Tag Archives: relationships

Giving Someone With Bipolar Disorder Bad News Safely

I’ve had a number of people tell me lately that they don’t feel comfortable telling me bad news. The idea that people close to me are hiding serious issues from me because they are afraid of triggering my bipolar disorder is extremely frustrating; while I appreciate that people are trying to be wary of my feelings, the plan almost always backfires. Hearing bad news and that the people closest to me have been hiding it makes for an even bigger mood implosion.

The best I can do is try to convey that I realize I have trouble processing bad news, but the manner in which that news is passed on to me has a huge impact on my reaction.

When frightening or serious news is dropped in my lap suddenly (without warning) it can feel significantly more shocking; likewise if the conversation ends moments later (and I haven’t been able to ask any questions or begin to wrap my head around the news) I often find myself trapped in emotional quicksand. The more I struggle to understand on my own, the faster I sink into depression, anxiety, and irritability.

Through my experiences I have devised some tips to help ease some of the emotional reaction in situations regarding passing-on upsetting news. Personally, these things have all lent themselves to a much more safe emotional environment and a quicker recovery from intense bipolar emotional reactions.

1. Be up-front that the news might be distressing.

Letting someone know that a conversation is going to take a serious turn (instead of taking the turn suddenly) can make serious news much less jarring. There is something to be said about being able to prepare oneself mentally before receiving bad or serious news, and part of what contributes to a bad emotional reaction in my case has often been feeling blindsided and totally unprepared to hear something jarring.

Having said that, I have found even very broad, general statements like, “I have something serious to tell you,” or “can we have a serious talk?” are effective in this arena. If I know I might be at risk of having an emotional reaction, I can do a better job of containing myself than if the news is just dropped on me suddenly.

2. Bookend the bad news.

The best way I have found to receive (and give) potentially upsetting news is to bookend the serious subject matter with more lighthearted information. Starting the conversation in a casual way to ease the tension before launching into serious content can help folks feel less anxious about the upcoming serious bit. Probably more importantly (to me anyway) is ending the conversation with something more light-hearted to bring the mood back to the present can help with avoiding being caught up completely in the emotion of the serious bit.

Often hearing bad news can put us in a situation where we feel attacked or fearful, even unsafe. Being able to laugh at a bad joke or talk about a cute puppy really helps nullify that feeling of fear that can be the beginning of a big emotional spiral. In my life, being able to sidestep that fear makes for a totally different reaction to bad news and I am able to focus on counteracting my shock more than having to counteract my fear.

3. Make it a dialogue.

One of the things that really feeds into my fear when I get bad news is being unable to get answers the questions I have about what has happened/is happening. I do not want my mind uncontrollably fantasizing about all of the questions I have (and it will) so being able to ask questions and get answers that I understand makes a big difference in how my reaction will unfold. If we don’t have time to have a dialogue about the topic (and not just be subject to a monologue) then the timing probably isn’t appropriate.

4. Consider timing.

A couple days ago I received some bad news about 15 minutes before I was about to go to bed. Needless to say, I didn’t sleep that night.

Likewise, stress can be a big factor in how reactive my bipolar disorder is in any given situation. Laying some bad news on me when I am already agitated or stressed will yield worse results than providing the same information when I am relatively stable or calm. Again, even in an unstable situation, following tips 1-3 can pave the way for a better reaction.

5. Life happens.

Life is full of good news and bad news, that is just the way it goes. Unfortunately, living with bipolar disorder can make getting bad news extremely disruptive to our lives and our relationships, but pretending that bad news doesn’t exist doesn’t help us learn to cope with our reactive nature or practice living a full life.

Ultimately, I want to believe that the people in my life are genuine with me and open about their lives and their experiences. Honestly, in times where I could tell people close to me were holding back bad news it felt almost more maddening than if they had just been honest! Though this is an area that is very sensitive for many people with bipolar disorder, being gentle about the subject matter and being respectful to our situation when being open with us can mean a world of difference -not just for us, but also for our relationships.

Leaving on a High Note

If you’ve ever watched Seinfeld you may remember Jerry (a comedian) advising his best friend George that the best thing he can do is to “leave on a high note.” Lately I’ve been trying to change some of my habits to reflect this idea.

A big problem I have been facing is that no matter what my mood is like during the day, it often takes a big downward spiral (even more downward in the event I am already depressed) in the evening before bed. Going to bed feeling so negative has lent itself to trouble sleeping and nightmares for me, so when I first discovered that the specific mindset I am in when I go to bed plays a big role in my ability to be fully rested the next day I began to do some experimenting.

Lately I have been trying to go straight to bed during a brief moment of contentedness. Sometimes that means booking it to the bathroom immediately after watching a show that has made me laugh or smile, or even going to bed earlier than I normally would (to cut off my emotional nosedive before it gets too out of control). Sometimes that means picking a moment where my rapid cycling is affording me a breath of fresh air from the depression I was experiencing moments earlier.

My general desire in these moments is to stay up later (because I may feel, for a moment, a bit better) but experience, at this point, has taught me that if I do the waves of depression and pointlessness can wipe out those small, good (or even just neutral) moments and leave me stewing for the rest of the night.

So far this experiment has provided me a slightly easier time falling asleep, and though I am sleeping slightly less, I am feeling more rested from the time I am asleep.

I have also been working to incorporate the idea of “leaving on a high note” with my therapy sessions. Let’s face it, they can get pretty… well… glum (is a nice word for it). Spending five minutes at the end of the session bringing the mood back to a happier or funnier place has helped me leave therapy sessions feeling slightly less like a sack of discarded potatoes.

This idea is also something that has made a big difference for me in terms of communicating with friends and family members as well. Leaving a conversation in the middle of something serious or even triggering without bringing things back around to a happier place has been extremely detrimental to my overall mental health. It is almost as if those negative topics, if not contained, spread through my system and drain me of all my energy. Encapsulating those moments in specific conversational bubbles (and moving to another lighter  bubble after hitting a dark one) seems to make a big difference for me, in terms of becoming triggered.

One of the things I like most about this idea is that no matter how dark, or weird, or awkward things get, there is always opportunity to make things a little lighter before moving on. While this is something I tend to do with humor, even something as simple as apologizing to the store clerk who I’ve just been short with has been enough to help me leave a potentially negative situation feeling slightly better. Sometimes it feels really important to me to recognize that I can’t always keep situations from being negative (or keep myself from feeling negatively about something), but if I do what I can to turn things around before walking away, that negativity seems to have much less power over me and doesn’t linger the way it might otherwise.

Maybe this holiday season a good option might be to leave on a high note. A polite goodbye before a party or gathering turns into total chaos could be the difference between a short, sweet appearance and that dreaded stressed out holiday meltdown. Not only that, but leaving when you feel good might also help keep you from feeling negatively about your friends, relatives, and yourself!

The Number You Have Dialed Has Been Disconnected

I don’t know if you have ever spoken and felt like nobody could hear you, but for me this feeling can potentially trump symptoms like delusions and hallucinations for the most maddening feeling I’ve ever experienced. Even when I am experiencing hallucinations or delusions (and maybe even don’t recognize it) I can talk to someone about it; but the times when my mouth and body do not convey what I want them to (or they do but in such a way that nobody can understand them) have left me (the innermost me) feeling like a phantom limb.

Last weekend, in a matter of days, I became engulfed by that feeling. Everything I was trying to say, the jokes I was making, the observations I attempted to casually convey, became hostile. It seemed no matter how I spoke or stood or gestured, people were genuinely afraid of me. Those desperate sorts of pleas hoping to convey my intense sorrow came out, instead, angry.

My manic episode from the week previous had turned dark, and as the depression I was experiencing became more and more intense, so did my apparent rage. The rage left me incapable of conveying the depression, and being unable to express myself left me feeling so isolated and alone that I could feel the depression feeding on it and growing exponentially.

When Monday rolled around I tried everything I could think of to crawl out of the disconnected, suicidal funk I was in. I emailed my psychiatrist only to find out he was on vacation. I called the intake coordinator for the new clinic I’m trying to access therapy through but she did not have time to talk. I called the crisis line (as I’ve been calling them a lot lately) but all the phones were busy! This, if nothing else, seemed like a sign, so I grabbed my purse and a book and went straight to the emergency room.

It can be very confusing to watch yourself begin to destroy your own life (your job, your relationships, maybe even yourself through impulsive drug or alcohol use) and feel like you are a passenger during the whole experience. Unfortunately, this is a feeling I am familiar with so I knew that the only real card I had left to play was hospitalization.

What I didn’t know was that I would be spending all day and all night in the emergency room before reaching that inpatient bed. I was awake for 36 hours and extremely alert and energetic (as I said, mixed episode) fueling those depressive and hostile waves that kept coming until I was (somehow now in an inpatient room) crying uncontrollably for hours, and periodically ripping up anything in my room I could find to rip up.

My goal was to outlast the episode until it switched into depression or stability (whichever came first), a fairly easy goal I figured, since my episodes cycle so rapidly and I was already 12 days into the mixed episode. Though it wasn’t fun (but hospitalizations never are) I seem to have outlasted the hostility and was expelled through the other end of the hospital Friday experiencing severe depression instead.

So I am home now, and though my decision-maker seems to be broken and I had a panic attack trying to go into the grocery store I am, seemingly, a free woman again.

My mind has still been trying to whisper all manner of horrible things to me, but I can eat food that wasn’t produced in a hospital now… so it makes all that a bit easier to live with.

Needless to say, my posts may be somewhat spotty for a bit. I’ve been very overwhelmed by a lot of the things that have happened this year, and several more big things are scheduled to go down this month.

In the meantime, take care of yourselves! I’ll be doing the same.

One Good (Manic) Turn Deserves Another

The last thing my (ex) therapist said to me (jokingly) was,

“…and I never got to see you manic!”

In my depressed state I shrugged and replied,

“it is rare these days… euphoric mania, anyway. It hardly ever happens anymore, frankly I can’t even remember the last time it did.”

Little did I know, within a week I’d be hunkered over my chest of drawers urgently rearranging my shirts because, well, is it better for them to be grouped by print or by sleeve length?? And, no, no, no, the underwear needs to be arranged in descending order of favoritism and then by color!

As much as I would like to say I saw this swing coming, I would be lying to you. Generally I would say I have a tendency to become manic in October, however I find that when I say that ahead of time it never actually occurs.

This time around I think I would like to blame the aggressive head cold that has been going around for my lack of catching the warning signs. Normally euphoric mania comes on largely in a physical way for me first, but I can’t say I felt any kind of awesomeness, electric humming, or skin-crawliness that I normally experience until much later on. This time around (because of the cold) I felt sinus pressure, ringing ears, a sore throat that lingered on much longer than I anticipated, and initially much more lethargy than I normally would when mania strikes. By the time I started to realize things were getting out of control it was a bit too late to divert it.

Of course, in hindsight I can say, “ahhhhhh, ok,” to the series of odd and rather impulsive actions that led up to my frantic laundry situation and subsequent hours of laying in bed awake, chest pounding, having rapid conversations in my own head. One would think I might have had a clue when the series of somewhat depressing situations I’ve found myself in lately became increasingly hysterically funny to me, or when I stopped each of five consecutive movies I was trying to watch halfway through because I no longer felt interested (and then the only movie that did hold my attention was The Silence of the Lambs), or when I cut all of the instances of the number “2” out of a cosmo magazine to see which one was “the best,” or when I spontaneously maxed out my credit card buying tickets to see The Who. I was even having trouble writing, many of my sentences were coming out backwards.

Contrary to popular belief, these are not things I normally do. I’m the kind of girl that usually just likes to wad her shirts up in a ball and shove them in the drawer, or look at the prices and fluid ounces of every bottle of shampoo in the store to make sure I am getting the absolute best deal before buying one. I know I usually claim I don’t do the “spending” thing with mania, but apparently this was an exception. (Boy, I hope I’m not inadvertently picking that habit up!)

To be fair, I think normally these are things my boyfriend would probably notice, however he was out of town for work all last week.

The episode seems to have peaked Saturday night and then turned to the dark side, leaving me experiencing four swings of “crazy girlfriend” type, hostile-agitated-mixed chunks appearing between mildly euphoric moments throughout the day.

I’ve been having trouble getting my thoughts together long enough to complete anything I’ve been trying to write, but I have a few ideas that I hope to get down soon. Thankfully I have been lucky not to experience any psychosis in the last week (knock on wood), however the sort of hostile, “I hate you” mood swings I’ve been having haven’t exactly been a walk in the park either.

I have my intake appointment with my new psychiatric clinic on Friday (hooray!) and though they are usually somewhat grueling, I will be happy to have someone around to help me untangle the big ball of emotional spaghetti in my brain again.

Viewing the Past Through Someone Else’s Eyes

While I’ve met many people who have had symptoms of mood or anxiety disorders appear in their 30’s or 40’s or 50’s and can only imagine how jarring the result must have been, I find myself at the other end of the spectrum.

Many of my childhood memories involve big emotional explosions (good and bad) and frankly, the anxiety I feel today spans back to as far back as I can remember.

Though my emotional journey has been somewhat complicated, it seemed to me (as an adult) that my experiences with anxiety haven’t been. The anxiety is something that has always been there, but for a long time I didn’t see it. The feelings I had were typical for me (for lack of a better word), I really didn’t know anything different.

I think the difficulty in this route (vs the sudden, immediate cresting of symptoms later in life) is that the realizations I have had about the depth of my anxiety have happened slowly over time. There was no one moment where everything became clear, it has been more like a trail of discoveries.

Discovering, for example, that I have been having panic attacks since I was in 5th grade and I didn’t know it (because it was something that just became part of my life).

Or discovering that my unruly digestive tract and IBS is related to the anxiety I have always experienced.

This time, a few weeks ago, I was cleaning up some papers before moving and found a note written to me by my boyfriend my sophomore year in high school. The note was one of distress, and he said I was acting completely different at school than I did when we were hanging out otherwise. Apparently in the setting of school, I could hardly speak to him, let alone do things like typical teenager hand-holding in public.

Though I don’t remember any of this taking place, I admit I was a little shocked when I read about it. What I do remember was that this boy’s interest in me finally detached the creepy tentacles of the teacher who had been sexually harassing me for the last two years, and for that I felt an incredible weight lifted off my shoulders.

Apparently even without that weight, my social anxiety was practically paralyzing. I admit, I don’t remember feeling terribly anxious about school, but based on that letter (and others) everything I did and felt was within the realm of what I already knew: a world based on anxiety.

It isn’t very often I find things like this that can lend such a different perspective on the past, but when I do I am thankful they can give a little insight about things that took place (and the status of my mental health at the time).

Moving; Looking at Life in Hindsight

This Friday I thought I would start by leaving you with some good news; after a very lengthy application process and some big hiccups we’ve been approved for the apartment we wanted!

Living in Seattle has involved a lot of moving for me. Since moving here in 2006 I’ve moved 8 times, and the last three years at our current place is the longest stretch I’ve gone in one place since moving away from home at age 18.

When I got to the city I was moving around so much I didn’t accumulate much (in terms of stuff) but having been staying put the last 3 years has meant diving into a much more intense packing process. Beyond the usual stuff I’ve gleaned (boxes and boxes of fabric, more rik-rak ribbon than any one person rightfully needs) I have also accumulated an extraordinary amount of paper goods.

Part of the anxiety I have involves keeping pieces of paper that I deem “important”. Apparently… this means everything. Like, a doodle I did of a dog, or our light bill from the 8th month we lived here. Looking back while packing, I can see clear periods where I attempted to clean some of this up and then slumped back into depression, leaving behind piles representing particular periods of time scattered throughout the apartment.

Most of the papers I’ve gone through in the last week have been repetitive. SSDI paperwork. DSHS paperwork. Insurance (or lack-thereof) paperwork. Yes, important at the time, but now a year or more later… useless.

Every so often I strike gold and find something useful.

“Oh good, I’m glad I really DID put a forbearance on my student loans!”

Because… who knows at this point. I can’t remember a whole lot!

In one of the piles I hit the equivalent of a gold nugget; the workbook I filled out during my last hospitalization in 2011. 

I leafed through it knowing I had scribbled crap down in there right before being released because I had found out filling out the pages was required rather late in the game. One loose page fell out though, and this one looked genuine. It said:

Positive Momentum

1.) On the left side of the page, identify which one of these areas you are struggling with the most and write it out. (Think about why you came in the door).

(I didn’t have the left side of the page, but what I wrote seemed pretty self explanatory.)

“Wearing the mask – I don’t normally express my feelings in a daily setting.”

2.) Ask yourself how you might be able to think about or do things differently to get some kind of positive momentum going for yourself?

“I would like to see a talk therapist again and continue gradually letting my boyfriend in.”

***

A few days ago when I read that, bells and whistles went off in my head, particularly the response to question one. Frankly, even though my symptoms have gotten noticeably worse since then (overall) I feel eons better after dropping the act, “the mask”, and allowing myself to show real emotion (even if it is out of proportion at times) instead of trying to keep it contained internally or just in journals.

I was happy to see that the response to question two is one that I have followed through on. Not only do I have a therapist (which has helped me continue to express those feelings from question one) but I have talked a lot to Corey about the things I am dealing with and he is usually the first to help me brainstorm a workable solution (even if that solution is to do nothing).

Sometimes it can be hard for me to look back, I normally don’t allow myself to read my own journals because I find them triggering and my blog posts are structured much more differently than my everyday sort of casual, emotional writing. It can be hard to know if things have really gotten any better, but this one piece of paper (found in thousands) was a nice reminder that I have moved forward and by continuing to do the things I’ve set out to do, I am continuing to help myself.

In a stressful situation, it is amazing how finding a needle in a haystack has helped bolster my confidence about getting things done and moving on to something different. After all, this single page is a real reminder of how different can be great.

Curbing Bipolar Overreactions

When it comes to bipolar disorder, it can be hard to discern which type of mood episode is more harmful in any given situation; the moods that pop up sporadically without warning or the big overreactions that can happen in response to a stressful situation.

I think for most people, understanding that bipolar disorder includes un-triggered mood episodes outside of our control is simple enough to attribute to the disorder itself.

But what about overreactions? These big mood flare ups have often been a bigger source of trouble for me when it has come to my relationships with other people, because it can become easy for others to write these actions off to “a dramatic personality”. It can be difficult for people to separate a mood disorder from what our culture has been putting on a pedestal (via reality television); the drama queen.

For this reason, it has become important over the years for me to learn to adapt in situations where big emotional overreactions might take place and find a solid method to curb those overreactions (or express them safely) so that my boss, my co-workers, my family, and friends aren’t subject to a toxic emotional blow-up.

Having said that, I don’t claim to have a 100% success rate. I definitely still blow up at people, but having a strategy in mind when these situations come up has helped me funnel most of my blow ups in such a way that I’m no longer destroying as many relationships because of them. Obviously, this is a system that tends to work for me, and though I can’t say for certain that it will work for everyone else, it is a good place to begin if you are interested in putting your own system in place to curb overreactions.

Alright! Here we go!

Step 1: Isolate

A lot of the time I am lucky and experience a delayed reaction when it comes to overreactions. I can put on a serious face while getting bad news, and it isn’t until 10-60 minutes later that I often experience the explosion of emotions that come after. This has been helpful because in that time I can seek out a “safe place” to be when the emotional wave hits me. In public or at work that generally means finding a restroom as quickly as possible, but that could also be as simple as removing myself from a group and stepping outdoors, or into a garage; any space where I am alone.

This tends to be a bit more difficult when I am in a situation where I am extremely reactive, or immediately angry at something someone has said to me. Though my success is not quite as good when it comes to curbing these types of overreactions, it can still be extremely beneficial to just turn and walk away. Walk away and isolate, again; garage, the front porch, or a restroom can all help out.

Step 2: Purge (safely)

Once alone I move on to the “purge” phase, which simply means expressing my emotions in a healthy way. The idea is to get as much of that excess emotion out as quickly as I can and do so in a safe way. 

Here are some of the safe ways that help me express my emotions in these situations;

  • crying
  • screaming into a pillow
  • punching a pillow
  • crumpling paper or leaves
  • writing out my feelings in a journal, on paper or a napkin
  • calling the crisis line to talk to someone
  • calling my therapist to talk to someone
  • calling my boyfriend (who is good at diffusing these situations)

These are just a few ideas, but there are many more ways to express what you’re feeling in a safe way. Personally, in these situations I tend to avoid calling most friends or relatives because when I am upset I can often say some very upsetting things. I have learned from experience that it is best for me to express my frustrations (or whatever I’m upset about) to a licensed professional who is familiar with mental illness, or to someone who knows that I am just having a blow-out and (usually) not a full-blown crisis.

There are days where crying is enough and I feel good enough to resume whatever my previous activity was afterward. Other days I need to do more (especially if there is anger or desperation involved) or I might need someone to talk me down.

Step 3: Walk

Getting out the emotion and the swirling vortex of thoughts is important, but for me I usually need to also expel a big wave of physical discomfort/energy as well. Failing to rid myself of the energy or tenseness that came with the emotions often results in the emotional wave coming back around for a second go. The easiest way I have found to do this is to go for a walk.

Walking gives my body a chance to relax through gentle exercise. The fresh air often makes me feel more calm, and being outdoors can change my perception from feeling “trapped” in a bad situation or with bad news to feeling much more free.

Certainly it is possible to combine steps 2 and 3, and sometimes I do (though I usually wear sunglasses in the city so people can’t tell I’m crying). Typically though I like feeling like I’m in a “safe place” while letting my emotions out, and it can be a big bummer when you’re trying to release an emotional meltdown and someone with a clipboard is trying to get you to fund a program for rescued dogs (oh the city!).

Usually I can see a drastic improvement in my mood after even as little as 15 minutes of walking. I tend to go on a lot longer than that if I have a choice (just because it helps me so much) but I know when folks are working or in school it can be difficult to be away too long.

I like to walk to music but I’ve made special playlists limited to upbeat, positive songs for these situations. I try to avoid any music that is too emotional during these times because they tend to have a big impact on my mood, and the whole point of this exercise is to improve my mood, not shift it to an equally dubious place.

Step 4: Distract

The one thing I can do to undo everything I have done up to this point is allow my focus to shift back to what upset me in the first place. That means when I return to whatever it was I was doing before the overreaction, I need a distraction. Really, it can be anything that keeps my mind away from obsessing about what just happened.

This could be anything from…

  • a game
  • a conversation
  • a piece of work that requires my full attention
  • music (again, upbeat)
  • art
  • cooking
  • giving blood (I used that as a distraction once at the office, it worked great!)

Seriously, anything that takes my mind off of what upset me is a winner. Ultimately, if I don’t distract myself well enough, I run the risk of having another overreaction triggered solely by the thoughts I have about the original situation!

I know this system isn’t perfect, but when I use it I find that I often feel much better anywhere from 15 minutes to an hour later. I know that might still sound like a lot of time, but when these overreactions were causing meltdowns for me that were lasting all day (or triggering bigger episodes lasting days or weeks) I can safely say I’ve seen a big improvement overall in rational time after overreacting vs. irrational time overreacting.

Sometimes it is also important to remind those around us that massive overreactions can be an equally difficult part of bipolar disorder. Even my boyfriend (who has six years of bipolar-girlfriend experience at this point) asked me on Friday why I spent an hour crying, and then an hour walking after we got some distressing news about our prospective new apartment. Somehow he was still baffled that I reacted that way after all this time… all I could do was explain that overreactions like this just come with the territory. It is one of those things I wish I could stop (before it even begins) but it has never worked that way for me.

Instead I have to do the things that I can to get those overreactions out of my system in a safe way so I can move on to doing the things I’d rather be doing!