Depression causes everyone it touches to forget that there was ever a time when depression was not in their lives.
When we, people living with bipolar disorder or depression, finally decide that it’s time for antidepressants and/or mood stabilizers, it takes at least two incredibly long weeks for them to start to work.
We really feel those 336 hours go by as though it was 336 years. We have no reason to believe that the medication is ever going to work.
Some of us already feel dead; meanwhile others of us are trying really hard not to commit suicide. Anyone who tells us to think positive thoughts needs to be yelled at. To the person experiencing depression, it feels permanent, any other possibility is hard to believe.
Depression causes us to forget who we are. If we are able to remember, it causes us to think of ourselves in terms of “who we were”. Depression gives us a new identity.
The identity depression gives us is:
“I hate my life.”
“I can’t remember ever being happy.”
“I don’t like doing anything.”
“Nothing feels good.”
“There is nothing good about me.”
“I’d rather be dead.”
If depression lets us focus, it doesn’t allow for there to be pleasure in anything. And when depression partners with anxiety (which it loves to do) all we can think about is the worst possible thing that could happen and believe that it is the only possible thing that can happen.
Things depression wants us to forget about ourselves:
“There was a time when depression wasn’t even in my life.”
“I still am the person I was before the depression was here.”
“I like my life much of the time.”
“I appreciate my life and have a lot to be grateful for.”
“I like people.”
“I am loveable. I love someone and they love me.”
“People care about me and want me in their lives.”
“I have everything I need and a lot of what I want.”
“I laugh a lot. I see humor in life.”
“By being here I make other people’s lives a little better.”
“I’m a good person.”
“People like me.”
Things we forget about depression:
Often depression comes into our lives when nothing has changed OR when we feel powerless about changes taking place. It comes into our lives when we fear change or anticipate overwhelm, instability, insecurity, loss or uncertainty. It comes into our lives during times of perceived threat.
Depression affects how and what we think and how and what we feel. How and what we think and feel often has nothing to do with what is actually taking place in our lives.
Depression, and its partner called Anxiety, get their power by focusing on what could happen and what might happen. However, their power rarely comes from what is actually happening.
Most of what we worry about never happens.
Depression limits our thinking. Our spectrum of thinking goes: LOUSY…BAD…WORSE…EVEN WORSE…HORRIBLE…HATE LIFE…RATHER BE DEAD. There is no space for other ways of thinking.
Depression needs fuel. When we believe that the feelings and thoughts of depression are permanent, when we believe that depression is who we are…we fuel depression. When we isolate ourselves or hide the depression from those we love by smiling and pretending to be fine, we fuel depression.
Suffering with depression is incredibly difficult and painful. However, the second most painful and difficult position is experienced by the person trying to love their partner, child, parent or best friend experiencing depression. In a way, it could be easier for the person who is suffering from depression, as they are able to seek out different methods that can help them to feel better. They can even go as far as trying something similar to the mataro blue strain to relieve some of their symptoms, even if it’s just for a while and until they can find a more permanent solution. Meanwhile, it can be harder for the family and loved ones of the person who is going through depression as they may not know how to handle the situation.
The rejection is heart-breaking. Feeling like your presence (doing anything in your ability to help) makes your partner worse or doesn’t matter at all really hurts.
In this blog we will explore strategies that will support you during the difficult times caused by depression.
Strategy #1: Do not take it personally
Nothing that is expressed or takes place during your loved one’s depression is personal.
When they reject you, and they will, IT IS NOT PERSONAL.
Rejection has nothing to do with you. Isolation is an instinctive response to suffering and depression.
Rejection can also be seen as an act of protection. Your loved one does not want to hurt you. The only thing depression can do is hurt you. Everything that is said is a reflection of the depression – the fear, the anxiety, the panic and the pain. It’s a very heavy load, if you take it personally, the load will become yours.
When someone is experiencing depression they experience the inability to be themselves and it feels permanent. When they can’t be themselves with you (ie. be loving with you) it hurts them more and makes the depression feel worse.
People often share with me that their loved one experiencing depression is able to talk with casual friends and acquaintances and that those people are helpful and it hurts.
My response to that is that partners, parents, children and best friends are different from casual friends, colleagues and acquaintances. Partners etc get to actually see the depression.
Casual friends, colleagues and acquaintances get to see your loved one’s “representative”. They get to see your loved one pretend to not be depressed. They get to distract your loved one. If your loved one does talk with them about their feelings, they’re not dragging them through the mud the way they do with you. Instead, they give their friends the “I’m struggling, but look how well I’m handling it” story.
Casual friends don’t know that when you’re loved one gets home that they can’t get off the couch and wish they were dead. Of course your loved one feels better when they get to pretend that they are okay.
Strategy #2: Accept that you cannot make your loved one be “not depressed” or feel good
This is a really hard thing for anyone to accept. Depression hurts not only the one experiencing it, but it also hurts the people who love them the most. Here is a metaphor that I share that has helped people develop acceptance of this statement:
When we come into life we are all given two things: a shovel and a bucket of shit.
It doesn’t matter in life that we have a bucket of shit. We all have it. We always will. It never goes away and no matter what you do the shit will always be there.
What matters is what we do with our shovel.
Some will use their shovel to take their own shit and put it in other people’s buckets. They never actually can get rid of their shit, they simply make other people feel like crap.
Some will use their shovel to stick in other people’s shit and then put other people’s shit in their own bucket.
Others will first use their shovel to cover their bucket from giving others shit and receiving other people’s shit and then figure out what they can grow with the shit that they have.
If you stick your shovel in your loved one’s shit who is experiencing depression, it doesn’t make the depression go away. It just puts the depression in your own bucket and adds to your shit.
You cannot make flowers grow in a bucket of shit that is not your own.
Instead of “making it better” take the pressure off yourself to fix it by:
Simply being with the person you love.
Sitting beside them.
Holding their hand.
Rubbing their head and their feet.
Validating their feelings. What they are experiencing is horrible.
Reminding them that what they are experiencing is temporary.
This won’t make the depression go away, but it will help them get through the suffering.
Strategy #3: Perspective: Depression is in a relationship with the person you love, not the person you love
Your loved one is not depressed. Depression is NOT who they are. Your loved one is experiencing depression.
They are in a relationship with depression that has them captured or held hostage. Its a bad relationship. A relationship that isn’t easy to get out of. However, depression affects them and when they have the strength they can affect depression.
It can help your loved one to hear that you know that this is not who they are and that you love them. It is also important for your loved one to know that you love them even though they are not themselves.
Of course they won’t respond the way you want them to…with love, affection and appreciation. However, deep down beneath all of the numbness, pain, anxiety, fear etc…your loved one is still there and need to be loved.
Strategy #4: Interpreting Rejection
When your loved one is in a depression rejecting you and pushing you away as best they can. They’re not saying, “I need you and want more of you.” It would be easy to allow their rejection to cause you to dive into a depression yourself and feel heart-broken.
Here’s an alternative interpretation to their rejection:
“I need to be alone.”
Interpretation: “I need to escape this by sleeping as much as possible. I can’t escape it as easily if you’re here talking with me about it. Why don’t you go do something you need to do for yourself.”
“I’d rather be with my friends [than you].”
Interpretation: “When I’m with my friends, it distracts me from how horrible I feel. My friends don’t ask me how I’m feeling. They don’t ask me if anything is wrong. If they see something is wrong, they wait until I share. If I don’t share, they don’t ask…they just keep talking about themselves.”
“I don’t know if I want our relationship.”
Interpretation: If your relationship was in good standing when your loved when went into the depression…”I’m not myself. I don’t like who I am being. This is not who I want to be. I don’t want to treat you this way. This feels permanent. If this is how I will always treat you. I don’t want to be with you.”
“You don’t make me feel better.”
Interpretation: “You can’t make me feel better even though you really try to. When I am with you, I still feel so depressed because I don’t get to pretend to be okay when I’m with you. When I’m with you I’m stuck feeling whatever I feel and there is nothing you can do to make me feel better.”
Strategy #5: Your Own Self-Care
When your loved one is experiencing depression, it is not your responsibility to make them feel better. You can’t. It is your responsibility to take care of yourself.
It is incredibly difficult to not be sucked in by the depression of your loved one because of how much you care. It is your responsibility to not be sucked in. It is your responsibility to take care of yourself.
Think about what soothes you, brings you joy, and nurtures you.
Here are some areas of self-care to explore:
Exercise / Movement
Being in nature / Being outside
Attitude of gratitude and appreciation
Forgiveness
Connection with others
Being Creative / Artistic
Self-Expression / Journaling
Therapy
Games / Playing
Cooking / Eating healthy
Conscious breathing
Meditation / Guided meditation / Yoga
Depression is incredibly hard on everyone involved. When you are loving someone with depression it is so important that you make the time to love yourself, to nurture yourself, and receive support in a way that is fulfilling to you.
So many people living with bipolar disorder have shared with me the pain of experiencing everything they know about themselves crumble away.
For some the crumbling happens in the experience of mania and depression. For others the loss of identity occurs when medication begins to work.
Here are some questions that revealed lessons learned from identity crumbling away. This is based on responses from people thriving with bipolar disorder:
What part(s) of yourself do you feel you lost?
“I no longer feel like myself. I see myself as a stranger.”
“I lost things that I knew that were true about myself. I am not who I believed myself to be.”
“My personality. My personality is different because of the medication. My personality is different because of mania. It is different because of depression. I don’t know what my personality is anymore.”
“My profession. I can’t do what I love to do.”
“I don’t think and feel the way I used to be able to think and feel.”
“My dignity and integrity.”
“I am afraid of myself.”
“Trust for myself.”
“I’m not the person people expect me to be anymore.”
“I hurt people. I now know how deeply I can hurt.”
How did you initially respond to losing these parts of your identity?
“I gave up. I didn’t have a reason to try.”
“I rejected the good things people said about me.”
“I was scared of myself and what I could be.”
“I was confused. I didn’t believe anything about myself was real.”
“I didn’t trust anyone, including myself.”
“I got angry. I felt powerless.”
“I didn’t want to be around anyone. I isolated myself.”
“I wanted off of medications. I didn’t want to be “better”, I wanted to be comfortable.”
What insight or experience did you have that changed your response to this loss?
“My psychiatrist shared with me everything that I wouldn’t be able to be in life. He listed all of the professions and roles I would never be able to have because he said that I can’t handle stress. He said I wouldn’t be able to go to college, shouldn’t have children, and will find romantic relationships to be very difficult for me…..My response to all of this in my mind was “F*** YOU! I’ll prove you wrong.” That experience completely changed me.” (This particular story is Robin Mohilner’s)
“I realized that I cared far more about what other people thought about me than caring about who I want to be. When I put effort into who I want to be, it changed my life.”
“My family believed in me. They trusted me when I couldn’t trust myself. They forgave me for the hurt I caused them. It gave me hope.”
“Just because my personality changed it doesn’t mean that my character changed. It doesn’t mean how I treat people changed. And just because I did some horrible things that I never thought were possible for me to do, it doesn’t erase all the years of good things about me.”
What helped you build your identity?
“I stopped trying to fit in and be like everyone else. It was very clear to me that I was not what people traditionally call “normal”. I couldn’t be normal no matter how hard I tried. So I gave myself permission to not have to be that way. I allowed myself to like myself anyways.”
“I tried to always do my best, to think my highest thoughts and separate drama from my feelings. Doing this gave me a place to stand.”
“Therapy. My relationship with my therapist helped me and challenged me to trust myself. I became aware of my own strengths, abilities, resources and limitations. I set reasonable goals and achieved them. That helped me begin to trust myself.”
“I educated myself. I did not rely on my doctors or professionals to know everything there is to know about bipolar disorder. I learned any and everything I could about bipolar disorder from as many places as possible.”
“I defined what bipolar disorder would be in my life. I chose for it to be a gift. I realized that it doesn’t have to define who I am, but it does affect me. I learned about what makes me vulnerable to an episode and it gave me a sense of power because this knowledge gave me control.”
“My belief system. I focused on exploring values and beliefs and choosing which ones fit me. It opened space for spirituality in my life.”
When someone has lost touch with reality the words to describe this experience, “psychosis” and “psychotic” often scares people. One automatic response to those words that many people have is “crazy”.
Reality is simply created by people agreeing on shared sensory experiences.
Psychosis simply refers to someone experiencing things with their five senses that other people are not able to perceive.
The five senses:
Sight
Some people see people or things that others do not see.
Some people see sounds or smells represented by shapes and colors.
Sound
Some people hear sounds or voices that others do not hear.
Some people feel sounds with their body or taste sounds that other people cannot.
Touch
Some people feel sensations in or on their body that other people cannot feel.
Some people can touch something that others do not perceive.
Taste
Some people taste flavors and textures that others do not taste.
Smell
Some people smell pleasing and displeasing scents that others do not smell.
What most people do not understand is that the EXPERIENCE of these sensations is very real.
When other people do not agree or share in these sensory experiences it does not make it any less real for the person who does.
These sensory experiences are taking place in a person’s brain.
What MAY be happening during these sensory experiences is:
There could be a communication problem in the sensory centers of the brain
Communication error between the sensory centers of the brain and the cerebral cortex (thinking part of the brain).
The messages coming from the five senses may get jumbled by the time they reach the sensory centers.
When someone is having these experiences, the goal is not to “snap them out of it”.
Instead, goals are to help loved one’s by:
assessing their safety in regards to harm to self and/or others.
meeting and supporting them wherever they are in their experience
helping them regulate if they are willing.
Five actions you can take to help someone who has lost touch with reality.
1. Do not challenge or try to disprove their experience
Instead, BE CURIOUS.
Some ways of being curious:
Ask them to tell you what they are hearing or seeing etc.
Ask how it affects them – behavior, thoughts, feelings etc
Ask how they feel about it
Ask them if they believe it is a problem or if there are ever times when it is problematic.
Ask them how it helps them.
This assesses for safety and prevents agitation.
If what they are experiencing is causing them to want to do harm to themselves or others, hospitalization is necessary immediately.
It is not helpful to tell someone who is experiencing psychosis that what they are experiencing is not happening. Doing so often causes agitation for the person and isolation.
2. Bring their attention to their body
There are several activities you can do to help someone bring their attention into their body. However, when someone is experiencing psychosis, you do not want those activities to be based on imagination. The activities should be physically based:
Breathing: have them notice their lungs filling. Some people may not respond well to listening to their heart beating it could cause some to become agitated.
Wiggle the toes, rotate the ankles, raise and lower the legs, or massage their own legs. You can do the same with fingers, wrists, and arms.
Put feet flat on the floor, sit with good posture and breathe
Rotate neck clockwise and counterclockwise. This can be done with the chest as well.
What these activities do is engage the sensory organs and sensory centers in the brain to the present moment in the body. This may help someone regulate their brain by focusing on the physical senses.
3. Focus on breathing
Breathing is consistently important in everything we do.
Ask them to take at least seven deep breaths, into their belly, and slowly release them.
Breathing deeply helps regulate the brain. Its like pressing the restart button.
4. Redirect them to thinking about a time & place where they felt good
If they are agitated, ask them to tell you about a time and place where they felt good (or whatever emotional state they are needing).
Ask them about sensory things like what they saw, heard, touched, tasted, smelled etc. This may help regulate the sensory areas of the brain.
5. Containment
If your loved one is a willing participant to be close to you, ask them if you may hug them. Ask them if you may give them a long tight hug.
This type of hug is not one in which you pat them on their back or rub their back. This type of hug is one in which you hold them tightly, without squeezing, and simply breathe deeply together.
This form of containment and breathing is very calming and may also be a “reboot button” for the brain.
I feel sorry for the boys I dated when I started dating.
I never outright said, “I’m bipolar, you don’t want to date me…do you?” (Hoping they’d say yes.) Nonetheless, this is what my actions said.
I remember the very first time I went on a first date….
Within the first 10 minutes I told him that I’m bipolar. Then I sat there and waited to see what he would say.
There was no second date.
What I came to realize is it is not that he didn’t like people who are living with bipolar disorder. He simply didn’t know me at all. He didn’t know what to say. He had no clue of what that meant and how it would affect him enjoying our time together.
Him not wanting a second date had nothing to do with who I am. It had everything to do with how I presented myself.
Online Dating…
I learned from normal dating that telling a guy in the first 10 minutes was a bad idea. So I wanted to protect myself from being rejected…I waited until I knew that I liked the guy.
Years ago, I decided to try online dating. I met this guy and told him nothing over the chatting on the internet…nothing over the phone…and let him get to know me on our dates. We had so much fun together. We had a lot in common (for people in their early twenties), we had similar backgrounds, interests, playfulness etc etc.
He really liked me. We were excited about each other. One night while sitting on the beach on our third date he shared with me that even though he talks about sex a lot that he’s really a virgin and shared his values, beliefs, hopes and dreams. I felt comfortable with him so I decided to share that I’m bipolar. I felt so at ease that I shared some of my stories and what I’ve overcome and my successes. We felt so connected and bonded after revealing these really important things. We were in fantasy land talking about our future.
The next date he told me that he does not want to see me anymore.
I was so hurt. I couldn’t understand. He seemed so happy about me sharing with him and he rejected me.
Later he told me that it wasn’t personal. He shared that his sister is living with severe bipolar disorder and that he didn’t want his children to go through that.
Even though it made sense…it hurt.
This changed how I did online dating….
I learned very quickly how painful it is to be vulnerable and have someone reject you. It was something I did not want to feel again and I was willing to do anything I could to prevent it.
Therefore, I got in the habit of telling guys on the phone before I even made a date with them.
The way I thought about it was that if we got to talking and liked each other that if I shared that I am bipolar and they still want to go out with me…then its safe…I won’t be rejected.
It was sort of effective dating.
I ended up dating other guys with bipolar disorder and other psychological disorders that didn’t bother me so much because I truly get it and I know how to respond to it; however, I wanted someone more emotionally grounded and stable than me. My choices and behavior wasn’t attracting that.
Dating While Manic
A number of years ago I experienced a self-controlled hypomanic episode and I thought I was out of the woods…but I was wrong. While still under the influence of mania I was really free, I met a guy online. My guards were completely down. I had no attachment to the outcome. I was completely free to say and do whatever I wanted. We hit it off on the phone. I shared with him that I was living with bipolar disorder before we met. I simply didn’t care how he responded. Without any effort on my part, he clearly saw that I was thriving and successful in how I live with bipolar disorder and wasn’t concerned at all.
On our very first date we had the “love at first sight” experience. We were in each others arms referring to each other as “soul mate” by the end of the first date.
By the second date, we were planning our lives together and talking about future marriage. We just knew that even though we didn’t know each other that we were meant to be together.
The following weekend he went on a camping trip with his friends and I was not invited.
While he was gone, I freaked out. I didn’t even know his last name. I panicked because the “relationship” was happening way too fast for me.
So I texted him sharing that I needed to slow down. I sent him probably 100 text messages while he was gone without him responding to even one. I was on an out of control emotional rollercoaster.
When I didn’t get a response from him I kept trying to correct or explain the previous message. I couldn’t control myself. I got angry and sad then rationalized my feelings all in texts to him. I just kept impulsively texting trying to explain myself. When he didn’t respond, I couldn’t stop rollercoastering and expressed every thought and feeling I had.
It turned out that he didn’t have phone service while he was camping.
He got all of my text messages at once.
When he got home, I received a text that said, “Never contact me again.”
I tried to explain myself, that it was mania. He didn’t care and wanted nothing to do with me.
Dating with bipolar disorder is really hard and can be very painful…but it is doable.
Building a loving, nurturing and healthy relationship is possible.
We will explore building relationships in another blog.
I invite you to share your dating stories and bloopers in the comments section.
Sharing with people that you are living with bipolar disorder can be a devastating and painful experience. However it can also be one that opens people’s eyes and is liberating for you. In this blog, I will share my own stories including the humor, the successes, and the times when it really hurt to share that I’m bipolar. The stories I’m sharing are about my first time ever revealing that I’m living with bipolar disorder, making friends, meeting new people, and the hardest….my dating stories. I will emphasize the lessons that I learned from each experience.
My First Time…
The first time I shared that I was living with bipolar disorder was in front of a high school summer school class of thirty students. I was forced to go to summer school weeks after being diagnosed because my family was really concerned with seeing me spend my days in a ball in the corner of the couch. After my first full-blown manic episode, I was in a depression so deep that I only knew I was alive because the spoon fogged up when it was near my nose. A teacher, who knew me as an enthusiastic bright student, saw that my head was down on the table since I started the class and I wasn’t participating at all. In front of the class he asked me, “What’s wrong, Robin?…Are you heart-broken?” My head felt like it weighed 50 pounds and was crazy glued to my desk. So I slowly lifted my face off of the table, leaving my head still on it, and in a tone that must have stated “don’t mess with me”…
I said, “No. I am crazy. I have bipolar disorder.”
I really don’t know how people responded to my lifeless expression. I can only imagine that it would really scare people to see me like that, especially knowing me and after seeing me manic. I’m pretty sure that rumors spread through school like wild-fire because everyone gave me space. My friends who were close to me before I was manic, disappeared…except for one. I felt like a ghost throughout the rest of high school. (Luckily, I was able to find support in a positive environment elsewhere.)
…What I Learned
It hurts. It really hurt to have people fear me.
That pain caused me to decide that I wanted to educate people about the experience of bipolar disorder.
From then on, I shared openly that I am living with bipolar disorder and worked hard at learning so that I could answer any question asked of me to the best of my ability.
Making Friends…
When I got back on my feet, I took off running in life. I didn’t have many friends. Nonetheless, I was determined to not only succeed in all the ways I was told I couldn’t…but also decided that I wanted good friendships.
My first day moving into the dorms at UC Berkeley was quite memorable for everyone on my floor…well, maybe even the building.
Everyone was nervous and uncomfortable about this huge change and new living situation. I came in, bouncing off the walls…so happily manic that it was contagious.
I welcomed everybody to my floor with a HUGE hug and smile. My enthusiasm, humor and spark brought almost everyone together laughing and playing. We all helped each other move in. People felt so comfortable in this very uncomfortable situation of moving in with strangers.
Then I led most of the people on my floor to each of the other dorm floors in our ten floor building and introduced ourselves to all the people in our building…practically going door to door. We were a tribe.
That same day, a group of us sat down in my room and I pointed out my behavior and shared with them that I’m living with bipolar disorder and was triggered into mania by the change etc.
There response was one of care and curiosity instead of judgment. They asked me questions about what its like to be bipolar and what I’ve overcome. I openly shared with them. Then they asked if there was anything they could do to help me…I told them that they were already doing it.
Everyone was so appreciative of my sharing that we all began sharing stories with each other of overcoming hardship. It resulted in the beginning of the closest friendships that I have had thus far.
…What I Learned
I learned that if I have confidence and inspire people that they won’t be afraid of me.
I was quite hypomanic and honest about it. It brought so much joy and freedom to other people without shame, judgment or fear. It tore down the traditional walls between people when they first meet. I inspired and empowered other people to connect with each other and share their lives openly.
I took the fear out of bipolar disorder for my friends. To this day, when my friends meet someone with bipolar disorder they treat them with so much acceptance, compassion and kindness. They have no fear and judgment because I destroyed the stigma.
Meeting New People…
I never walk up to anyone, shake their hand and say, “Hi I’m Bipolar.”….ANYMORE. When I was young, that was basically the first thing that came out of my mouth and then I “fire-hosed” people with everything I knew about bipolar disorder. Fire-hosing is like when someone asks for a glass of water, putting a fire-hose to their mouth instead. I did this because I was so proud of what I had achieved in my life. I had proven all the stigma wrong. I wanted everyone to know that what people believe about bipolar disorder is not true. I’m not as open and free when I meet brand new people as an adult. First I see if they show interest in me. I do this by genuinely being interested in them. I am naturally curious and want to hear stories and learn about people’s lives. If someone shows interest my profession, I share openly with them about what I do as being a therapist (but without going into my specialization…bipolar disorder). If they continue to be interested and want to know about my passion, then I confidently share with them my love of helping people who are living with bipolar disorder. I share that I have this tremendous passion and sense of duty because I too am living with bipolar disorder…. Then I invite them to ask me questions and I share my experience, listen to their awareness and understanding and answer their questions to the best of my ability.
…What I Learned
People only fear and judge people living with bipolar disorder when they don’t understand it. When people understand and have compassion for what they fear, the fear can no longer exist.
Dating…
Oy Vey! There is so much I could say about this that I’ll have to write about this in my next blog that will be up Wednesday….
In the comments section, I invite you to share your stories and bloopers of “coming out” with bipolar disorder.
So many people have shared with me the pain that they experience from their loved ones who reject them or refuse to acknowledge that they are living with bipolar disorder.
In this blog, I will do my best to expose some of the things that may cause people to reject and deny support to people living with bipolar disorder.
My goal is to uncover the pain that people are going through when they don’t respond the way we would hope. I hope that those reading this will have a greater understanding about painful responses from the people you care about who aren’t able to be there for you yet.
To reach this goal, we are going to break down the complex responses:
Denial
Insecurity & Fear
Shame & Guilt
Denial
Denial broken down into pieces:
Rejection
“This is not happening. My daughter is not experiencing mania, she’s just moody.”
“This is not happening. My son is just going through a lot of financial stress.”
“My husband can’t be bipolar. He is the provider for our family.”
“My wife is not bipolar, she has a drinking problem. That’s all.”
Awareness
“This cannot happen to me. I could never have imagined this.”
“People with bipolar disorder are crazy…they’re insane…my _______ can’t be bipolar.”
“This can’t be happening, I know everything that goes on in my family. I would know if this were happening.”
Possibility
“This is not possible. This doesn’t happen to me.”
“It can’t happen. No one in my family or anyone I know has ever had it. It’s not possible.”
What is
Declaring that the evidence, experiences or facts that support what is happening is not true.
“It’s not true.”
“This is all lies.”
“None of the doctors we’ve seen know what they are talking about.”
The message I want you to notice and take home about the denial response is that it is a reflection of where the person is able to be right now. It is a mental and emotional place that is self-centered and experiencing a great deal of fear and pain. It is not a reflection of you.
Insecurity & Fear
Insecurity broken down into pieces:
What are people going to think of me…
“What will my friends think of me if they know that my child is bipolar.”
“What if people think I did something to my child that caused them to be bipolar.”
“What if people think I was abusive.”
I failed…
“I must have done something wrong raising my child.”
“I wasn’t a good enough parent.”
“I am a bad mother.” “I am a bad father.” “I am a bad sibling.” “I am a bad spouse.”
What does it say about me…
“Does this mean I am bipolar?”
“If I were a better parent, my child wouldn’t be suffering with this.”
I don’t know what to do…
“I don’t know how to help my (loved one).”
“I don’t know what to say or how to act.”
“What if I make them worse?”
The message I want you to notice and take home about the insecurity and fear response is that it is a reflection of the person’s fear and insecurity AND it has nothing to do with you.
Shame & Guilt
Shame and guilt broken down:
Its my fault…
“I did this to my child. My child has my genes.”
“I wasn’t there for him/her when s/he needed me.”
“I didn’t teach them good coping skills.”
I am embarrassed…
“I am embarrassed that my child is bipolar.”
“I am embarrassed that my spouse is bipolar.”
“I’d be less embarrassed for my child to be a drug addict than mentally ill.”
The message I want you to notice and take home about the shame and guilt response is that it is a reflection of the person’s beliefs and fear of other people’s opinion AND it has nothing to do with you.
Many people find it incredibly difficult to acknowledge and accept that they are living with bipolar disorder….let alone be willing to get help. They have really good reasons.
Here are some perspectives people have shared with me as well as my own experience that I have overcome in order to get to be who I am.
I share this is so that people who want their loved one to admit they have diagnoses can understand where their loved one is coming from.
“This way of thinking and being is normal for me. I have always been this way. Why should I need a doctor, medication and therapy to feel “normal”. This is what I know. Nothing is wrong with me.”
“I’m not hurting anyone but myself. I don’t care what people think about me.”
“This is who I am. I don’t want to change.”
“I don’t want to be controlled by medication. I don’t want to be a robot……I am afraid that if I take medication, I will lose who I am.”
“Struggling with the ups and downs is something that I know how to do well. I don’t know what I would do with myself.”
“I am so scared of medication. I have heard stories of people not being able to feel and think. I have heard stories of people not able to be who they were. That really scares me.”
“I can’t believe that the most wonderful, beautiful, life changing experience didn’t come from God and is considered as a disorder…I can’t believe that it means there is something wrong with my brain.”
“I don’t want to be treated as though I am crazy.”
” I don’t want to find out that there is something wrong with me.”
“Society has a problem for not valuing and putting to use your creativity, brilliance and energy. I have something to offer just the way I am.”
“Moses saw a burning bush and said God was talking to him…AND he’s a prophet. Why is it that when I see God and we talk that I am crazy?”
“I love mania.”
“I don’t see it as a problem.”
Underlying Fears:
“What if no matter how hard I try, I can’t be “normal”?”
“What if I can’t be fixed?”
“I am broken.”
“I don’t belong. No one will accept me.”
“My life feels over.”
“I don’t know who I am.”
“No one will love me. I am not loveable.”
“I am so scared of myself.”
No one can be forced to see that they are living with bipolar disorder. No one can be forced to take action and receive treatment.
Have compassion and empathy.
People usually do not seek out treatment unless it affects their functioning on the following levels:
They feel out of control of their mind and body.
There loved ones do not feel safe being around them.
They are at risk for self-harm or a danger to others.
They are not able to function in their work.
They are not able to be the partner they want to be in their romantic relationship due to their behavior and emotion.
They are having difficulty maintaining friendships due to their behavior.
Sometimes people are not able to see that this is taking place. They are so deep in the mania that they can’t see what is happening.
Therefore, it is important for loved one’s of a person who is allegedly experiencing bipolar disorder to share their concerns and help them develop their awareness.
Before we get started, I want to help everyone understand why in my writing I use the terms “we” and “us”. The key reason for doing this is because stigmatization, judgment and the fear people have of people living with bipolar disorder can be very isolating and create a great deal of self-shame and self-fear. I use “we” and us” to remove stigma, judgment and fear in order to create belonging and acceptance. I also use “we” and “us” so it is very clear that I am writing about an experience that I belong to as well.
This blog is in response to someone asking for help to better be able to help her loved one who is struggling with rapid cycling…and I’m broadening this to include both rapid cycling and mania.
#1 Thing you can do to help the one you love is by taking really good care of yourself – emotionally, mentally, physically, your health etc.
It is incredibly hard to help someone who is experiencing mania or rapid cycling. The reason why hospitalization exists, besides being at harm to ourselves and others, is to slow us down. Hospitalization removes whatever supports mania and medically slows us down and forces our bodies and mind to stop running a million miles a minute and rest. Being forced to slow down can feel like death or simply horrible.
The goal of this blog is to help intervene before hospitalization is needed.
This blog is about how to help someone you love slow down and gain some control during mania or mixed episodes without hospitalization. It is not easy.
A gem I have gained from my experience from experiencing mania is how powerful the mind-body connection really is. When my mind and emotions are going a million miles a minute there is no rational way to THINK myself out of this process. However, my body can only go so fast. I learned that if I can slow down my body and gain awareness and control in my body that it has a profound affect on my mind.
What I hope to share are some tools that can be helpful to the ones you love that I have learned from experience and professional education that have been successful in slowing down mania or cycling and building awareness and control.
Help loved ones gain control of their mind through their bodies by:
Shifting our attention to our breath.
When we focus on our breathing it brings our attention away from what is taking place around us and in our minds. Our attention goes directly to expanding and contracting our lungs. Our attention goes to breathing as deeply into our bodies as we can and releasing our breath.
By focusing on our breathing we experience control. Our awareness decides how deeply we breathe. We have the power to control our breath which can either slow down our body or speed it up.
GOAL: Breathe deeply and slow down the breath which will regulate the rest of the body and the mind.
How you can help:
Don’t judge, label or say things like “You’re out of control. You’re manic. You’re crazy etc”
Instead say something like, “I’m feeling scared/sad/down/lost/frustrated etc, will you hold my hand (or sit beside me) and breathe with me?”
Creating a safe place for us to contain ourselves
When we feel out of control in our bodies, a long tight hug really helps. There is something incredibly containing about a hug that is grounding for a person who feels out of control.
The hug not only helps us stand, but it also helps us to emotionally center ourselves. We feel emotionally connected, present and a hug is an act of love.
GOAL: Hug your loved one until they let go, don’t let them go. By hugging them they feel safe, wanted and loved. This containment creates self-control in both their body and mind.
How you can help:
Simply say, “I want to hug you, may I give you a hug?”
With your words
When we are manic or rapid cycling we don’t respond well at all to words, we are not able to be rational…especially when sentences start with the word “You…”.
GOAL: To not make us feel bad about ourselves, when we are manic or rapidly cycling and are out of control…we already feel bad about ourselves.
How you can help:
Make “I” statements. Start your sentences with the word “I”. For example, “I feel scared when…” “It concerns me when…” “It’s problematic for me when…” etc.
Giving us space.
When you can’t express how you are feeling, it is incredibly frustrating when someone keeps asking you “What’s wrong?”, “How are you feeling?”, “Are you okay?” etc.
GOAL: Give us space so we can ride out the emotional rollercoaster.
How you can help:
Help your loved one create a space when they are okay that feels safe to them. This space will be where they go when they experience an emotional rollercoaster.
Forgiveness
Mania, depression and mixed episodes cause us to express ourselves and emotion in ways that are very hurtful. We often feel ashamed of what we do and say. We are often not kind in how we treat the people we love during these times of incredibly emotional rollercoastering. We are so disappointed in ourselves and feel so much pain for how we treat those we love during an episode. Forgiveness is a gift that we need to receive.
GOAL: Help us heal and recover by forgiving us for the pain we cause.
How you can help:
If you remind your loved one that you know that how they are behaving is not who they are…that it is the mania or depression. Let them know that you love them and that the mania or depression is hurting you.
Don’t let bipolar disorder be an excuse for bad behavior. Help your loved one see the difference. Therapy can be very useful to build this awareness.
In this blog I hope to create a better understanding and compassion for people living with the diagnoses bipolar disorder, schizoaffective disorder, and borderline personality disorder.
Often times society sees people living with bipolar disorder as people to be feared and are seen as dangerous. Society has no clue as to what schizoaffective disorder is. And often when people think of borderline personality disorder there is so much judgment and rejection that it can feel incredibly hopeless to the person experiencing it.
It’s important that I acknowledge that I do not have personal experience living with schizoaffective disorder or borderline personality disorder. I DO live with bipolar disorder and have a much greater understanding of how it affects people. Nonetheless, I hold a tremendous amount of compassion for anyone living with diagnoses that are incredibly stigmatized and misunderstood.
What I hope to give you in this blog:
Shine a light that empowers you to be proactive in how you choose to live with the challenges caused by whatever conditions and circumstances you are dealt.
I hope to remove the judgment and stigma and instead invite you to have compassion and understanding for these experiences.
An awareness that any diagnosis is NOT who we are. Diagnoses are something we live with, we are in relationship with it. This means that it has the power to affect us and we have the power to affect it.
When professionals make a diagnosis we look at the following criteria and to what degree it affects one’s life:
Mood (defined as a temporary state of mind or feeling)
Behavior (defined as the way one acts or conducts one’s self, especially towards others) / Changes in Needs and Interests
Changes or Patterns in Thought Process
Sense of Self
In today’s blog we will explore the diagnoses bipolar disorder, schizoaffective disorder and borderline personality disorder from the criteria of Mood with compassion. Following blogs will cover the other criteria.
Mood
Bipolar Disorder:
It is important to note that bipolar disorder is defined by the presence of mania. The diagnosis is not dependent on the presence of depression.In this blog, we will only explore from the perspective of mania.
The mood component of mania is defined as a temporary state (at least a week or can be less) in which mood is:
Unusually elevated, euphoric or expansive
Experiencing these mood patterns can feel so incredibly good that it is hard to recognize that mania is present. They may be the superhero “I can fly” feelings that we dreamed about experiencing as children and now they are REAL feelings.
Unusually irritable
No one usually wants to take responsibility for their irritability. Irritability is one of those things that just doesn’t make sense. It’s not usually based on what’s happening right now. It’s based on what happened in the past. And it usually is from things we don’t address.
When irritability happens in the experience of mania in bipolar disorder it’s because bipolar disorder puts the pot of our emotions on a stove or in a pressure cooker. Our emotions boil over. Meanwhile, bipolar disorder is stirring the pot, mixing all of our emotions together without any regard to what’s taking place here and now. No matter what those emotions are, when this is happening to you, you’re going to be very irritable.
Often feels as though every possible human emotion is being expressed in the same time period.
To make sense of this from a brain perspective, see my blogs on the bipolar brain.
During this experience we are our most scared and at one of our most fragile times in which our life is at tremendous risk. This is a time when we feel completely out of control not only in our own minds, but also in our bodies. It is so hard to share that we are in danger with anyone because we are so afraid of what will happen to us. Often times its like we are having an out-of-body experience. We are watching ourselves be completely out of control, but there is nothing we can do about it. We know we are not crazy, but we are having a crazy experience and we can’t explain what’s happening and why.
Shifts in mood happen impulsively or swiftly with or without trigger
This is so painful because there are so many consequences. During these temporary times, our family and friends don’t know how to be around us and are scared of us. They are walking on egg shells. It’s hard to be a friend when people can’t feel safe with us. We feel so alone and so isolated. We don’t know how to repair what was broken when we were out of control. It is very easy for shame, blame and guilt to set in.
There is a loss of control in the mood shift, yet there is an awareness of the shift in mood
Often times people think that there is a lack of awareness when people are experiencing mania. I tend to disagree. I think people are so scared of what they are experiencing that there is an abundance of denial, fear and shame. I do not believe there is a lack of awareness. No one ever wants to feel completely out of control, let alone acknowledge it to other people who have no clue as to what its like.
I have found people living with bipolar disorder to have incredible sensitivity and self-awareness.
Note: If someone has lived with bipolar disorder untreated for a long time, it is possible for them to feel as though it is their personality. And maybe it is, I believe it is possible to have a manic personality and it is possible to have rapid and consistent temporary mood changes. Anything is possible.
Schizoaffective Disorder:
Same as bipolar disorder or major depressive disorder (depression without mania) or any other mood disorder.
The key difference between schizoaffective disorder and other mood disorders is that the delusions and hallucinations take place during times when mania or depression are not taking place. This means that psychosis occurs beyond mood disorder episodes as well as during them. If you are suffering from something similar, then it might be a good idea for you to seek help. You could always check out an inpatient facility like Honey Lake Clinic that can help support you through this disorder. However, the decision is up to you.
In my opinion, this may be the most difficult and painful mood disorder that people experience. I can only imagine how scary it would be to not only have to live with mania and depression, but to also experience delusions and hallucinations during the times when mania and depression are not present. Nonetheless, I am confident that there are gifts and beauty in every experience. I trust that we don’t get to hear about the goodness that comes through these experiences because as a society we silence that. (For example, prophetic wisdom and vision.)
Borderline Personality Disorder:
Here’s where people often get confused. It is quite confusing to recognize the difference between someone experiencing bipolar disorder and borderline personality disorder.
People living with bipolar disorder can also live with borderline personality disorder.
The reason why it is considered a personality disorder versus a mood disorder is because here mood shows up as character traits that are consistently unstable possibly on a daily basis that can last anywhere from a few hours to a few days. It gets very confusing with rapid cycling bipolar disorder. So keep reading to better understand.
It is important to understand that borderline personality disorder appears to have a very strong nurture / environmental components that are often found to be passed on from one generation to another.
Research has shown that people experiencing borderline personality disorder often did not grow up in an environment / family that offered them stability and predictability.
Their environment may be one that lacked defined and consistent boundaries.
In fact, people nurtured in this way often grow up in an environment where they never really know if and when they will have their needs met. This is incredibly traumatic to a person.
A key component that people share with this diagnosis is the experience of emotional abandonment from their primary caregivers / parents. The response to these experiences are a persistent fear that they will be abandoned emotionally or physically in any relationship.
Anyone living in these nurture / environmental conditions would experience tremendous pain and fear. When your primary caregivers abandoned you emotionally and/or physically or you lived with the fear that they would, relationships may be so difficult and frightening. It makes sense of how someone could live with such a deep need to belong, to be loved and to have their needs met.
It has been described to me by a client in this way, “Its like going through life walking on glass and you get so used to it that it provides the comfort of a blanket.”
This does not mean that all people living in this type of environment will grow up to live with borderline personality disorder, it simply makes them vulnerable to having the following response in life.
These following MOOD characteristics are a response to growing up in this type of environment:
Intense dissatisfaction with life
Irritability or anxiety
Intense anger and/or difficulty controlling anger
Intense fear of abandonment
Consistent idealizing and devaluing of others
May have consistent suicidal ideation
Note: We are only discussing characteristics of mood, this is not a complete diagnosis.
A key difference from bipolar disorder is that people living with borderline personality disorder do not experience elevated, euphoric and expansive mood. They don’t feel invincible and on top of the world.
In Part Two we will explore this from the perspective of Behavior and Changes in Needs and Interests.
Part Three will cover Thought Processes and Sense of Self
Depression causes everyone it touches to forget that there was ever a time when depression was not in their lives.
