Category: Coping strategy (Page 3 of 3)

Last Wednesday, I hit the wall. I struggled to get out of bed, I felt no desire to eat and I found music irritating. These are all signs of the start of a depressive episode for me. Just by coincidence, I had my appointment to see my psychiatrist on Thursday. Her assessment was that I was not experiencing a depressive episode but a psychosocial problem. She determined that the isolation that Covid-19 has imposed on my life has had a significant negative impact on my mental health.

People with bipolar disorder need structure and commitments. It prevents us from getting into ruts that can lead to the physical symptoms of depressive episodes. I volunteer with seniors at an agency called the Kerby Centre. I love the laughs that I share with the warm and appreciative staff and working with seniors gives me a sense of fulfillment. The Kerby Centre is providing crucial support to seniors in the Calgary area during Covid-19 but the building has been closed to the public and volunteers for the majority of the year so my position has been put on hold temporarily.

I cannot replace the time I spend at the Kerby Centre, but I can find other activities to sustain myself until the pandemic is over. After discussing several solutions with my psychiatrist, the most appealing idea that emerged was crochet. Crocheting is good for your brain and having a finished product will give me a sense of accomplishment. Many years ago, I learned how to crochet mainly out of curiosity and because I wanted to crochet stuffed animals as Christmas presents for my nieces and nephew.

This year, Covid-19 has changed Christmas celebrations. I will not be spending time with family during the holiday season. I will miss our traditions including singing Christmas Carols. When we sing “The Twelve Days of Christmas” we are all assigned different parts of the song to sing solo. I will miss my brother puffing up his chest, tilting his head back and extending his arm like an opera singer before he bellows, “Five! Golden! Rings!” He does it every year and it still makes everyone laugh.

We may not be able to hug, kiss or shake hands with one another but we are all still connected. I will not see any of my family members in person this Christmas but that does not change how much they love me and how much I love them. We all still care for our friends and neighbours even though the virus has robbed us of our ability to show it in the way we have all our lives. When the pandemic is over these gestures will take on a special meaning for us and we will never take them for granted again.

Everyone one who has bipolar disorder has symptoms that are similar in nature, but they differ in severity and how they manifest. I have Bipolar 1 which is the severest form of the disorder. I have had three full blown manic episodes that resulted in hospitalizations and a loss of almost everything that was important to me.

Now, my life is structured so that I have minimal stress, medication that works for me and an excellent psychiatrist. This does not guarantee I will not have another manic episode, but I am doing everything I can to prevent it from happening again.

Despite being on medication, I still experience depressive episodes. Depressive episodes are not an extreme form of feeling low that everyone experiences. They come with a set of physical symptoms like poor concentration, body aches, inability to enjoy anything, fatigue and appetite issues.

In my case, when I am experiencing a depressive episode my appetite can become so low that the sight of food can make me feel ill. During severe depressive episodes, I can end up eating just one bun and butter a day. As a result, I have health problems because my weight has gone up and down so many times.

It has been some time since I have had a severe depressive episode. I am constantly mindful of where my appetite is at. When I notice that I am starting to feel like eating is unappealing I force myself to eat. I have learned that if I do not do this my energy level drops, and my depressive episode can go from manageable to severe.

Even though I do not feel like eating when I am having a depressive episode, logical positive associations to food can help. My family is from Pakistan. I was born in Canada and I know very little about Pakistan but I do know how to enjoy the food.  

When I am well, I make chicken curry and chapattis, flat unleavened whole wheat bread. When I make the curry, I think of my father teaching me how to make it. I remember him showing me how much spice to add by spilling some out on to his hand. When I said I needed to use measuring spoons he would not allow it nor was I permitted to write down the recipe. I found this frustrating at the time.

Now, I understand that my father was trying to teach me that making curry in our family is not about following a list of instructions. It is an intuitive experience of making a dish by feeling what is right. Now, when I measure spices in my hand, I feel connected to my father.

When I make chapattis, I add water to the flour in a way that I cannot remember learning. My hands seem to know what to do. To knead the dough, I wet my knuckles just like my father. When I work the dough into balls and press down on them gently before rolling them flat, I remember my Nana’s wrinkly hand doing the same when I was a child.

When my mood is low, I do not have the energy to make this type of food but if I buy it, I can eat it. Not because I look forward to the flavour but because of all the positive memories and feelings that come with it are enough to overcome the lack of appetite. Of course, if someone makes it for me that is especially helpful.

Thank you for reading my blog this week. If you have positive experiences preparing food with your family feel free to share them in the comments below. All other comments are also welcome including issues with food you may have.

When you have bipolar disorder the value of practicing gratitude can be difficult to appreciate. It is hard to be grateful after a manic episode when you have lost all your money due to overspending and lost employment and friendships because of your behaviour when you were acutely ill. Plus, a severe depressive episode will likely follow which includes the symptom of having negative thoughts making it hard to be grateful for anything.

In the depths of a severe depressive episode, practicing gratitude will not snap you out of your symptoms no more than gratitude can instantly regulate your blood sugar if you had diabetes. However, if you are able to reach out of the darkness and grab one thing you are grateful for then that may give you hope that there is a reason to keep trying to rebuild your life. Without hope, you can begin to question the value of your existence and that can be a dangerous place to be.

I have not had a severe depressive episode in some time, but I still find there is value in practicing gratitude. Everyday, I make a list on my phone of the things I am grateful for having in my life. When I am not experiencing a depressive episode, this helps me take a positive perspective on every aspect of my life. If I am having a depressive episode gratitude serves a different purpose.

During depressive episodes, I do not enjoy music, I find it irritating. When I am feeling well, I listen to music to give me energy to start the day but on the “bad bipolar days”, music does nothing for me. I am tired and everything seems to take double the will power to complete. My appetite is poor, so I have trouble eating which further decreases my energy level. Jovial and spontaneous conversation is difficult which is embarrassing, and it makes me feel less connected to people in my life.

My gratitude list does not make my symptoms vanish when I am having a depressive episode, but it does help me press on despite not feeling well. I can look at past weeks’ lists and remember I have had better days. I am grateful for the reminder that I am not cured. Bipolar Disorder is a chronic illness. Medication gives us the chance to have a positive life, but it does not take away our symptoms entirely. When I have a depressive episode, it reaffirms the fact that I need to keep my routine, attend peer support, stay active and see my psychiatrist regularly.

It is not helpful for our family and friends to point out that we should be grateful. It comes across as invalidating the struggle we are having. In my case, I just let my family know I am having “a bad bipolar day.” That way, they do not ask for details on what is wrong with me or try to give me a pep talk. We all know this happens to me from time to time and I just need to be patient and try to be a little more active until it is over. It would not be helpful for my family to ask me if I am having a “bad bipolar day.”

Using gratitude lists the right way can help maintain stability and create a larger space for joy for people with bipolar disorder. This combined with knowledge about the illness can be effective in reducing the impact of chronic symptoms of the illness as well as help drag us through the tough times. It is one more tool one can use to have a good life despite having bipolar disorder.

Jerry Seinfeld once said that most people are more afraid of public speaking than of death. He went on to say that this meant at a funeral most people would rather be in the coffin than giving the eulogy.

I like public speaking, but it still makes me nervous. I find it thrilling and I generally talk about issues related to bipolar disorder, so I feel like I am helping break down the stigma. I attend Toastmasters International meetings once a week to learn how to improve my speaking skills and it assists me with managing my bipolar disorder. I am sure there are other clubs where people can practice public speaking, but I have only been to Toastmasters.

It may seem counterintuitive to recommend an activity that is anxiety provoking as a tool for managing bipolar disorder since most of us have issues with anxiety. However, my experience with Toastmasters has provided some benefits that I had not anticipated when I signed up to improve my speaking skills.

One of the greatest challenges of having bipolar disorder is self isolating. During depressive episodes, the world becomes clouded in darkness for us. When you are dealing with the aches, extreme fatigue and an inability to experience enjoyment, leaving the house can seem pointless. Plus, we avoid social situations because conversing is hard when you are suffering and thinking of something to say when you have poor concentration is difficult.  

Unfortunately, once you start to stay home too much depressive episode symptoms can get worse and leaving home to socialize or run errands becomes next to impossible. You become trapped under a blanket on the couch alone and friends and relatives begin to wonder why you have disappeared from their lives. It is like falling in a pit and the longer you spend at home the deeper the pit gets.

Having commitments can help combat the problem of self isolating. Employment, volunteer work, sports teams or other clubs can serve this purpose. I have found Toastmasters has some aspects to it that are well suited for people with bipolar disorder.  

Even on my worst days, I can attend a Toastmasters meeting. The requirements of my presence are minimal. If I wanted to, I could sit in the meeting and hardly say a word and I would still feel like I have had a meaningful connection to people.

Toastmasters meetings have an agenda that is scheduled down to the minute which gives it an energetic pace. Since every minute is planned, I don’t have to struggle with trying to make conversation when I don’t feel well. The option to socialize before and after meetings remains on the good days.

The other benefit of toastmasters is the applause. If you woke up in the morning and received applause wouldn’t that make you feel good? At toastmasters if you decide to do a speech, you will be applauded for your effort. There are evaluations of your speeches that help you improve your public speaking skills, but they are heavily weighted to point out your strengths (and everyone has strengths). Even if you don’t speak it’s fun to be in a group of energized people and applaud for others.

For activities like this, it can be hard to go to the first meeting and researching where to go can be a challenge when you are not well. Having family and friends help with finding a club can at least remove that hurdle. The first three meetings at many Toastmasters clubs are free so having a support person go with you to attend your first meeting can be helpful.

Toastmasters has helped me make new friends, improve my public speaking skills and it is a meaningful aspect of my routine. Currently, all meetings are via Zoom, so it is helping me deal with some of the isolation that Covid-19 has imposed on my life and it gives me something positive to look forward to every week.

Irritability is one of the most frustrating and damaging symptoms of bipolar disorder. Some of the awful things I have said when I have been acutely ill caused me shame and embarrassment for years. Now that I have been stable for quite some time I still get minor bouts of irritability from time to time.

My volunteer job entails working with seniors and once in awhile I will notice that I am getting irritable with the seniors. Who gets snippy with nice elderly people? When I hear myself talk like this, I realize that I am irritable and I try to say as little as possible. It feels like I am holding my breath. Eventually I have to say something and then I hear myself sounding curt but I feel powerless to make it stop.

Recently, during a time of irritability, a friend invited me to go for a walk. We walked through a densely wooded area of a park and I remembered something a close family friend said to me about Forest Bathing. This is a practice in Japan called Shinrin-yoku where one spends time in wooded areas to become healthier and gain a positive sense of well being. After our walk through the mini forest in the heart of the city I still felt irritable but the severity of it had decreased significantly.

In my view, I have to do my best to prevent my irritability from damaging relationships. I do this by taking my meds regularly and I try to make healthy lifestyle choices to decrease the chances of becoming acutely ill. If I know I am having an issue with irritability I will leave the situation and inform the person I am with that I am going to walk for thirty minutes and then I will come back.

I am fortunate that my family understands that some of the awful things I have said when I have been acutely ill was just noise that my episode was producing. This did not help my sense of guilt and shame. Peer support helped me deal with that aspect of the experience.

In my opinion, irritability is not our fault but that doesn’t mean we get to flip out just because we may be experiencing. We need to do our best to be responsible for keeping it in check with lifestyle choices and working with our psychiatrists to find the right medication.

For family and friends I am not sure what to say. I am reluctant to give the impression that any level of irritability is ok but at the same time I hope there is the possibility of compassion depending on the circumstances. Now that I have had a lengthy period of stability, I know that if I am irritable it’s best for me to take some time to go for a walk and maybe even avoid people for a little while. I appreciate my friends that understand this and do not take my absence personally.

Irritability is definitely one of the toughest aspects of having bipolar disorder. Our best hope in dealing with it is the right medication, exercise, a meditation practice and being mindful of our choices when we are around people.