Bipolar 2 From Inside and Out

Posts tagged ‘coping mechanisms’

Men’s Mental Health and the Manosphere

June, which is coming up faster than you think, is Men’s Mental Health Month. We can expect PSAs about depression and PTSD, messages that men are allowed to have feelings and seek help, and actors and sports stars admitting they have reached out to other men who were having problems.

Teens and young men in particular need to see and hear these messages. In addition to raging hormones and brains that aren’t fully developed in the impulse control regions, young men don’t often learn how to deal with troubled thoughts and feelings, and they can fall victim to addiction to violent video games or online gambling. These powerful forces influence them in ways that are detrimental to their mental and emotional health.

And on top of all that, they can be lured into unhealthy feelings and behaviors by the Manosphere.

What Is the Manosphere?

The manosphere is a section of the internet, including social media apps, Reddit, YouTube, blogs, podcasts, gaming forums, websites, and communities that give a voice to dissatisfied, lonely, frustrated, and frequently hostile men. Their needs are real, but the solutions offered for them are harmful. The manosphere likely originated from the men’s rights movement, which promoted the idea that men were treated poorly in custody decisions and other areas of life. Much of the blame was directed at feminists. One of the manosphere’s main complaints is that by encouraging men to get in touch with their softer sides and emotions, men are being feminized, and that’s a bad thing. They call giving in to feminist thinking “taking the red pill,” a reference to the movie The Matrix. Red pill content is pervasive on the internet and often referred to in real-life conversations.

The manosphere seeks to offer a different definition of masculinity that they say young people are not receiving. Unfortunately, what the manosphere presents as an alternative is toxic masculinity and a return to caveman-like behavior. Women who object to what they are promoting are viciously and often obscenely attacked online. Women in the #MeToo movement are met with stories of false accusations of rape, and women are routinely pictured as sex objects and/or adversaries. In addition, segments of the manosphere promote anti-LGBT+ views, racism, and other forms of hate speech. And the “incel” community (involuntary celibates), who blame women for not being sexually attracted to them, have been known to attack women physically in real life. They have a sense of entitlement when it comes to women’s bodies.

Why Is the Manosphere Harmful to Men’s Mental Health?

First, denizens of the manosphere preach extreme self-reliance. And they deny that psychological problems even exist. Men who ask for help are seen as weak. They’re supposed to handle all their difficulties themselves. They ignore or scorn messages that seeking help for mental health is legitimate. There’s tremendous stigma attached to seeking help for depression, anxiety, loneliness, and relationship problems. And the manosphere teaches maladaptive coping mechanisms, rage, and aggression disguised as bonding and shared hardship.

Then, too, the manosphere promotes messages they call “male empowerment” or self-improvement. Teens and young men are particularly vulnerable. It sounds so positive and harmless—or fun, as parts of the manosphere claim to turn boys and young men into “pick-up artists” who scoff at the idea of consent. Empowerment, as the manosphere defines it, appeals to youngsters who feel alienated and discontented. It also results in disrespectful harassment and even violent behavior towards women and trans people they see as pushy or threatening, including authority figures such as teachers, women who blog about video games, and their female classmates as well.

The masculine ideal in the manosphere relies heavily on the physical attributes of video game and action movie heroes or bodybuilders: toned and ripped, square-jawed, and athletic. Achieving this is called “looksmaxxing,” and teens and young men are particularly susceptible to it. Preteen and teen girls already get messages from the media that their looks are deficient and in need of sometimes extreme improvement; now, preteen and teen boys are getting similar messages. This process results in significantly lowered self-esteem, and the manosphere seems to offer a solution, such as ads for products, coaches, courses, and supplements, often dangerous ones, that will help youngsters achieve the “right” body type. (Teens have actually been advised to tap on their face with a small hammer to achieve the “chiseled jaw” look.)

What to Do About the Manosphere

Combatting the malign influence of the manosphere will not be easy. Manosphere influencers present messages that appeal to teens and young men, who don’t realize how harmful they are. Getting young males to listen to messages that men are allowed to have, and do have, mental health difficulties, and that seeking professional help is acceptable, isn’t a “sexy” message that plays on insecurity, misogyny, and blame-shifting. But it’s something that needs to be done before we lose a generation of young men to a vision of toxic masculinity.

Another avenue that needs to be considered is educating young men with critical thinking skills and information on how the internet works. They need to be able to examine manosphere content with an eye toward how reliable the information they receive is and what the poster has to gain. They need to understand that when they click on a link or watch a video, they will receive more content related to that interaction—more videos of Andrew Tate and other influencers, more links to other manosphere sites, more content that espouses misogynistic and patriarchal views, and more looksmaxxing promotion.

We need safe, male-friendly, and peer-to-peer spaces in families, schools, and counseling practices for young men to process what they hear versus what they feel. They need to know that talking to other young men and to mental health professionals about their problems, questions, and difficulties is a valid way to get the support they need. We need to offer alternatives to the manosphere, examples of nontoxic masculinity, and ideologies that don’t present women as the enemies of men. We need to present messages that there is no one way to look or to be if you’re male, and no one way that women view men or act toward them. In particular, those messages need to come from male role models in boys’ lives and in the media. And those messages need to be appealing and repeated. Of course, women have a lot to offer, too. But until the influence of the manosphere is tamed, women’s messages are likely to be discounted, ignored, or even violently rejected.

That’s a lot to ask of a PSA.

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mental health

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When Journaling Doesn’t Work

If there’s one thing people tell you to do when you have a mental health issue, it’s to start a journal. They may not call it that. They may say it’s a place to write affirmations, or things you’re grateful for, or aspirations. But what they really mean is a journal, a written record of what’s going on inside you.

But sometimes that doesn’t work. You may not be in touch with your inner feelings yet enough to know what your dreams mean or whether you need to explore your inner child’s trauma. It may simply be too soon.

Writing isn’t a bad idea, though. It just may be a mistake to call it a journal or to try to make it a way to explore your inner life. But there are other things you can do while you’re waiting until journaling is right for you.

One avenue you can try is other forms of writing. Don’t even think about your difficulties and how to solve them. You can get to that later, probably with the help of a therapist. For now, just write poetry. About anything. Your cat. The tree outside your window. The guy you just met at a party. Literally anything. Don’t try to be deep. Don’t try to write something meaningful, something for the ages.

Just put words on paper. Lord knows, they don’t have to rhyme. And don’t show it to anyone. The idea isn’t to impress anyone with your innate poetic talent. It’s just to get used to the idea of putting words on paper. Sure, it will feel weird at first (especially if you do try to make it rhyme). You don’t have to set any kind of goal like writing a poem every day or even every week. Just every once in a while, sit down at your computer (or, if you must, sit with a legal pad under a lilac bush) and write a poem. Or revise one you wrote the week before.

If you feel so inclined, try setting your poem to music. Strum that old guitar you haven’t dug out in months, or noodle around on GarageBand. Don’t make it a chore. Try it, just for the heck of it. Or you can decide to scrap the poems and just play around with music. There’s nothing that says you have to write poetry. What you’re doing doesn’t have to involve words at all.

Or, if none of that appeals to you, pick up a pencil and doodle, the way you do when you’re on infinity hold on the phone. Start with boxes and squiggles. If one of them starts to look like a pirate chest, go for it. See if your doodle turns into that, or something else. Draw a cartoon face. Then draw a setting for it. Is this your pirate? Is it a bartender? Is it an astronaut? Or take an empty candy wrapper and tape it to a sheet of paper. What can you make of it? Is it the body of a bird? Does it remind you of a ballet dancer’s costume? Does it begin to look like the tree outside your window? Just keep doodling.

The point of all this is not to create Great Art or to spur Great Revelations about your inner life. The point is simply to let yourself play—with words, with sounds, with sketches. Or pottery. Or katas. Just get used to the idea of letting something inside you come out. It doesn’t have to be important and meaningful. If it’s meant to be, that will come later.

I tried to start a journal once. It was pathetic. I recorded my daily activities, which at the time consisted largely of deciding whether to get out of bed that day. I recorded what I felt (depressed). Each page, each day, was the same. It was boring and no help at all. I was a dud at journaling.

Instead, I started this blog. In it, I was free to write about myself, but also about what I saw and heard in the world around me—what other people thought about mental illness and whether I agreed with them. Things I’d heard in the news and how the stories made me feel—outraged or comforted or confused.

It wasn’t journaling. I learned a lot from it, though (primarily that journaling wasn’t for me). No affirmations. No dream analysis. Over the years, though, it’s given structure to my week and a place to say things that aren’t necessarily profound. To ask questions and grope for answers.

Go thou and do likewise. Or go thou and do something else. The medium doesn’t matter.

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mental health

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Self-Care Definitions

It used to be that when you said “self-care,” you were talking about spa days, shopping sprees, mani-pedis, indulgent desserts, or wine tasting. Or, as Marge Simpson so eloquently put it while ensconced in a bubble bath, “a banana fudge sundae! With whipped cream! And some chocolate chip cheesecake! And a bottle of tequila!”

Pretty quickly, that definition of self-care was recognized as a bougie, upscale fantasy available only to a wealthy person. Not to say that it isn’t relaxing or restorative, but it’s clearly not for the majority of those overwhelmed, traumatized, or otherwise suffering psychologically. They need something more than a beauty regimen and a spending spree.

A Better Definition

The next definition of self-care adds up to basic physical health and hygiene. You know, all the things you’re supposed to do to lead a healthy life: eat right, hydrate, get enough sleep, take showers daily, walk daily. And the things we’re supposed to do for mental health and hygiene: get outdoors, reach out to friends and family, take your meds, exercise, go to therapy, journal, practice affirmations.

All those actions and activities can help your mental health, it’s true. But they work best if you’re already fairly stable. There have been times in my life when all I could do was eat Cocoa Puffs and take my meds. When you can’t even get out of bed, telling you to get out of bed isn’t likely to work. It can even make you feel worse because you know you should do those things, someone’s telling you to do those things, and you’re so deep in the hole that you can’t do those things. Then you beat yourself up for that.

The Self-Care Box

I think that when it comes to self-care, you should start small. When you do begin to see a ray of light, take note of the things around you: comfort objects, things that have distracted you and pulled you out of your misery for even an hour or two in the past. Surrounding yourself with these items or knowing where to find them is, to me, a valid form of self-care.

I’ve seen recommendations that you prepare a self-care shoebox containing the things that soothe your five senses: ones that you can touch, taste, hear, see, or smell. That’s a good idea, but the things that soothe me don’t fit in a box, especially my blue blanket, my cat (just try to put a cat in a box not of his own choosing), a DVD player, and discs of The Mikado, The Pirates of Penzance, and The Three (and Four) Musketeers. I could probably fit a bag of ginger snaps in a self-care sensory box.

Instead, I just make sure I know where these things are. They’re all in my study (except sometimes the cat), which is, in effect, a large sensory box itself. My husband knows my self-care regimen and steps in as needed to provide the items I don’t have. And, after I’ve restored myself a bit, he’ll try to coax me out of the house with the promise of lunch at a favorite restaurant. Or even Waffle House, which is very close by and doesn’t require much effort, like getting out of sweatpants and into a skirt.

If you don’t have a study, keep your comfort objects in one room of your house: bedroom, living room, basement, rec room, or wherever. The important thing is to know where to find them when you need them.

Today’s Self-Care

I do journal, or at least I write in my blogs and post them weekly. When I’m overwhelmed, my schedule keeps me tied to the world. I know I have to have something written by Sunday at 10:00 a.m. It motivates me to get out of bed and kick my brain into gear. It’s less random than journaling, which can easily fall by the wayside. And if I’m still depressed, anxious, or overwhelmed, I can write about that. Thanks to my bipolar disorder, I have a ready supply of topics.

Right now, today, I have my blue blanket and my word processing program. The cat is in the doorway and likely to curl up on my comfy chair or my lap and sleep. I have a bag of ginger snaps on my desk and more nutritious things like fruit within easy reach. I’ve taken my morning pills, which live in a bag that hangs on the doorknob near my bed. I’m set for the day. I don’t need cheesecake or tequila.

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mental health

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A Bipolar Breakup

A recent issue of BP magazine had an article on surviving a breakup as a person with bipolar disorder. It noted that “a split can trigger manic or depressive episodes.” It also noted that “there’s typically a period of destabilizing upheaval as the newly single adjust to life on their own, perhaps in different surroundings.”

I can vouch for the mood episodes and destabilizing upheaval. My senior year in college, I experienced a breakup that was not just destabilizing but devastating. At the time, I was not diagnosed, but it’s now clear that I was in the grip of a major depressive episode, between not having any idea what would happen to me after college and the train wreck that was the relationship.

The article also described how to maintain stability, avoid dangerous rebounds, and prioritize self-care when a relationship ends. They advised readers to avoid rebound relationships, not stop their medication, see or seek a mental health professional, avoid isolation by using their social support network, take their time, and allow themselves to heal.

This is no doubt good advice, but it’s easier said than done. I wasn’t able to put all of it into practice. I had no mental health professional (and wasn’t ready to look for one), and was unmedicated, unless you count the benzo I was given for my TMJ problem and the wine our neighbors poured for me.

As for rebound relationships, I met the man I would eventually marry the weekend before I left where I was living to return to my home state. But it’s hard to call it a rebound relationship, as for over a year, we saw each other only twice, but simply corresponded. So I guess you could say I took my time.

However, one year wasn’t all I needed to heal. Neither the flashbacks and nightmares nor the crying were finished in that time. I had to repair my relationship with my parents. I had to realize that I needed psychiatric help and begin that journey. I had to rebuild my social support system and find the wherewithal to interact with them.

When you consider everything, it took more than a decade. By the time my “rebound” guy and I got married, I was still not healed. He had to cope with my distress as I tried to shake off the memories. He tried to understand my longstanding depression (but really couldn’t until he experienced a depression of his own). The people in my support system soon realized that I would back out of plans, often at the last minute, and that if I did show up, I could be preoccupied and uncommunicative.

The good news is that I finally did heal. My husband and I now have a strong relationship unclouded by the specter of that failed one.

So, what would I advise someone to do in the aftermath of a bipolar breakup?

First of all, take the time you need to heal, and don’t worry if it doesn’t happen quickly. The death of a relationship engenders grief. And as with the death of a person you cared about, grief takes as long as it takes. There is no official timeline or cut-off point. I’m not saying you should dwell on a past relationship, but that there are many facets to such a breakup, and you may have to heal from one after another. You can’t rush it, so don’t try. Unresolved memories and grief can pop up again when you least expect them.

Next, while you’re taking your time to heal, also take the time to do the work. Find a therapist or psychiatrist and go to your appointments faithfully. If they give advice (they may not), take it. If they give you homework, do it. If they say something that resonates with you, think deeply about it. See where it fits into your life and your situation. If it doesn’t seem to do so, discuss it further in a later session.

Finally, don’t overlook “glimmers.” These fleeting reminders of the things that remain good in your world are worth treasuring. What they are will be personal to you. The sight of a blue jay flying past your window or hummingbirds fighting over a feeder. The smell of cinnamon rolls baking. The sound of a song you love being played over the sound system of a restaurant you visit. The cuddly warmth of a blanket or a hug. The taste of your favorite kind of chocolate. Use all your senses to identify the presence of things that bring you, if not joy, at least a smile.

Give it time. You will get over that relationship.

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mental health

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Time Out

It’s been a while since you’ve heard from me, and I wanted to explain. I’ve been in and out of the hospital.

No, not the mental hospital. All this was purely physical. Well, it had certain effects on my mental health, but the reasons for my multiple stays were due to my body, not my brain or emotions.

It all started back in April, when I had my left knee replaced. This was a long-anticipated thing, necessitated by the fact that my knee was “bone on bone” (the doctor’s words) and the fact that the steroid shots were no longer working.

I will admit to having possibly unwarranted fears that I would wake up from anesthesia with mental deficits. I was assured that this had never happened. (I assume they meant while having a knee replacement, not ever. It has to have happened ever.) So I sucked it up and went under the knife, as the saying goes.

The operation went well. The aftermath, not so much. Time in the hospital, learning how to use a transfer board and walker. So far, so good. But when I went home, it turned out that I wasn’t healed sufficiently to be on my own. I fell. And kept falling. After one fall resulted in a pretty bloody shin, I was advised to go back to the hospital to make sure the artificial knee was still in its proper place. I then went to a post-acute care facility (nursing home), where it turned out I had an infection on my still-not-entirely-closed scar. I stayed and got PT.

Back home. No more falling (thanks, PT). But three days later, my leg swelled up from my toes to above my knee. I called the nurse hotline, and they advised me to go back to the hospital, where they determined that the fluid was not building up in my heart, as feared. Back to the rehab. I practiced walking and got to the point where I could (sort of) climb stairs.

Back home. Then I fell in my study and broke both sides of my ankle. Back to the hospital (fentanyl in the ambulance, ketamine anesthesia while they set it, and general anesthesia while they put in metal pins and plates). Back to the rehab, leg swathed in bandages and not allowed to put weight on it. (Ever tried standing while putting no weight on one foot? Don’t.) PT became interesting. The only way I could use a walker was with a knee sling, which is, at the least, awkward.

Finally, I got a boot and was able to put some weight on the foot. PT went better from then on, and after a while, they took the boot off and allowed me to put full weight on the foot. Eventually, I came home.

While I was at the rehab, I didn’t take my laptop. In addition to the fact that I was on pain meds and muscle relaxants for a lot of the time, I worried that my electronics would be stolen. So, no writing.

Now I’m at home, having outpatient PT, and I walked 250 steps with the walker yesterday.

But this blog is about my bipolar disorder. So, here’s what happened to my moods.

I tried hard and managed to stay mostly positive, like those TV commercials where people hold a little smiley face card in front of their faces. I faked this by slapping on a perky affect and making my voice rise in pitch when I say, “Yes, I’d love to go to PT.” “Yes, a shower sounds great.” “Can I try 15 minutes on the stationary bike today?” or “Next, I’d like to learn how to stand and pivot. Is that something I’d be able to do now?”

I did this especially for the PT folks, who took my willingness to try as a sign of progress. But there were times when I realized how impaired I actually was, and I felt depression. My husband has been very supportive, but he’s also pressuring me to get to where I can climb stairs again and walk up and down the wheelchair ramp we had installed. I can’t walk the ramp or the stairs with my walker, so doing that would mean I’d have to use a cane, which I do have but haven’t used in months. I need to have better balance and more stamina before I can even try that.

But I can write. So I am.

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mental health

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What Won’t Work

Actor/comedian Stephen Fry discovered at age 37 that he “had a diagnosis that explains the massive highs and miserable lows I’ve lived with all my life.” It was, of course, bipolar disorder. In documentaries, podcasts, and books, he has talked very openly about his condition, spreading the word about stigma and the necessity of getting help.

Fry once said, “You can’t reason yourself back into cheerfulness any more than you can reason yourself into an extra six inches of height.” And he’s right. If one could, I would have done so. With years of debate behind me and an extensive knowledge of rhetorical fallacies, I can argue nearly any proposition into the ground. I should have been able to reason my way out of depression.

But no.

Fry was right. There’s no way to reason cheerfulness into your life. Emotions are not so easily controllable, especially if you have bipolar disorder or another mental illness.

Nor can you reason yourself into having thicker skin. Throughout my youth, I was described as “too sensitive.” I was genuinely puzzled. I had no idea how to make my skin thicker (and it was never explained to me how such a thing could be done). It took a long time and many life lessons and mistakes to make any progress at all.

There are other things that won’t make you mentally well, either. Expecting the first medication you try to be the cure is unrealistic. It can take a long time (in my case, years) before a medication or even a combination of medications will ease your suffering. And if you can’t work out a medication regimen that works, other treatments such as ECT, TMS, EMDR, or ketamine therapy are not guaranteed to work, or at least not completely. If you go into those kinds of therapy expecting a complete cure, you may be disappointed.

Trying to wait it out or tough it out is likewise ineffective. Again, this is a strategy I have tried. I used to believe that my depressive episodes would abate if only I waited through them until they went away naturally. Eventually, my mood might improve slightly, but that was due to another mood cycle kicking in. Naturally, depression was still there, waiting for me to fall back into it.

I know this may be controversial to say, but religion won’t cure mental illness, either. Having a supportive religious community around you can be an asset—if you happen to find a church, synagogue, mosque, or other community that treats people with mental illness in a caring way. Prayer and sacred music can be a great adjunct to other treatments, but by themselves, they’re not a cure.

Exercise and yoga are not cures. They are also great adjuncts to other treatments. They can increase your number of spoons—if you have enough spoons to do them. But if someone with bipolar disorder or depression can’t manage to get out of bed, how are they going to avail themselves of the benefits?

Likewise nature. It’s a great way to lift your spirits to walk among spring flowers or autumn leaves or to plant a vegetable garden. But again, you have to be at a certain level of recovery to be able to do these things.

Changes in your physical circumstances may lighten your mood for a while, but they aren’t a cure. My mother used to believe that if only I got a better job, my depression would lift. And it did, but only for a little while. It certainly didn’t cure me. There were plenty of things about the job and about my brain that brought the depression roaring back.

So, what are we left with? Therapy and meds, and other medical treatments such as ECT, TMS, and maybe ketamine or other novel medications. One can hope that science will discover better ways, like fMRI, that can determine which treatments will be more effective. But it’s far from clear how soon that will be and when they will be available to the average person.

So, when is your reason an asset? When you’re deciding which treatment and which adjuncts are right (or possible) for you. For example, I had to think long and hard—and do extensive research—on whether I should try ECT.

I’m not a doctor, and Your Mileage May Vary, but for now, all I can recommend is to keep on keeping on with what we know can work. There’s no guarantee that these options will work, at least not for everyone. But they’re the best options we have.

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mental health

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Anxiety Lies, Too

There are a number of mantras in the mental healthcare field: Mental Health Matters, My Story Isn’t Over, It’s Okay to Not Be Okay, Men’s Mental Health: Let’s Talk About It, You Are Stronger Than You Think.

The most common expression, perhaps, is: Depression Lies. Lots of people say it to themselves and others. Jenny Lawson says it frequently in her blog posts and books. It means that when you’re depressed, your mind tells you things that aren’t true—that you’re hopeless, useless, bad, unlovable, unloved, incompetent, incapable of ever feeling any better. And because you’re depressed, you believe them. You have an inner critic that repeats the false messages. They’re with you all the time, whatever you do. They keep you mired in your hopeless condition. It takes a long time to turn off those inner voices and their negative messages. It takes work.

But another truism that doesn’t get as much attention is this: Anxiety lies, too.

Anxiety tells you that you’ll fail, that only bad things await you, that you shouldn’t even try to achieve your goals, that something will thwart you, that you have only bad luck and you can’t change it, that every fear you have will come true, no matter what you do.

Anxiety can keep you from doing the things you want to do, whether that’s getting on an airplane, applying for a job, or starting a conversation. The inner critic from depression has its anxiety equivalent: your inner defeatist.

And when you have something to do that by all objective standards would make anyone anxious, like having an operation, taking a final exam, or getting married, your inner defeatist won’t let you accomplish it, or at least not without immobilizing fear. When I say immobilizing, I mean that literally. You can become so anxious that you can’t move—can’t get out of bed or out of your house, stop your hands or knees from shaking, force yourself to enter a room, or even speak.

So, what can you do when anxiety lies to you? How can you defeat your inner defeatist?

I have help on this one. My husband serves as my outer realist. When my anxiety soars and I’m catastrophizing, he helps me stay grounded. He tells me when my fears are unrealistic. He goes with me to difficult occasions like visits to the dentist. He reminds me of times when I’ve gotten through similar situations in the past. I can—and do—lean on him. He reminds me that anxiety lies.

But what can you do if you don’t have an outer realist like Dan? One thing you could try is to seek your inner Mr. Spock. Ask yourself if it’s logical to fear this event. Is it logical to think you’ll get a zero on the test you’ve studied all week for? No. You may not get 100, but getting a zero isn’t likely or logical. However, this strategy doesn’t usually work. Anxiety whispers: “You’ve been studying the wrong things. You’ll freeze up.” But it lies.

Another way to try defeating anxiety is to make a list of what you’re anxious about and assign a probability to each one. How likely is it that your plane will crash? Find statistics to reach a reasonable answer. (The answer is seven fatal accidents in over 40.6 million flights.) But, practical as this sounds, it doesn’t work well either. Anxiety whispers in your brain: “You’ll be on the one that crashes.” But it lies.

Another technique is to look at your track record. Of all the times you’ve been introduced to a stranger, how many times have you been unable to even say hello? Never? Anxiety whispers: “This time you won’t be able to.” Anxiety lies.

You could also find a sympathetic support person who can walk you through your anxiety. It doesn’t have to be someone who’s around all the time, like my husband is. You may have a friend that you can call for a reality check and a pep talk, or someone who will go with you to that doctor’s appointment. An outer supporter is more powerful than an inner defeatist. Someone who has been through it themselves can tell you from lived experience: Anxiety lies.

Perhaps the most effective way to defeat your inner defeatist is to talk back to it. Say, “I know you’re lying. My anxiety is real, but I know I can do the thing, or at least part of it. You don’t exist. I don’t have to listen to you.”

And of course, your therapist and your meds can help you during times when anxiety lies to you, when you are inclined to believe what it whispers to you anyway.

Let this become your mantra: Anxiety lies. Say it whenever anxiety whispers its dire warnings.

Anxiety lies.

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mental health

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Politics, Mood, and Self-Care

It’s difficult for me to maintain a positive mental attitude when I’m troubled by bipolar disorder, especially the depression part. It’s even more difficult in today’s political landscape.

I don’t care what your political persuasion is or who you voted for. I don’t care if you’re for or against DEI or ICE. What I care about these days is what’s happening to mental healthcare in our country. But let’s leave government policies and programs for another day. Right now, I want to discuss politics and mood disorders.

We seem to be overwhelmed by politics, but also by our reactions to politics. Friendships have broken. Families have been torn apart. Lots of people suffer from cognitive dissonance when their brains try to balance their love for friends and family and distress at their views.

None of us knows what to expect next. The difficulty isn’t limited to one side or the other. People who want smaller government are learning that the cuts will include public services such as extreme weather forecasting and disaster recovery. Others with differing views are afraid to travel abroad because they fear that, even with passports, they may be detained when they try to return.

The situation is especially hard on people with mood disorders. People who have phobias or anxiety disorders can find their feelings increasingly out of control. Those who suffer from depression have exaggerated fears. Most debilitating of all is the not-knowing. Am I overreacting? Are these fears reasonable or exaggerated? Will the things I fear never happen? Should I watch the news? Should I avoid watching the news?

I’m suffering from news-dependent symptoms myself. I hesitate to discuss politics with friends unless I already know their opinions are similar to mine. And with new acquaintances on Facebook, I share memes and chat about books.

But when it comes to not getting overwhelmed, I have a few suggestions. Most of them you may already know—they’re versions of basic self-care.

Remove yourself from the trigger. Get out of the room or the house when the talk turns to politics. Offer to go on a beer run. Leave the room and make yourself a cup of tea. Tell your friends or relatives you need to get some air. The outdoors is largely a politics-free zone, aside from bumper stickers and billboards. If you walk with a friend, stay on non-threatening topics like your pets. And prepare a neutral topic to suggest: Do you think the Dodgers have a chance this year? What do you think of Beyoncé’s country album? Should I go on a Disney cruise this year or a trek to the Grand Canyon?

Self-soothing. Music is another way to distract yourself from the present chaos when you take that walk or any other time. Personally, I prefer music with lyrics, as instrumental music gives me too much time and space to contemplate difficult topics. If you wear earbuds (even without music), people are less likely to engage you in conversation.

Use distractions. If you read, stay away from news magazines, the internet, and newspapers. Instead, you may want to revisit books from your childhood. There’s nothing wrong with reading children’s books. They may take you back to a more pleasant time, or you may discover aspects of a book that you never noticed when you were young. Or try a new genre, such as a romance or mystery that isn’t likely to contain much politics. Old classics like Dickens or Austen are good choices, too.

Limit your exposure. Allow yourself 20 minutes for listening to or reading the news. You can do this more than once a day, but leave a couple of hours in between. Clean the bathroom or watch a reality show. Organize your closet. Plant flowers or herbs.

Do things that lift you up. Pray. Sing. Bake bread. Work on a journal or a painting. Do life-affirming activities that will improve your outlook and your spirit.

Oh, yeah. And remember to take your meds, especially if you have an anti-anxiety pill. You’ll need them.

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Weed: Yes Please or No Thanks?

I know that some people swear by the benefits of marijuana for relieving their psychiatric symptoms. They find it calms their anxiety, lifts their depression, and helps them sleep. I know others who avoid it completely. It makes them dizzy and paranoid, which isn’t relaxing at all. Which group is right? Or is either side wholly right? Is marijuana a potential treatment or a potential setback? Or do both these views have their merits?

Let’s start with a look at medical cannabis. In 1850, cannabis was officially recognized as a treatment for a variety of conditions, including gout, snakebite, excessive menstrual bleeding, leprosy, rabies, and insanity, among others. It was inexpensive, widely available, and didn’t require a prescription. But its use declined because it was difficult to control the dosage, opiate-derived medications became popular, and cannabis couldn’t be administered by injection. Recreational use of cannabis was prohibited in all states, thanks in large part to scare campaigns. Fees and regulations made it less likely that doctors would prescribe it. By 1941, it was no longer considered a medical drug. Recreational use, of course, continued. By the 1970s, marijuana was prohibited in all contexts including medical, but investigation of its medical uses increased because it was reported to help cancer and AIDS patients with pain and nausea. It was also beneficial in treating glaucoma patients. State and federal laws differed, however, and in practical terms, marijuana might or might not be available legally.

By the 2000s and 2010s, many states permitted the sale of marijuana or CBD (which is not psychoactive) for medical use, including relieving seizures in children. CBD products are legal in some jurisdictions and not in others, and enforcement varies. Laws in some places are so liberal that there are legal commercial stores on many streets.

The conditions cannabis can be used for differ from state to state, and the restrictions change frequently. It’s hard to keep up with which states allow it for what conditions. PTSD is the psychiatric illness most likely to qualify for medical marijuana use. Some doctors believe that it’s also useful for anxiety, depression, Tourette’s syndrome, and anorexia. CBD and THC (the psychoactive component) are being studied for the treatment of bipolar disorder.

The medical community cautions people with psychiatric disorders about using marijuana. One study cited by the Psychiatric Times found “a strong increased risk of manic symptoms associated with cannabis … an earlier age of onset of bipolar disorder, greater overall illness severity, more rapid cycling, poorer life functioning, and poorer adherence with prescribed treatments.” On the other hand, Medical News Today has reported that users say marijuana use has reduced their anger, depression, and tension, and created higher energy levels.

Other studies have found that marijuana use had negative results on memory, decision-making, coordination, emotions, and reaction time, as well as an increased likelihood of disorientation, anxiety, and paranoia. Some reports suggest that marijuana use makes it more “likely” that psychiatric patients will develop schizophrenia and psychoses.

So, what are the takeaways? First, the results from all these studies are generally self-reported by the marijuana users and therefore subjective. Second, now that medical marijuana is in greater use and easier to get, there may be more thorough studies in the future (much of the cited studies were done 8-10 years ago, though they were still being reported as recently as 2024).

Bipolar patients have been using marijuana to alleviate both manic and depressive symptoms and report that it works better for them than conventional medications and also alleviates the side effects of those drugs. The drug’s calming effects may help with manic symptoms and the euphoric effects may explain the relief of depression reported. But heavy use has been associated with increased symptoms, thoughts of suicide, and the development of social anxiety disorder.

Perhaps the positive effects of marijuana for bipolar disorder are influenced by the expectations of the users: If they expect it to decrease anxiety or lighten their mood, it’s likely to. Still, heavy or daily use should likely be avoided because of possible negative side effects.

My own use of CBD has been confined to legal hemp-based gummies. I have found them to produce unhelpful, uncomfortable sensations, making me unbalanced and prone to falling, which I really don’t need. But that’s me, and it’s anecdotal evidence. Another person I know experiences relaxation and euphoria with no negative side effects.

To answer the question posed in the title, my personal answer is “No thanks,” but I’m not saying that should be the answer for everyone. It looks like a case of “Use at your own risk.”

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Overeating and Bipolar Disorder

When you think about co-occurring disorders associated with bipolar disorder, you generally think of drug or alcohol abuse. But there’s another one you should consider: eating disorders.

For example, binge eating is a problem that many people with bipolar experience. Both conditions typically begin at a fairly young age. Both are experienced in cyclical patterns. And both are associated with changes in energy levels and eating patterns.

There’s scientific evidence that the two conditions are related. For example, research has shown that 30% of people with bipolar disorder also have problems with binge eating, Binge Eating Disorder (BED), or bulimia, and more than 9% of people with BED also have bipolar disorder.

The two disorders are intertwined, affecting each other. Someone experiencing a manic episode may be likely to overeat or binge, probably because of impaired impulse control. Depression, on the other hand, may lead to decreased appetite and low energy that makes it difficult to prepare food.

That’s not always true, though. The revved-up feeling of mania can lead someone to skip meals. Depression can lead a person to eat more “comfort foods,” which are often laden with carbs and sugar, as a coping mechanism, however maladaptive. These foods may increase serotonin and so make the person feel better temporarily. Either way, the over/undereating can cause stress while shopping or preparing food, or result in dissatisfaction with body image.

Medication for bipolar disorder can also have an effect on eating behaviors. We all know that certain drugs cause weight gain as a side effect. Antipsychotics, for instance, may contribute to increased eating because of changes in the brain’s reward system and a decreased ability to tell when you are full. And weight gain may lead to cycles of bingeing and purging.

Research has also shown that people with co-occurring bipolar and an eating disorder also may have PTSD, indicating a possible link between the conditions. It’s thought that people who have experienced trauma may use eating as a control mechanism.

At any rate, the combination of the two disorders is complex, and it’s likely that a person with both conditions may need help from a team or a holistic approach to treatment, both psychological and medical. It’s been suggested that topiramate (Topamax) or lamotrigine (Lamictal) can be considered, as these mood stabilizers don’t appear to result in weight gain.

Personally, I had a combination of the comfort food eating/skipping meals cycle. When I was in college, my weight fluctuated from roughly normal to too thin. Since then, thinness has not been a problem, possibly because of the medication I take. I certainly have a desire for comfort foods like mashed potatoes, pasta, and large amounts of cheese. One of my crazier comfort foods has been ridged potato chips with cream cheese, topped with M&Ms. My husband knows that when I want those particular ingredients, I’m sliding into depression. Lately, I’ve been swinging between comfort foods and skipping meals. On the other hand, I’ve lost 18 pounds since the spring. (My doctor asked me how I did it and I replied, “Eating less” rather than “skipping meals.” He thought I meant portion control, which I do try to do.) My bipolar disorder, while mostly stable, is still a cause of (less extreme) mood swings. My eating habits are likely just that—habits that I need to break. And I need to increase my activity, which should be easier once I get my knees replaced.

At any rate, I’ll try to keep an eye on my consumption and ask my husband to help me when it comes to eating better. Now that the holidays are almost over, it’s time to get back on track. Losing another 18 pounds sure wouldn’t do me any harm.

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