Category: Coping strategy (Page 1 of 3)

How routine and structure help in maintaining a positive life when you have bipolar disorder

July 7, 2024 / Allan Cooper

A healthy routine and structure has helped me be more resilient, reduce fluctuations in mood and has contributed to a sense of happiness and fulfillment in my life.

During acute depressive episodes, many people end up spending most of their time in bed. There are logical reasons for this. The most obvious being that during depressive episodes one of the symptoms is an incredibly high level of fatigue. Plus, the warmth of being under the covers helps ease the physical pain that one also experiences during these episodes. Once your symptoms become more manageable, finding a routine and a structured life can help create a more consistent feeling of wellness when you have bipolar disorder.

The first thing I do every day is take my medication. I make sure to put them in the same spot every night before I go to bed. During my last severe depressive episode my concentration was poor. Often, I wouldn’t be sure if I took my medication or not. The idea of filling up my own pill organizer when I was unwell seemed impossible. I had my pharmacy put my meds in blister packs until I was able to fill pill organizers on my own. I have an alarm on my phone that tells me when to take my meds in the evening. I have had occasions when a change in residence or life events disrupted my routine and I got into a pattern of saying to myself it’s just one dose multiple times. This has led to manic and depressive episodes. It’s a priority for me that I am consistent with taking my medication.

After my last episode, volunteer work helped provide the structure I needed to get back into a life where I could do more in a day. Even though, it was just for three hours twice a week it gave me a reason to shower, interact with people and it made me feel like I had a weekend. Even on the days I didn’t volunteer, I started to get up and structure my days as if I would be volunteering. It also helped me get my sleep routine on track because I was staying up late and waking up at random times because there was no reason to get up early.

Finding a peer support group that I could attend once a week was the next addition to my schedule that was helpful. It kept me accountable for lifestyle choices that promoted wellness and it provided connection and a commitment that was within my capacity to keep. Organizations like the DBSA have online peer support groups for people who have bipolar disorder.

Walking to my volunteer job was a nice way to add a little bit of exercise to my day. I don’t walk as much as I used to but I play tennis or badminton once a week. I usually walk when I notice a depressive episode starting which prevents them from getting worse and lasting as long. I imagine if I made walking a more consistent part of my routine I would probably have less episodes but nobody is perfect.

When you have bipolar disorder it is crucial that you get enough sleep. For most of the people that I have met who have bipolar disorder a lack of sleep can be a red flag that their mood may be going high. Finding a sleep routine that suits your individual needs is important. I go to bed around 10:30 pm. For some, complete silence is necessary. I can’t sleep in complete silence because it becomes an opportunity for my brain to be filled with stimulating racing thoughts. I use headphones to listen to the same Netflix show every night. It interrupts the verbal chatter that goes on in my head and since I have been listening to it for very many years, it has become boring for me so it helps me sleep. I don’t watch the show, I just listen to it. I used to listen to old radio shows like Our Miss Brooks, but for some reason that stopped working so I had to try something else. If the amount of sleep I am getting becomes worrisome to me, I contact my psychiatrist.

Family and friends can support people who are developing a routine by inviting them to join you when you are doing a regular activity, such as walking. It’s important that it is an invitation rather than an appointment when people are severely unwell. For example, if someone said, “I am going for a walk tomorrow. If you’re up to it, would you like to join me?” This takes some pressure off, and it makes it easier for someone who has bipolar disorder to participate. If the person is unable to go on the day, it’s important you go on the walk anyway.

Adding structure and routine into your life when you have bipolar disorder can relieve stress, make you more consistent with taking your medication and help you build a support network. This can empower you to create a life that includes long term consistency and resilience.

8 Steps to Rebuild Your Life after an Acute Depressive or Manic Episode.

June 9, 2024 / Allan Cooper

After my first manic episode, I lost my job, my dream of becoming a Japanese interpreter, all of my money, all of my friendships and relationships with the people I had in Japan and my marriage ended in a divorce. Since then, I have had two manic episodes and a depressive episode that destroyed my life in a similar fashion.

I haven’t had an acute manic or depressive episode since 2010. Now, I can reflect on what I did to rebuild my life. I am only sharing what worked for me. I am not suggesting that this is a foolproof simple way of rebuilding your life.

1. Rest
This one is hard for people to understand. Acute manic and depressive episodes take a physical toll on the body. Just like any other illness, one requires rest to recuperate from this. How much rest do you need? Everyone who has bipolar disorder is different but I, and many people I have met, have taken a year while for others it may be months. When I ignored my bodies need for rest, it made me feel worse because I would beat myself up for not being more active. It’s not uncommon for people to need to spend many hours in bed during this time.

2. Work with your psychiatrist to the best of your ability
There is no x-ray or blood test a psychiatrist can use to diagnose how symptomatic you are. I’m not a psychiatrist and I do not know what goes into the decisions they make for treating their patients but I do know that the more information I can provide my psychiatrist the better. This may include completing mood charts, notes on side-effects, and descriptions of how much you are able to do in a day. If possible, try to get your medication in blister packs otherwise you might be frustrated with trying to remember if you took them or not.

3. Keep Moving
After my first manic episode the fatigue was so bad that every step felt like I had heavy weights shackled to my ankles. I had to brush my teeth with both hands and showering was like climbing a mountain. When you are this unwell exercising may not be possible but any movement helps. If at first, you just try to walk from your bed to the TV as much as possible that’s a win. Everyday, try to move a bit more than the previous day and eventually you will gain momentum and your activity level should grow exponentially.

Step 4 Get on the other side of the door

During an acute depressive episode, my anxiety is extremely high. The idea of leaving my home becomes horrifying. However, the longer I isolate the worse my symptoms get. My goal became just to get on the other side of the door and exit my place. I had no destination in my mind, or how long I would be gone. I just put on my runners and left.

5. Peer Support
Finding a peer support group for people who have bipolar disorder can be extremely helpful. For me, it helped give me hope to know that other people who have bipolar disorder were able to recover and the tips I learned from them were helpful. Plus, talking to people who understood what I was going through helped a lot. Many people who have bipolar disorder are kind, compassionate, fascinating, intelligent, and just cool people to spend a couple of hours with. Organizations like the Depression and Bipolar Support Alliance (DBSA) have online peer support groups for people who have bipolar disorder.

6. Grieve the Losses
A manic or depressive episode can lead to huge losses in life such as job loss, financial instability, divorce, loss of relationships with colleagues, and friends. It isn’t our fault that the episodes happen, but many people and organizations cannot separate who we are as people from the behaviour they see when we are not well. Acknowledging, the pain of these losses and addressing them through journaling, counseling and/or peer support was helpful for me.

7. Volunteer Work
When you are well enough, volunteer work can be a great way to transition back into a more active life. There is a full range of time commitments from a couple of hours a month to several hours a week. Volunteering can provide more structure into your life, create connection with people who are appreciative of your help and it can give your a sense of fulfillment.

8. Identifying Your Capacity
The last step may be the hardest. At some point, we have to reflect on patterns that have emerged after multiple episodes. Bipolar disorder can be highly reactive to stress. For some, full-time work, a busy social life, an intense workout routine and a family may be possible. For others, this level of activity could result in recurring episodes. A person who can do more than other people who are limited in the scope and how much they do are not more successful. They simply have a greater capacity to do more.

Dealing with the devastation that comes as a result of acute manic and depressive episodes is awful. It takes time, patience and support but it is possible to find a life you enjoy again.

Allan’s Mania Season

May 26, 2024 / Allan Cooper

People seem to be aware of depression occurring during the darker months in Canada but there is a different season that those of us who have bipolar disorder have to pay attention to and for different reasons. It’s springtime. I like to refer to the spring as, “mania season,” because this is the time of year when I, and many people I have met who have bipolar disorder, are more likely to experience hypomania which can build to full-blown manic episodes. This phenomena is officially called Spring Mania (Psychiatric Times) .

I live in Calgary, Canada and during the winter we have approximately 8 hours of daylight per day. In the springtime, that changes to 15 hours a day. My bipolar disorder can react to the increased number of daylight hours in a dramatic fashion. Most of my hypomanic and manic episodes have occurred in the spring. For me, the consequences of this happening are extreme because I have the more severe type of the illness, Bipolar 1, which means I have full blown manic episodes that can include psychosis. This has happened 3 times in my life and all of them caused irreparable harm to relationships with colleagues, some friends and family members, job loss and a struggle with maintaining enough money to meet basic needs. Since the consequences are so severe, I am hyper vigilant in keeping an eye on my mood in the spring and if something starts to go wrong, I act immediately to ensure that I don’t become acutely ill.

I have learned that the first symptom I experience when my mood is becoming elevated is irritability. I notice that when I talk to people my words have a tiny bit more of a bite to them than usual. Nobody else notices the change but I can because it’s not like my usual demeanor and the way I communicate. I also notice that I have thoughts that describe my irritation with the world. Thoughts like: Why do people in Costco always get in my way? How come everyone is driving like idiots? Why is person x taking so long to complete x?

The other symptom I notice is that it is very difficult to calm down and rest. It feels like my blood is almost vibrating at a different frequency than the rest of my body. Regardless of how tired I feel, if I lie down, take deep breaths or close my eyes, my body will not calm down. I feel like I must keep moving but that makes the feeling worse.

When this happens, I go into my bathroom, put a towel at the bottom of the door so that it is completely dark and wait and see if anything changes. If I start to feel better, it confirms for me that my mood is becoming elevated. I sit in the dark for as long as possible and that stops my symptoms from getting worse. After I feel more settled, I close all the blinds in my house and wear sunglasses. I don’t do anything stimulating. I don’t go on my phone, watch TV or go outside. I just sit in as dark a room as possible and try to stay bored. I cancel all of my commitments including work, socializing and sports activities. If my symptoms get worse, I will call my psychiatrist and she will decide if any adjustments need to be made to my medication. Generally, when I do this my symptoms only last a few days. I have not had a manic episode since 2010 and I believe this self-awareness and my medication has made this possible.

This strategy will not work for everyone. Bipolar disorder presents differently in every single person. Unfortunately, the only way to figure out a method for yourself is to reflect on what was going on before your last and previous episodes to see if you can identify any patterns that can give you a clue that you may be becoming unwell and then working with your psychiatrist to develop interventions that will work for you specifically. For me, this process took many years and I think it is important to have some space after an episode to grieve the losses you may have experienced, heal from the shame and physically recover from the depression that follows before you start thinking about how to identify when you may be experiencing an uptick in your mood.

For family and friends who have loved ones in their lives who have bipolar disorder there is very little you can do to help in this learning process other than be supportive and compassionate just like you would for any other physical illness. It is difficult for people who don’t have bipolar disorder to understand the subtleties of the start of mania. I have heard many stories of well-meaning family members expressing concern over someone who has bipolar disorder’s mood when often the person is simply having a normal valid emotional response to a certain circumstance. Peer support provided by people who have bipolar disorder are better able to have these conversations that people can learn from. Organizations such as the DBSA, The Depression and Bipolar Support Alliance have online peer support groups for people who have bipolar disorder.

I have heard many mental health professionals say that bipolar disorder is an illness that can be managed. I think that is unfair to us. I think we can thrive and have exceptional fulfilling lives with meaningful volunteer or paid work, and healthy relationships with colleagues, friends, family, and romantic partners. We may not be able to engage in specific activities and everyone who has bipolar disorder differs in their capacity for how much activity they can do in one day. I believe with the right medication and strategies based on self-awareness it is possible for all of us to have a positive life.

Addressing Self-Isolating When You Have Bipolar Disorder

October 9, 2022 / Allan Cooper

When you have bipolar disorder it is easy to feel like you are alone and disconnected from the rest of the world. Our symptoms are difficult for people to understand because they only see behaviour that they might find frustrating, confusing and maybe even scary. This can lead to ruptured friendships, job loss and distancing by family members. Plus, some of our symptoms include negative thoughts and anxiety which may lead to an illogical fear of leaving our homes.

During my last manic episode, I was experiencing a lack of inhibitions which led to an impulsive decision to move to a small town. I was still high and experiencing psychosis when I moved there and I only have vague memories of what happened when I arrived. When the manic episode ended the tremendous darkness of a severe depressive episode seeped into my body.

I had never lived in a small town, and I did not know anyone who lived in the community. My mania had caused me to lose my job and I lost any connection I had to my former colleagues. My behavior when I was high caused ruptured friendships and distance between me and my family members. My appetite tanked. The most I would eat during the day was one sausage roll and maybe some orange juice. Some days, I didn’t eat anything at all. I didn’t have enough money to even get the internet or cable TV so I watched the same three DVDs everyday and I listened to the radio. I was so exhausted and achy that I spent most of my time in bed.

When my mood is low my anxiety is high. This means when I was awake, I was in a constant state of fear even though I was not in any danger. Plus, I was afraid that people would recognize me from when I had my manic episode if I went out in public and I feared how they would react to me. I would only leave my home to get necessities and then I would hurry back to lie in bed with body aches, fear and awful negative thoughts bombarding my brain.

I am fortunate because I have family members who care about me and were determined to support me regardless of the fact that there were no signs that I would be getting better anytime soon. They called me everyday imploring me to keep eating and encouraging me to keep trying to get better. In retrospect, all of those phone calls were crucial in helping me through that period in my life.

At some point, my energy improved, and I spent less time in bed, but I was still fearful of leaving my home. I made a goal to just get on the other side of the door to my house. It didn’t matter what I did or where I went after that. I just needed to get on the other side of the door. Once I was able to leave my home I found support and connection to people at a local church and gradually I started to feel more comfortable outside my place.

The piece that really made a huge difference for me is when I reconnected with my friends who have bipolar disorder. They understood what I was going through and reminded me of the tools I needed to implement to rebuild my life. Their support helped me tremendously in getting my life back on track.

Getting stuck in self-isolation is scary. You become imprisoned in your own home. The longer the isolation lasts the larger the gap between yourself and the rest of society feels. For me, the only solution was to just get on the other side of the door to my home. I had to take that one step that opened me up to the possibility of returning to the support and potential for joy that comes from being connected to people. This one step eventually grew into a life that I enjoy that includes a sense of fulfilment and stability.

Ten Tips for Having a Positive Year in 2022 When You Have Bipolar Disorder

December 31, 2021 / Allan Cooper

Here are my top ten tips for having a positive life when you have bipolar disorder. They are based on my own personal experience and what I have learnt from my psychiatrist and peer support.

1. Ask Yourself What Is Best For Your Mental Health

When I am faced with a difficult decision the first thing I ask myself is what is best for my mental health. When you have bipolar disorder you have to be mindful of how you spend your energy because we cannot afford to waste any if we want to maintain a positive life.

2.Take your meds.

There is no cure for bipolar disorder, but the right medication can give us a chance to have a positive life. Finding the right medication is generally a long process but there are things you can do to speed things up and make your treatment more effective. Bring as much information as possible with with you when you see your psychiatrist. This can include mood charts, a list of when and how you experience your symptoms and any side effects that your medication is giving you. There is no blood test or imaging device that a psychiatrist can use to treat your bipolar disorder. They rely on what we report to make their decisions. Do not discontinue your meds without psychiatric consultation because you feel fine. This would be like discontinuing diabetes medication because your sugar levels have returned to normal.

3. Don’t be hard on yourself.

People who have bipolar disorder often blame themselves for their symptoms. This can create a sense of discouragement which leads to less activity and ultimately worsens symptoms. I have found it is better to acknowledge that I am having a depressive episode which comes with real physical symptoms of fatigue, aches and pains, poor concentration, and an inability to enjoy things. When this happens, I just try to do my best to keep going. It doesn’t matter what I do or how well I do it I just try to keep moving, stay out of bed and keep my commitments. If I can do these things the day has been a success

4. Attend Peer Support.

Having people in your life who understand what you are going through, provide encouragement and tips on how to deal with it can be extremely helpful. I frequently say peer support is like magic, and for many of us, it is as important as medication. During the bad days, it is nice to have peers who truly understand the challenges that come with having the illness and authentically applaud every effort made to overcome symptoms.

5. Keep moving.

If you can commit to an exercise routine that is fantastic, but any amount of movement is good for the vast majority of people who have bipolar disorder. When I notice depressive episode symptoms starting, if I begin to walk regularly the episodes are not as severe and they do not last as long. When you are not well, the thought of exercise can be overwhelming, and you may not have the physical energy to do it. If that is the case, then just keep moving. Just do the best you can to stay out of bed.

6. See your psychiatrist regularly.

It is important to have a routine on when you see your psychiatrist even when things are going well. Bipolar disorder symptoms can change quickly and access to a psychiatrist is important. If your symptoms are becoming acute contact your psychiatrist right away and see if you can see them prior to your next appointment. If I was a psychiatrist, I would rather see a patient before things become severely acute rather than have to treat someone who needs to be hospitalized. I imagine there are psychiatrist who do not or cannot accommodate that type of care, but it is important to do the best we can to advocate for ourselves to receive the treatment we require.

7. Attend therapy.

Not everyone with bipolar disorder needs to deal with trauma from their past but if you do it can make living with bipolar disorder difficult. An innocuous event may trigger a flash back which results in stress making our symptoms worse. Therapy can also teach us skills to address negative thinking patterns that cause stress, anxiety and relationship problems.

8. Practice Mindfulness.

Mindfulness is a method one can use to stay in the present moment and, with practice, it can provide relief from the constant thoughts that bombard your brain when you have bipolar disorder. It can also help reduce the pain of memories of events that happened when we were acutely ill that cause shame and reduce anxiety.

9. Have a structured routine.

People with bipolar disorder thrive when they have structure. The right level of commitments and activities is different for everyone but a routine that includes meaningful work, paid or volunteer, physical activity, a healthy social life and recreation can create a life that people can enjoy.

10. Welcome Joy Into Your Life

Happiness is not a symptom. If you feel good and you are not having symptoms of mania then enjoy it. Do what brings you joy. If you are creative then create to your hearts content. Maybe volunteering, helping others or random acts of kindness brings you joy. It doesn’t matter what it is, just try and make space for it in your life.

Happy New Year everyone! I hope it brings you all the joy and prosperity you can handle. Please leave a comment below to tell me what you think of my list. Did I leave anything out? Are some of them ridiculous? Are some of them brilliant? Any feedback is appreciated.

Rebuilding Your Life After a Severe Episode

November 22, 2021 / Allan Cooper

Having bipolar disorder can result in many losses that may destroy one’s belief in the possibility of returning to a positive life. Acute manic or depressive episodes can result in a lose of employment, relationships with a spouse, friends, and colleagues. Plus, it is common for people to lose all their money and assets.

For example, one could have a severe manic episode that results in an extreme amount of spending which can burn through people’s savings and assets. During this episode, one can become irritable which can lead to a loss of a job or relationships. If you experience psychosis such as hallucinations, paranoia or delusions of grandeur, people do not understand you are simply not well and may become fearful of you which can also lead to a loss of relationships. Perhaps, your spouse decides they cannot deal with the drama of your illness, and they leave. In just a couple of months, you can lose all your money, assets friendships, job, and spouse.

At the end of a manic episode a depressive episode will follow which includes symptoms like extreme exhaustion, body aches, poor concentration, suicidal ideation, and an inability to enjoy anything. It feels like you are a shell of a human being and it’s easy to become hopeless. However, it is possible to rebuild your life after this happens even though it seems impossible. I, and many other people who have bipolar disorder, have been able to claw their way back to a life they enjoy after these types of incidents.

My first depressive episode was the greatest amount of suffering I have ever experienced. I had lost everything. My career, marriage, all of my money and most of my friendships. My appetite was so poor I hardly ate anything, and I had to use two hands to brush my teeth. I spent several months lying in bed. This is common during depressive episodes because the fatigue is extreme, and the warmth of the bed helps ease the pain of the body aches.

To recover from this episode I made incremental improvements in my life on a daily basis. My first goal was to spend more time sitting up in bed rather than lying down the whole day. Eventually, I was able to spend more time out of bed. Then, I built on the tiny successes everyday. I would simply do my best to make the day a little bit better than the previous day. Eventually, this created a kind of moment that helped me start down the path of wellness.

This November I have been participating in Move for Movember, an initiative where I have to walk 60 km in one month for the 60 men who die by suicide every hour around the world. You can donate by clicking here. I was hesitant to participate in this campaign because last month I walked 0 km. But I used the same approach to completing the challenge that I have used to rebuild my life when bipolar takes so much from me. At first, I just did 2 km/day. Everyday, I managed to do a tiny bit and recently my walks have been longer. I have completed 56 km and there are still a few days left in November.

When bipolar disorder destroys your life the thought of ever having a life you enjoy again seems unfathomable, but it is possible. Methodically rebuilding your life one small piece at a time is the only way to get your life. Many people who have bipolar have done it so there is always hope that life will get better.

Fall and the Winter Months When You Have Bipolar Disorder

September 27, 2021 / Allan Cooper

Over the years of facilitating peer support groups for people who have bipolar disorder, I have noticed that some individuals have their symptoms change in the Fall and Winter. In Calgary, during these months the days become shorter, and it can be uncomfortable to go outside in the cold weather. People tend to become less active and more isolated. All of these factors can lead to depressive episodes. There are some people who struggle with symptoms of mania or hypomania during the winter but most people I have encountered generally see their mood dip.

I used to really struggle during the Winter. My mood would become so low that I would have a hard time functioning. My psychiatrist had to make tweaks to my medication every year to help me get through it. For me, taking Vitamin D everyday has helped and doing fun activities like badminton and winter hiking have contributed to improving my quality of life in the winter.

Some people who have bipolar disorder sit in front of a light box every morning in the Winter. These lamps that are used to treat Season Affective Disorder, an illness that causes depressive symptoms in the winter, can also help people who have bipolar disorder. If you have bipolar, using these lamps can trigger manic episodes so it is important to work with a psychiatrist to determine the best way to use them.

Having bipolar and leading a positive life is a lot of work. You have to be aware of your symptoms but not focus on them so much that it brings you down. You have to watch your stress level and use any tool available to you like exercise, meditation or counselling to keep it in check. You have to look for patterns like your bipolar disorder reacting to a change in season, negative relationships or the nature of the work you do. Once you learn how your own particular bipolar works and you find the right medication and coping mechanisms you can have a positive life that brings you moments of joy despite the suffering.

I hope you found todays blog interesting. I would be interested in hearing stories of other people who have issues with the change in season. I am a very curious about people who do not live in Calgary and what the winters are like where you live and if there any challenges during the winter months where you live.

Back To Stress

September 13, 2021 / Allan Cooper

In Canada, life takes on a more serious tone in September. This is the month that children go back to school after their two-month summer holiday, students of post secondary institutions return to classes and many people’s jobs get busier after our brief warm summer months. This transition can cause a considerable amount of stress for everyone. High levels of stress are not good for people with bipolar disorder.

My bipolar disorder is highly sensitive to stress. Elevated stress levels played a significant roll in my first and subsequent full blown manic episodes and all my severe depressive episodes. If I am not mindful of the amount of stress I have in my life the consequences can be devastating. Every acute episode I have had has resulted in a loss of employment, relationships, and all my money. There are many things you cannot control when you have bipolar disorder but if you can decrease your stress level this can help lower the likelihood of acute episodes and help manage chronic symptoms.

The first thing to consider is to take an objective view of your bipolar disorder to figure out how much activity you can do. Bipolar disorder is not like a broken leg where the symptoms and treatment are the same for everyone. Everyone’s bipolar disorder is different. Some people can be so reactive to stress that employment would cause them to have a severe manic episode that could include psychosis or depressive episodes that have the possibility of death by suicide. Reflecting on the events that led to previous episodes can give you a sense of what you are capable of doing.

Regardless of whether you are working or not, stress needs to be managed. In Canada, since many activities start in September it is often the time of year we choose to make commitments. It is important to keep in mind the limitations of your illness when you agree to add an activity to your life. It is easy to agree to do more than you are capable of doing when your symptoms are in remission.

There are other wellness practices that can help reduce stress. Mindfulness, a life practice that grounds people in the present moment through activities like meditation and yoga can make a dramatic change in stress levels. Any form of exercise, peer support groups and incorporating recreational opportunities or volunteer work into your routine are all excellent ways to reduce stress.

Despite our best efforts, life will surprise us and we will end up having to deal with intense moments of stress. The best we can do to mitigate the damage these events cause on our lives is create a healthy routine and use as many tools as possible to decrease our stress level. This will not guarantee that we will not become acutely ill, but it gives us a better chance of maintaining wellness.

Bipolar Disorder and Stress

May 31, 2021 / Allan Cooper

Stress management plays an integral role in maintaining a stable life when you have bipolar disorder. High levels of stress can trigger acute depressive and manic episodes. The frequency and severity of these episodes can be reduced by a lifestyle that is conducive to a lower stress level. Having a life that is suitable for your tolerance of stress, healthy relationships, a support system, counselling, and other wellness practices can help manage the symptoms of bipolar disorder.

Finding an activity level that is congruent with someone who has bipolar disorder’s tolerance for stress comes from experience. It is only after having multiple episodes can it be determined how sensitive an individual’s bipolar disorder is to stress. Once a pattern emerges, decisions can be made on matters like the capacity to maintain employment or attend school. These decisions can be hard on one’s self esteem, but they may be necessary for long term stability.

When you have bipolar disorder, navigating personal relationships in a positive way can reduce the chances of stress induced acute symptoms. There is no black and white approach that can be used to do this. Using relationship skills is more of an art that takes into consideration the consequences of changing behaviour, one’s sense of duty, power dynamics and the nature of the relationship. Learning about healthy boundaries and other social skills an be helpful. The Canadian Mental Health Association offers free courses online on these topics in their Calgary Recovery College.

You cannot maintain stability without a support network. Psychologist Kelly McGonigal makes the argument that stress is good for us as long as we seek the support of others in her TED talk How to Make Stress Your Friend. While this view may be extreme for people who have bipolar disorder, it illustrates the value of having support. The support of family and friends is essential for people who have bipolar disorder and peer support groups like those offered by OBAD or the DBSA can be life changing.

Counseling can play a significant role in reducing stress. People who have experienced trauma from life experiences or their episodes can benefit from therapy that addresses these issues. Counselling can also help with negative thought patterns, emotional dysregulation, and relationships.

Mindfulness, a life practice that grounds you in the present moment, and exercise are often recommended as ways to decrease stress. While it is true that incorporating these two things into your life will reduce your stress it may be a challenge to maintain a routine that includes these activities given the constant change in our symptoms. For this reason, I feel it is important to decrease stress in multiple areas of life.

Maintaining a positive life when you have bipolar disorder requires a lot of work. One must be mindful of their symptoms, be an active participant in finding the right medication, and create a life with a manageable level of stress. It takes a long time to build all of this into your life but usually the suffering decreases along the way and the frequency of consistent moments of joy increase.

This will be my last written blog until September 6, 2021. For the next three months, I will be sharing a link to my podcast, “The Bipolar Disorder Moment” where I will be reading excerpts from my book , Brain Betrayal: The Allan They Never Met, every week. My book has not been published yet but hopefully a publisher will pick it up in the near future.

Please subscribe to my site if you would like to receive a link to my blog emailed to you every week.

Bipolar Disorder and Shame

May 24, 2021 / Allan Cooper

One of the most awful aspects of having bipolar disorder is dealing with the shame that comes after having manic and depressive episodes. Our symptoms are caused by a chemical imbalance that makes us behave in ways that can be confusing, hurtful, and problematic to those around us. Because our illness causes a change in behaviour it is difficult for people to separate our symptoms from who we are as people. As a result, individuals in our life may change the way they treat us after an episode. This along with memories of the episode can all contribute to a heavy sense of shame.

After manic episodes, people who are impact by the episode may react to the person who had it with anger, resentment, and fear. It is not my place to say which of these feelings are valid or not valid, but I believe the fear is often a result of the media and entertainment industry’s love of portraying people who have mental illnesses as violent. We are no more likely to be violent than the general population. Feelings of anger and resentment are valid but a challenge to process because we would never choose to behave the way that we do when we are acutely ill. Being the brunt of this type of negativity is hard on our self esteem and it diminishes our ability to have a positive sense of self.

The shame that comes from depressive episodes can be different. These episodes may result in friends breaking off contact from you because you are no longer pleasant to be around. You may lose a job because you are not able to perform your duties or a relationship with a spouse may end as they feel you are no longer capable of being a positive influence in their life. These episodes are not our fault, but the consequences on our lives are considerable and can be hard on our sense of self worth.

It is not just the reaction of people around us that is difficult, but the memories of our behaviour can bother us as well. I remember saying awful things to loved ones during the height of my irritability and the confused faces of people who did not understand my psychosis. These memories used to weigh heavily on me, and they made me wonder if I deserved to pursue a better life.

One of the ways I recovered from the overwhelming shame was by attending a peer support group at OBAD. It was nice to meet people who had bipolar disorder that managed to have a positive life and almost everyone could relate to my experience of dealing with shame. Attending the group and trying to focus on living in the moment rather than ruminating on the past has helped.

I have heard stories of family members repetitively reminding people who have bipolar disorder of their behaviour during acute episodes because they are angry or hurt by what happened. While it is understandable that one would want to seek comfort after being hurt by these events, constantly reminding someone of their behaviour when they were acutely ill is hurtful. It may be more helpful to seek out support from agencies like the Organization for Bipolar Affective Disorder, the Canadian Mental Health Association and the DBSA who have groups and resources for family members of people who have bipolar disorder.

Feelings of shame after acute episodes can be so debilitating that it may hinder the possibility of returning to a functional life. Even if I deserve to be punished for the pain my illness has caused people connected to my life, surely a life sentence of crippling shame would be an excessive punishment. To minimize the negative impact my illness has on those around me, all I can do is make lifestyle choices that are conducive to making my symptoms manageable. I cannot do this if I am stuck in shame.