When I think of the things that trigger bipolar episodes for me, the initial things that come to mind are physical pain (like headaches or having the flu), graphic violence on tv and in movies, and music (usually the slow, sad, self-reflective song can put me into a state of depression almost immediately).
What I consider less frequently is conversation, particularly insensitive conversation, because I have systematically rid myself of most of the people in my life who continuously made insensitive comments.
Now, as someone who has been living with bipolar disorder for over ten years, I know that at the heart of it, I am an incredibly sensitive person. Given that fact, it seems fitting that my kryptonite, the person who can send me into an episode in a matter of seconds, is just the opposite; the insensitive person.
What baffles me about the many people I have known who have been insensitive is that most of them don’t know they are acting that way. For this reason I’ve often given these folks the benefit of the doubt (despite wondering why they don’t seem to pick up on the fact that I am enraged or in tears after whatever comments they have made) and allowed them to continuously hurt me by triggering episodes over and over and over again. Thankfully as I’ve gotten older, I’ve cut most of these people out of my life entirely.
As someone who spends most of my time trying to avoid becoming upset or upsetting the people around me, it is incredibly frustrating to me that there are so many people out there who don’t pay any mind to what they say or how what they say affects others.
I want to clarify that I am not suggesting everyone dumb-down their conversation for people with bipolar disorder, but I think there are ways to bring up sensitive topics without doing so in a triggering way. Chiefly, I think supportive, positive talk is key… but I’ll get to that in a bit.
Most of the time I am triggered in conversation it is because the person I’m talking to seems to be pointing out very intense, true fears I have about my life (but not in a gentle or supportive way).
For example, I was meeting up with an old friend for lunch who I hadn’t seen in over a year. I was feeling pretty nervous about having put on some weight, and the second thing out of my friend’s mouth (well, ex-friend now) was, “wow, you’ve really put on some weight!”
I’ve also found myself in uncomfortable positions where people have gone on to me at length about buying big expensive toys for themselves when they knew I was homeless and couldn’t afford to feed myself.
Beyond the fact that any human being might be distressed (or even just flat out offended) by such remarks, people with bipolar disorder often have exaggerated emotional responses to things that shock or upset them. In conversation you might find that, having triggered this response, the result might be like flipping on a light switch and the “on” phase of the switch is accompanied with tears, a sudden silence in conversation, or intense hostility or agitation.
Having bipolar disorder often feels like actively playing a game of Jenga, with every new experience each day we’re having to re-balance ourselves to keep from toppling over. It takes a lot of time and patience, and when someone comes in and can make one comment that smashes everything we’ve built… well, the emotional tidal wave that follows makes it incredibly difficult (for me) to rationally be able to stop and say, “well old chap, it seems that wasn’t a nice thing to say. Care to change the subject?” While I realize a lot of people seem to act this way because they aren’t aware they’re doing it, I have had a very difficult time pointing my frustrations out to them without also, you know… eating them alive.
Here’s the thing about bipolar relationships: it takes two. No matter how hard the person with bipolar disorder is working cognitively (plus therapy and taking medication) we still need the people in our lives to act like civilized human beings who take an interest in how their words and actions affect those around them! If the people you talk to seem to get extremely upset when you do, consider that you might be half of the problem. Sensitive people are sensitive, but I can easily have active conversations with myriads of people who do not elicit the same response as someone who is acting insensitively.
The insensitive person’s response when I am triggered by a comment makes a big difference in how the next few minutes (or weeks, if it is a bad episode) unfold as well. I’ve known some people who can immediately detect my change in mood when this happens and while one or two have said something about it (even a simple, “maybe that didn’t come out right,” is enough to help me feel like the person didn’t mean to upset me) it seems more often the person just ends the conversation. To me, this is the worst case scenario, because it seems like these people recognize they’ve hurt my feelings but don’t have any intention of apologizing or acknowledging it to my face. If I am thrust into an episode of depression because of one of these situations, the scenario where I feel abandoned and like the person talking to me doesn’t care about what just happened will be much worse, and I will often be stuck… fixating on what happened for days, if not weeks.
What does that tell you? Just say something. If you’ve stumbled into a place in conversation where you’ve upset the other person, apologize. You don’t need to apologize for your point of view, or even for what you said, but if you care about that person and feel bad about upsetting them… say so! All it takes is one, “I’m sorry I upset you,” to help diffuse the situation.
For the record, here are a few topics that are generally considered triggering for me (if you find you are easily triggered, skip past the bullet points):
- Violence, that includes being on the receiving end of violence or an instigator
- Rape (unless we are talking about Game of Thrones and even then, this can only be mentioned as a passing remark), definitely no rape jokes.
- Animal cruelty
- Self harm
- Sexual harassment
- People’s weight, my weight, or people telling me how to lose weight
- People telling me what and how to eat
- Money, or all of the expensive things you are excited about buying. I can usually give people a pass on this once or twice, but it is difficult for me to hear this (particularly from my family) when I am struggling financially. This is a tricky subject, because though I am generally interested in what people are spending money on to enjoy their lives, it also is a continuous reminder to me that I do not have those things.
I would say (as a general rule for conversing with me) if I’ve told you that I am stressed or worried about something, don’t go on to describe the worst case scenario to me! The thing is, I’ve already thought about it a dozen times or more, and I am having a conversation about it to be reassured by someone, and to stop feeling so stressed out about it.
The key to having a conversation with someone who is sensitive is to couple up feelings with words. Consider your own feelings as a model. If you’re about to say to someone, “wow it looks like you’ve gained some weight,” consider how it would feel if someone said that to you. Would you be happy that they noticed and brought it up, or would you feel self conscious? Chances are, if you say that to someone else, they will ALSO feel self conscious!
If someone tells you, “I am really stressed out about starting my new job,” don’t exacerbate the situation. If you know (based on what this person has told you before) that they left their old job because their old boss was really horrible, perhaps skip the part where you mention, “yeah, I hope your new boss doesn’t suck too.”
Sometimes (ok, most times for me) people who get stressed out easily need help focusing on the positive. Most insensitive remarks focus on things that we have negative connotations with, so focusing on a positive remark (instead of the initial negative one) can make a big difference in conversation.
For the scenario above with our friend who is stressed out about starting a new job, a positive spin might be to say, “the new company you’re going to be working for seems really cool,” or “I bet it will be nice to be able to start fresh,” or “once things become routine at work I bet it will be a great fit!”
The most common questions I get from parents and friends of people with bipolar disorder is wanting to know how can I be supportive?
Be positive. Let us know you understand we’re stressed (don’t tell us not to worry), but try to help us look on the bright side.