Bipolar 2 From Inside and Out

Posts tagged ‘coping mechanisms’

Bipolar Creativity

Does bipolar disorder enhance creativity or hinder it? That’s the question, and it’s one I want the answer to as much as anyone. After all, I am a writer, blogger, and editor. (And if you don’t think being an editor is creative, you’re probably thinking of a proofreader. I’m one of those, too.)

BP Hope magazine recently published a series of articles on the topic. In one, writer Francisco X. Stork wanted to say to a mother who reported that her son refused to take his bipolar meds, fearing that they would stifle his creativity, “If her son truly has bipolar disorder, then whatever he thinks he’s doing while in its grip is not art.”

That’s harsh, but I have an inkling of where he was coming from. Stork says that what he wrote under the influence of mania and even hypomania was “gibberish.” He points to his four published, well-received novels as being products of his creative powers while medicated properly for his bipolar disorder.

I think the operative words there are “medicated properly.” Stork adds, “Does medication affect my work? Yes. But not nearly as much as the unfettered symptoms of bipolar disorder do.”

I’m not saying that medication is necessary in order to be creative. There are no doubt and no doubt have been many creative people who were unmedicated or improperly medicated. Most of them we don’t know about because they lived before bipolar was a diagnosis or proper medication existed.

Stork’s opinions bear out my own experience. I write two blog posts of around 500-800 words each, almost every week since 12 1/2 years ago. I’ve been told by others and seen for myself that when depression or hypomania creeps up and attacks me, I lose not the overall ability to write, but the ability to write well. When I’m depressed, I write depressing things or have a hard time writing at all. I usually force myself to do it, but it’s certainly not my best writing. And when I’m hypomanic, I’ve been told (and believe) that my writing is unfocused, rambling, and/or poorly structured.

BP Hope ran another article by Donna Jackel. The key takeaways included these:

  • Mild hypomanic traits, like extra energy and fast thinking, may boost creativity, while severe symptoms can hurt it.
  • Mania may spark ideas, but mood stability can make it easier to focus and follow through.
  • Treatment doesn’t mean losing creativity, and stopping medication to protect it can carry serious risks.

Those points, I feel, are important. Jackel reports that “A review pooling 13 studies and nearly 1,900 people found a real, but very small, connection between bipolar disorder and creative-thinking scores — one that showed up mainly when people were feeling stable or had mild symptoms, and disappeared during depressive episodes. Mood state, in other words, may matter just as much as the diagnosis itself.”

Kay Redfield Jamison has also addressed the question in her many books. One question she has asked is “Does hypomania cause creativity, or do the two simply run in parallel?” And one answer may come from Sheri L. Johnson, PhD, a psychology professor at UC Berkeley, who studied people who self-identified as highly creative and living with bipolar disorder, and found that “More than half the participants described unique states of creative thinking that benefitted their work.” More than half also “considered creativity central to their identity.” She hopes that these findings will help reduce the stigma surrounding bipolar disorder and other mental illnesses.

The links between bipolar and creativity are complex. Other research has shown that “People with stronger hypomanic traits came up with more ideas overall, but when judges rated how good those ideas actually were, they scored lower on average….A flood of ideas during hypomania, in other words, isn’t the same as a flood of good ones.”

Painter Missy Douglas recommends performing other creativity-related tasks while manic or hypomanic, such as running errands and preparing her materials. “I come up with a lot of complex, involved ideas for new projects in the studio during these times, but bringing them to fruition doesn’t normally happen until I’ve calmed down, if ever,” she adds.

Creative activities can help mitigate bipolar symptoms, however. Art therapy that includes sketching, painting, and even ceramics and making collages is a way to experience emotional release. Writing and journaling are good for mood management. Other people find music and movement good as coping tools, or use expressive dance for emotional regulation.

All in all, bipolar disorder may not be good for creating art, but creating art can be good for bipolar disorder.

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Receiving Help

Sometimes it’s harder to receive help than it is to give help or to ask for it.

I’ve needed lots of help with my bipolar disorder over the years, and my husband has consistently been there to give it. His help has been the embodiment of the wedding vow “In sickness and in health.”

He’s held me when I’ve been depressed and tells me when it seems like I’m shifting into hypomania. He’s my “emotional support animal.” And he helps me with tasks of daily life like meals and showers.

Recently, though—well, really, throughout the past year—I’ve needed physical help as much as or more than emotional support. I’ve been through a series of physical challenges that started when I had a knee replacement and have progressed to the point where I am in pain every day and very nearly housebound. The kinds of help I’ve needed have been complicated and sometimes embarrassing.

I’ve been feeling guilty, needy, and insecure because my care requirements have increased so much. I know Dan is feeling insecure too, because he keeps asking me whether he’s taking care of me well enough. We’re both finding the situation stressful. I reassure him that he is doing a great job, and I try to make sure it’s not a thankless task.

Tonight we watched a movie on video together and had a pizza. It was a good break for both of us. But afterward, my bandages needed changing so I could get ready for bed. And so it goes.

Dan is about to experience his own set of physical needs as he needs a medical procedure, too. I hope I can repay a little of his care and kindness by giving some back to him. And I hope he’ll ask for help when he needs it. Like he does, I’ll do the best I can to give help while balancing both our needs.

Is all that confusing? Well, it’s no wonder. It’s a confusing topic, and I’m confused by it. Here’s what I know about help in a nutshell, though.

  • Asking for help. If you can do it, this is the first step. Ask for what you need. Ask as clearly and specifically as you can: “I’m feeling lonely/distressed/in pain. I need to talk to someone.” “My dressing needs to be changed.” “I need to eat something.” (Sometimes it’s easier if you phrase them as needs rather than wants. Asking for what you need makes it clearer that it’s not just a whim or something you could easily do without.) But if it’s all you can do at the moment, at least say, “I need help.” It improves the odds that you’ll actually get help. Then you can figure out the details later.
  • Giving help. If at all possible, give the person what they ask for. They know their own needs better than anyone else. Don’t guess. Sometimes the helper will need to ask questions to clarify. “Do you need to take your meds right now or with a meal?” “Which size bandage does this wound need?” If you can’t give the help right away, explain why not. “I’ll go to the store and pick up your other prescription. Then I’ll pick up lunch on the way back. Is that okay?” “I’ll be there in 20 minutes. Can you wait that long?”
  • Receiving help. This is the part no one tells you about, and it can be tricky. Say thank you, even if you didn’t get exactly what you asked for, and even if you’re in pain. Your helper is doing the best they can. Sometimes all they can do is part of what you need. Later, they may be able to do the rest of it.

All this is true, even if you have a paid caregiver. But if it’s a partner or family member, it’s even more essential.

Here are things to keep in mind:

You need help. Everyone does at one time or another. Everyone. No one is truly self-sufficient.

You deserve help. Help isn’t something you have to earn. Your needs are important.

You can get help. But in many cases, you have to ask for it. And you may have to keep asking. Don’t give up.

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Mood Music

Last week, I got to go out and hear live music—the Stray Cats, one of my favorite bands, were having a reunion tour with some new music, and I had tickets for it. I looked forward to it with great excitement (and a little anxiety, which proved warranted when a violent thunderstorm started as we were driving home on the highway). Aside from the thunderstorm, however, the evening was magical.

And I needed it. I’ve felt myself sliding toward the depressive end of the scale lately.

My Music

When I’m depressed, I always forget the power that music has to restore me. I have plenty of music accessible to me, on my Mac, Pandora, Spotify, and other sources. I even have Pandora on my iPad and my phone, so I can have music with me at all times. But I don’t remember, and I don’t make use of this inestimable resource that is always at my fingertips.

Of course, there’s nothing to compare with live music when it comes to restorative power, and I’ve been sorely short on that. I remember times in years past when I went out to hear live music as often as several times a week. Later in life, it became a lot less common, only happening every month or so. Now, it’s so uncommon that it doesn’t happen even once a year.

Listening to music—and singing along, loudly, enthusiastically, and totally off-key—clears the cobwebs out of my brain. I return to the same music over and over, favorite singers and songwriters, bands that no longer exist, artists who are now dead. I don’t object to new music, but it doesn’t hold all the memories, the weight and history, of music that I already love.

Bibliotherapy and Music Therapy

The idea of bibliotherapy is pretty well known. Self-help books abound (for all the good they do), and therapists sometimes recommend books and articles to their clients. Music as a part of formal therapy might be much more difficult to make work, however. One person’s soul-touching music is simply background music even to others who know that person well.

No one but me can prescribe what music “works” best for me on any given day. Are what I need raucous tunes to lift me up or calm ones to settle me down? Do I crave hearing a particular artist or band? Should I search out songs by a favorite songwriter that have been covered by others? Or do I simply click shuffle and let my vast playlist decide for itself?

There’s some science behind the idea that music can be good for people with depression. Listening to music has been associated with increases in neurotransmitters like dopamine, and the lessening of the levels of the stress hormone cortisol. Emotional release is another way that music works, allowing you to access feelings that you can’t actively name. “Active engagement,” such as playing an instrument, writing lyrics, or “intentional listening,” is also said to be good for grounding. It certainly activates more areas of the brain.

Still, we’re talking about some awfully subjective findings. A study-of-studies found that TAU (Treatment As Usual) with added music therapy “was superior to TAU alone for anxiety and functioning,” but that the combination “was not more effective than TAU alone for improved quality of life.” Maybe it’s just me, but I’d think that an improvement in anxiety and functioning is an improvement in quality of life.

Formal Music Therapy

That meta-study was looking at formal music therapy, however. What does that entail? One site I visited described individual and group music therapy like this:

“In individual music therapy sessions, a therapist works one-on-one with a client to address their specific needs. This personalized approach allows the therapist to tailor interventions to the client’s preferences, whether it involves playing instruments, songwriting or listening to music. Group music therapy sessions provide a supportive environment where people can engage with others through music. These sessions may involve collaborative music-making, improvisation or group discussions about the music’s impact. Group sessions foster a sense of belonging and provide opportunities for social interaction.”

I’ve never had that kind of music therapy. I’ve had to create my own with Pandora listening sessions and tickets to the Stray Cats. But I hope that if I’m ever in need of the formal variety, there will be some place where it’s available to me. For now, I’ll enjoy the subjective improvement in anxiety and functioning that I can build on my own.

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Living With a Bipolar Family Member

Let’s start with this: A bipolar family is like any other family. They have good times and bad. They live with each other; they fight with each other; they care about one another. They deal with each other’s differences and problems. But they have the added stressor that one or more members of the family have bipolar disorder.

What does this mean for a family? It does mean that there are likely to be difficulties that other families don’t face. Depending on how severe the disorder is, whether the family supports their relative in getting treatment, and the resources available to them, their lives will look quite different.

My Family

My family was unprepared for me to develop bipolar disorder. They knew that I was different, and often didn’t know what to do with me, particularly when I went into depressive episodes and retreated from the world, crying hopelessly. I remember this happening in seventh grade in particular. I had been publicly humiliated at a birthday party and spent days curled up in a bean bag chair, sobbing uncontrollably. My parents knew that something was very wrong.

Nothing happened for quite a while. When I was in high school, my behavior had gotten so off-kilter that it was recommended I go see the district psychologist. My parents left the choice up to me, and I didn’t go, for reasons that now seem completely ridiculous. I should have taken the opportunity.

Later still, when I was diagnosed and medicated with Prozac, my family was encouraging, but had some issues. My mother, who got a lot of her information from TV talk shows, said she had heard that Prozac was a “ticking time bomb.” My father had no objection to my therapy as long as he didn’t have to go (which no one had ever mentioned). But they continued to give me love and emotional support throughout, though they never really understood my condition or what I was going through. I don’t think they ever did, but they never gave up on me.

Other Families

I think it’s vitally important for family members of someone with bipolar disorder to learn all they can about the disorder. This will require bravery and openness on their part. But learning all you can about bipolar disorder will help you help your family member in the best possible way.

Of course, the kind of support a person with bipolar needs will differ greatly depending on how severe their symptoms and their disorder are. If they are subject to mild to moderate depressive phases, don’t try to “cheer them up.” It won’t work. Instead, talk therapy and/or medication, or, if they’re in a more severe depressive phase, an alternative therapy like TMS or ECT may be called for. Hospitalization is definitely an option if the family member has suicidal ideation.

If they’re in a manic phase, don’t just tell them to “calm down.” That won’t work either. Instead, help them be more grounded and keep potentially harmful behaviors in check. How you do this will vary depending on how their mania manifests. If they are given to reckless driving, for example, you keep the car keys and drive them where they need to go. If they’re an overspender, keep the credit cards and PIN numbers out of reach.

Help your bipolar family member in specific ways. Encourage them to seek therapy. If needed, drive them to their therapist appointments. Pick up refills of their medications for them. Get them a pill caddy to make it easier to take their medications as prescribed.

If your family member is experiencing delusions or psychosis, don’t argue with them about hallucinations, which are very real to them. They may also be suffering from anosognosia, which means they don’t even recognize that they are ill. You may have to intervene more directly, whether that means taking them to the emergency room or admitting them to a psychiatric facility. Do all you can while keeping yourself and the rest of your family members safe. If you or your loved one is in immediate danger, don’t wait—take action!

Kinds of Support

It may seem that you are taking agency away from your family member, and that is to some extent true. But until they’re more stable and able to demonstrate agency over their own condition, helping them negotiate the practicalities of their illness is likely the best thing you can do. You can’t change your family member’s disorder or change them; in most cases, all you can do is support them.

Remember there’s help available. In addition to your local or county National Alliance on Mental Illness (NAMI) chapter, you can get in touch with Depression & Bipolar Support Alliance (DBSA), the Bipolar Caregivers website, or bphope.com, which has online support groups. That last link will take you to a page that lists other organizations and resources that may be available to help you.

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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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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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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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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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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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