How are you? How was your New Year’s eve? Did you go to a party? Stay at home? Did fireworks keep you up? Let me know in the comments, or email me! I promise to reply.
My week was lovely. My immediate family (husband and two great kids) just arrived home from a two-week trip to Arizona, where my mother-in-law lives. I adore her, so the trip was a great one.
We also spent time with my husband’s father and his wife, and my husband’s brothers. A great deal of my side of the family live in Arizona as well, so my husband and kids were able to visit them also.
But it’s good to be home. I missed my bed. I mentioned previously that I was having trouble sleeping without a sleep aid. I am pleased to announce that I successfully slept each night of the two-week trip without taking anything except my usual Risperidone. That was surprisingly difficult to do!
If you’re on meds, have they helped you? Thanks for listening!
I have suffered from bipolar disorder I for decades, but I didn’t know that my condition had a name for a long time. It wasn’t until after a psychotic break following the birth of my son 11 years ago that I was diagnosed, and started managing the illness. Thankfully, my bipolar disorder is not the treatment-resistant type, so I have responded well to medication and therapy.
Here are 11 lessons I learned after 11 years of managing bipolar disorder:
Lesson #1: Take my Medication, Everyday
Like almost everyone who takes medication for a chronic illness, I found myself not wanting to take my pills. Could I manage my disorder without them? Do I have to take my meds everyday? The answers to those questions are: no, I can’t, and yes, I do, respectively.
I learned the hard way that I have to take my medication every day. If I don’t, I end up manic, anxious, or depressed, and sometimes all three at once. Mania and depression presenting at once is called a mixed episode, which I have on occasion. They are the most dangerous of all the episodes if left untreated, because I think awful thoughts and have the energy (and lack of impulse control) to act on them. For me, taking my medication daily is the only way to head off these episodes.
Lesson #2: Take my Medication on Time
Taking my meds on time (morning meds in the morning, night meds at night) is something I still struggle with. My psychiatrist recently told me to take a medication I was taking at night in the morning, which I am not at all used to, so I often forget to take them. But I’ve found that if I take the medication which shares a caffeine pathway in my brain at night, then I’ll be up all night, which can lead to manic episodes. It’s a balance I’ve yet to master.
Lesson #3: This Mental Illness is Lifelong
Until the past several months, I hadn’t suffered a depressive or manic episode in six or seven years. I thought, foolishly, that the mental illness had simply–poof!–disappeared. The fact that I can’t just make mental illness go away has been one that I’ve struggled to accept. I can manage my disorder, but it is always with me.
Lesson #4: Make Peace with my Diagnosis
Like many people diagnosed with a mental illness, I struggled at first with my diagnosis. I couldn’t be bipolar, I thought. I wasn’t crazy, like the people surrounding me in the mental hospital I committed myself to. But I was and am mentally ill. Making peace with my diagnosis only came in time, after I had figured out how to manage my condition. Like lesson #3, I had to realize that this mental illness is lifelong, and I needed to deal with it.
Lesson #5: Take my Bipolar Disorder Seriously
If left untreated, my bipolar disorder will wreck my life. Over the years, I have taken my medication consistently and attended therapy religiously. But when I didn’t, my carefully constructed life fell apart–and how. I have since learned that I must take my mental illness seriously. Like a diabetic, one slip up is enough to send me into a spiral of destruction. I can never stop managing bipolar disorder, ever.
Lesson #6: Honesty is the Best Policy
I’ve found that, when it comes to my moods, honesty is the best policy. When my son asks me how I’m feeling, I will tell him that I am anxious, depressed, fine, or feeling “up.” I don’t ask him to manage my emotions, but he is able to adjust his expectations of me accordingly. He is extraordinarily empathetic and mature for his age, and I have no doubts that’s because of how my mental illness has affected him. In other cases, being honest about my bipolar disorder to people other than my immediate family ends up with the same result. For more information on how to disclose your disorder to friends and family, click here.
Lesson #7: Gather a Support System
For many, many years, I was too depressed to gather a strong support system. I had moved away from all my friends and family for my husband’s job, and felt isolated. Making new friends, especially when I had an infant to care for, seemed impossible. It’s only been fairly recently that I’ve reconnected with my family (and been honest with them; see lesson #6), and made new friends who understand mental illness. This support is crucial to my wellbeing. If I had known how much not having a system in place affected me, I would have pushed myself hard to make friends sooner.
Lesson #8: Manage my Sleep
Staying up all night for a week is what triggered my psychotic break and first real manic episode. I have learned the hard way that sleep is my best friend. When I don’t sleep, I end up firmly in the middle of a manic episode, depressive episode, or mixed episode. Sleep is crucial for anyone with bipolar disorder, but I need more sleep than the average adult (about 9-10 hours a night vs. 7-8). I cannot function without sleep.
Lesson #9: Trust my Mental Health Team
Like many people who suffer from mental illnesses, I have had upwards of seven psychiatrists, and two therapists. They keep moving on me! Building trust in a new treatment team is so difficult, but I have to advocate for myself and learn to trust every time change upsets the apple cart. The lesson that my mental health team is only acting in my best interest has been a difficult one to learn. I now rely on my current psychiatrist and therapist with my life.
Lesson #10: Know my Triggers
Learning common bipolar triggers took time, and effort. I didn’t do a lot of research about bipolar disorder when I was first diagnosed, and what a fool I was. Figuring out that I needed good sleep hygiene (see lesson #8) took a period of trial and error, during which my husband and child suffered as I wasn’t present for them. Learning what triggered my manic or depressive episodes, and how to manage those triggers, was crucial in learning how to manage my disease.
Lesson #11: Therapy is Awesome
Though I was attending therapy for nine months before my diagnosis, learning coping skills in therapy was invaluable. I have attended innumerable sessions with a therapist over the years, and doing so has helped me: be more present as a parent and wife, learn how to manage my bipolar disorder, and figure out how to deal with family situations like a tense Christmas. Therapy is awesome. I highly recommend prioritizing counseling sessions if you can afford them. Many therapists take clients on a sliding scale.
Over the years, I have learned several more lessons than just these 11. But these are likely the most important. Many of these lessons are common ones learned by people who suffer from mental illnesses. If you suffer from bipolar disorder and are newly-diagnosed, take heart. Do research on your condition, take your medications, and never stop fighting.
Are you ready to disclose that you have a mental illness? Read on to figure out how to tell your family, friends, and maybe even your employer that you have a disorder.
1. Prepare Your Listener
In order to best disclose that you have a mental illness, you need to prepare your listener. It’s sort of like writing an essay: first you tell him or her what you’re about to say, then you say it, then you summarize what you’ve just said. Preparing your audience is called “process talk.” Try this: “I want to talk to you about something I’m struggling with. It’s taken me a lot of courage to come this far. I hope you’ll support me.”
2. What You’re Dealing With
Next, you want to give concrete examples of what your mental illness is. Explain a situation or two where you’ve struggled, such as not being able to get out of bed for weeks, or going on multiple unplanned spending sprees when you’re manic, if you have bipolar disorder. Cementing your mental illness in your listener’s head will help them understand exactly what you’re facing every day. Consider providing educational materials such as articles or pamphlets about your mental illness. NAMI.org is a great online resource for the National Alliance on Mental Illness.
3. Ask for Help
Suggest ways your audience can support you. This can involve asking for more breaks or other accommodations at work or school, or simply asking a friend to understand why you can’t hang out as long. You can also ask your loved ones to help you find a doctor and follow through with an appointment, if you feel that your friend or family member will understand and be helpful. Set boundaries here, too: you know yourself best, and you need to explain whether you need advice or just need your audience to listen.
4. What to Share
You definitely don’t need to share everything. Plan ahead as to what you feel comfortable sharing about your experience. It’s perfectly reasonable to explain that you don’t feel like talking about something in particular. If you do feel there are good parts to your illness, like things you’ve learned, try to share those.
Explaining your illness to a listener is an intense experience, and a personal decision. Practice in front of a mirror or with a licensed professional, like a therapist, who may be able to answer any concerns you have. Keep in mind that you need to prepare your listener, explain your illness, and ask for help.
Tune in next week for part three of this series: “Disclosing That You Have a Mental Illness, part III: If.”
One of my strongest memories from the mental hospital, explained in a scene in my upcoming book, Committed, is what happened when I used a poor choice of words in front a group of the other patients. I commented on the awful food at the hospital, saying, “Doesn’t that just drive you nuts?”
All of them flinched. The effect of my words was immediately apparent: I had wounded them. I apologized profusely, and then my roommate said something I’ll never forget: “Don’t worry, we’re used to it.”
It took me a few moments to realize what, exactly, they were used to: the prevalence of “nuts,” or, rather, the misuse of words that could apply to them. “Nut” is defined by Merriam-Webster as “a foolish, eccentric, or crazy person.” Words like crazy, nuts, and psycho are often misused, and stigmatize people who actually suffer from mental illnesses. I admit that, now, every time I hear the word crazy in public, I, too, flinch. There are so many more precise words to be used rather than just defaulting to the standard “nuts.”
Just like people don’t use the word “retard” to describe mental handicaps anymore, I contend that “nuts” is equally harming and ablest. “Crazy” and other terms usually don’t refer to actual psychotic people, but are used to dismiss the way people–mostly girls and women–feel. When “crazy” is used to describe irrational, frightening behaviors, it wounds people who suffer from mental illnesses by making them feel as if their disorder is out of control. These words have power, and that power is used to isolate people by making them feel abnormal–in a bad way. Mental illness is not the reason behind all bad behaviors. Plenty of neurotypical people can be jerks.
Here is a great list of words to use instead of insane or psycho, such as “naive, mistaken, confused, misled, misinformed, uninformed, [and] ignorant.” The author, Jennifer Kesler, also points out that a job or weather cannot be “schizo” or “bipolar.” Only a person can be those things, and saying they have bipolar is more correct than “is” bipolar, because you don’t want to define them by their illness.
Many people who suffer from mental illnesses don’t feel hurt when this language is misused, and even call themselves crazy. But others do feel attacked by it. I don’t mean to police language, but if one can avoid harming people who feel this way, then why not?
“What do you mean he’s mentally ill?” the woman said. “He just needs to get his act together!” I was sitting in an Olive Garden the other day, and overheard part of a conversation from a very loud patron. I tried to ignore her, but she said something that caught my attention: “Well, how do you define mentally ill?”
Hearing that made me think about what a good question it was. How do you define mental illness? Mental disorders are more prevalent than heart disease, cancer, or diabetes. Twenty-five percent of American adults and thirteen percent of American children are diagnosed each year with a mental illness, per the National Institute of Mental Health (NIMH). The causes of mental illnesses are still unknown, though recent research points to genetics as well as environmental stressors.
According to the Mayo Clinic, “Mental illness refers to a wide range of mental health conditions–disorders that affect your mood, thinking and behavior.” Generally, these illnesses cause dysfunction in your life. Examples include schizophrenia, eating disorders, bipolar disorder, phobias, unipolar depression, and many more. These conditions are classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th. Edition (DSM-V). Published by the American Psychiatric Association, the DSM-V is considered the guide to mental health issues. It covers five dimensions of mental illness:
• clinical syndromes, such as bipolar disorder
• developmental disorders and personality disorders, such as autism and borderline personality disorder
• physical conditions
• severity of psychosocial stressors
• and highest level of functioning in the last year, which is a measure of the mentally ill person’s ability to meet life’s demands on an annual basis.
But how does society define mental illness? There are stereotypes of the disordered person ranging from unpredictable to slovenly. Countless news stories report people with mental health issues as violent, while research shows that they’re no more violent than the general population. In fact, they are more likely to be the victims of violent crime. Thesaurus.com even lists “crazy” as the second synonym for violent.
What’s even worse is how society has treated the mentally ill. In Ancient Greece, physicians used to drill holes in people’s heads to let the evil spirits escape, and ostensibly cure their disorders. Institutionalism was rampant from the 1800s to the 1950s, and some patients were even chained to their beds and left in filth. It was as recent as the 1930s that lobotomies and malarial infections were the leading treatments for the mentally ill.
So, when the woman in the Olive Garden spoke about her friend’s husband, putting him down for suffering from mental health issues, I was irritated with her. People who endure these grueling conditions and their families have enough to deal with without others questioning their diagnosis.
Most people with mental illnesses are aware that they can sometimes be inappropriate or different than others. Mental disorders are not something you can just will yourself to cure. They require treatment ranging from talk therapy to medications, and some are even treatment resistant. Many people who do not receive treatment are unable to cope with their lives, which in turn causes them to not be able to keep the house clean or hold down a job. Many more can control their mental illness, or mitigate symptoms—with treatment.
Treatment has come a long way since the insulin-induced comas of the 1930s. But it’s not far enough. Communities have been slow to offer housing support and life skills training for the mentally ill who were deinstitutionalized in the 1950s. People who suffer from mental health disorders need more care than society has been willing or able to give.
Better funding for research into disorders would be a good start. The National Institutes of Health (NIH) estimated that the organization would spend $396 million on mental illness research in 2016, compared to $1 billion for diabetes research.
But what can individuals do for those of us who suffer from mental illnesses like bipolar disorder? Be kind to the mentally ill. Learn about various diagnoses and the stresses that trigger them. Advocate for better housing options and more funding for research. With these efforts, concerned people can make the world a better place for those with mental health conditions.