5 Ways to Cope with a Diagnosis of Mental Illness

Hearing a diagnosis of mental illness can be heartbreaking for many. Some people feel relief at finally having a name to put to their issues, where others may become angry or afraid because they have a disorder to cope with.

However, a diagnosis is important because it means that you can move on to treatment. Doctors can use their experience with similar diagnoses to construct a personalized plan to address disorders, and advise you about future health risks. Most importantly, insurance companies will have a reason to apply aid now that they have a name for the condition.

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

But what do you do with a diagnosis once you have one?

1. Learn

First, learn about your diagnosis. Ask your doctor to recommend books or websites, like nami.org, the official site of the National Alliance on Mental Illness. Once you learn the basics, like what the symptoms of your illness are, you can transition to learning about treatments and what you can do to help your recovery.

2. Find Doctors

Next, create a treatment team. Ideally, you’d have a therapist and a psychiatrist–or nurse practitioner–who can prescribe medication for you. Presumably you already have one, if you have a diagnosis. But make sure your team is rounded out. There are low-cost options for mental health services out there. Try looking into support groups offered by local NAMI chapters or ant your local library. Ask your doctors if they offer sliding scale fees based on income. If you’re near a university, see if they have a graduate program for psychology, where a therapist-in-training can take you on as a client. Here’s a list of 406 free or low-cost clinics in Washington state, 138 of which offer mental health services.

3. Journal

Writing down your troubles is a proven way to start addressing them. If you have concerns about your diagnosis, write them down so you can bring them up with your doctors later. Scribble down what you plan to do as a result of this diagnosis, whether it be sharing your condition with loved ones or keeping it close to your chest. Figure out whether you need to adjust your treatment team, regarding whether or not you’re relating to the people responsible for your care.

4. Find a Team You

Team You, a term taken from the delightful blog Captain Awkward, is a term used to describe the supportive, unbiased people in your life like counselors, psychiatrists, parents, reliable sitters, religious figures, and friends who may or may not have kids of their own. This assistance is invaluable to a person dealing with a diagnosis of mental illness. Unfortunately, collecting a solid Team You takes time. If you’re a parent, then hopefully you have parent friends—ideally ones who you are comfortable explaining your struggle to. Attend groups from Meetup.com or local libraries. Try out classes, and take notes on your classmates as well as the subject material. Toddler groups are excellent places to search for potential allies, too.

5. Hold Yourself Accountable

Once you have a treatment team and a Team You in place, don’t flake out on them. Attend your doctor’s appointments and take your meds. Keep updating your journal regularly with shifts in your moods, so you can find out if the treatment plan you’ve been given is working. Keep up with your friends and allies.

A diagnosis of mental illness isn’t a life sentence. Many people can and do recover completely from their disorders, and more severe mental conditions can be managed. Help is out there. You are worth exploring every avenue of care.

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8 Myths About Mental Illness

Mental illness is widely misunderstood by the general public. People who suffer from mental disorders can find that many myths surround their condition. These misconceptions contribute to stigma, making it more difficult to seek treatment and manage disorders. We’d like to dispel some of these fictions.

1. People Can Use Willpower to Recover

While there is no definite cure-all for mental illness, it definitely can’t be treated by willpower alone. People can’t just “snap out of it.” If only managing a condition were that easy! Conversely, treatment such as medication, psychotherapy, and Electroconvulsive therapy (ECT) actually works. Scientists are frequently discovering new advances in treatment, and with them, sufferers of mental illness can manage their disorders and lead healthy, productive lives.

2. Mentally Ill People Can’t Work

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Credit to flickr.com user Cat Branchman. Used with permission under a Creative Commons license.

Nope, this is bogus as well. People with mental disorders can and do contribute to the workplace and home. Most of the time, the mentally ill are excellent at “covering” for their illnesses, which basically means that they can successfully pretend that all is well. They can be so good at covering, friends and family don’t even recognize that the disordered are mentally ill.

3. It’s Just Bad Parenting

No, no, no. The causes of mental illness are varied, including genetics, physiological changes, and environmental stressors. Neglect and unusual stress in the home tend to exacerbate underlying conditions which have biological causes. It’s not the parent’s fault that a child develops mental illnesses. Which leads us into our next point…

4. Children Can’t Be Mentally Ill

Children make up a great percentage of the mentally ill. More than half of all mental illnesses show up before a child turns fourteen, and three-quarters of them appear before the age of twenty-four. Even very young children can demonstrate symptoms of mental disorders.

5. Mentally Ill People Are Violent

Dead wrong. Suffers of mental illness make up a meager 3-5% of the incidences of violent acts in society. Hollywood has a terrible habit of stereotyping the mentally ill as violent, from Norman Bates in Psycho to Jim Carrey’s character in Me, Myself, and Irene. In fact, disordered people are ten times more likely to experience violence than the general population.

6. Mental Illnesses are Uncommon

This is absolutely not the case. One in five adult Americans endure mental illnesses each year. Roughly six percent of the population suffers from a debilitating disorder. You’re not alone if you have a mental health problem.

7. Most Mentally Ill People are White

Actually, most mentally ill people are minorities. African Americans are the most at-risk group, vulnerable to mental disorders such as depression due to increased stress from economic disadvantages.

8. People Can Recover With Drugs Alone

Medications and ECT are only part of the equation. The rest is talk therapy, which most people prefer to use rather than drugs, and peer support groups. These latter strategies try to lessen the effect of environmental stressors, which can trigger or exacerbate underlying conditions.

These myths are damaging to the mentally ill. By educating yourself about mental disorders, and spreading the truth about them, you can help combat dangerous misconceptions which stigmatize sufferers of mental health issues.

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Nature vs. Nurture: The Causes of Bipolar Disorder

What causes bipolar disorder? Scientists aren’t actually sure, but are taking into consideration several risk factors, such as genes, brain structure, and environmental causes.

Genes

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Genetic studies of twins have shown promising results with regards to bipolar disorder. According to a a study by Berit Kerner, “The heritability of bipolar disorder based on concordance rates for bipolar disorder in twin studies has been estimated to be between 60% and 80%.” However, if one identical twin develops Bipolar I, the rate of the other twin developing it is roughly 40%, compared to fraternal twins at 5%. Parents have a 10 to 15% chance to pass bipolar disorder to their children if one parent has the disorder, compared to 30 to 40% if both do. This means genetics play a crucial role in the transmission of bipolar disorder.

Brain Structure

Recent evidence suggests that the structure of the brain may contribute to people developing bipolar disorder. MRI studies have found the over-activation of the amygdala, which processes memory, helps decision-making, and controls emotional reactions. People who are manic showed decreased activity in the interior frontal cortex, which assists problem solving, memory, language, judgment, and impulse control. Certain psychiatric medications work on neurotransmitters, suggesting that these messenger chemicals play a significant role in the function of bipolar disorder, but no one knows how exactly they’re responsible.

Environmental Factors

Stress is a significant predictor of bipolar disorder in people who are susceptible to the disease. Life events such as childbirth, trauma, job loss, or grief over a death in the family may trigger a mood episode. My mania and subsequent psychosis was set off by the birth of my first child, Nolan, but my second child’s birth did not trigger anything. However, substance abuse, hormonal issues, and altered health habits can also spark the illness.

Many factors set in motion the development of bipolar disorder. With more research, scientists will discover the roots of the disease, and possibly be able to prevent it in the future.

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What is Bipolar Disorder?

Bipolar disorder, also known as manic depression, is a chronic mental illness characterized by swings between depression and grandiose moods. Over five million people live with the illness. The disorder often runs in families, affects women and men equally, and appears around the average age of twenty-five.

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Credit to flickr.com user Al King. Used with permission under a Creative Commons license.

To fully explain bipolar disorder, we must first look at the two “poles” of the disease: mania and depression. Mania includes racing thoughts, elevated mood, over-excitement, a lack of a need to sleep, irritability, impulsive decisions, and sometimes delusions. Depression includes feeling sad or sluggish, overeating, insomnia or over-sleeping, severe lack of energy, trouble making decisions, and possibly thoughts of suicide. People with bipolar disorder can swing between these two states over periods of days, weeks, months, or even years. Rapid cycling occurs when four or more mood episodes happen over the course of a year, which is difficult to treat. Four episodes per day is called “Ultradian Cycling.”

Mixed episodes occur when symptoms of mania and symptoms of depression happen at the same time, increasing the risk of suicide. It is very difficult to treat a mixed episode, as most medications do not treat both sets of symptoms at the same time.

Children with bipolar disorder tend to have tantrums that last for hours, and possibly turn violent. Thirty percent of kids who have a major depressive diagnosis will eventually receive a diagnosis of bipolar disorder. During mania, kids tend to have trouble sleeping, be irritable, and speak quickly about a variety of topics. Depressive episodes see children complaining a lot about stomachaches or headaches, have no interest in fun, and possibly think about death or suicide.

There are three types of the disorder: bipolar I, bipolar II, and cyclothymia.

Bipolar I

Bipolar I is diagnosed when a person suffers from manic symptoms longer than seven days, or severe enough to require immediate hospitalization. Depressive episodes often last two weeks or more. Both states prevent normal function, and require treatment in order for the individual to fully live their life.

Bipolar II

Four times more common than Bipolar I, Bipolar II is characterized by both depression and hypomanic (“below mania”) episodes, but not full-blown mania.  Often productive, persons with Bipolar II are rarely hospitalized.

Cyclothymia

Cyclothmia is a tricky diagnosis with manic symptoms less severe than Bipolar I and depressive symptoms less severe than Bipolar II. Impact on productivity varies; some individuals may be hyper-productive with little impairment, whereas others are manic or severely depressed for most of their lives. Cyclothimics may have periods of stability, but those last less than eight weeks.

There are several risk factors under consideration. Genetics may play a part, though studies of identical twins have found that one twin may develop the disorder while the other twin does not. Brain scans show that the structure of the brains of sufferers of bipolar disorder have differently sized portions of the brain compared to healthy people. Family history seems to contribute as well, as those who have a family history of the disorder tend to develop it more often than those who do not.

Treatment for bipolar disorder requires a range of psychotherapy and mood stabilizing drugs like lithium and Depakote. Electroconvulsive therapy (ECT) is also used, with mixed results. Several illnesses are comorbid with bipolar disorder, such as Attention Deficit Hyperactivity Disorder (ADHD) or anxiety-related illnesses. These related conditions make it difficult to treat the underlying bipolar disorder, as stimulants used to treat ADHD can sometimes trigger a manic episode. 

With treatment, people with bipolar disorder can lead productive, healthy lives, managing their illness as it comes.

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What is Cyclothymia?

I once met a man at a writer’s conference whose behavior screamed “hypomanic”. He spoke rapidly, walked fast, made grand gestures, and was prone to heavy drinking and smoking. I often saw him pacing or fidgeting. At any given moment, I expected him to burst out of his skin, unable to contain his elation.

He was also an inspiration to many. The great majority of his conversations consisted of probing questions about who the addressee was, and how were they going to improve themselves—today? What were their dreams, and why weren’t they acting on them already? He oozed charisma, and garnered quite a fan following.

Lucky for him, he had an amazing Team You present at the conference: a group of his friends who had all known each other since their school days. They took shifts watching over him when he inevitably crashed. They explained that their colleague would go, go, go–sometimes for up to a month and a half. Then he’d sleep for about a week, curling into himself in the throes of an awful depression.

When I explained his behavior to my therapist, she said, “That sounds like cyclothymia.”

Cyclothymia is largely considered to be a “weaker” form of bipolar disorder. Episodes of mania and depression are not as severe and do not last as long. Psychotic features aren’t usually present. Some people with the weaker form eventually develop full-blown bipolar. It is suspected that cyclothymia is passed down genetically.

The disorder is difficult to diagnose because it shares so many characteristics with Attention Deficit Hyperactivity Disorder (ADHD), including, “increased energy, distractibility, and impulsive or risk-seeking behavior.” The symptoms also overlap with certain personality disorders. In addition, cyclothymia is frequently comorbid with other disorders, which means that a doctor may have one or more diagnoses to sift through.

Symptoms are usually treated with lithium carbonate and Seroquel, provided the patient desires treatment. Most people with cyclothymia are productive, sometimes to extremes.

Disclaimer: I do not claim to know enough to have diagnosed my friend, nor do I expect or want my therapist to do the same.

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Hypomania: A Closer Look

Out of all the states a bipolar person flows through, hypomania is the most coveted–and the most difficult to give up. I’ve often thought of it as a zen state, but rather than letting everything go via meditation or practice, I magically gain the ability to keep track of everything I think I need to in my overcrowded brain.

In 2010, I wrote this anecdote as a journal entry, during a time when I was struggling to adjust to new dosages of my medications. I don’t think I could describe the sensations of hypomania any better today:

When I’m in a hypomanic state, my senses are on fire. Colors are brighter and smells are stronger. I’m a bit more sexual, more confident, more outgoing. Everything—everything!—is alive with passion and potential and emotion. I feel sharp and witty whether I truly am or not.

Stability, on the other hand, is bland. As if someone turned down the saturation in my life, all that’s left are shades of gray.

It’s easier to discern truth from fiction (and stupid ideas from smart ones) when I keep having water thrown in my face, but the process washes away quite a bit of the life I knew and enjoyed previously.

Normalcy is bittersweet.

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What is Hypomania?

People in a hypomanic episode usually have feelings of euphoria, irritability, increased sexuality, and competitiveness–but less than someone with full-blown mania. In Latin, “hypo” means below, so the definition of hypomanic as, “appears less intense than manic” follows logically.

Whereas inability to focus permeates mania, my experience with hypomania has been completely different. Increased focus and feelings of contentment means that I am incredibly productive while hypomanic, and I don’t doubt that this drive and ability applies to other people in such a state as well. Hypomania is a very pleasurable episode to be in; I have often felt as if I am coasting along in my day, accomplishing anything I set out to do with my super-human energy. It is part of the reason bipolar people often grieve for the hypomanic episode while depressed or normal. Similarly, medication compliance is difficult while this a state of ecstasy.

A hypomania diagnosis is also the main difference between Bipolar I and Bipolar II. People with the former suffer from full-blown manic episodes complete with psychotic features like hallucinations and delusions of godhood, whereas Bipolar II people deal with depression and hypomania only.

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What is Mania?

The bipolar sufferer is a creature of extremes, and nowhere is that made more clear than during manic episodes. Often depicted as the default bipolar state in popular culture, mania is a psychiatric state defined by symptoms of gradiosity, irritability, pressured speech, and rapid thoughts.

The manic person may go from euphoric and impervious in one second to angry and snappish in the next. They often speak too quickly and become frustrated with everyone around them, who they percieve as moving too slow. Inability to concentrate due to the flood of ideas in a manic person’s mind means they start projects and then drop them before they’re even half-done (eg: I have piles of unfinished craft projects all over my house).

Spending increases, sometimes to extreme levels, and the purchases are rarely thought through. Increased sexuality and the desire to express such feelings sometimes leads to affairs or other drastic acts. People undergoing a manic state also tend to have an inflated sense of their own mortality; most of the time, it feels good to be a god, so compliance with medication and therapies is rare. Oftentimes they do not know they are manic, and one of the first issues to address when treating them is to get them to a point where they can be reoriented.

A diagnosis of mania is also the primary difference between Bipolar I and Bipolar II: the former requires an extreme manic episode lasting at least one week, possibly with psychotic features such as hallucinations or delusions of godhood. Sufferers of Bipolar II deal with depression and hypomania only.

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