Getting Support During a Bipolar Depression Episode

Trigger Warning: This post contains a brief mention of suicidal ideation. If you are suffering from suicidal thoughts, please talk with someone from the Suicide Prevention LifeLine at 1-800-273-8255 or www.suicidepreventionlifeline.org.

Anyone who suffers from bipolar disorder also suffers from depression. That’s just the nature of the beast. Sometimes depressive episodes can be debilitating. I’d like to share what my friends and family around me can do to help support me during an episode, and inspire you to make your own list to present to your family and friends. If you can’t bring yourself to make a list, then please feel free to print this article out and hand it to them.

Let’s dig in.

depression
A picture of a white woman holding her head. Credit to flickr.com user Amy Messere. Used with permission under a Creative Commons license.

1. Help Me Keep my Environment Clean

One of the major problems I have when I am suffering from depression is keeping my environment clean. During an episode, my house usually looks like a tornado hit it.

The depression-messy house cycle has been anecdotally supported for a long time. In short, the low energy and overwhelming feelings common to depressive episodes contribute to the inability to keep the house clean, and the resulting mess contributes to depression–specifically to shame. It’s a nasty cycle, one which is difficult to break.

At one point, during a very severe depressive episode years ago, I allowed dirty diapers to pile up on the floor of my living room. My mood–and subsequently my ability to keep the house clean–has improved immensely since the time my son was in diapers, largely due to appropriate medication and therapy.

One way my family and friends can support me–or any of their loved ones suffering from depression–is to encourage me to keep my environment clean. When I’m in the throes of depression, I need external motivation to pick up my space. This is best conveyed through praise and validation for my accomplishments. Please, I tell them, notice if I’ve done the dishes twice in a row, and thank me for doing so.

But if I’m in the midst of a completely soul-sucking depressive episode, I may need more help than just encouragement. When I’m that low, I need to be in a clean environment no matter how it happens. I may need my family and friends to step in and actually do the dishes rather than just thank me for them. There is a time and place for that level of help, and it’s okay to ask for that kind of support. Even hiring someone for me is useful.

I encourage you in turn to tell your family and friends what you need, be it reminders to do however much work you can handle or help tidying your space.

2. Encourage Self-Care

When I’m in the belly of the beast, I sometimes need help taking care of myself, including personal grooming. Brushing my teeth is a struggle. During my senior year of college, I suffered a suicidal depressive episode so bad and so lengthy that I didn’t eat or shower for weeks. My mom drove to my college town two hours away from her home and washed my hair for me. Then she took me to a crisis center, which helped me get back on an even keel. Neglecting myself made my depression worse.

If you are neglecting yourself, I encourage you to reach out to those around you. If you feel you have no one and are suicidal, immediately go to a crisis center. Do not wait.

3. Watch My Kids

This is a tip for the parents among us, but one of the best ways to support a parent in the midst of a depressive episode should be obvious: watch the kids. If I don’t get time to rest and recover from 24-hour parenting duty, I start to tune out my children and am not the present parent I would like to be. This is even worse when dealing with depression. I try not to neglect my children while depressed, but parenting while suffering from a depressive episode is incredibly difficult. Being able to briefly hand them off to my husband or a babysitter to recharge my batteries is crucial for my recovery during depression.

If you have children and are suffering from depression, try to arrange alternative supervision for them so that you won’t have to take on all their care by yourself. The best time to plan this is when you’re well, but if you didn’t, then call on your friends and family as much as possible during your depressive episode. If you don’t have friends and family around, google drop-in daycares in your city, or ask members of your church if they’d be willing to babysit. I know internet research and making calls is the last thing you want to do during an episode, but getting some time to yourself is crucial for healing.

4. Listen While Maintaining Healthy Boundaries

One of the stressors on me when I’m depressed is the fear that I’m overburdening my friends and family with my negative feelings. Thankfully, my sister is very good at taking care of herself by letting me know when she needs a break from my negativity. She is a great listener, and often provides me a space to feel vulnerable without being judged.

If you can find people who can listen to you while taking care of themselves, they can be an invaluable resource to you. There’s a certain give and take between a person suffering depression and his or her supporters, and the ultimate goal is for everyone to be healthy.

Final Thoughts

The best ways to support me while I’m in a depressive episode is to help me take care of my environment and myself, watch my kids for me, and to listen while maintaining healthy boundaries. This is what works for me. I encourage you to figure out what you need from your loved ones and don’t be afraid to ask for those things. Certain people will better be able to support you than others, and in different ways. Identify these people and lean on them for support.

I wish you well.

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How to Communicate with Family During the Holidays When You Have a Mental Illness

family photo2
A picture of a mother, father, and their three children peeking out between white frames, as a family photo. Credit to flickr.com user Louish Pixel. Used with permission under a Creative Commons license.

The holidays can be a source of great joy for many people. But the season of celebrations can also be fraught with tension, especially when families get together. But if you have a mental illness like bipolar disorder, then navigating the heated conversations at the dinner table can be triggering and difficult. Read on to find out how to communicate effectively with family during the holidays when you have a mental illness.

1. Know Your Limits

One of the most effective ways to communicate with difficult family members starts with you knowing yourself. Before you find yourself pushed to your limits, advocate for breaks for yourself. Excusing yourself for a brief walk or a breath of fresh air will do wonders for your disposition. There’s no shame in seeking time away to ground yourself. If you suffer from bipolar disorder, check out this post on common bipolar triggers and how to manage them to avoid falling into a depressive or manic episode.

2. Redirect the Conversation with Humor

When you find yourself facing people asking probing questions about anxiety-producing topics like your reproductive plans, try gently redirecting the conversation using humor. Don’t answer the question if you don’t feel like doing so, but do try to give the asker a witty (and possibly self-depricating) comment. This is easier said than done, of course, and if this puts more pressure on you, use the next tip instead.

3. Firmly Establish Conversational Boundaries

Some family members may have the unfortunate tendency to expound on their offensive political opinions to others, especially captive audiences around the dinner table. Don’t take the bait and argue with them. Instead, firmly establish conversational boundaries. Try saying something like, “Aunt Mildred, I understand that you feel that way. But I don’t want to talk about X, Y, or Z tonight. Let’s just enjoy the party, please.” If Aunt Mildred continues, then use tip one and gently extricate yourself from the conversation to take a break.

4. Enlist the Help of a Trusted Family Member

If you have a loving spouse or partner, or even a beloved family member you are close to, enlist his or her help in managing other more divisive people. Check in with your partner and ask them to check in with you every half hour or so during parties or other family gatherings. If needed, develop a signal between the two of you so he or she can rescue you from unpleasant conversations.

5. Lean on Existing Support Systems

If you are traveling and won’t be able to meet with your usual therapist or psychiatrist, then make sure to have crisis hotlines or warmlines programmed into your phone. If you’re bipolar, one national warmline provided by Nami Orange County can be called at 877-910-9276. Online support groups can help as well; try HealthfulChat’s room focused on bipolar disorder.

6. Avoid Alcohol

This isn’t a fun tip, but alcohol can add fuel to the fires of family conflict. Staying sober will reduce the chances of your saying something you regret. If you do choose to imbibe, then know your limits, and drink plenty of water to avoid having a hangover the next day.

7. Eat Properly and Get Plenty of Sleep

This tip is similar to tip 1: take care of yourself. Try to avoid sugar as much as possible, stick to your normal, healthy diet, and go to bed at reasonable hours. If you take care of your body, then you will be better equipped to handle family members who talk your ear off. Also, take your meds.

Final Thoughts

Communicating with your family during the holidays when you have a mental illness isn’t an insurmountable task. Just make sure to take care of yourself–removing yourself from conversations if necessary–avoid alcohol, get support, and establish firm boundaries.

You can do this.

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Hiatus Announcement for The Bipolar Parent

It’s time for me to take a break.

cassandra stout photo
Blogger Cassandra Stout. Protected under a Creative Commons license.

I’ve been burned out with family responsibilities and dealing with some intense conversations in therapy, and my blog has suffered for it. You may have noticed a dip in quality, for which I apologize for. I’ve only written a single post in the past six weeks. In short, while I have the motivation to blog, as I don’t want to disappoint you guys, my readership, I have lost the inspiration. I don’t want to churn out low-quality posts just to have something up on Fridays, so it is with a heavy heart that I’m announcing a hiatus until the first Friday in September, 2019. I promise to start blogging again then, and to give you the level of detail and quality you expect from The Bipolar Parent.

Thanks so much for being here with me. Until September.

-Cassandra Stout

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Family Study Emphasizes Distinct Origins for Bipolar Disorder Subtypes

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Credit to flickr.com user Kat Grigg. Used with permission under a Creative Commons license.

The most common subtypes of bipolar disorder, bipolar I and bipolar II, stem—at least in part—from different biological causes, according to a new study published in Biological Psychiatry. Despite genetic overlap between the two subtypes, each subtype tended to cluster within families, suggesting a distinction between bipolar disorders I and II.

The study, by Dr. Jie Song of the Department of Clinical Neuroscience, Karolinska Institutet, Sweden, and colleagues helps settle controversy over the relationship between bipolar I and bipolar II disorders. Although genetic similarities indicate overlap between the subtypes, the new findings emphasize different origins. According to Song, this is contrary to a common notion among many clinicians that bipolar II disorder is merely a milder form.

“We have tended to view the two forms of bipolar disorder as variants of the same clinical condition. However, this new study highlights important differences in the heritable risk for these two disorders,” said Dr. John Krystal, Editor of Biological Psychiatry.

The study is the first nationwide family study to explore the difference between the two main subtypes of bipolar disorder. Dr. Song and colleagues analyzed the occurrence of the bipolar disorder subtypes in families from the Swedish national registers. Although a strong genetic correlation between bipolar I and bipolar II disorder suggests that they are not completely different, the family occurrence for each subtype was stronger than co-occurrence between the subtypes, indicating that bipolar I and bipolar II disorders tend to “run” in families separately, rather than occurring together.

“Within the context of our emerging appreciation of polygenic risk, where gene variations are implicated in several disorders, the new findings point to only partial overlap in the risk mechanisms for these two forms of bipolar disorder,” said Dr. Krystal.

The study also provided some additional clues that bipolar I and II disorders have distinct origins. Only bipolar disorder II showed gender differences—the proportion of females to males was higher in bipolar disorder II but not bipolar disorder I. And bipolar I clustered together in families with schizophrenia, which was not apparent for bipolar disorder II.

“Hopefully, our findings increase awareness of the need for refined distinctions between subtypes of mood disorder,” said Dr. Song. The distinction between the subtypes also has implications for treatment strategies for patients. Dr. Song added that future research is warranted to characterize new biomarkers to improve treatment and prognosis.

Text provided by Elsevier.

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