partner to one, but he ended up finding some value in knowing other actual, real-life people who were going through variants of the same struggle he was. Some of them are doing great and serve that role model function; others are kind of depressing but serve as a really good reminder of why staying on your meds is a good thing. If nothing else, it may help you feel less isolated.

I'm sorry you're in a bad place. This is hard, but you are reaching out and looking for ways to get through this bad patch, and that alone is a really good step to be taking. I hope you get some good ideas here and some help from your medical professionals.
posted by Stacey at 7:30 AM on April 29, 2013 [1 favorite]

I've taken advantage of the times I don't feel like crap to write myself letters that I can read when the inevitable downward spiral starts. To remind me that I have been through these feelings before and made it out, sometimes just reading "Hey, this is the bipolar, the world isn't objectively going to shit" helps me remember that This Too Shall Pass.

I've got collections of silly internet links and pictures of cats, too, distracting stuff that can at least make me smile for a minute.

I get down about taking the medication sometimes and (I think this is part and parcel of that) down about self-care, and the times when you don't want to do self-care (whatever that looks like for you) are often when you need it most. Try to go easy on yourself. Sometimes you might have to cancel social engagements and stay in and take a bath. Or if you're an extrovert, you might have to pry yourself out of the house and go be with people. Just realize you've got to be gentle with yourself when you're feeling this way.

Having a friend with a similar diagnosis to talk to can help a lot.

As far as dealing with the diagnosis goes: I was first diagnosed as a teenager and spent years and years denying it and ignoring it. It's taken a very long time to get to the point where I could deal with it and try psychiatry again. Congratulate yourself on what you're doing now. It's hard but it's worth it.

And remember that having bipolar puts you at greater risk of suicide. I have a sort of plan for myself when I start having suicidal thoughts, and a couple of trusted people who I can go to. Having a plan can help you feel less out of control and stay safe.

That all feels a little disjointed but I hope you find something useful in there. If you'd like you can MeMail me any time.
posted by fiercecupcake at 9:17 AM on April 29, 2013 [2 favorites]

(This is a sockpuppet used for straight talk about sex and mental illness.)

This has been my diagnosis for over half of my life; I first received it as an involuntarily institutionalized, involuntarily medicated, and inutterably terrified 14-year-old, and it has been relentlessly parroted back to me in the intervening decades.
It can be seriously terrifying trying to explain your thoughts and behavior to people who do not share these traits, and seriously gratifying to find someone who will listen to you and take what you say at face value. I've been seeing a licensed social worker twice a month for about two years but after a series of events that seriously screwed up my brain, I do not and will not ever again ingest any psychiatric medication whatsoever.
Of course, if you feel that medication might be a good option for you, I would certainly recommend seeking out a psychiatrist in addition to a talk therapist (therapists will usually have a few psychiatrists with whom they work in concert, so you can usually get a referral that way).
Here are some things that have helped me deal whenever the winds whip up:

1. Having at least one friend or confidante with whom all brain-storm reports can be shared without fear of judgment, institutionalization, or recrimination. Enacting this rule just means that where I once felt fully alienated and alone, there are now a small handful of amazing people who will, if I ask them to do so, regularly drop me a text or give me a call a few times a day to ask if I've been eating, if I've left the house to do anything except go to work, if my spending levels are staying under control, etc. It is extremely useful to have someone who understands your baseline of "normal" (= highly functioning, not actively despairing). Maintaining an open line of communication will allow both/all of you to recognize when you are deviating from that baseline, so any/all corrective actions can be pursued right then and there rather than after you wake up to discover you've been wallowing in suffocating misery for weeks/months on end.

2. Choosing a therapist that is the same gender and approximately the same age as me, so I can see with mine own eyes what it is like to live successfully at this juncture in life. (I used Psychology Today's Therapist Search.) Have you been seeing a therapist, or would you be open to doing so?

3. Adopting a dog + taking up mindfulness meditation. I won't say it "cured" me, but a few months of snuggle time with a puppy as accompanied by regular practice and discussion at a Buddhist sangha put me 75% of the way there, with the other 25% consisting of simple daily maintenance tasks -- work, self-care, exercise, healthy eating, drinking water, making sure I get out and socialize (no booze!) at least once a week, getting up when the alarm goes off no matter what. Learning to let go of my thoughts after really, truly internalizing the fact that they are just thoughts -- a series of electrical impulses existing only inside my brain, rather than an immutable reality that had simply not yet made it outside the confines of my skull -- was a game-changer.

4. When I feel the rocks start to crumble at the precipice, I let everyone around me know that there is a landslide coming, so they won't be offended when I temporarily drop off the face of the earth in an attempt to conserve precious psychological and emotional resources and energy. In addition to accepting and understanding the occasional bout of radio silence, my friends have made themselves equally available to provide creature comforts in times of need (coming over to cook/feed me, watch crappy TV, drag me outside for a walk, shell out for a plane ticket to somewhere fun/healing, etc.). Do you have a local support system that could do this for you?

5. Cutting up my credit cards, because I know hypomania has set in when I start buying things absolutely indiscriminately. Whatever sorts of behavior you are currently aware of as stuff that is likely to lead up to a dark spell? Try to name it, pinpoint it. Then you can start wrangling it as effectively as possible -- not just as a facet of your BPDII, but as a standalone issue (ex: when I was learning about how to control my spending, I used spending addiction resources, not BPD resources).

6. Keep a daily diary, both to observe how your moods shift and sway in real time and as a long-form historical record. Scratching out just a sentence or two every day will help you grasp any/all triggers that may bring about either the mania or the depression. Learn your own warning signs, the ways in which you may be consciously or subconsciously changing moods or states. Write this information down in a place where you can easily go back to reference it, so you can start to recognize when you have begun a downslide and when you are on the way back up -- or way, way up. Make sure to write down what helps, too, no matter how seemingly inconsequential ("very rough day today. took a warm bath, listened to some of my favorite records, called some friends over to watch some garbage TV... felt a tiny bit better!").

7. Realizing that I do not have to label myself with any kind of diagnosis whatsoever if I don't want to. The last time I was in the hospital, a doctor asked me if I had read anything written by Kay Redfield Jamison within a minute of when I'd sat down in front of him; when I replied in the affirmative, he said, "Good, but you should read it again because you have what she has, you're just like her" -- and that was deemed to be the end of conversation as well as my only doctor visit for the next week. Well, I am here to report that we're not 'just like' anyone. Your illness will affect you differently than other sufferers, for better or worse; your needs will vary from the rest of ours; your chemistry is unique. If it empowers or helps you to reference or recognize your diagnosis, do it, but if it makes you feel helpless or alienated, let it go without guilt or shame.

8. Forgive yourself. Look in the mirror and say "I forgive you, I love you, I understand you, it is all right." Do it every day, especially when you think you're completely full of shit. Record and hold on to every tiny victory. Take photos of yourself when you are feeling good and place them alongside photos of other things that make you happy. Write down times that others have recognized you as possessing kindness, generosity, joy, and love. "Fake it 'til you make it" never rings so true as it does for bipolar folks.

Also, I found this 2011 NYT series on successful, high-functioning people who suffer from serious mental illness to be empowering, enlightening, and inspiring. There's also The Icarus Project, an on-ground and online support group for those suffering from mental illness ("We believe these experiences are dangerous gifts needing cultivation and care, rather than diseases or disorders.").

I hope the answers in this thread help you find at least a little bit of peace. Sending you much love, much respect, and good luck.
posted by electroshock blues at 9:24 AM on April 29, 2013 [10 favorites]

Oh! Something else. About the feeling "damaged and despairing." Something I write to myself in those notes is to remember that this is NOT a failure of will. I get into this mode of "it's so lame to be depressed, nobody is going to want to be around this, just think yourself better! It's your fault, you're wallowing."

It's not your fault, you are not failing to think yourself better, this is a disease and you aren't going to snap yourself out of your sad any more than you're going to think your way out of food poisoning. There are things you can do to make it less horrible, sure, but it's not a failing that you can't just get over it.
posted by fiercecupcake at 9:46 AM on April 29, 2013 [2 favorites]

You might find this recent NY Times article on bipolar disorder useful.
posted by danceswithlight at 10:10 AM on April 29, 2013

This is my diagnosis (7 years now). I find it most helpful to remember that it's not ME and it's not REAL. I cannot trust what my brain is telling me when I'm depressed, or in a mixed state (I never get exuberantly hypomanic anymore). I tell myself 'this will pass', and it always does. Always. And I see my psychiatrist often.

Loss of self? I know this well. I tell myself that it will be a long, hard road, but someday I will, after throwing all my effort into it, retrieve at least some of that self. Even if it's when I'm 50. I've become a different person, but made peace with that. We all change no matter what, disease or no disease. Our hopes and dreams are not the same at twenty as they are at thirty and no one is immune to this. I think we all find ourselves disappointed by this, and so you and I are not alone in it - not at all.
posted by kitcat at 11:20 AM on April 29, 2013

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