One of the last tasks my doctors at the psychiatric hospital made me do before releasing me to the wider world was to make an emergency health care plan for future mental health crises.
At the time, I thought this plan was stupid. I was manic and therefore invincible, and I would not be having any more mental health crises, thank you very much.
Once I came down from my high, I realized that having such a plan—with emergency numbers and the names of my doctors—in an accessible place was an excellent idea.
But how do you make a mental health crisis plan? And what is it?
What the Plan Is
A mental health crisis plan is a series of steps to take when you experience a psychiatric crisis. You write down the steps when you are well and place the completed plan in a place where you and your loved ones can reach any time you need it.
As a person with mental illness, having a crisis plan is of utmost importance. You never know when a mental health episode will strike and will knock you off your metaphorical feet.
Caregivers and crisis teams can help you best when they’ve been prepared to honor your wishes. So you need to tell them what those wishes are with a mental health crisis plan.
Making the Plan
An emergency mental health crisis plan should include:
Your contact information and directions to your home.
A description of what a crisis situation looks like for you.
Contact information for your supporters.
Phone numbers for your therapist, psychiatrist, and primary care physician, as well as any other doctors working closely with you to manage your mental health.
A phone number for the local Psychiatric Emergency Response Team (PERT). Do not hesitate to call the emergency number for your country as well.
A list of all prescribed medications and doctors who prescribed them.
A signed waiver from you giving all providers permission to speak to your supporters during the crisis, as well as giving supporters permission to speak to each other.
Anything you need to be mindful about for your health in general (e.g. allergies, dietary restrictions, etc).
Arrangements for your children should you need to be away from home.
Similarly, arrangements for your pets should you need to be away from home.
How supporters should settle disputes.
A list of all prior hospitalization dates and previous major crises.
A list of acceptable and unacceptable treatments and why (allergies, etc).
A list of acceptable and unacceptable people involved in your treatment and why.
Your signature and the signatures of two witnesses and (preferably) your attorney.
If you type a document up on a computer, you can change it whenever you like. Simply email an attached copy to your supporters. But keep a printed copy available in an accessible place in your home for your supporters as well.
If you are in a crisis, the last thing you need is to make decisions about your care. Make a mental health crisis plan today to prepare yourself and your caregivers to take care of your in a way that you find acceptable.
Do you have a new father in your life? Read how to support him and his family on this post by the Bipolar Parent!
Most everyone has heard of postpartum depression, the devastating mental health condition that affects many mothers after giving birth. But did you know that some researchers estimate that up to 25% of new fathers suffer depression in the first year after their child’s birth? And the number jumps to 50% if mom is also depressed.
We hear quite a bit about women’s transition to new motherhood, but very little about men’s transition to fatherhood. While supporting maternal mental health is a worthy goal and should continue, we need to support paternal mental health as well.
Immediately following Father’s Day on June 21st, 2020, is International Father’s Mental Health Day. Founded by Postpartum Support International’s Dr. Daniel Singley as well as paternal postpartum depression survivor Mark Williams, the awareness day aims to create social media buzz about the mental health of dads.
New Fatherhood Has Its Own Changes and Challenges
Having a new baby doesn’t just change the biology of women. Men undergo massive hormonal and biological changes as well. Testosterone goes down, prolactin goes up, and entire areas of a man’s brain grow. This equips the father to care for his newborn.
And aside from biological and hormonal changes, fatherhood brings its own unique stresses.
First, the partnership between the parents have changed. Sex is off the table, at least for a while, and sleep deprivation makes handling conflicts over parenting, finances, and other issues more difficult to handle–right when the conflicts ramp up.
The lack of emotional and physical intimacy, especially for men who depend entirely on their partner for emotional closeness, is a bitter pill to swallow for many new fathers.
Speaking of finances, a mother who has just given birth needs at least six weeks to recover, maybe more if she’s had a C-section. She will be out of work for at least that time. Since parental leave in the US is so abysmal, and new parents have very little support on a state and federal level, the stress for keeping the family afloat while the mother is recovering falls to the other parent.
The father may also feel that his bond with the new baby is not as strong as the mother’s bond, so he may feel left out of building a relationship with his newborn.
In addition, there are psychological stresses to parenting. The new dad must resolve conflicts about his own childhood and his own father, looking for a model for his own parenthood. If the new dad has a bad relationship with his own father, he may have to seek role models elsewhere–something few people do before impending fatherhood.
All of these stresses and conflicts impact a new dad’s mental health. As I said in the first paragraph, up to 25% of new fathers suffer depression in the first year of their baby’s life.
How to Support Our Fathers
The mental health of our fathers matters, and not just for the father himself.
If the father of the household is emotionally healthy, he can better respond to a newborn’s cries and model emotional resilience to his children. When a father is emotionally supported, he can be a better partner, and maternal mental health improves.
But a dad, especially a new dad, should not be supported just because his mental health impacts others. The father is a human being with his own unique struggles who needs help from not only the people around him, but state and federal governments.
If you have a new dad in your life, offer him and his parenting partner a meal. Check in with the parents on a regular basis, especially after the first two months, when most support around them has usually dried up. Offer an ear to the new father (and mother) if your relationship is close–and even if it isn’t.
Join organizations such as Postpartum Support International, and see what you can do to advocate for new parents, especially fathers, who are often left out of mental health conversations. Include new dads in these conversations as much as possible.
As for the governmental level, write your senator or representative to insist on paternal leave policies in your state. There are many benefits to paternity leave:
Fathers who stay home with their newborns develop a greater bond with their babies, which lasts long into the child’s life.
Children whose dads stayed home with them have better mental health and cognitive test scores than those children whose fathers stayed away.
And the mental and physical health of mothers whose parenting partners stayed with them–and set up an equal parenting relationship–was greatly improved.
Paid parental leave policies are crucial for the mental health of both parents and their children.
Washington state has just passed a state-wide policy requiring three months of paid leave for fathers who work at large companies, occurring any time within the first year of infancy.
My brother-in-law, a new dad himself, is taking two months off of work in June and July to spend time with his wife and baby. (He took one off earlier, when the policy was less robust.)
My sister told me that having her husband work at home during the coronavirus outbreak was wonderful for their little family. He helped her cook and clean, bonded with their baby, and supported her mental health by opening up communication on tough issues they’d been facing in their relationship.
Paid paternity leave is a wonderful way to support our new fathers.
Our dads, especially new dads, need our help. Society has neglected them and told them that in order to remain strong, they must stuff their anxiety and depression. This does a disservice to the men in our lives.
The benefits to emotionally supporting a father are numerous. Fathers need support not only on a personal level, but also governmental. We need to advocate for them and include them in mental health conversations.
With a concentrated effort, we may be able to lower the incidence rate of depression among new fathers.
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.
Confronting a loved one about their recent behaviors due to their mental illness can be dicey, especially if the disease is something like bipolar disorder.
If you find yourself needing to confront a friend or loved one about, say, their manic spending spree, approach the person with compassion and empathy. Try to put yourself in their shoes.
Above all, try to separate the person from their mental illness. Attempt to recognize that their unpleasant behaviors are part of the disorder and not a part of them. Most of the time, they don’t want to act out of control.
Here are some tips to help you address the behaviors of a friend or loved one with bipolar disorder.
When They’ve Been Manic
If your friend or loved one is manic and is acting out, do not hesitate in getting them the help they need. Ask them if you can call their psychiatrist or therapist. Ride the wave of their mania, but try not to contribute to their episode by agreeing to help them with wild, obsessive projects.
As tempting as it is to address their behaviors in the moment, they won’t understand you or be able to respond appropriately. The time to confront them is after the manic episode is under control and they’ve become stable again.
If your loved one has been cheating on you due to a hypersexual manic episode, explain to them how you feel about that. You may feel betrayed and unwilling to trust them. You may feel sad, as if you were not enough to satisfy their urges. You may feel a plethora of negative emotions, many of them directed at your partner and not their mental illness.
Again, try to separate your friend or loved one from their illness. It may be difficult to do at first, but do make an attempt. Unless your relationship was already failing, your partner didn’t mean to hurt you.
Dealing with hypersexual feelings can be extremely difficult, especially in the heat of the moment. People on a manic high tend to be pleasure seekers. They’re always looking for the next good feeling. Flirting and sex is just one way to feel great about yourself.
When the manic episode is over, then the remorse sets in. People coming off of a manic high usually feel terrible; the crash of depression often follows manic episodes, and for good reason. They wonder how they ever could have hurt their spouses or loved ones, and wonder how they’ll be able to make it up to them.
Usually, people suffering from bipolar disorder don’t have the tools to help them rebuild trust.
Explain to your loved one how you feel, and also tell them what they can do to help put your mind at ease. Maybe you need them to check in with you at night so you know where they are and what they’re doing. Maybe you need space to figure your feelings out. Try to set parameters that you both are comfortable with.
Similarly, if your loved one has gone on a manic spending spree and blown through their financial cushion or your joint bank account, explain how that behavior made you feel.
Manic spending sprees come from the same place that other forms of infidelity come from: the inability for the bipolar person to see the consequences to their actions when in the throes of a manic episode.
Tell them that you can’t trust them with money anymore when they’re manic, and that you will be keeping a close eye on your shared finances. If you need to carry the charge card rather than your spouse while they’re manic, then do so.
When They’ve Been Depressed
Confronting someone about the things they’ve done when they’re depressed is a difficult prospect. You want to be careful to blame the disease and not the person for their behaviors, as that might set off a wave of remorse and trigger another depressive episode.
Unlike dealing with a person in the midst of a manic episode, you can tell a person suffering from a depressive episode how you feel, but do be careful to separate your feelings about the disease from your feelings about the person.
Fortunately, depression is usually less harmful to spouses than mania. But there are still behaviors that people suffering from depression do that can be difficult to handle.
For example, people who are depressed may engage in self-harm or suicidal behaviors. You may have felt scared and helpless. Explain to your loved one that you would miss them terribly if they died, and that you felt scared for them.
This is the extreme example. Not all people who face depression hurt themselves. But depression is a very selfish disease. People who suffer from a constant barrage of negative emotions, ranging from guilt to anxiety to hopelessness–and even anger–tend to withdraw into themselves and think only of themselves.
Tell your friend or partner that you love them, if you do, but that it’s hard to love someone who doesn’t love themselves. Not that they are hard to love, but that the disease is.
Explain to your partner exactly what you need. Perhaps you need them to ask you how you’re feeling more often, and geniunely listen. Maybe you need a weekend off from their complaining about their anxieties. Perhaps you need to take some time to yourself.
Whatever you need, don’t be afraid to tell the depressed person that you need it, but be compassionate.
But do recognize that even a simple request for space might end up with your spouse feeling rejected. Reassure them that it’s not about them, but your inability to handle the disease for extended periods of time.
Telling your friend or loved one how you feel is crucial to maintaining a healthy relationship. Communicating with them how you’ve been impacted by their behaviors is the first step towards their acknowledgement that they’ve hurt you. Often times, we need that acknowledgement to forgive them.
Confronting someone in the middle of a manic episode about their behaviors is generally a bad idea, as you will often be rebuffed. Similarly, confronting someone in the middle of a depressive episode may be a bad idea because it might send them on downward spiral of guilt and shame.
So try to address the undesirable behaviors after the person is back to what you consider to be normal–a stable mindset. Tell your friend or loved one how their behaviors made you feel. But do separate the person from the disease.
Communication is one of the most difficult parts of a relationship, but it is crucial for the mental health of both partners. You can support your spouse while making your feelings heard. You can forgive them, and address the disease as a team.
How are you? I genuinely want to know. My week has been busy.
Hello, hello! Welcome to the Bipolar Parent’s Saturday Morning Mental Health Check in: Lightbox Edition!
How are you? Have you been getting some sun this week? How’s the weather holding up for you? How’s your mood been this week? What are you struggling with recently? What challenges have you been facing in parenting? Please let me know in the comments; I genuinely want to know.
My week has been busy.
On Tuesday, I had an appointment with my primary care physician, who ordered blood tests to see if there are physical causes to my depression. I wasn’t fasting (I’d eaten snack at toddler group with my kiddo before the appointment), so I couldn’t take the blood tests until Wednesday, which I did.
On Thursday, I saw my psychiatrist. He boosted my dose of antidepressant (Wellbutrin), prescribed an anti-anxiety med (which starts with a B, but I can’t recall the name), and told me to get a lightbox, as I probably have seasonal affective disorder. He said the lightbox will probably cost $150-500 and may be reimbursed by insurance.
I told my husband about the lightbox, and his immediate response was, “Okay, I’ve ordered one on Amazon. It should be here tomorrow.” He told me that the one I needed (with 10,000 lux, or units of light) was on sale for $30. A second lightbox was on sale for $25, so he bought that one, too. So now I have two, one for my bedroom and one for my desk. I adore my husband.
On Friday, I walked to the store, pushing Toddler in the stroller, to pick up my prescriptions. Apparently the pharmacy only received orders for the antidepressant. I called my psych doc and left a message asking the office to re-fax the prescription order. I always play phone tag with them, which is extremely frustrating.
Taking care of my mental health is so difficult and expensive. There are multiple doctors involved, and our insurance has a high deductible which just reset this January. The antidepressant prescription was $51. So, with the addition of the lightboxes, that’s over $100 spent just this week, not to mention the cost of the doctor’s appointments.
I’ve also eaten out for lunch every day this week. Not because I couldn’t plan ahead and pack sandwiches, but because I’m depressed, and one of the ways I find myself trying to feel better is going to restaurants. It works in the moment, but afterwards I feel buyer’s remorse as each fast food meal is forgettable, unhealthy, and expensive.
Spending this much on myself makes me weak in the knees. My husband would say that I am worth the cost, and “it’s just money.” Having grown up below the poverty line, I am struggling with prioritizing my own wellbeing.
But I need to, if not for me, then at least for my kids. They deserve a mother who is sound in mind and body. I need to prioritize my own contentment. And stop going out to eat unless it’s a special treat, like our family Sunday brunch.
I cover my week being cooped up in the house, and ask you about yours!
Hello, hello! Welcome to The Bipolar Parent’s Saturday Morning Mental Health Check in: Ice Edition!
How are you? Is it snowing where you are? Have you been stuck in the house? How cold is the weather? What about your self-care routine–have you been sticking to it? Let me know in the comments; I genuinely want to know!
My week has been utterly depressing.
I am used to a certain routine of preschool on Mondays and Wednesdays (where I meet with a friend from my writing group to write and clean the house, respectively), and toddler group on Tuesdays, which I attend with my kiddo as a co-op preschool.
Then the snowpocalypse hit. There’s still ice on the roads in our neighborhood. As I’m a anxious driver who has crashed in icy conditions before, I am very reluctant to drive.
School has been canceled for both my kids pretty much all week and we’ve been cooped up in the house. We all are suffering from cabin fever.
We normally go to a park or an indoor playground every day, even after toddler group on Tuesdays. I am ill-tempered due to nature’s inconsideration of my need for routine. My toddler has watched all sorts of random Netflix shows this week.
But it’s not all bad; we could be dealing with a power outage, like we did last year.
Luckily we live within walking distance of a grocery store, so my husband has been hoofing it there to pick up milk and bread. I am thankful that he was able to work from home.
So that’s been my week. How’s yours been? Have you, too, been cooped up in the house? Let me know in the comments!