Bipolar 2 From Inside and Out

Posts tagged ‘mental health’

Channeling Positive Thoughts

Everyone who reads this blog (and some who don’t) knows what I think of the positivity movement. To put it in words of one syllable, I hate it.

I hate the memes and signs that say “Good vibes only,” or “If you want to feel better, smile,” or “The only disability is a bad attitude.” Or, worst of all, “You don’t need meds, you need to change your thinking.”

This attitude bugs me because it’s too close to the “Think and Grow Rich” gospel, which I can’t stand either. There are people who go around making money by pushing this attitude (or “attitude of gratitude,” as some phrase it).

To me, it dismisses the real emotional pain that many of us feel and the difficulty of making progress toward a happier, more fulfilling life. If it were as easy as just smiling, we wouldn’t have a crisis of mental illness and a lack of appropriate treatments. In real life, however, wishing mental illness away won’t help. You have to work hard at it, take your meds, go to therapy, do the work, and keep trying even when it feels impossible.

Recently, however, I at least partially changed my opinion on positivity. I had my left knee replaced and was faced with a series of complications, from repeated falls to lymphedema (This involves retaining fluids, in my case in my legs, and lots of swelling. It can lead to heart failure, which is why the docs were so concerned.) I had two stays in the hospital, followed in each case by a stay in a post-acute rehab. (Well, okay, a nursing home, but I was on the short-term wing.) All told, my hospital stays and post-acute stays ate up two months. One of my episodes between rehab and back to the hospital lasted only three days.

When I was in the rehab unit, I had Occupational Therapy and Physical Therapy. I don’t really remember much about the first stay, except that I was still affected by the Lasix I had been given in the hospital, so toileting and transfer from the walker to the toilet were things I had to relearn. When I first began, I needed to have a “spotter” in my room and a red cord to pull if anything went wrong. Later, I was deemed skilled enough to manage by myself. All I can say about that is that I was glad I had recently bought a 10-pack of underwear.

The second stay in rehab was more intense. I had to learn some very basic things all over again. How to walk with a walker and a cane without limping. How to sit down into a chair slowly rather than flopping or flinging myself down on it.

OT consisted of relearning to do everyday tasks like showering using a shower chair or bench (every few days, which is a lot more than I had been capable of before rehab). I had to learn to stand on both feet while I did a task like working a jigsaw puzzle to strengthen my balance and put away groceries in the little kitchen they had set up. And I had to learn how to put on compression stockings without help. (This was made easier when my OT person sent me a link to a pair of zippered compression socks I could order. Zippy socks. Of course, I had grippy socks too.)

PT included remembering to sit without my legs in a descending position (they found the one reclining chair in the facility for me to use) and to sleep with the foot of my bed raised. And there were the exercises. I learned to do foot pumps, quad sets, snow angels, glute squeezes, marching, leg lifts, and others using resistance bands. I increased the number of reps and sets for each. I walked for longer and longer distances with a cane. I did first ten, then 15, then 20 minutes on a cycling machine (my favorite). And they asked me what goals I had, and I told them that I needed to walk up 18 steps to get into the house and up to the bedroom on the second floor, and I wanted to be able to walk from the front door, up the gravel driveway to the car. There was a set of four stairs that I climbed up and down with my cane, and they advised me on how to walk on gravel with my walker.

So where does positivity come into all this? The staff appreciated my willingness to try and to try a little more the next day. Whenever I accomplished anything, they said, “Good job!” They told me that when they told some patients that it was time to do PT, they simply turned over or looked away. But I saw patients with more severe conditions than mine trying and trying again.

I made it my goal to increase my workouts daily, to do quad sets and leg lifts even when sitting in the recliner or lying in bed. I learned to decrease both my sodium intake and my fluid intake. And when I walked in my walker down the hall to the PT gym, I was by God positive. I had the determination to do more than the day before, or at least as much. I thanked the therapists for their help. I kept trying, even when it was hard.

So, in that way, it was like being positive about getting better with my mental illness. In that aspect of my life, too, I did the work. I learned new coping techniques. I kept up with what my therapists taught me. I believed in the power of my meds to help stabilize me, no matter how long it took or what anyone said.

It was a grueling education, but I think I came away with a greater respect for the power of positivity — when it’s combined with hard work. Just smiling won’t do it. Smiling and working to improve your situation can.

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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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Advice from the NYT

On December 30, 2024, the New York Times offered an article: “10 Ways to Keep Your Mind Healthy” in 2025, by Christina Caron and Dana G. Smith. Now, I’m not saying that their advice was bad. I’m just saying it didn’t go far enough. All of their recommendations are things we already know. Someone with a simple need for better mental health may get something from the article. But for someone with a mental disorder, it’s inadequate. Here’s what they said.

1. Move your body.

“If you’ve heard it once, you’ve heard it 1,000 times: Physical activity is one of the best things you can do for your brain.” Well, we have heard it 1,000 times. The Times notes that people feel better after a workout, but that ones who have a consistent exercise routine, there’s less risk of depression (and dementia). They attribute this to better blood flow and connections in the brain. This is hardly revolutionary advice.

2. Address your anxiety.

Easier said than done. NYT says: “Many Americans are anxious.” They suggest the following solutions. Face what makes you anxious to break the pattern of fear. They say that you can do this kind of exposure therapy with or without a therapist.

They also recommend that you focus on your values rather than anxiety. I’m not sure how this is supposed to work. One suggestion they give is to volunteer in your community. Then they advise that you not catastrophize—but they don’t tell you how to do that, except for journaling about whether you had an appropriate amount of worry compared to the situation.

3. Challenge your brain.

The authors note that this is “still up for debate,” but they say that crossword puzzles, reading, and brain games “can’t hurt,” especially regarding dementia. The most definite thing they way is that such pursuits “can’t hurt.” A professor of psychology adds that “chances are that’s probably good for your brain.” But “good for your brain” is a long way from mentally healthy.

4. Get a good night’s sleep.

Lack of sleep “can affect how they experience stress and negative emotions. They might also be more likely to ruminate, be quicker to anger, have more negative thoughts or find it harder to cope with stress.” Those are serious symptoms, and for once, the NYT recommends actual therapy—Cognitive behavioral therapy for insomnia, or C.B.T.-I. They note that it is more effective than medication. At last, some useful information!

5. Get unstuck.

Good idea, but how to do it? According to the NYT, you should conduct a “friction audit.” which basically means identifying your problems and trimming them away, whatever that means. They also recommend “futurecasting,” or imagining you aren’t stuck and what steps would get you there. “Try to do at least one step each day.” Baby steps are good, of course, but doing one per day isn’t practical for most people with mental disorders. A therapist might help with this, but the NYT is silent regarding that possibility.

6. Stay cool.

At last, something that you may not already know! “Studies show that hot days impair our cognition and make us more aggressive, irritable and impulsive.” Typical ways of cooling off are recommended: stay cool and hydrated, use air conditioning or a fan, spritz yourself with cold water or take a cool shower, or go to a nearby cooling shelter. Nothing there but obvious remedies.

7. Quiet your inner critic.

If only we could! The inner critic is a real thing, and it makes you miserable. But the trick is how to do it. The authors suggest “letting go of that nagging feeling…and giving yourself credit credit for what you accomplish.” They do quote a psychology professor who suggests using “you” or your name rather than “I” when you engage in internal dialogue, which I take to mean affirmations.

8. Take care of your physical health.

This sounds good; the body and brain, of course, are interrelated. The NYT recommends taking a quiz about your physical health that analyzes common health conditions and behaviors such as blood pressure, cholesterol, and exercise. It’s said to estimate your risk for depression, as well as dementia and stroke. But most general practitioners these days use a specific depression screening quiz with more questions particular to that condition.

9. Make a new friend.

This is a great idea. People with mental disorders need a support system which can certainly include friends as well as family. One problem is gaining the courage and social skills to make overtures. The Times notes that loneliness can increase brain inflammation that damages brain cells and the connections between them. Then the article recommends reaching out to a friend or family member, joining a club, or attending a support group. Reaching out is difficult for people with depression in particular. Waiting for someone to reach in to you is sometimes all you can manage.

10. Forgive — or don’t!

Contradictory advice? Certainly. The Times article suggests that “forgiveness is an emotional process rather than an endpoint.” So, should you or shouldn’t you? Maybe. Forgiving someone who’s hurt you may lead to fewer negative feelings, the Times says, but they also recommend a book called You Don’t Need to Forgive: Trauma Recovery on Your Own Terms by Amanda Gregory.

I know what you’re going to say: This article is intended for the general public. It makes no mention of the many things such as therapy and medication that can help you achieve a healthy mind if you have a mental disorder. That the actions mentioned are meaningful adjuncts to those interventions.

But the title is misleading. I first got treatment for my mental health when I saw a sign for a mental health clinic and realized that whatever I was feeling, it wasn’t mentally healthy. At that point I received therapy, and later was prescribed medication. And they truly helped.

I would hate to think that someone like me would ready this article and think that the suggested actions, by themselves, will make a person mentally healthy. They are great adjuncts to proper treatment but won’t solve many problems that people with mental disorders have. If, like me, your only realization is that you don’t feel mentally healthy, the article may prevent or delay getting significant treatment.

So, go ahead. Try all the advice in this article. But if you still don’t feel you’re on an even keel, seek other kinds of help.

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We Don’t Talk About It

When I was first diagnosed with depression (later bipolar disorder), my family was somewhat less than understanding. My father was concerned that he might have to go to family counseling, with the implication that it would involve analyzing or blaming him. My mother informed me that Prozac, which I was prescribed, was “a ticking time bomb” and later said that she thought that if I got a better job, I wouldn’t be depressed anymore. And my sister was dismissive about paying someone a lot of money just so I could talk.

I admit that I did not handle this terribly well. I missed the opportunity to educate my family about these psychological conditions. (I did tell my sister that I was going to a community mental health service that had a sliding scale for payment.) In my defense, I was new to the concepts too, and had barely begun to educate myself about them. I did gradually learn more, but their initial reactions kept me from saying much about it to my family.

As stigma goes, this was pretty mild. They didn’t try to tell me there was nothing wrong with me. They didn’t blame or shame me for reaching out for therapy (other than my sister). But because of this, I didn’t receive much support from my family which would have made my journey easier. That only happened when I married a man who knew something about psychology and learned what would help and what wouldn’t.

Stigma can be a familial problem, but it also happens at a societal level. But mental health concerns are very low on the list of many legislators’ concerns and priorities. Some have denied that mental illness even exists or responded to it by clearing away the unhoused or creating sober houses. Mental illness is seen as a consequence of PTSD, which is talked about mostly in the context of veterans, seldom about other causes like abuse. Also, most of the fundraising for veterans seems to concentrate on limb loss and traumatic brain injury. If funds are going to specific mental disorders other than PTSD, it isn’t emphasized, despite the need.

A lot of what we hear about mental illness is about SMI or serious mental illness. And that often gets conflated with the problems of homelessness, addiction, and violence. But what about all the people with Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Personality Disorders, and even Schizophrenia who live in homes and families, who have families of their own, and who have jobs? They’re very rarely talked about. They don’t get emergency funding. They don’t require street psychiatry, emergency housing, forced commitment, and other services that are needed for the most severely ill. They’re not high-profile.

They’re called “high-functioning” and then largely ignored, left to deal with their disorders on their own. Many of them miss out on the therapy, meds, and lifestyle changes that might help them, either because they don’t know where to go or don’t have the funds to access them. Insurance pays for quick fixes of 6-8 weeks, which are the merest band-aid on their problems. Supportive families, biological or chosen, can help them maintain their relationships, living situations, and jobs, but public attention isn’t focused on them in any meaningful way. There are ad campaigns that say “It’s okay not to be okay” and encourage friends to reach out, but they’re vague and short on what to do when you realize you need help. Hotlines focus on suicide and self-harm. They’re certainly needed, but so are resources for the day-to-day, less dramatic disorders.

Stigma, confusion, lack of education, ignorance, and even hostility keep us from the conversations that might lead to actual, useful change. Let’s open up those conversations with our families, friends, coworkers, the press, local and national government, and anyone else who’ll listen. Blogging and maintaining a Facebook group (Hope for Troubled Minds) are among my contributions to the effort.

I’ll keep trying if you will.

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Being There

Sometimes there’s just nothing you can do. A friend or family member is in distress—depressed, angry, disappointed, anxious, frustrated, or whatever. They may have experienced major trauma or be in the throes of some emotional upheaval. There’s no way you can solve the problem, and sometimes it’s simply better not to try. Not every problem can be fixed, and not everyone wants you to fix their problem. Sometimes it’s simply futile because there is no solution. Sometimes it’s insulting to even suggest that you might be able to fix it.

What do you do then? You sit with the person as they experience their feelings and say nothing. They don’t need advice. They don’t need conversation. They simply need the presence of another person. They just need you to be there.

Therapists sometimes recommend that when you have a strong feeling, you sit with it for a while. You don’t jump up and try to do something that will make it go away. You don’t ignore it. You don’t try to ignore it. You simply sit with the feeling and feel it. Later, there will be time to talk about it. First, you simply identify the feeling, if you can, and then be there with it.

Being there for another person is a great gift to them. In the face of strong emotion, they may not have the ability to talk about it. Having someone who will simply lend their presence in a time of turmoil gives comfort when it’s needed, unobtrusively.

You don’t have to simply sit when you’re being there for another person. You can touch them, place a hand on their shoulder. You can make them a cup of tea. You don’t ask if they want one. You just do it. The tea will be there if they need a soothing beverage. You will be there if they need a soothing presence.

Our society is so action-oriented these days. When we can’t solve a problem, we feel helpless. And that may be true. We’re helpless to change the situation, helpless to cheer up our friend, helpless to take pain away.

But being there may be the only action that is needed. The power of being there is the promise that, if your friend does need something concrete, something that you can offer, you will be there to provide it. In the meantime, there is nothing that either of you needs to do. Being there is the offering.

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Where to Go First

Most of the advice about depression that’s out there says that the first place to go for help is your primary care physician. That may seem counterintuitive. After all, doctors are notorious for being oblivious to psychiatric problems. Either they dismiss them, assuming that all their complaints (especially those of women) are “all in their head,” or they over-diagnose mental illnesses and pass out pills indiscriminately. At least, those are the stereotypes.

The reality can be far different. Family doctors can absolutely have a positive role to play in diagnosing and treating mental illness.

The last time I went to my primary care physician (for a nail fungus), the nurse practitioner, after taking my vitals, proceeded to ask me the questions collectively known as the Depression Screener. “Do you feel like a burden to your family/do you no longer enjoy things you used to All the time/Most days/Sometimes/Once in a while/All the time” and so on.

My blood pressure was high that day and I see a psychiatrist and take all kinds of psychotropics. I’m sure all that is in my file. “Can’t you just put down that I’m anxious and depressed and leave it at that?” I asked.

“Let’s go through it anyway,” she said. And so we did. No surprises. I was anxious and depressed.

The depression screener may not have been useful for me, but it is for lots of people. There are a lot of seniors, for example, who are living with depression without realizing it. Children, too. Teens. People of all ages. Finding them and getting them help when it’s in the early stages can help them avoid a life of misery and despair.

Not every person gets to find out through the screener. My mother, who was in a nursing home, made some remarks that suggested to me that she was depressed—extremely depressed, including suicidal ideation. I excused myself, found her doctor, and told him what she said, and that I believed she needed antidepressants. Rather than pushing back, he believed me and prescribed them.

Of course, it’s easy enough to beat the screener. The answers are fairly obvious. In fact, I know one person who gave all the answers that would keep him out of the psych ward. But fortunately, most people answer the questions truthfully and get the help they need.

But back to primary care physicians. They’re also helpful in cases of depression, anxiety, and other mental disorders. They know about the most common antidepressants and other psychotropics and can prescribe them to get you through until you can see a psychiatrist. They can give you a referral to a psychiatrist. And, difficult as it is for a first-timer to get a prompt appointment, they can keep monitoring your condition, prescribing as needed, until there’s finally someone who’s taking new patients. My own family doctor was willing to keep prescribing all my medications when one psychiatrist retired and I had to find a new one and wait for an appointment.

My primary care physician is part of my treatment team.

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What Gaslighting Isn’t

Gaslighting is a form of emotional abuse, but it’s not the only one.

Gaslighting is a very particular kind of emotional abuse in which the perpetrator tries to make the victim think she (or he) is crazy. They do this by denying their perception of reality.

Gaslighters say things like, “I (You) never said that.”

“You’re making that up.”

“That never happened.”

“I don’t remember saying (doing) that.”

And of course, “You’re crazy.”

There are other kinds of emotional abusers, however. One of them is the puts the victim in a position of “learned helplessness.” This often starts with “love bombing,” or flattering and professing love until the victim is hooked. This often happens when the two people live together.

Suddenly, there’s a change. The victimizer turns hateful, putting the victim down. They say things like, “You’re stupid.”

“You’re ugly.”

“You can’t do anything right.”

“You’re lucky to have me. No one else would have you.”

The, just as suddenly, the victimizer changes. Again, they’re all love and kisses, flowers and gifts, positive messages. The victim thinks they’ve changed. They believe the promises to do better, to be more attentive and loving.

These are lies. The victimizer has no intention of changing .hey’re just stringing the victim along. This is called “intermittent reinforcement.” The victim goes on hoping that the good side of their partner is the real one and all the losing statements and gestures are true. So they keep hanging on.

The situation is even more complicated if there is physical abuse—battering—going on. The victimizer is likely to do the same things as the emotional abuser. They apologize extravagantly and promise never to do it again. They can also blame the victim, saying, “I wouldn’t hurt you if you didn’t make me so mad.”

There are other tactics the abuser uses to tie the victim to them. They cut off the victim from their family and friends. They keep tight control of the finances. Children and pets are also obstacles that keep the victim helpless (this is also called “learned helplessness”).

But that’s not gaslighting. That’s emotional and physical abuse. For it to be gaslighting, the quality of tricking the victim into believing they’re going crazy, that their reality is false. Of course, the gaslighter may also use some of the techniques of the emotional abuser in addition.

The word “gaslighting” is a trendy word these days. Most of the time, what someone means when they use the word is emotional or physical abuse, or living with a narcissist.

However, as different as these problems are, there is one solution to all of them: Get out. Staying with a gaslighter, emotional abuser, or physical abuser is a losing proposition. They won’t change, no matter how many times they say they will.

Getting out will be difficult. The abuser will usually have the situation rigged so that’s difficult for the victim to do. Lack of money, lack of friends, isolation, maybe no transportation, no place to go are all impediments to escape. And though police response may be improving, it’s often not, especially if there hasn’t been battering. And we know how well restraining orders don’t work.

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The Varieties of Grief

Loss and grief affect us all. If you’re lucky enough that they haven’t yet, they’re coming. You won’t know when or why or how, but they’re unavoidable. There’s no way to prepare for them, either. Loss and grief rock your emotional balance and your mental health.

You’ve no doubt heard of Elizabeth Kubler-Ross’s Five Stages of Death and Dying—denial, anger, bargaining, depression, and acceptance. (Some people say there are seven stages, including the usual five plus shock and guilt.) The stages apply to other kinds of grief besides death and dying.

The thing is, not everyone experiences grief in the same way. You may not experience all five (or seven) of the stages or not in the order they’re usually presented. You might skip anger, for example, or begin with depression. It depends on the type of loss you’re experiencing and your psychological makeup. If you suffer from clinical depression, for example, it’s easy to get stuck in that stage of grieving a loss. If you have anger management issues, you might experience that before you get to denial, or you might skip over bargaining.

Nor is there a time limit on grief. The experts say that six months to a year is a “normal” time for grief to last. Obviously, this is not hard and fast. If it takes you two years or more to return to full functioning, that’s how long it takes. No one should push you to “get over it” in what they consider to be an acceptable length of time (but they probably will).

That said, there is a condition called Prolonged Grief Disorder. When grief lasts for years and interferes with your daily life and functioning, you may be suffering from it. If this is the case, you should consider getting professional help.

Grief enters your life in any number of ways, and not always ones you expect. Here are some of the common and less common ones.

Death

Death is what you usually think of when you consider grief and loss. This is usually the death of a loved one, but it can even be caused by the death of a public figure such as John F. Kennedy or someone you look up to and admire even if they’re not a family member or close friend. Even the death of a beloved pet can lead to very real grief that often is not understood by others.

Loss

There are kinds of loss other than death. If you work at your dream job and the company suddenly goes under or you are let go, you can feel grief and go through the same stages of grief as someone who experiences a death. You might be in denial, for example, or experience a period of bargaining or anger. Losing your home to financial reversals or a natural disaster is another example.

Health

If your health deteriorates severely, you can experience grief or a sense of loss over the things you used to be able to do. If you lose a limb, for example, or are paralyzed by disease or accident, you can feel grief over your new situation and again, denial, anger, bargaining, and depression. Even normal aging and the loss of abilities that often accompany it can cause you grief.

Relationships

The death of a relationship can also cause grief. Whether it’s by divorce, estrangement, or abandonment, you suffer because of the loss. You could obsess over the good times you spent together or be troubled by memories of the relationship when you least expect them, such as when you encounter a reminder of the person.

Ambiguous Grief

Ambiguous grief occurs when the outcome of a situation is unknown. A missing child is an obvious example. You don’t know whether they’re still alive or whether they’ve been abducted and killed. You bounce between hope and despair. You may be angry at God for allowing the situation or at the police for not solving the case quickly. If you have a loved one who is homeless and experiencing a serious brain illness, you may not know where they are or if they’re safe. You imagine the worst. You could blame yourself, even if it’s not logical. Bargaining is one typical response, a case of the “if only’s.”

There are support groups for many kinds of grief, such as for the bereaved, crime victims, or those with a family member in hospice. (This could be called anticipatory grief.) Other kinds of grief, such as grief over the loss of a job, home, or friend, usually don’t have any kind of support group. Friends and family members may try to offer support, but that’s not the same as a group with a mental health professional as a facilitator. Being with other people who have also experienced a particular variety of loss or grief can be a profound relief or lead to healing and acceptance. At the least, it’s a safe, nonjudgmental space where you can process your feelings.

Grief is deeply personal. Although there are commonalities to the experience, there is no one blueprint for grief. What you experience is in some ways unique to your situation. Length and depth of grieving can’t be quantified or predicted.

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Prayer and Bipolar Disorder

My mother believed in the power of prayer, and thought I should do more of it. I can’t say she was wrong. She prayed for self-improvement (for God to take away her bitterness at a relative) and for social issues (returning prayer to schools). I don’t know whether she ever prayed for an end to my bipolar disorder (she kept most of her praying private between her and God), but I never have. I don’t think it works that way.

So, what do I think about bipolar disorder and prayer? I think there are many things about bipolar disorder that you could pray about.

You could pray that science finds better treatments for bipolar disorder.

You could pray that you find a support system that helps you (or give thanks for the one you already have).

You could pray that you find a therapist, or a therapy, or a psychiatrist, or a medication that helps you. (Though I would recommend putting some effort into doing this one yourself as well as praying.)

You could pray that you have the strength to get out of bed in the morning or the peace to sleep at night.

You could pray for understanding of what you’re going through—from another person, an employer, the world at large, or even yourself.

You could pray that you don’t do too much harm while in the grip of mania or depression.

You could pray that you will recognize when someone is reaching out to you and that you will have the ability to accept.

You could pray that you have the courage to reach out to someone else, and the wisdom to keep reaching.

In my opinion, what you can’t do is “pray away” the bipolar disorder. If you’ve got it, you have to find a way to live with it. If prayer helps you do that, more power to you. But, again, in my opinion, prayer is not a cure for the disorder. There are some things that are meant for religion or philosophy to make better, and things that science has a better shot at.

You can point to various miraculous remissions of cancer or other diseases, or make the argument that removing demonic possession would now be called healing of mental illness. And if those give you comfort or hope, again, good for you.

St. Dymphna is the patron saint of the mentally afflicted (though personally, I think she should be the patron saint of abused children). If she, or God, or some other higher power of whatever religion or denomination or sect can lessen your suffering, go for it.

I just don’t believe that you—or I—personally will be cured of bipolar disorder by prayer.

Feel free to disagree with me.

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What Does FINE Mean?

I get tired of acronyms—letters that spell out a word and may also stand for the first letters of a word. NASA is okay with me, but I dislike SMART goals, TSA, ATF, and every other government agency. Even more annoying are ones that go on too long and are mystifying to those not already in the know. For example, HHGttG stands for Hitch-Hikers Guide to the Galaxy to SF (science fiction) fans or SMoF (Secret Masters of Fandom).

There are also lots of slogans that make more or less sense, depending. Just Say No. Just Do It. Me Too. Hold My Beer. Keep on Truckin’.

Plenty of acronyms are associated with mental illness, too. SMI. AOT. CARE Courts. BPD. There’s also the infamous FINE. When someone asks how you are and you tell them, “fine,” what that really stands for is Freaked out (or fucked up), Insecure, Neurotic, and Emotional (or empty).

One acronym I’ve been seeing lately is ASK, which stands for Acknowledge, Support, Keep-in-touch. It’s meant to be the “Stop, Drop, and Roll” of how to help a friend who’s having emotional difficulties. I’ve seen PSA (another acronym) ads promoting it on Showtime and MTV (another acronym that is no longer valid). As slogans go, it’s not too bad, although Acknowledge seems a little vague until it’s explained, but Support and Keep-in-touch are pretty clear.

The acronym ASK is associated with the Active Minds organization. Their website is easily findable if you enter “Active Minds” into Google. (The search term ASK brings up too many unrelated hits.) The website it takes you to offers interactive YouTube and “digital experience” links that demonstrate the principles.

Less memorable is ALGEE Assess risk, Listen nonjudgmentally, Give reassurance and information, Encourage appropriate help, and Encourage self-help. It’s a “Mental Health First Aid Action Plan” for helping someone in mental or emotional distress. Assess risk refers to risk of suicide, which may be too complicated a task for non-professionals. The second E, Encourage self-help, refers to suggesting “self-care, self-help strategies, or other ways to get support, such as going out for coffee to talk things over.” Personally, I think the acronym ALGEE is not very memorable and the explanation of the letters is not exactly intuitive.

The slogan that I found most puzzling (although it did get my attention, so it was effective there) is “Seize the Awkward.” The phrase focuses on the idea that, while it may feel a little difficult or awkward to speak to a friend about mental health concerns, you should accept that feeling as natural, then move past the awkwardness and start a helpful or meaningful conversation. The Seize the Awkward website has a lot to offer. There are nine ads for young adults featuring popular or famous spokespeople from music, sports, and other categories. The Ad Council has also provided GIFs, Instagram images, and posters you can use to spread awareness on your own site or location. There is a Campus Toolkit which includes resources on break-ups, loss, suicide, LGBTQ suicide, and racism.

I hereby retract my objection to Seize the Awkward because of its memorability and thoroughness. It’s wonderful. Right up there with Just Do It.

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