Learning to practice effective self-care to manage bipolar disorder is not easy, but it is worth the effort, and it will get easier.Continue reading
In order to live a healthy, balanced, productive life with bipolar disorder you need to learn how to get off the rollercoaster and live with stability and consistency.Continue reading
Once when I was struggling with a depressive episode I went to a counseling appointment and told my counselor how discouraged I was. I felt so frustrated that I was depressed, it felt like failure to me. It seemed like I had climbed a mountain, learning how to live well, and now I was all the way back down at the bottom. I was frustrated and angry because in my mind I thought I had to start all over again.
My counselor responded to me with one of the most profound insights that I had been given into the treatment of my disorder. She said that treating bipolar disorder follows the same pattern as the addiction recovery cycle. She showed me a diagram of the addiction recovery cycle and explained that becoming depressed isn’t failure, it is just a shift in where I was in the cycle.
It is important to understand that these stages do not necessarily always occur in this order, and sometimes you can be in more than one stage at a time, and even regress to a previous stage. But understanding the stages and the basic progression is important to learning how to view your bipolar disorder in a healthy way.
Understanding the stages of the recovery cycle will help you better understand your disorder and have a healthier outlook on your personal responsibility for selfcare. 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.
Stages in the Recovery Cycle
In this stage you don’t recognize or acknowledge that you have a problem. This can occur before diagnosis, but often continues after diagnosis, too. Prior to my diagnosis I had a feeling for a few years that there was something wrong, but I didn’t really know what it was. I spent a lot of time feeling like my mood swings were my fault, a lack of self-discipline.
After diagnosis there were many times when I went through periods where I questioned my diagnosis. Often at the beginning of a manic phase I would start to feel happy and productive and I would think things like, “maybe it really was all in my head, I don’t have bipolar disorder and I don’t need medication. I’m fine.”
In this stage you may also feel angry that you struggle with bipolar disorder and feel like you shouldn’t have to work so hard to feel well, so you aren’t going to try at all. You may feel hopeless, like there is nothing you can do about it anyway, so why try. You might feel like you should be able to take care of things on your own, you don’t need anyone’s help, you can take care of yourself. Or you may like the feeling of mania, and not want to lose that exhilaration, rush, creativity, etc. that you get when you are manic.
In this stage you recognize and acknowledge that you have a disorder that needs treatment. It is just the beginning of the process, though, you know you need assistance but may not be fully committed to the journey yet. This could last for a while because it can feel scary to seek a diagnosis or to admit that you need help. There is also fear that there may not be any relief for you. Because of negative stigmas associated with bipolar disorder, it takes a lot of courage to reach out for support.
In this stage you are committed to changing and you are ready to get help. This looks like making an appointment with a doctor or a mental health counselor, or reading a book on mindfulness meditation. Each time you recognize the need for a new tool or step you enter this stage.
This stage is when you take action, when you apply what you learned in the preparation stage. This is when you start to see and experience change. This stage can be challenging when you first enter it, because you are trying something new. It is really important to have support from others who will encourage you and cheer you on as you choose each day to keep trying.
You enter this stage when you have established habits and patterns that help you live a healthy, balanced, and productive life. One of the challenges I experienced in this stage the first few times I entered it was anticipating the next manic or depressive episode. I was so used to the cycle that steady consistency sometimes caused me to feel anxious.
This is one of the reasons that it was so helpful to me to learn about this recovery cycle. I learned to stop dreading potential interruptions, and instead viewed it as an opportunity to learn and grow. There is no cure for bipolar disorder, but with consistent, persistent effort you can get to a point where you go long periods of time, sometimes years, without any serious episodes of mania or depression.
This is just what it sounds like. It is a recurrence of the mania or depression that throws off the new routine. Your response to this will determine where you land in the recovery cycle. The more you learn about your disorder, the more you recognize that it is a disorder and not moral or personal failing that causes you to relapse, the sooner you can work your way through the stages of recovery back to maintenance.
I have also found that the more times I make it to the maintenance stage the more faith I have in myself that I can get there again. I know the way back, and so I can pick myself up, dust myself off and keep moving forward. I never enter precontemplation anymore.
Understanding the recovery cycle has taught me that I am responsible for myself and for treating my bipolar disorder. I acknowledge that I have bipolar disorder, and I accept that I will have it for the rest of my life. If I do not acknowledge and accept that, I risk hurting myself and those I love the most–my husband and children.
Understanding this recovery cycle has helped me to view my disorder in a healthy way. Relapse is not failure, it is just a shift of where I am in the cycle. This understanding has been a significant step on my journey to living a healthy, balanced and productive life.
The Path to Wellness is Not Linear
The analogy that I used earlier of climbing a mountain to represent my path to wellness is really not accurate. In fact, 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.
One of the greatest benefits of discovering the recovery cycle is understanding the nature of bipolar disorder better–in a more realistic and productive way. There is no cure for bipolar disorder, just like there is no cure for type 1 diabetes. It is a medical disorder in the body that you can learn to manage so that it minimizes the impact on your life. But it will never go away completely. The goal is to learn to proactively manage your disorder within the Preparation-Action-Maintenance-Relapse stages of the cycle.
As you learn and practice using the resources and tools necessary to live a healthy, balanced, productive life, your transitions through the stages will be easier and the skills you develop will improve. As you implement the tools and gain experience with those skills you will gain confidence in yourself and your ability to recover when you experience a manic or depressive episode. You can also learn to spend greater periods of time in the maintenance stage of the cycle.
If you are ready to begin your journey to mental and emotional wellness, I invite you to sign up for my free guide to creating a personal Mental Health Emergency Response Plan. This is a fantastic resource to help you manage your relapses in a way that will minimize the impact on you and those you love. It will also help you develop a plan to move out of relapse and back into wellness. There is hope and there is help. I hope you will join me on this journey to living well with bipolar disorder.
The first yoga pose I ever remember doing was Child’s Pose. I remember reading about it in an article when I was in college. The article stated it was a restorative pose that helps to stretch the back muscles and relieve stress. I used the pose frequently to stretch my tense back, and I loved the calm I felt when I was in the pose.
My next experience with yoga was several years later when I was a mother with young children. A friend of mine invited me to go to a yoga class with her. I had never been to a yoga class before, but I loved it from the first. I loved how the stretching and calm approach made me feel physically, mentally and emotionally.
I only went to a few classes because finding childcare was difficult and I couldn’t afford the class fees. But I really loved how I felt when I did yoga. In the years after that I sporadically practiced yoga with DVDs and YouTube videos. I loved doing yoga, but because I was still relatively new to the practice I didn’t fully appreciate how beneficial yoga could be to my mental, emotional and physical health.
Finally, a couple of years ago I stumbled across Yoga with Adriene on YouTube. I was looking for yoga stretches to help me with running and found some videos of hers. I really love her videos. She is easy to follow and understand in the directions she gives. She also has a calming, positive voice and presence that help you feel that she really cares about you and your wellbeing and she genuinely wants to assist you.
It was also around the time that I was learning about mindfulness meditation (see my post on Mindfulness). As I was learning about mindfulness I discovered what is referred to as “mindful movement.” It was yoga poses!
I started to learn more about how your muscles can take a beating from your mind when you are unaware of what is happening in your thought processes. You store tension, anxiety, anger, fear, etc. in your muscles and it wears you out. The negative emotions and thoughts are amplified by your physical reactions that are happening automatically, without you even being aware of it.
Yoga is a fantastic exercise for the mind and body that helps to counteract the brain’s assault on the body. When coupled with mindfulness meditation practice, yoga can help you to improve your physical, mental and emotional health dramatically.
First, yoga helps you release tension and stress in your body.
When I first started doing yoga I thought it was just a fancy way of stretching. I knew all about stretching because I was an athlete in high school and college. My coaches were always reminding us how important it is to stretch before and after practice to protect your muscles from injury. But I had never cried when I stretched–unless I hurt myself.
The first time I cried during one of my first yoga classes I was caught off guard. I wasn’t in pain, in fact the crying felt good. It felt like all of the anxiety, stress and built up tension trapped in my body was being released. It was so therapeutic and cathartic. I find myself crying occasionally when I practice yoga and I have learned that this is helping my body and mind to let go of emotional stress that had built up in muscles.
Second, you learn to mindfully focus on your breath.
Most yoga is slow, and you learn to move through poses in time with your breath. This helps you pay attention to your breath and be intentional with deepening and slowing your breathing, which is part of mindfulness practice. Breathing is something you do without thinking most of the time.
When you are struggling with a mood disorder that causes depression and anxiety your body can have negative reactions that can restrict or speed up your breath. Breathing in a reactionary state like this makes you feel helpless and compounds the feelings of stress and panic.
As I have practiced yoga over the past few years I have noticed how restricted my chest feels when I try to take full breaths. Over the years of having bipolar disorder my normal state was often anxious and stressed, so my chest was used to being tight and restricted. I frequently felt like I couldn’t get a full breath of air.
Yoga has taught me to be mindful of my breathing and intentional about taking slow, full breaths of air that have helped to relax my chest and open my lungs. It has also helped me be more aware of when my chest does tighten up in reaction to something. I can then be mindful of what is happening to cause it and deliberate about choosing how I want to handle the trigger or situation.
Third, yoga helps you be mindful and compassionate with your body.
The slow, deliberate movements require you to focus on your body. When you have bipolar disorder you feel like things are happening to you. You often don’t feel like you have control over your mind, and that causes reactions in your body, which increases the feelings of helplessness.
Yoga helps you to slow things down, and pay attention to how your body feels and take responsibility for the care of your mind and body.
One of Adrienne’s mantras when you are practicing with her is “find what feels good.” This means pay attention to how your body feels while you are practicing and don’t force it to do things that hurt you.
One of the great things about practicing in my home is that I don’t feel any outside pressure to do certain poses or stretch more than my body is able. Yoga teaches you to listen to and honor your body. While you want to challenge yourself, you don’t want to hurt yourself. Yoga can help you learn the difference.
Fourth, yoga helps you build confidence in a powerful way.
When you first start to practice yoga there can be a lot of challenges. You are learning how to breathe correctly (sounds silly, but it is true) and discovering inflexibility and weakness in your body. There are also challenges with balance, even in mountain pose–standing straight up–that can feel discouraging.
But steady, consistent, persistent practice will slowly help you improve in all of these areas. Anyone can do yoga. You can individualize your practice to meet your needs and you will look forward to the practice because of the calm, peace and confidence that are the benefits.
I really love that you can practice yoga anywhere and in any mental state. When you don’t have the energy, physical or emotional, to go on a walk or run, a yoga practice is a great substitute. There are many different kinds of practices you can do from physically challenging to restorative. I always feel better mentally and physically after I practice and I can feel that I have taken an important step on my path to mental wellness.
One important self-care tool for living well with bipolar disorder is regular exercise. One of the challenges I have found over the years, but especially during the COVID-19 pandemic, is the expense, inconvenience and limited access to facilities for working out. Our family has moved a lot (six times in eight years) and each time a new set of challenges presented themselves.
Some places were a long distance from a work-out facility or pool, some places the fees were prohibitive, and it always involved extra time to get to the facility, and figuring out child care while I was working out.
All of this was compounded by the challenges I was having when I was in a depression. I was already struggling with limited emotional resources for motivating myself to do something, and all of these obstacles made it harder to stay consistent and easier to give up.
The two forms of exercise that I have come back to over and over the past two decades as a mother that were most effective, convenient, and physically and mentally beneficial were walking and running outside. Really, I could simply say that all you need is a good, supportive pair of shoes and you can walk or run anywhere, with children in tow. But I will tell you more about why these really are the most ideal forms of exercise for mothers with bipolar disorder.
First, running and walking are very convenient forms of exercise.
There are a lot of different forms of exercise, many of which require memberships, equipment, facilities, babysitters, etc. Walking and running are simple and accessible, and the only investment is a good pair of shoes. I have taken my babies and toddlers on walks and jogs with me in the stroller.
When my children were a little older I would take them to the track where they played in the grass while I ran laps around them. Sometimes they would even run with me. Now, I get up in the early hours before my husband leaves so that I can make sure I get my run in before the day starts. It is so convenient because all it involves is getting dressed and stepping outside to go run. I don’t have to drive anywhere or make arrangements for my children.
It is also possible to run or walk wherever you are, so you can maintain your exercise routine even if you are out of town. They really are the most convenient forms of exercise I have ever done (with the possible exception of yoga, which I talk about in Bipolar Disorder: Yoga for Your Mind and Body).
Second, they are both very efficient forms of exercise for your entire body.
Both walking and running are great cardiovascular workouts that help strengthen your heart and produce endorphins that help reduce stress and elevate your mood in a short amount of time. When you have children there are a lot of demands on your time. Finding an efficient way to exercise is important so that you can do it consistently.
In the past when I have tried to do other types of exercise–swimming, group classes, etc.–I have always had something come up that would get in the way eventually, especially during the pandemic when everything was shut down. I wasn’t just doing the exercise, I was having to spend extra time going to the facility for the class or to swim. I spent at least two to three times as much time as I do when I run or walk.
Third, there are physical and psychological benefits to running or walking outside.
When you run or walk outside you get the benefits of sunshine, fresh air, change in scenery and even social contact. An article by Advanced Neurotherapy identifies four key benefits to exercising outside: 1) increased oxygen levels from being in fresh air helps improve brain function; 2) spending time outdoors in natural scenery has been proven to improve concentration; 3) increased vitamin D from sunshine improves healthy brain function; and 4) exercising outside helps to reduce stress.
Being in the fresh air is good for your body and your mind! Living in the Midwest I even learned I could run in really cold weather, just layer up!
There are additional benefits to your brain if you don’t wear headphones when you run that are similar to mindfulness meditation. Years ago when I started walking and running outside I didn’t wear headphones for safety reasons since I usually walked or ran alone.
As I have walked and run without earbuds outside over the years I have really been amazed at how incredible the benefits are to my mind. Mindfulness meditation (see my post on Mindfulness) is about learning how to be present in your mind and in the moment you are in at the time. When I am walking and running I love to be aware of how my body is feeling, what my brain is thinking, and I frequently have inspiration come to mind about challenges that I am dealing with at that time.
The change of scenery has interesting psychological benefits. First, when you are running outside you can see how far you have come and there is a feeling of accomplishment. You feel like you are getting somewhere. There are changes in elevation or terrain that keep your brain active and engaged.
There are also the benefits of seeing different scenery to your mind. Whether you are in the city, suburbs or country, there is always something to interest your brain. When we lived in a small town I had a favorite run that would take me past a field where cows grazed. When I ran in the city I found the buildings and people interesting to look at, which brings up another benefit to running outside–people.
I love the semi-social nature of running outside. When you pass someone else you can wave or smile at them which gives you a sense of community and the act of smiling can help you feel better emotionally. I have had times, too, when I have been part of a running club or walked with friends, and that social connection has improved my emotional wellbeing.
As moms we have built-in sources of stress and demands on our time and energy that test us on a daily basis. When you combine this with a mood disorder like bipolar disorder it can feel like a losing battle. But when you have a simple, convenient, efficient form of exercise as part of your self-care routine that can help your physical and emotional health, you can develop a habit that will be another step on your path to living well and healthy with bipolar disorder.
One of the things that I have learned in my journey to wellness with bipolar disorder is just how much our physical, mental and emotional health are interrelated. When one is suffering or unwell it impacts all of the other areas. Likewise, improving your health in one area can positively impact the other areas, too.
I found this especially true with my physical health. When my body was not well, either out of shape or sick, it had a noticeable negative impact on my mental and emotional well-being. For this reason, I have learned how important it is to take care of myself physically and why exercise is such an important self-care tool for maintaining mental and emotional health.
My Early Experiences with Exercise and my Bipolar Disorder
In high school and college I was a competitive swimmer. After my diagnosis in 1998 I frequently would talk with my doctors about how I noticed that when I was a competitive swimmer, during those teenage and young adult years, my symptoms seemed to be much more mild and manageable. One doctor suggested that the training and competition might have kept me in a perpetual hypomanic state, which helped to stave off major depressive episodes. This made sense as I looked back on that time and the patterns in my life.
I tried to find ways to recreate that over the years. I felt like this was an important element to being well, but as I got into a career and then married and began having children I was unable to train enough to recreate that same physical intensity that proved so beneficial during my younger years. I also struggled to make myself exercise at all when I was depressed. As my illness got worse, exercise started to become counterproductive, draining finite emotional and mental resources and compounding my depression.
Once I finally found the supplements that helped balance the chemicals in my brain (see Bipolar Disorder: When Medication Doesn’t Work) I started the process of learning the place of exercise on my path to healing. The right kind of exercise in the right way really is key to maintaining optimal mental and emotional health.
The Downside to Training for Triathlons
When I first started to exercise after I got on my supplements I went back to what I knew, training for competition. I decided to sign up and train for my first triathlon. I knew how to train, I had developed a lot of physical and mental self-discipline related to training when I was a competitive swimmer.
So I bought books and watched videos on training for triathlons and went to work. I loved the familiar feeling of physical exertion that gave me an endorphin boost, and a sense of accomplishment. And when I participated in my first triathlon I was reminded of how much I loved to compete. It was thrilling!
Unfortunately, when it was over I got depressed, and I didn’t understand why. I tried to make myself exercise, but the effort was mentally exhausting and drained me. Instead of filling my emotional reservoir, it was draining it. I concluded that I didn’t like exercising for the sake of exercising, and that I needed to have a competitive goal to work towards in order for it to be beneficial to my mental state.
The problem this created was that I got into a pattern of training for events, which caused me to become hyper focused on the training, often at the expense of my family. It also created a hypomanic state while I was training, and this resulted in a crash and a depressive episode when the event was over. I didn’t know what to do. I could see that exercise had a positive impact on my mental health, but I couldn’t figure out how to access those benefits without hurting some other aspect of my mental or emotional health.
Exercising in a Mindful Way
The first breakthrough occurred after I had started to practice meditation (see my post Bipolar Disorder: Why Mindfulness Meditation is Necessary). I was feeling really stressed one day and I was having a difficult time getting myself to go on my training run. I decided to run without my GPS tracking app and to just take it easy. It was such an enjoyable experience for me.
I experienced a lot of the same benefits I received from meditating and felt positive and rejuvenated when I was done. I started to see that taking a walk or run, without trying to push myself to achieve a certain time or goal, helped my mental state. I started to do that more frequently, just walking or running for the sake of the experience, and I really started to love it.
I also learned how beneficial it is to not wear headphones or earbuds while exercising (see Bipolar Disorder: Walking and Running). Not listening to anything while you exercise keeps your brain from being distracted and allows you to focus on what is happening in the moment and reap the meditative benefits of the exercise and the outdoors.
Exercise for Health Rather Than Weight Loss
The next thing that helped me to really benefit emotionally from exercise was to focus on being healthy, rather than losing weight or getting slimmer. When I focused on something I didn’t like about myself–like my body or my weight–as a reason for exercising it created a negative experience with the entire process and made me feel more stressed.
I found myself so focused on my weight and appearance that if I wasn’t losing weight or seeing any noticeable difference in my body I would get discouraged and depressed. It also created a lot of stress leading up to the exercise because my mind was negatively focused, and it created anxiety for me rather than relieving it. When dealing with bipolar disorder you already have so much negative self-talk in your mind, you don’t need to feed it by creating additional reasons to dislike yourself.
Choose to focus on exercise to become healthier, physically and mentally. As you focus on positive rather than negative motivations it will help you feel more excited about exercising and look forward to it, rather than dreading it.
Exercise for Stress Relief
I have also found that exercise is extremely beneficial to relieving stress and anxiety. When you focus on the exercise and your breathing, especially outdoors (I also discuss why this is beneficial in my post on Walking and Running) your mind is able to subconsciously sort through problems you are having and often come up with solutions you hadn’t considered.
This will give your mind relief from the stressors and worries that sometimes overwhelm you and give your body a physical outlet for the physical symptoms of stress. You will be amazed at the insight and inspiration that can come when you exercise outside without headphones. You will also find you feel physically invigorated the rest of the day.
Exercise for Self-discipline and Self-confidence
Finally, I have found that when I am exercising consistently, I am more productive in my life overall. It takes consistent self-discipline to begin and maintain an exercise routine. Keep your exercise routine simple, accessible and a small time commitment (usually 30-40 minutes) so that it doesn’t require more than you can consistently give.
Following this pattern will make it much easier to follow through on your commitment to yourself and you will gain confidence in your ability to follow through and stay consistent. You will be able to apply that self-discipline to other areas of your life. Regular exercise will give you more energy, focus and confidence to meet the other commitments and priorities in your life.
My mindset about exercise really has changed. I am now focused on the mental, emotional and physical benefits it gives me. I have removed the stressors associated with it (training stress and body image stress) and I have found that exercise really is key to maintaining a healthy body and mind. Our bodies and minds are truly inseparable, and when you take care of your body (in a healthy and balanced way), it really does help you care for your mind.
I do not receive any compensation for the link in this post to take you to the book I recommend. It is there simply for your convenience.
Years ago I was reading the book The Seven Habits of Highly Effective People by Stephen Covey in yet another attempt to fix myself with a self help book. As I was reading one day I came across this passage, “Between stimulus and response is our greatest power–the freedom to choose.” As I read that statement I knew that was the key, I needed to work on making space between the stimulus and the response so I could choose how to act. Unfortunately, no matter how hard I tried, I just couldn’t create that space.
With bipolar disorder it is nearly impossible to discipline your brain. When you’re in a manic or depressed state your mind is bombarded by a tsunami of intrusive thoughts and overwhelming emotions that all feel very real. This, coupled with the exhilaration of mania or the exhaustion of depression make attempts to take control of what is going on in your own mind feel useless and futile. As long as my illness was in control of my brain, I felt like I was in bondage to bipolar disorder, and I felt hopeless.
The first glimmer of hope was when I finally found the supplements that I take that balance out the chemicals in my brain (see my post Bipolar Disorder: When Medication Doesn’t Work). That made it possible to create the space, because the chemicals were finally in balance. The next step was getting into counseling to get help identifying unhealthy thought patterns and habits that I needed to change (see my post Bipolar Disorder: Why Counseling is Essential).
Now I needed to learn how to create that space between stimulus and response so that I could choose for myself how I wanted to think, act, and live. This is where I learned the value of mindfulness meditation in taking responsibility for my life.
My Introduction to Mindfulness Meditation
The first exposure I had to the practice of mindfulness was around 2006 when one of my sisters was getting her masters degree in Marriage and Family Therapy. She recommended a guided meditation cd by Jon Kabat-Zinn. I bought the cd, listened to it for a few minutes, and thought, “what kind of hippy, dippy stuff is this?” I put the cd back in its case and didn’t look at it again for several years.
In 2013, when I was pregnant with my third baby, a friend of mine recommended that I try hypnobirthing. I really wanted to have a natural birth and I was very open to her recommendation. Hypnobirthing is a form of mindfulness practice, and the birth was such an amazing experience that I wanted to have another baby just so I could do it again (my husband said no, we’re done).
In 2014 my mom told me that she and my stepfather had started practicing mindfulness meditation to help with some health issues. They were using the same guided meditation cds that my sister had recommended. Because of my experience with hypnobirthing I was more open to it. This time I bought Kabat-Zinn’s book Full Catastrophe Living to try to understand the science behind the practice.
I only made it through two chapters of the book and three weeks of sporadic practice before I gave it up. The practices were so long that even though I could see the benefits of the practice, I was really having a hard time consistently finding 45 minutes a day to dedicate to it. The book was also difficult for me to read because it was 499 pages long and way more information that I wanted or needed.
A Simple Program That Works
Then in 2016 a childhood friend of mine posted on Facebook about his struggle with anxiety and depression and how much mindfulness meditation had helped him. He referenced a book I hadn’t heard of, Mindfulness: An Eight-Week Plan for Finding Peace in a Frantic World by Mark Williams and Danny Penman, both of whom had studied or worked with Jon Kabat-Zinn. I got the book and decided to try again. This book was so easy to read and understand and the practices were shorter.
I had a few false starts with this program. I struggled with consistency and prioritizing the time for practice. Little by little, though, I was starting to learn the tremendous value of mindfulness meditation. As I began to read and practice consistently I finally started to see why this was so essential to my healing.
Why You Need Mindfulness
Often when you have a thought or experience, your mind tries to decide how to engage with it by going through its “files” of experience and pulling up every possible scenario in the past it thinks is related, and every possible outcome that could result from the present situation. It does all of this–without you realizing it–to tell you how you should feel, think and act in response.
When you live with bipolar disorder this scenario is amplified because you have ceded control of your mind already. It doesn’t even occur to you that this process takes place, let alone that you could change it. You have learned to believe that you are a victim and that your mind has a mind of it’s own–you’re just along for the ride.
This is a terrible way to live, and I have learned that it is not necessary. You can take responsibility for your thought processes, and mindfulness meditation teaches you how your mind works and how to change it effectively so that you can regain ownership of your mind.
Learning to Exercise Your Mental Muscles
This process takes time, like beginning an exercise program when you are totally out of shape. The way this program is set up reminds me of a couch to 5k running program. It is designed to slowly retrain your mind and help you exercise your mental muscles. The book is so simply written and straight forward.
Each week you read a chapter that teaches you a new principle and then there are guided meditation practices to teach your mind that principle. Just as with exercise, consistency is the key. And you have to make it a priority, which means making the time in your day to do the mediation practices for that week. The amazing thing is that the small amount of time that you dedicate to the practice doesn’t feel like a sacrifice once you start to experience the benefits.
I have experienced tremendous benefits in my life as I have consistently practiced mindfulness meditation. I am more consciously aware of the thoughts I have entering my brain, and instead of letting them run away from me and take over, I decide what I want to do with those thoughts. I am so much more effective and efficient with my time and more focused in my mind. I have more time for the things that really matter to me.
Best of all I have much healthier emotional responses to things. Because I don’t let my mind run away from me, I decide what I want to do with thoughts that used to get me worked up emotionally. It really is wonderful to not feel like a victim to an out of control mind anymore.
Meditation Practice, the Key to a Balanced, Healthy Day
My meditation time is an essential part of the beginning of my day now, helping me to remind my brain who’s in charge. It is also the way I calm my mind at the end of the day so I can have a restful night’s sleep. I have also learned how to use my breathing to recenter myself when I am in a stressful situation so that I am able to handle stress in a healthy way.
I heard a saying once that I now understand in the context of mindfulness,
“If you are depressed you are living in the past. If you are anxious you are living in the future. If you are at peace you are living in the present.” -Lao Tzu
Mindfulness teaches you how to live in the present so that you don’t get swept up in the current of your thoughts and lose control of your mind and your emotions. As Covey said, “Between stimulus and response is our greatest power–the freedom to choose.” Mindfulness teaches you how to create that space between stimulus and response so that you can have that freedom to choose. It is the next essential step on the path to wellness.
When I was first diagnosed with Bipolar Disorder I immediately knew that I did not want to go to counseling. I had developed an aversion to counseling in my youth because the only thing I knew about it, other than portrayals in the media, was that I remember my grandmother frequently saying, “my therapist said this” or “my therapist said that.” I remember thinking that I didn’t ever want to be dependent on someone else to know what to think or how to act. My independent and immature mind decided that counseling was not for me.
For the first few years I would see my psychiatrist regularly for medication evaluation and changes, and then I would buy self-help books, sure that it was just a matter of learning how to exercise more self-control and self-discipline. But no matter how hard I tried, I wasn’t making any progress. I had a fundamental misunderstanding about what counseling was and why it was an important, even essential piece to becoming mentally well.
It Really Is All In Your Head
When you struggle with Bipolar Disorder it distorts the way you see and experience the world. Emotions and thoughts are meant to help us know how to interact with the world. But, when the chemicals that cause emotion are out of balance and “misfiring” you can end up with a very distorted view of your life and your experiences.
You won’t even realize it because that is just how your brain works and it feels normal to you. But over time the instability and unpredictability of the mood cycles, and the external damage you do, especially to relationships, begins to provide mounting evidence that something is actually wrong. It really is all in your head, and you need someone professionally trained to help you to sort out the behavior and thought patterns that are contributing to your mental disorder.
The first, most important step on the path to taking charge of your brain is getting the chemicals in balance. I wrote about my experience with this in the post Bipolar Disorder: When Medication Doesn’t Work. Once you have found a way to get your brain chemistry balanced, though, you still have work to do.
Someone to Help You Learn to See
I described it to someone once like this: Imagine a person who has been colorblind her entire life finds a treatment that miraculously allows her to see color. Just because she can see blue, pink, orange, etc., doesn’t mean that she automatically knows what those colors are. She needs someone to help teach her brain how to understand the world she is now able to see.
The second essential step on your journey to mental wellness is to work with a mental health therapist or counselor. This person has been trained to help you work through your thought processes and habits to identify unhealthy thought and behavior patterns that need to be changed, healed, or eliminated in order to help you interact with life in a healthy way.
One example from my personal experience illustrates the benefits of counseling in identifying unhealthy thought patterns. When I was growing up I would frequently get depressed, and each time I did I would beat myself up for every little thing I did that I thought I’d done wrong because I believed that those actions were causing my depression. It created a habit in my mind that over the years contributed to increasing the severity of my depression.
Even after I got my brain chemistry balanced, if I found myself getting down, my brain would go into autopilot, identifying all the things I had done wrong recently, which would increase my depression in a downward spiral. Working with a counselor I was able to identify this unhealthy thought pattern and learn how to stop it so that I didn’t experience these self-induced depressive episodes.
Your counselor can also help you to identify and work through trauma that you may have experienced that is impacting your mental wellness. Trauma is defined as “a deeply disturbing or distressing experience.” Trauma impacts your mind, body and soul, and depending on the severity often requires profession intervention to heal from it.
Just as a severely broken bone requires medical intervention, trauma usually requires someone professionally trained to help you identify and heal the damage. Trauma can be severe, but there are also times when seemingly innocuous experiences can be traumatic because of the way we experience them, which is especially applicable to a person who has lived with Bipolar Disorder.
Working on Boundaries
Another area I have learned is challenging for those of us who have experienced life through the lens of mental illness is setting and respecting boundaries. This is an important area to work through with a counselor because he or she can help you first to learn what healthy boundaries are and why they are essential to living a healthy, happy life. You will also work to discover why you may struggle with implementing and respecting boundaries. Finally, your counselor will provide support and feedback to you while you make the necessary changes to integrate healthy boundaries into your life.
Be Patient with the Process
These are just a few of the many ways counselors are essential guides on the journey to mental wellness. One of the things that I have learned is that this is a process that takes as long as it takes, don’t be impatient with it. Sorting out the way your brain works can be challenging, but you will identify therapy goals with your counselor so that you can measure progress and have a focus for your therapy.
One of the biggest problems for me once I started going to therapy was that for many years I would only seek counselling when I was in crisis, and never in an effort to work through the brain and behavior patterns and habits I had developed while struggling with a brain that was misbehaving. This was such a mistake and caused tremendous discouragement and frustration for me. When I finally realized how critical it was for me to seek counseling not just for the crises in my life, but to prevent them, I finally saw real, lasting, meaningful change in my mind and my life.
Mental Health Checkups
I will likely never stop going to counseling all together. Just like a diabetic has checkups with their doctor to make sure everything is going well, it is important to have “mental health checkups” regularly with your therapist to make sure you are still moving forward on your journey to optimal mental wellness.
It takes a lot of emotional energy to establish yourself with a therapist you feel comfortable with and the more they get to know you the better they can help you. So once you find a counselor or therapist who is effective and you trust–even when you have reached your therapy goals–it is important to check in once every 3, 6 or 12 months (you decide with your therapist) for your “mental health checkup.”
I am so thankful for the counselors over the years who have helped me learn how to live well with Bipolar Disorder. Counseling is not a crutch, it is a necessary tool that will help you on your journey to learn how to live a healthy, balanced, and productive life with Bipolar Disorder.
This is Part 2 in a 2 Part Series. To read Part 1 See Bipolar Disorder: When Medication Doesn’t Work
Before you read further I need to make two things VERY clear.
First, I am not a mental health professional. Everything I am sharing is based on my personal experience and I encourage you to do your own research, as I did, to find what is right for you. Some people respond well to medication and the side-effects are manageable. If that is the case, wonderful, the first piece of your puzzle is solved!
Second, if you do decide to try the supplements that I use, I strongly encourage you to do so under the care of a mental health professional–your psychiatrist, or a licensed psychologist. DO NOT EVER go off of psychotropic medications cold turkey or on your own. They are very dangerous and can have severe, sometimes life threatening withdrawal symptoms.
I DO NOT RECEIVE ANY COMPENSATION FOR RECOMMENDING THIS SUPPLEMENT. I RECOMMEND IT BECAUSE IT HAS BEEN SUCH A BLESSING IN MY LIFE.
If you are feeling that you may cause harm to yourself or someone else, please seek immediate professional assistance.
Pregnancy and Postpartum on Medication
Pregnancy brought an entirely new set of issues. Most of the mediations I took over the years were dangerous for pregnancy, so in order to safely navigate pregnancy I had to go off of all meds except one very low dose of an antidepressant. I had a plan set up with my psychiatrist and my obstetrician when my husband and I decided to try conceiving to make sure I was safe. Both of my pregnancies during this time followed the same trajectory. Each time I got severely depressed at the beginning of the pregnancy, in fact that was how I discovered I was pregnant each time. I was so depressed that I decided it was unwise to try this, and I was asked to take a pregnancy test before going back on my medications. Each time I was pregnant.
The first trimester I was depressed and very morning sick, but as soon as I began the second trimester I felt better physically and emotionally. The rest of the pregnancy was wonderful. I used to joke that the hormones of the second and third trimesters made my chemical imbalance disappear. The only real issue I had during my pregnancies was anxiety–excessive worry and nightmares–but even this wasn’t really too bad.
The real problems occurred about three months after I gave birth. The first three months postpartum were like a happy little bubble, and then the world came crashing down on me. Both times I began to rapid cycle, from depression to hypomania and back, and I had to stop breastfeeding immediately and go back on all my medications. Then the nightmare really began.
Each time I developed postpartum hyperthyroidism. My thyroid went into overdrive, I lost most of my hair, I lost an excessive amount of weight very quickly–I was eating a ton of food, but I was always hungry and I was 25 pounds underweight. I looked anorexic and some people thought I had developed an eating disorder. The worst symptom was that I was dizzy all the time and even passed out occasionally. I was afraid to drive or carry my baby because of it.
The postpartum hyperthyroidism corrected itself both times, but the second time was significantly worse and I was warned not to have any more children or I would destroy my thyroid.
In 2008, after ten years of treatment, I had two small children and I was clinically depressed and suicidal. This was the beginning of the hospitalizations. The first hospitalization covered a period of 6 weeks and included a full-course–12 treatments–of electroconvulsive therapy (ECT), which wiped out my memory of that time. I also experienced my first psychotic episode, which changed my diagnosis to Bipolar I.
The treating psychiatrist at that hospital didn’t believe me when I told her that I didn’t react well to lithium and insisted that I go on it. I became suicidal as a result and ended up with a second hospitalization. My primary psychiatrist notated my file with lithium as an allergy after that. After I was released from the hospital for a second time my mood swings were so severe that my husband didn’t know what to do anymore. I had serious personality changes, intense anger and hypersexuality, and I attempted suicide, resulting in another hospitalization at a third facility.
When I was finally released from that facility I felt like my life had no value. I had actively sought treatment, done everything my doctors told me to do, and nothing worked. I felt like my life was going to just be about surviving. I felt sorry for my husband and children. I had no hope anymore that things would ever get any better, but I didn’t want to put my husband and children through a suicide, so I felt completely lost and helpless, and so did my doctor.
Treating the Cause–Finding the Supplements that Saved My Life
In early 2010 I was introduced to the first of two supplements that would change my life. My mother called me to tell me about a friend of hers whose husband had bipolar and had started taking a supplement that helped him lessen his mood swings. I was dubious because I had tried some natural supplements before that didn’t do anything for me. But, I didn’t feel like I had much to lose at this point and my doctor agreed that it wouldn’t hurt to try, so I started taking it.
Over the following couple of months I started to feel overmedicated with my mood stabilizer and my doctor slowly titrated me off of it. I was cautiously optimistic. The most dramatic change for me was the cessation of the migraines that had started after I had ECT. I was so excited, but I stayed on my antidepressants because I didn’t feel safe going off of them.
A few months later a good friend of mine told me about a supplement called EMPowerPlus that was produced by a nonprofit company called True Hope. This company was dedicated to helping people with chemical imbalances to live healthy, mentally balanced lives through supplementation aimed at balancing out vitamin and mineral deficiencies common in many people with chemical imbalances in the brain. What was more, they had research to back it up that I was able to provide to my doctor. They had 35 clinical trials at different universities across the United States and Canada, and an 80% success rate with helping people manage their illness with few if any symptoms.
After I provided the literature about EMPowerPlus to my doctor he was happy to help me transition off of my medications onto this new supplement. He was as desperate to find a solution as I was. Over the next few months, with the help of my doctor and True Hope’s nutritional support staff, I carefully titrated off of my medication and onto the supplement. It felt like a miracle. As my mind began to clear and heal I started to “wake up” and my brain felt healthy for the first time in my adult life. I still had a lot of work to do–counseling, exercise, meditation and yoga–but taking the supplements put me firmly on the path and made mental wellness possible.
Pregnancy and Postpartum on the Supplements
One amazing benefit to taking the EMPowerPlus was the healthy experience with my third pregnancy. Because it is a natural vitamin and mineral supplement it was not only safe for pregnancy but highly beneficial. I experienced no symptoms of depression during the pregnancy, and most exciting I had no health issues postpartum. My thyroid has worked perfectly over the past 10 years, and I had no recurrence of the postpartum hyperthyroidism. In fact I had to work hard, like most women, to lose the ample “baby weight” that I gained during the pregnancy.
EMPowerPlus is Unique, not Just Another Vitamin Supplement
One important lesson I learned over the past decade is that EMPowerPlus is not a “normal” vitamin and mineral supplement. It won’t hurt someone to take it for general health purposes, but it is specifically designed for people who suffer from mood disorders like bipolar, depression and ADHD. Other vitamin and mineral supplements will not do the same thing, as I discovered for myself one year when I tried to switch to a different supplement I thought would work the same. I found myself cycling between mood swings about five months after I started the other supplement, and I finally recognized the mistake and switched back a few months later.
True Hope’s founders developed the supplement based on common vitamin and mineral deficiencies found in many people that suffer from these mood disorders. Over the years the formula has been refined to meet the specific nutritional needs necessary to help people with bipolar disorder, depression and ADHD to have more balance in their mood and mind. They have also continued to do research and discovered additional supplements that help to further refine and personalize the treatment for each individual.
Over the past ten years, with the help of the True Hope nutritional support staff, I have been able to tweak the supplementation, figuring out the appropriate dosage, healing my digestive system so that it could appropriately absorb the nutrients, and adding in a few additional nutrients that my body was deficient in so that I could experience optimal mental health. With these supplements–together with my work with counseling, exercise, meditation and yoga–I am learning to live a beautiful, productive and hope-filled life.
This is the First Step on Your Journey to Mental Wellness
Again, I am not advocating that someone go off of their medications on their own, especially not cold turkey–that is dangerous and can be life-threatening.
I transitioned off of my medications and onto the supplements under the care of my psychiatrist. True Hope can provide your doctor with the documentation on the clinical trials that will help him or her to see the efficacy of this treatment option.
These supplements may not be right for everyone, but they were right for me. If you are struggling finding a medication(s) that work for you and you feel hopeless, I encourage you to investigate EMPowerPlus with your psychiatrist to see if it might be right for you.
The path to mental wellness is begun by first giving your brain the help it needs to function well–either through medication or supplementation. Then you will truly be capable of taking responsibility for your life and working towards real mental wellness.
Before you read further I need to make two things VERY clear.
First, I am not a mental health professional. Everything I am sharing is based on my personal experience. I encourage you to do your own research, as I did, to find what is right for you. Some people respond well to medication and the side-effects are manageable. If that is the case, wonderful, the first piece of your puzzle is solved!
Second, if you do decide to try the supplements that I use, I strongly encourage you to do so under the care of a mental health professional–your psychiatrist, or a licensed psychologist. DO NOT EVER go off of psychotropic medications cold turkey or on your own. They are very dangerous and can have severe, sometimes life threatening withdrawal symptoms.
If you are feeling that you may cause harm to yourself or someone else, please seek immediate professional assistance.
When the chemicals are out of balance
Have you ever heard anyone say something like, “Just snap out of it, it’s all in your head”? While the quip is meant to dismiss what is happening in the brain as something within your control, there is a lot of truth in the second part of that statement. It really is all in your head.
Your brain controls everything, it tells you how to feel, act, etc. and when your chemicals are out of balance you can have overwhelming emotions and intrusive thoughts that either have no outside cause, or are excessive and out of proportion responses to outside stimuli. It causes confusion, anxiety, stress and insecurity when you don’t feel like you can trust your own mind.
Chemical imbalances are like diabetes
One doctor that I had helped me to understand what was happening in my brain the best when he told me that my bipolar disorder was like having diabetes.
In diabetes a person’s body is not producing insulin, the hormone responsible for regulating glucose in the blood. When this occurs it causes all kinds of problems in a person’s body, from fatigue and irritability, to loss of sight, limbs and even life. It is not the person’s fault that they have this condition, they have no control over whether their body produces insulin or not. But they can live a healthy, productive life if they learn how to monitor their blood sugar, give their body insulin shots when needed, manage their diet, lifestyle, etc. Without the outside intervention of insulin, however, any hope of a normal, healthy life is non-existent.
My doctor told me that living with bipolar is similar to living with diabetes. There is a chemical imbalance in the brain that affects the function of the moods, thoughts, emotions, etc. If we could figure out how to balance the chemicals in my brain I would have a chance at living a healthy, productive life. This analogy really helped me to understand my disorder in concrete terms. It is hard when it is “all in your head” to know if it is real. Here was a doctor telling me the chaos in my head wasn’t my fault and that there was a way to manage it. So I persevered in my quest to find the right medication combination.
My Life Before Diagnosis
Although I had exhibited symptoms of bipolar for years starting in early adolescence (I have clear memories of suicidal thoughts in junior high) I didn’t start to experience the full effects of the illness until age 20, which was brought on by severe trauma from my first marriage. I still wouldn’t be diagnosed until four years later, one month before I graduated from college.
The first people to recognize that there was something wrong with me were my aunt and uncle. I lived with them off and on over a four year period in college and I worked for my uncle my junior year. The time they spent with me helped them to see the patterns–the dramatic mood swings, the hypomania and severe depression–and they could see that it was increasing in severity. They called my parents to let them know they suspected a chemical imbalance.
My parents knew something was wrong, but they didn’t know what it was. They wouldn’t hear from me for weeks, and then when they did I had a new life plan all mapped out–I was going to Russia to study Russian and I would then become a diplomat, or I was going to get my PhD in math and become a math professor, or I was going to China, to learn Chinese and study foreign policy. Each time I was so sure THIS was the right path and I was often so convincing that they believed me.
My senior year was the worst. I would be depressed for weeks at a time, not attending classes, watching television or sleeping, and then I would get manic and stay up for days, writing papers, taking tests, and ace my classes–I was even on the dean’s list.
I knew something was wrong, but I felt embarrassed because I thought I was making excuses for myself. I was sure that I could fix it if I just had more self discipline. I remember the day I called my parents crying and told them I knew something was wrong with me and I needed help. It was so hard to do, but I felt like I was drowning and if I didn’t get help I was going to die.
Initial Diagnosis and Treatment
My aunt went with me to my intake appointment with the psychiatrist. I was severely depressed at the time and she had to supply a lot of the answers to the doctor. Unfortunately because these illnesses are diagnosed based on symptoms I was misdiagnosed initially with depression and anxiety disorders, given a prescription for an antidepressant and sent home.
By the time I had titrated up to the full dose of the medication and it had built up in my system enough to cause the mania I had moved home to my parents’ house in a different state. I found a new practitioner who, after her intake with me in my manic state, changed my diagnosis to Bipolar II and put me on Lithium.
I remember shortly after I started the Lithium I was taking the bus to work and as I sat on the bus I felt like I could feel each of the billions of neurons in my brain disconnecting and I was sure I was going crazy. I called my mom from work crying because I felt insane. I was having a bad reaction to the Lithium and was advised to discontinue it immediately.
Playing Guess and Check with Medication
I didn’t tolerate medication very well, for the first three years being on my initial antidepressant I was exhausted constantly. No matter how much sleep I got I was always tired, and I could fall asleep anywhere, and sometimes did.
When my doctor finally changed my medication the withdrawal symptoms were scary. I was so dizzy for a couple weeks that I often couldn’t stand and I even passed out on the sidewalk of a busy city street walking home one day. I was terrified.
I struggled trying to find a mood-stabilizer that would work. I didn’t tolerate any of them in a therapeutic dosage, so my doctors were constantly fiddling with combinations, add a little here, remove a little there. And the side effects were intolerable.
The most common issue was excessive fatigue, but often I would feel dull or dead inside, some gave me stomach problems and digestive issues, and the worst ones caused my heart to race and my anxiety to go through the roof. I was always stressed when I would have to go have liver function tests. I knew that in my effort to keep from being crazy I was destroying my liver–robbing Peter to pay Paul as the saying goes. In the end nothing really worked. I continued to cycle, and the cycles were getting worse along with my symptoms.
Over a decade I worked diligently with my doctors to try and find something to help. I believed that like the doctor said, this was like diabetes. I just needed to find a way to balance the chemicals in my brain. However, unlike diabetes, the cause of the imbalance was a mystery. Medication wasn’t actually treating the root cause of the problem, but treating the symptoms, and then adding additional medications to deal with the side effects..
Working with psychotropic medications is like playing guess and check with your brain, the doctors tried one cocktail after another. At one point I was on 7 different medications, and I felt like a zombie–mindless, dull and dead inside–nothing really worked. I continued to cycle and my illness got worse. I was starting to feel hopeless.
This is Part 1 in a 2 Part Series. To read Part 2 See Bipolar Disorder: An Alternative to Medication