I had the opportunity to be interviewed by Desiree Argentina on her podcast The Wellness Project with Des and it was a wonderful interview. She asked me:
To share my story
How old were you when you were diagnosed with depressive disorder and anxiety? And when did you get an accurate diagnosis of bipolar disorder? (8:33)
How did you know something was wrong and what were your earliest memories of something being off or different? (9:04)
At what point did your family realize that there was something off and you needed help? (14:40)
Did your family know about bipolar disorder? Or did they just recognize that something was off a bit? (16:10)
Can you talk a little bit about how your family approached you? Can you explain that? Some family members and loved ones don’t know how to approach it, don’t know what to say, don’t want to offend the person. How can someone go to someone in an empathetic supportive way? (16:55)
Can you speak about how bipolar disorder affected your relationships with your family, romantic relationships, relationships with your children? (19:40)
Would you mind sharing what techniques helped your relationship with your husband from going to therapy together? (24:30)
Can you share what steps you took to heal yourself to get better and could you share your self-care regimen? (27:54)
I was so grateful to have the opportunity to speak with Desiree. She asked fantastic questions and we had a very productive conversation about how to successfully navigate diagnosis, relationships and treatment with bipolar disorder.
Desiree is a mental health therapist. Her goal with her podcast and social media is to help others transform their lives by providing actionable and practical steps to live a fulfilled life.
I had the opportunity recently to be interviewed by Paris Prynkiewicz on her podcast Master Your Mental. In the interview Paris asked me about:
my experience with bipolar disorder (my history and how things turned around for me),
what coping with mood cycles used to look like (unhealthy) versus what managing mood cycles proactively looks like now,
how and why I started helping moms with bipolar disorder and what my favorite experience so far has been with that, and
what is my number one most powerful tool that I use in my self-care.
I loved speaking with Paris about how I have learned to live well with bipolar. It was a really amazing conversation. Paris’s mission with her podcast, social media and book are to offer encouragement and hope to others with bipolar disorder and it was an honor to be on her show. Enjoy!
I remember when the Covid-19 pandemic hit in the beginning of 2020 and the shutdown started I was relieved at first. I was struggling at the time with managing what felt like overwhelming commitments, so having everything canceled all at once was a huge relief.
That reprieve was short lived, however, as the previous, predictable stressors were replaced by new, unpredictable ones. I was obsessively watching the news and the case count. I was overwhelmed by the requirements of online schooling and trying to keep my children on task all day long.
I was dealing with my own fears about what was happening and also carrying the burden of my children’s fear, disappointments and pain as their world was turned upside-down. To top it off, every time I left the house it felt like traversing a minefield, wondering if today was the day I would contract Covid.
I was also deprived of many of my self-care tools–going to the gym, hanging out with friends and family and going to therapy in person. It didn’t take long to settle back into old, unhealthy coping mechanisms that wore on my mental health and caused me to get severely depressed.
Increasing Mental Illness
The experience I had during the pandemic was not uncommon. There was a surge in the number of people struggling with mental health challenges because of the increase in stressors and decrease in the normal healthy outlets for the stress.
The pandemic made clear the damaging effect of a serious, prolonged crisis on individual mental health. Numerous studies have been conducted on the impact of the pandemic on mental health with estimates of the increase in rates of depression and anxiety ranging from a 25% increase cited by the World Health Organization1 to a massive six times increase found in a study conducted by Boston College2.
Having bipolar disorder can make you especially sensitive to major stressors. Disruptions to routine and increases in mental or emotional strain can trigger mood cycles that then add to the distress. This means it is essential to learn to be proactive with your bipolar and prepare to handle stressors more effectively.
Since there is no cure for bipolar disorder, mood cycles will be a reality of life going forward. If you fight your bipolar or ignore it, you will lose. The alternative is to accept that you have bipolar and learn the tools to live well with it.
You can learn to manage your disorder so that you stay in maintenance mode for longer periods of time and the severity of the mood cycles can lessen. But you will still have cycles and it is essential to learn how to deal with them more effectively.
Mental Health Emergency Response Plan
Accept the reality of your mood cycles by developing a Mental Health Emergency Response Plan (ERP). An ERP helps you proactively manage your mood cycles in order to lessen the impact of the mood cycle on you and those you love and shorten the duration of the cycle.
In this plan you:
Identify your Emergency Response Team – who are the people who are willing and able to offer support and what are the boundaries you set for that assistance?
Develop an Early Warning System – What are your triggers and what are the symptoms that indicate you are experiencing a mood cycle?
Determine your Auxiliary Power – When you have limited emotional and mental resources during a cycle, what are your priorities?
Learn how to Reboot Your System – How do you get yourself back to maintenance mode?
The more you utilize your ERP the more effective a tool it becomes in helping you proactively manage your mood cycles. Each time you use your ERP you can evaluate it to see what worked and what you can improve. To get a free guide to create a Mental Health Emergency Response Plan click here.
Back-up Supply of Medications or Supplements
The second priority is to prepare a back-up supply of medication or supplements–ideally a month. The pandemic presented some unexpected challenges like supply chain shortages, shipping issues and the shutdown caused many doctor’s offices to cancel or postpone appointments. Running out of medication or supplements that you need to keep your brain and emotions balanced can be dangerous. Discuss with your doctor what you can do to be prepared for a situation like this.
Counseling or Therapy
Third, counseling or therapy. Learn to use therapy proactively rather than waiting until you are in crisis. Therapy is a crucial tool for managing bipolar disorder. Bipolar disorder is truly “all in your head” and it can affect the way you see the world. Therapy can help you identify, process and heal trauma, unhealthy thought and behavior patterns and unhealthy boundaries. Using therapy proactively will eliminate some triggers and help you manage others more effectively.
Prior to the pandemic shutdowns I was going to the local recreation center for exercise each day, and my youngest was going to the child watch. When the shutdown occurred I no longer had access to the gym or childcare. I struggled for months because I wasn’t exercising. I finally realized how important it was to have a way to exercise that isn't dependent on anyone or anything else. That was when I started running again and doing simple HIIT and yoga workouts in my living room.
The benefits to the change in my routine have been that I:
Save money on gym membership and childcare,
Save time traveling to and from the recreation center,
Have a simplified self-care routine that is easier to sustain, and
Have improved mental health because I am more consistent with my self-care.
Finally, it’s important to cultivate a support system. One of the big challenges during the pandemic was the feeling of isolation. That coupled with the increase in the use of social media caused many people to become more depressed and anxious.
It is critical to develop a support network that you can stay connected with, even if it is only virtually. This connection helps you have the mental and emotional support you need to navigate highly stressful situations and experiences.
Some people to remember in your support system are:
professional support (psychiatrist/therapist),
family and friends, and
group therapy or online support groups
During the pandemic I was grateful for my support system. I was able to meet virtually with my therapist. My siblings and I started using Marco Polo and Zoom to chat online with each other. I joined some Facebook groups to find support from the bipolar community, although I discovered that some of the groups were not very helpful.
I was looking for a community of individuals with bipolar that were trying to live well with it. The negative experiences I had led me to create Bipolar Moms Learning to Live Well. It’s important that the groups you join support your goals to live well. This Facebook group is designed to offer support from others who understand what you’re going through and proactive solutions to help you learn to live well with bipolar.
The pandemic was a stressful experience, one that I am not in a hurry to repeat. However, it has helped me to identify ways that I can be more proactive and better manage my bipolar disorder and for that I am grateful. It is possible to live a healthy, balanced, productive life with bipolar disorder. There is hope and there is help!
I didn’t start off having suicidal thoughts. It started with nightmares. Vivid, intense nightmares about dying and I would wake up feeling horrible inside. This went on for years until it progressed to daydreams about dying. I would have random images or scenarios pop into my head of things that could cause my death.
I knew intuitively that my mind was suffering with my bipolar disorder and it was trying to find a way out, but I didn’t realize the full implications of what I was experiencing. I didn't recognize the danger these thoughts posed to my safety.
When this first started I recoiled from the thoughts and images. I felt anxiety and fear when I would have them. But as the years went on and my disorder grew worse I started having thoughts like, “your husband would be so much happier if you were dead and he could find a better wife,” or “your children would be so much better off if they had a better mom who wasn’t sick.”
I didn’t tell anyone about the thoughts I was having because I was so embarrassed and ashamed of them. It made me feel crazy and I didn’t want anyone to know how broken I really was. So, I hid them and suffered alone.
Then in 2008 I had a breakdown. I was hospitalized three times in three different hospitals in two states. During that time I finally gave in to the thoughts that had been plaguing me and made two attempts on my life. I don’t remember much of what happened because during one of my hospitalizations the doctors performed a full course of twelve electroconvulsive therapy treatments and I lost most of my memory from those months.
It took years for my husband to talk to me about what happened because it had been so traumatic for him–he was the one to stop me both times.
When I was finally released from my third hospitalization I had an experience that changed everything. One sunny morning a few weeks later I was watching my children play. My daughter was 4 and my son was 2. I was looking at my daughter and had a very clear thought come into my mind, “if you ever succeed in ending your life it will ruin hers. Your daughter will believe it was her fault and she will spend the rest of her life blaming herself.” I was shocked! I had come to thoroughly believe the lies my mind had told me, that my children would be better off if I was gone.
As soon as I had the thought, I knew it was true, she would believe it was her fault and it would ruin her life. That day I made the commitment that I would survive for my children.
If that was the best I could do, I would do it.
I loved them more than my own life and I would do anything for them.
From that point on I decided that I would not let the thoughts of death or suicide stay in my mind unchallenged. I would ask for help if I was having those thoughts and not let myself feel shame or embarrassment anymore.
This was the first time in over a decade after my diagnosis that I truly, proactively, took responsibility for my mind. I thought I had before. I had diligently gone to psychiatric appointments and tried to take my medication, but I didn’t feel like I had any control over my mind. I felt for years like my bipolar disorder was in the driver’s seat and I was just along for the ride. But I now realized that I couldn’t let my bipolar be in charge anymore: it was trying to kill me and I wasn’t going to let it.
When you have bipolar disorder, it feels like there are so many things working against you. You have a disorder that really is all in your head. When you have those horrible, intrusive thoughts while you are floundering in the dark heaviness of depression, it is so easy to believe they are true because they correlate with what you are feeling.
I didn’t understand that I shouldn’t believe every thought that came into my mind. I didn’t know that it was possible to separate myself from my thoughts and challenge them.
With bipolar disorder it is embarrassing, discouraging, and yes, unfair, to keep making mistakes or poor decisions because of the mood cycles, especially mania, and then have to deal with the consequences for your decisions. Each time you give into impulses that are bad or make decisions based on irrational thoughts it’s humiliating to have to deal with the aftermath. This naturally results in feeling insecure and makes it easy to believe that everyone would be better off without you.
It can also feel like your life is not worth living because you spend so mucheffort just trying to manage your disorder and don’t feel like you have anything to offer beyond that.
The wonderful thing is that:
you can learn to separate yourself from your thoughts, decide which ones to believe and dismiss the bad ones,
you can learn to manage your disorder so that you don’t keep making the same mistakes and poor decisions, and;
you absolutely have so much to offer because you have infinite value and purpose well beyond your disorder.
It is possible to learn to manage your bipolar well and live a healthy, balanced, productive life.
The first step is to create a Mental Health Emergency Response Plan (ERP). An ERP will help you to take responsibility for your mood cycles so that you lessen the impact on you and your family and shorten the duration of the cycle. One very important piece of your plan will be your Emergency Response Team.
If you are having thoughts of self-harm or death decide who you will talk to or what you will do when you have those thoughts. This was a really important piece for me. It was important to have someone to talk to when I was having intrusive, negative thoughts because there were times when it was too much for me to manage on my own.
Think of those thoughts like having an intruder in your home that wants to harm you. If that happened you would call for help, you wouldn’t allow that threat to remain unchallenged. Do not allow those thoughts to stay in your mind. Identify them and challenge them. This is something that is especially important to discuss with your therapist. Create a plan ahead of time so that you will know what to do when it happens.
Second, you need to develop a self-care plan that helps you begin to effectively treat your bipolar disorder. There are several important tools that will help.
Proactively seeking treatment with a good therapist
Learning to practice mindfulness meditation–this is an especially important tool for identifying and challenging intrusive thoughts
Additional self-care tools like yoga, exercise and simplifying your life.
If you would like additional guidance on how to effectively manage your bipolar disorder you can join the monthly membership program that guides you through the steps & tools necessary to manage your bipolar disorder well. For more information click here.
Finally, seek support from others who understand what you’re going through. Having bipolar disorder can be very lonely and isolating. It is hard to not feel broken and flawed. Seeking positive, encouraging support from others who are struggling with the same disorder will lighten your load and lift you up. You’ll gain strength to live well while managing your disorder. For moms with bipolar disorder you can join my free Facebook group Bipolar Moms Learning to Live Well.
If you have thoughts of harming yourself or thoughts of dying, please reach out for help. Life with bipolar disorder can feel hard and overwhelming. Your mind might tell you that everyone would be better off if you weren’t here, BUT THAT IS A LIE! Challenge those thoughts. DO NOT BELIEVE THEM!
You are irreplaceable. You can manage your bipolar disorder well and live a healthy, balanced, productive life.
I was having a conversation with a friend the other day. She asked me what I would say to someone about how to live well with bipolar disorder? As I began to answer I realized that my answer would be slightly different depending on where they were on the journey to wellness with bipolar.
In the first decade after my diagnosis with bipolar disorder I developed the false belief that the ultimate goal with bipolar disorder was to learn how to suffer well with it. I diligently took all the medications that were prescribed to me and went to counseling, but nothing was working. I felt alone and isolated because no one understood what was going on with me, least of all me. I didn’t understand what was happening in my mind and I began to feel hopeless.
I thought I was doing my best, and in some ways I was, but I was suffering, and so were my husband and children. I usually felt out of control with mania or hopelessly depressed. I would go through periods of angry belligerence when I felt it was unfair that I had to suffer this way, so everyone else would have to just learn to deal with it, too.
It can be really difficult to learn how to take responsibility for yourself with bipolar disorder when you don’t understand what that looks like, or how to do it. Having a disorder that is “all in your head” can be challenging to treat because the symptoms of your disorder feel normal to you, even though they are unhealthy and often self-destructive.
Accepting Your Diagnosis
Accepting responsibility for yourself and being proactive in learning to live well with bipolar disorder require you to first accept that you have bipolar disorder and that there currently is no cure for it. This is not something to become discouraged about. There is no cure for type 1 diabetes and yet people live well with it all the time. They learn the tools necessary to manage their disorder. It is the same for living with bipolar disorder.
You can learn how to manage your bipolar effectively so that you are able to live a healthy, balanced, productive life. But you have to be willing to:
accept that you have the disorder, and
accept that you are responsible for learning and applying the tools to manage it.
Accepting that you have bipolar disorder and that you have a responsibility for managing it effectively requires a mindset shift.
Process Your Grief
First, you need to allow yourself to grieve. “When you are diagnosed with bipolar disorder you suffer a loss. You lose who you thought you were. You might feel angry, discouraged, alone, hopeless, lost, and all of these feelings are part of the grieving process. It is important to recognize this process and acknowledge the feelings that you are having as valid.”
“It is also equally important to work through this process, ideally with a mental health counselor, so that you don’t get bogged down and lost in it. It is normal to mourn the loss of who you were, or who you thought you were, but you need to look forward and embrace who you are and who you can become.” (Bipolar Disorder: The Stages of Grief)
Second, you need to not compare yourself and your life to others who don’t have bipolar disorder. “You cannot stop having bipolar disorder, [and] comparing yourself to who you were in the past, or who you think you should be will prevent you from progressing to wellness and becoming the best version of yourself.”
“It is especially damaging, when you have bipolar disorder, to compare yourself to others because it creates a stumbling block to becoming well. Your mind is already prone to negative self-talk. Comparing yourself to others who don’t have bipolar disorder is like pouring gasoline on the fire.”
“When you are focused on the gap between where you are and who you think others are, it causes discouragement, depression and despair. You begin to define yourself by what you lack and by your bipolar disorder, instead of your unique qualities and gifts that make you special.” (Bipolar Disorder: You are not broken!)
The Path to Wellness is Not Linear
Third, it is critical to understand what learning to live well with bipolar disorder looks like. I used to think that it was like trying to climb a mountain and when I got to the top I would be better.
“That analogy is counterproductive at best, and damaging at worst. The idea of climbing a mountain is a linear path, which means that if you get manic or depressed while you are working to learn to live well, you get knocked back down to the bottom. It reminds me of the game Chutes and Ladders where if you are unlucky enough to land on the wrong square you slide backwards on the board, sometimes to the very beginning.” (Bipolar Disorder: The Recovery Cycle)
Learning to live well with bipolar disorder follows the same pattern as the addiction recovery cycle. “Understanding the stages of the recovery cycle will help you better understand your disorder and have a healthier outlook on your personal responsibility for self-care. Learning how to apply the recovery cycle to yourself will help you to stop feeling like you have failed when you have manic or depressive episodes and choose to accept more responsibility for yourself and your disorder.” (Bipolar Disorder: The Recovery Cycle)
Once you accept your diagnosis and your responsibility to learn to manage it you have taken your first step on the path to wellness. The next step is to develop a Mental Health Emergency Response Plan for yourself. This plan helps you accept responsibility for your mood cycles and create a plan to manage them more effectively to minimize the impact on you and your loved ones and shorten the duration of the cycle. To get your free guide to create your Response Plan click here.
You then need to work to learn and apply the tools necessary to live a healthy, balanced, productive life.
Learning and applying the tools necessary to live well with bipolar is a process that requires patient, persistent effort. Make sure you surround yourself with people who will support and encourage you in this journey.
“While you are working through this process it is so important to have encouraging support. You need professional support–psychiatrist and/or a good therapist. If you are married or in a serious relationship you need the support and encouragement of your partner. And you need support from others who know what you are going through.”
“I started a Facebook Group to provide positive, encouraging support for moms trying to learn to live well with bipolar disorder. Bipolar Moms Learning to Live Well is a group of women who are ready to take responsibility for themselves and who are willing to do the work to learn how to live a healthy, balanced, productive life with bipolar disorder. If you are ready and willing, join us!” (Bipolar Disorder: The Rollercoaster)
Where are you on the journey?
Determine where you are on the journey to living well with bipolar disorder. Do you still need to work on your mindset? If so, start with the posts on mindset.
I remember the day I went to my first appointment with the psychiatrist. I was so severely depressed I couldn’t really think of what to say. My aunt–who I had lived with off and on during college–came with me to my appointment and she answered most of the doctor’s questions. She knew me pretty well from the outside, but she didn’t know what went on in my head. The result of the visit was that I was misdiagnosed with depression and anxiety disorders and put on an antidepressant, which triggered a manic episode.
“It IS All in Your Head!”
For the first several years after I was diagnosed I struggled with feelings of frustration, discouragement and even anger as I tried so hard to get well but nothing was working. One of the challenges with treating bipolar disorder is that it really is “all in your head.” Even though people sometimes use that phrase to diminish or dismiss the symptoms and challenges that come with bipolar disorder, it is actually quite accurate.
Bipolar disorder is a chemical imbalance that affects your mood and mind. This creates a paradox for you because your doctor diagnoses you based on symptoms, but the only one who can really provide accurate information is you. How do you know what information is relevant?
How do you know if the thoughts you are having are rational or if they are being caused by the mood imbalance? How do you know which thoughts and behaviors are unhealthy if they feel normal to you? How do you know what to talk to your therapist about if you don’t know what is causing your problem in the first place?
Challenges with Using a Mood Tracking Journal
One of the things that was recommended to me over the years by doctors and therapists was keeping a mood tracking journal. I really wanted to get well so I kept trying but it was so challenging for a number of reasons.
First, I had a really hard time remembering to do it. Self-discipline and consistency was something I craved for years, but felt incapable of having because of the dramatic shifts in my mood. When I was manic I would have racing thoughts that would fly by faster than I could write. So much of what I wrote in a manic state was incomprehensible, and I often would get so frustrated with writing that I didn’t want to do it because it was too slow.
When I was depressed I struggled to function at all, and making my brain think was difficult if not impossible. I didn’t want to write about how I was feeling, and when I did I often would tear the pages out of my journal because I was embarrassed by what I had written and didn’t want anyone to see, including my doctor and therapist.
Second, I would usually go two or three months between appointments with my doctor and then it was only a 15-20 minute “med check” appointment. How was I supposed to convey the information that was in my journal to the doctor in any beneficial way? The questions the doctor was asking me weren’t in my journal anyway. He would ask me questions about the effectiveness of the medication. What time of day I was taking it? How did I feel afterwards? When were the side effects occurring in relation to when I was taking them? How intense were the side effects?
I usually didn’t remember the answers to all of his questions and it was so frustrating because nothing seemed to help. I was continuing to experience mood cycles and I didn’t ever know if I could trust my own mind. The mood journal wasn’t helping me with that.
The other issue with using a mood tracking journal was that it was so subjective and inconsistent that it was impossible to see patterns or identify triggers. I started to suspect that I was actually triggering mood cycles in myself through thought and behavior patterns, but the mood journal wasn’t helping me identify the triggers. I was guessing based on what I was experiencing, but the thoughts and behaviors were so normal that I couldn’t really see what was happening before it was too late.
Trying to keep a mood tracking journal was so frustrating for me! It wasn’t helping me understand my mood cycles or triggers and it definitely wasn’t helping me answer my doctor’s questions. It just felt like one more thing I was failing to do.
Trying Out Mood Tracking Apps
I wanted a tool that would help me understand my brain better and help me provide better, more complete information to my doctor and therapist so I could get more effective treatment. That was when I started to try out mood tracking apps. The idea of using a mood tracking app came to me when I was trying to remember to take my supplements consistently. I really struggled with that, I kept forgetting to take them consistently at the same time, and sometimes I forgot to take them altogether, or I couldn’t remember if I had taken them.
I decided to set alarms on my phone to remind me to take my supplements because I had my phone with me all the time. Then one day I had the thought, what if I could keep track of my mood on my phone, too. So I started looking for and trying out mood tracking apps.
The first few apps I tried weren’t very good. They had limited function and understanding the information that I was tracking was not easy. Then I found the Bearable app.
I want to mention here that I do not receive any compensation or benefit from Bearable for talking about or sharing the app. I love the app because it has helped me so much and I want you to know about it because I am hoping it will help you, too!
The Bearable app is amazing! It is really easy to use, super customizable and the “Insights” tool it has to analyze the information that you track is fantastic! It helps you see patterns and connections in the data you track. It will help you understand your mind and your cycles better and enable you to provide a goldmine of relevant information to your doctor and therapist so you can get more effective treatment.
I love that it is so simple and easy to use and it’s on your phone. Most people carry their phone with them all the time and so you can simply set alarms to remind yourself to enter the information a few times a day. The information you enter only takes a couple minutes, too, it is so easy! You just click through the items you are tracking and tap the buttons and you’re done. You don’t have to think too hard about any of it, which is really helpful if you are depressed or having a hard time thinking.
Another thing that is really useful is how many different factors you can choose to track. Some helpful factors you can track are mood, energy level, medication or supplements (and any side-effects), sleep, and symptoms. There are so many different factors that can affect your mind and your mood cycle. You can choose what to track and customize the app to make it work for you.
One of the best ways it has helped me is understanding my mood cycles more clearly. This has helped me in two ways.
The first is understanding the symptoms of my mood cycles. I don’t experience manic episodes very often any more, but any time I become really productive and feel inspired to do a project I start to get anxious that I might be getting manic. This is because for years anytime I was highly productive and feeling inspired it was an indication I was entering a manic episode. I discovered that the anxiety I felt worrying about whether I was getting manic was actually triggering mania in me.
Using the app has helped me identify specific symptoms that are characteristic of mania for me. Now using the Bearable app if I start to worry that I might be entering mania I look to see if those symptoms are present. If they aren’t then I work on my mindfulness to reassure myself that I am not manic, just productive and inspired.
If I find that the symptoms of mania (or depression) are present then I have my Mental Health Emergency Response Plan to proactively manage my mania (or depression) to lessen the impact on me and my family and shorten the duration of the episode.
The second way this app has really benefited me is to help me identify triggers that cause mood cycles. I have worked through many of my triggers with my therapist and eliminated them through therapy. Some triggers I have eliminated from my life through boundary work. Other triggers I have learned to manage in a way that lessens their impact on my mood cycles.
Therapeutic vs. Analytical Tools
I have learned that journaling and mood tracking apps serve different purposes and they both have value as tools for treating bipolar disorder. Journaling has tremendous value as a therapeutic tool when you are working with a therapist to process trauma, work to change unhealthy thought and behavior patterns and implement healthy boundaries. I have used it for this purpose and it really helps.
The Bearable app is an analytical tool. You simply track the information each day in an easy and accessible way. The app then does the work for you to analyze the information you have tracked. It is designed to help you understand your bipolar disorder better and provide more complete and accurate information to your doctor and therapist so they can help you more effectively.
If you are ready to learn how to live well with your bipolar disorder, join my FREE “Better with Bearable Mood Tracking Challenge” going on now, through April 25. The challenge will help you learn how to use this amazing tool to live a more healthy, balanced, productive life with bipolar disorder.
When you have bipolar disorder it can feel like your disorder is in the driver’s seat of your mind and you are just along for the ride. It can create a helpless, hopeless feeling when you feel like your mood cycles are happening unpredictably and you don’t have any control over them. That helpless feeling can make you feel like your life is not really yours. You are being “lived” by your disorder.
Years ago I had a doctor try to help me with accepting and understanding my bipolar disorder by comparing it to type 1 diabetes. It was a helpful analogy because diabetes is a straightforward, clear cut disorder with an easy to understand issue–your body is unable to regulate its blood sugar naturally and so you have to help your body.
As I have learned more about diabetes from friends who have it I have been amazed at how similar the experience of learning to manage diabetes is to learning to manage bipolar disorder.
Monitoring Blood Sugar
When someone is diagnosed with type 1 diabetes she is informed by her doctor that she has a disorder in her body that makes it impossible for it to naturally regulate its blood sugar. She is instructed that she will need to give her body assistance by monitoring her blood sugar multiple times a day, every day, for the rest of her life. The information she gains from monitoring her blood sugar level will help her know if her body needs insulin or additional sugar to keep her blood sugar within a safe range.
She also learns that she has to be careful about food choices to make sure her body doesn’t get overloaded by too much sugar and cause a serious overcorrection that can be dangerous. She might have a small piece of cake, but remove the frosting, or if she’s at a restaurant and orders lasagna she might take half of the piece of lasagna home to avoid eating too many carbohydrates at once. The doctor can teach her some of the basics of how to make safe food choices, but most of it is learned by experience.
She will learn that there are other factors that can impact her blood sugar level. Stressors can have an impact, in either direction up or down. Sleep, the amount and quality, can impact her blood sugar. A friend of mine once told me that there are over 45 different factors that can affect your blood sugar level.
Each person is different and it is important for them to learn to proactively identify which factors impact their blood sugar and manage those factors by making choices or setting boundaries that help them proactively care for their disorder more effectively.
It’s Not Fair!
Someone with diabetes might feel like it is unfair that they have to be so vigilant in monitoring and managing their blood sugar all the time. I would agree with them, it isn’t fair. But fair has nothing to do with the reality of their situation.
A friend of mine who has diabetes also has a son with diabetes. She told me that he hated having diabetes as a boy. He just wanted to be “normal” so once when he went to a scout camp for a week he didn’t monitor his blood sugar and didn’t use insulin. As a result he ended up in the hospital in critical condition.
Fair or not, someone with diabetes has a choice. She can choose to monitor her blood sugar proactively, actively working to keep it balanced so she can live a healthy life. She can also choose to deal reactively with her diabetes, neglecting to monitor and manage her blood sugar and end up being forced to face the consequences of getting sick and ending up in the hospital. She has a choice to make every day.
How to Monitor Your Mood Balance
This comparison helped me understand my disorder better because they are so similar. With bipolar disorder my brain is unable to regulate my moods and emotions in a healthy way and I need to give it help with medication/supplementation, counseling, self-care and managing stressors.
One challenge I had, however, was how to “monitor” my mood, or check my “chemical balance.” I remember telling my uncle one day back when I was in college that I wish there was a way to analyze my brain chemicals to identify what was out of balance. Unfortunately that technology doesn’t exist yet.
Over the years I have discovered a way to monitor your mood simply and effectively using a mood tracking app.
I use the Bearable app. This is not a sponsored post, and I don’t receive any benefit–financial or otherwise–for recommending the app. I recommend it because it is the best mood tracking app I have used.
Using a mood tracking app helps you to begin to identify your mood cycles, symptoms and triggers so you can “monitor” your mood balance and learn how to treat it effectively. Similar to diabetes, you should track your mood balance multiple times a day, regardless of how you are feeling, so that you are able to create a more accurate picture for yourself, your doctor and your therapist.
With Bearable you are able to track:
Factors that can impact your mood (i.e., places, social interactions, activity level, menstrual cycle, personal care, productivity, appointments, social media, weather, etc.)
Medication and/or supplements
You can customize almost anything within each category. That list may look like a lot and seem overwhelming, but it is very easy and quick to input the information by simply tapping the relevant items. It only takes me a few minutes each time I “check my mood.” You can also set up reminders for yourself throughout the day.
There are a number of benefits to using a mood tracking app consistently to monitor your mood cycles.
Bipolar disorder and other mental illnesses are diagnosed based on symptoms and the more information you can provide to your doctor the more accurately he or she can be in your diagnosis and treatment.
You are able to learn to identify what the symptoms are that indicate you are either entering or in a manic or depressive state.
You can identify triggers that may cause mood cycles.
You can see more clearly how effective your medications are and track any side-effects you might be having–both the frequency and severity.
You can also identify how things like sleep, nutrition and menstrual cycle affect your mood cycles.
Using a mood tracking app you are able to understand your bipolar disorder better–learning to recognize what your manic and depressive episodes are saying. You are also able to provide a gold mine of information to your doctor and therapist so you can proactively seek more effective treatment.
What Do You Choose?
With bipolar disorder you have a choice. You can choose to be reactive and allow yourself to be “lived” by your disorder and face the consequences of becoming more unbalanced, or you can choose to be proactive and use tools like a mood tracking app to “monitor” your mood balance, helping you live a healthier, more balanced, more productive life with your bipolar.
It is possible to live well with bipolar disorder. There is hope and there is help!
Over the past few years there has been an increase in the public discussion of mental health due to the increasing stressors in the world. This is such a positive shift towards awareness of mental health needs and challenges. One important aspect of this conversation is the distinction between mental health and mental illness. These terms are not interchangeable, and understanding the definitions of both and their relationship is important for anyone seeking treatment.
The Center for Disease Control (CDC) definition of mental health: “Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices.”
The CDC definition of mental illness: ‘“conditions that affect a person’s thinking, feeling, mood, or behavior.” These can include but aren’t limited to depression, anxiety, bipolar disorder, or schizophrenia.’
Another way to put it is:
Mental illness is to mental health
what physical illness is to physical health.
There are different ways that our bodies can become physically ill, some examples are:
You can contract a virus or disease that is temporary and can be healed over time, sometimes requiring outside intervention–like contracting the flu or a sinus infection.
You can develop a disease that may have some genetic predisposition but was brought on by neglected health–like heart disease or type 2 diabetes.
You can experience physical trauma that causes damage–like a broken leg.
You can be born with or develop a disorder that causes the body to need external assistance–like type one diabetes.
While some illnesses may be the result of negligence or poor personal care, most people acknowledge the value and importance of professional intervention in the care and treatment of these physical ailments. In general physical illness and disorder is not stigmatized and people will seek treatment for their illnesses or injuries.
Unfortunately the same is not always true for mental illnesses. Our society has made great progress towards acknowledgement and acceptance of mental illness, but there are still stigmas that cause people to resist diagnosis and treatment. The result is unnecessary suffering.
Mental illnesses, according to the CDC website, are among the most common health conditions in the United States.
More than 50% will be diagnosed with a mental illness or disorder at some point in their lifetime.
1 in 5 Americans will experience a mental illness in a given year.
1 in 5 children, either currently or at some point during their life, have had a seriously debilitating mental illness.
1 in 25 Americans lives with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression.
Mental illness has a broad range of causes and diagnoses, just like physical illness.
Some people can have a temporary illness brought on by environmental factors or as a companion with physical illness.
Some may neglect their mental health and suffer a breakdown or the onset of chronic issues like anxiety or depression.
Others may experience severe trauma that causes emotional or mental damage resulting in mental illness.
Some people are born with a genetic predisposition to developing a mental illness.
Years ago I was struggling with accepting my diagnosis and need for treatment. My psychiatrist at the time asked me if I would feel the same if I had been diagnosed with type 1 diabetes. I said no, of course not. Diabetes is a real, very serious disorder that if not treated could result in serious illness and even death. The doctor then told me that a diagnosis of bipolar disorder was no different.
He said that bipolar disorder is a chemical imbalance in my brain that, if not treated, will continue to get worse and cause me to get more ill, and possibly even die. He told me that with proper treatment, however, I can live a healthy, balanced life, just like someone with diabetes who treats their disorder regularly.
This comparison shifted my thinking about being diagnosed with bipolar disorder and helped me to focus on treatment and learning the tools necessary to live well with bipolar. To learn more about accepting your diagnosis see Bipolar Disorder: The Stages of Grief.
Over the years I have discovered that there are many tools that are necessary to properly treat my bipolar disorder. As I have learned each new piece it has helped me to live a healthier, more balanced and more productive life.
Medication and Supplementation
This one is the most obvious, but also one of the most difficult. One of the biggest reasons for this is that there is not an exact science to identify which medication or combination of medications will be right for each person. I used to say that my doctor was playing “guess and check” with my meds to try and find the right ones.
For me, finding medications that worked never happened. I really wanted to get well, and I tried everything my doctors prescribed. But I struggled with terrible side-effects and was often not able to tolerate a therapeutic dose of the medication.
Thankfully after over a decade of struggling and searching my doctor and I found a nonprofit that had developed a supplement specifically for people with bipolar disorder. After my doctor reviewed the studies that had been done on the supplements he worked with me to transition me to them and they worked!
A few months after I transitioned to the supplements I woke up one morning and felt like I was truly awake for the first time in over a decade. To learn more about my experience with medication and supplements see my post Bipolar Disorder: When Medication Doesn’t Work.
The struggle to find the right combination of medication and/or supplements can feel discouraging at times, but most people with bipolar disorder need something to balance out the chemicals in their brains. Thankfully there are any number of options to help doctors in the process of discovering what each patient needs to get balanced. Additionally there are a growing number of practitioners that are discovering the benefits of micronutrients in the treatment of bipolar disorder.
Counseling and Therapy
This is another tool that may seem obvious but many people, like myself, resist going to counseling. For me, it was the result of stigmas and a misunderstanding of what counseling was. Growing up I had heard a relative frequently say, “my therapist said this” or “my therapist said that” and I remember thinking “I will never let someone else tell me what to think.” Unfortunately the result was that when I was first diagnosed with bipolar disorder I said I was willing to take medication, but I refused to go to counseling.
Over the years, however, I discovered that counseling is an essential tool to help someone with bipolar disorder learn how to live well. When you have bipolar disorder you frequently see the world through a distorted lens and can develop unhealthy thought and behavior patterns, unhealthy boundaries and may have unhealed trauma. All of these can continue to cause mood cycles, even after the medication or supplements are correct. To learn more about counseling see my post Bipolar Disorder: Counseling is Essential.
Mental Health Emergency Response Plan
An especially valuable tool for proactively managing your bipolar disorder is a Mental Health Emergency Response Plan. This plan helps you take responsibility for managing your mood cycles more effectively, rather than reactively just suffering through them.
In this plan you:
Identify your Emergency Response Team
Develop an Early Warning System
Determine your Auxiliary Power
Learn how to Reboot Your System
Developing this plan helps you proactively care for your mood cycles in a way that lessens their impact on you and your family and shortens the duration of the cycle. To get a free guide to creating your own Mental Health Emergency Response Plan click here.
Developing a self-care routine that you do daily to keep your brain and body healthy and balanced is also essential. Some important tools in your self-care tool box are:
Years ago I had a friend whose father developed type 2 diabetes. His doctors gave him strict instructions about how he needed to care for himself in order to keep himself healthy. He was told he could live a long, healthy life if he was willing to follow the care instructions given to him by his doctor. Unfortunately he didn’t listen. He liked the habits he had that were against the doctor's orders and he lost his legs, his eyesight, and ultimately his life.
Bipolar disorder is a treatable mental illness. It isn’t necessary to suffer indefinitely, being at the mercy of your mood cycles and doing damage to your life and relationships. It is not easy, but it is absolutely possible to live a healthy, balanced, productive life if you are willing to do the work necessary to learn each of the tools. There is hope and there is help!
One of my favorite animated children’s films is Inside Out by Disney. It makes you laugh, cry and is a genuinely wonderful movie. But more than that, it is extremely insightful and teaches some powerful lessons, even for adults.
One of the messages of the film is that feelings aren’t good, or bad, they just are. And not only that, they have a purpose. Learning to understand the purpose of the feelings is a powerful thing. Instead of feeling bad that you are experiencing certain feelings, and shaming yourself for those feelings, you can learn to feel your feelings, understand what those feelings are telling you, and then decide what action you should take based on what you are experiencing.
In the film Inside Out, the main character Joy, gives a breakdown of what each feeling’s purpose is: Fear is “good at keeping Riley safe,” Disgust “basically keeps Riley from being poisoned, physically and socially,” Anger “cares very deeply about things being fair,” Joy’s job is to keep Riley happy, and Joy doesn’t understand what Sadness is supposed to do, and keeps trying to prevent Sadness from having any influence on Riley.
As the film goes on it becomes apparent that Sadness has a very important role to play for Riley. When Joy finally understands Sadness’s purpose, she encourages Sadness to play her part. With the help of Sadness, Riley is able to get the help she needs to adjust to the changes and challenges she is facing in her life.
When the brain is functioning in a healthy balanced way, feelings are produced by experiences. For example, in the movie fear is caused by Riley encountering dangerous situations, disgust is caused by encountering unappealing food or social situations, and anger is brought on by perceived unfairness.
What If Your Emotions Are “Misfiring”?
What do you do when your emotions are misfiring because of a chemical imbalance or unhealed trauma? If emotions are occurring because the chemicals in your brain are out of balance and not necessarily because of normal outside stimuli, are they no longer valid or useful? Should you label your emotions as bad, or not listen to them when you are experiencing a mood cycle?
One of the challenges I faced when I was first diagnosed was that I didn’t know how to trust my feelings anymore. For the years that I went undiagnosed I had listened to the feelings that I was having and tried to interpret them according to what I had been taught by others.
When I felt the intense, euphoric exhilaration of mania I believed that all the irrational thoughts that were in my head were not only rational, but inspired. I made sweeping changes because of those thoughts and feelings and I told everyone. It all felt right and real.
When I crashed into depression I believed all of the negative, self-destructive thoughts that were in my head because they matched the negative, self-destructive feelings I was having. I hid myself from the world and tried to numb my brain by binge-watching television and movies.
I develop irrational thought and behavior patterns based on this cycle and by the time I was diagnosed those patterns seemed normal to me. This continued for years after my diagnosis because even though I was trying to find the right combination of medications to balance my brain and working with a therapist nothing seemed to help and I just felt broken and hopeless.
How do you live a healthy life if you don’t know if you can trust your own mind and feelings? It can make you feel insecure and unsure of yourself. Or you may feel belligerent and angry and decide that you should be able to just live on the rollercoaster because that is the way you were made and everyone else will have to just deal with it (see my post Bipolar Disorder: The Rollercoaster).
One important tool to develop when you are trying to learn to live well with bipolar disorder is to learn how to recognize when feelings are produced by the chemical imbalance. You need to learn to identify the signs that you are manic or depressed and then understand what those mood imbalances are trying to tell you.
The feelings produced by a mood imbalance can serve a purpose. It is like they are speaking a different language and if you learn to interpret them correctly you can then understand how to respond in a way that is healthy, even if your brain isn’t healthy at the time.
How Do You Identify Signs of a Mood Cycle?
In the beginning it may be difficult to distinguish between healthy emotional responses and unhealthy ones, because it all feels normal to you. For this reason it is critical to begin tracking your moods and symptoms. Tracking your mood and symptoms will begin to help you create a more accurate picture of what is happening in your mind and identify when you are experiencing a mood cycle, what the associated symptoms of your mood cycles are and even what may have triggered it.
There are a number of ways to accomplish this. You could use a journal, a spreadsheet, or an app. My favorite tool is the Bearable app. (I DO NOT receive any benefit or compensation from recommending Bearable, I recommend it because I love it!)
I struggled with using a mood journal because it required me to think and often I couldn’t think clearly enough to put what I was feeling into words. I also struggled with remembering to write things down frequently enough to create an accurate picture. Another issue I struggled with is how to convey what I had written to my doctor and therapist. Weeks and pages of journal entries can be difficult to condense and quantify, and that can make it challenging to see patterns and connections.
The Bearable App is fantastic because it is very user friendly. It allows you to keep track of your mood, different factors that could trigger cycles, medications, sleep, and other helpful information. The app is very easy to use and you can set reminders for yourself to input your information each day. It is very customizable, and it gives you a way to view insights to see trends and connections.
When you discover the symptoms of your mood cycle you can learn to understand what your depression or mania is trying to tell you and you can then respond to it in a healthy way.
Learning How to Respond to a Mood Cycle
Some of the ways you might respond are:
Discussing a medication or supplement change with your doctor or customer support. If the mood cycle is being caused by medication or supplements not doing their job you may need to adjust or change them. Always work with your doctor if you are on medication or customer support if you are taking supplements. DO NOT make these changes on your own as it can be dangerous.
Working with a therapist. A good therapist can help you learn to identify if your emotional responses to things are healthy or unhealthy and how to handle the unhealthy responses in a healthy, balanced way. Your therapist can also help you identify if your mood cycle is triggered by unhealed trauma, unhealthy thought or behavior habits, or unhealthy boundaries.
Learning to practice mindfulness meditation. Mindfulness is a very effective tool to help you learn to separate yourself from your thoughts and feelings in a way to look at them more objectively and determine if those thoughts or feelings are healthy or unhealthy. Mindfulness is an important tool to learn if you want to learn how to live well with bipolar disorder.
Developing a Mental Health Emergency Response Plan. Your plan will help you learn how to take responsibility for your mood cycles and manage them more effectively–lessening the impact of the cycle on you and your family and shortening the duration of the cycle.
Just like Joy learned that Sadness served an important purpose in Riley’s mind, you can learn to understand what your mania and depression are telling you and learn to respond in a healthy way, even if your mind is unhealthy at the time. Taking responsibility for your mood cycles, instead of giving into them or fighting them will help you progress on your journey to learn how to live well with bipolar disorder.
If you are a mother with bipolar disorder and you are looking for support in your effort to live well with it please join our free Facebook group Bipolar Moms Learning to Live Well.