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.

 Everyone who has bipolar disorder has their own unique version of the illness. We all understand what it is like to be stuck in the physical anguish of a depressive episode and the euphoria of hypomania but the severity of our symptoms, how they manifest and how we respond to medication is different. It is important to learn as much as possible about your bipolar disorder to have a positive life.

For example, after my last manic episode, a psychiatrist told me that taking too much pleasure in creative thinking, solutions to problems or philosophical ideas can trigger a manic episode for me. He called this, “Intellectualizing.” When I reflect on all three of my manic episodes, I realize they were all triggered by intellectualizing. This means, I am careful about what I talk about and think about. I do not push my brain to the edges of philosophical questions, and I am mindful of how excited I get about my own thoughts.

I have learned from my experience of having depressive episodes as well. When I am in my car and I notice that I keep changing the radio station I start to wonder if my mood is dipping. An inability to enjoy things is a symptom of depressive episodes and this can be the first sign that this is occurring for me. Then, I think about whether or not I am having other symptoms like poor appetite, fatigue, and lack of concentration. If I am, I add more physical activity to my routine. This does not make me feel better, but it prevents things from getting worse. I force myself to eat to prevent my appetite from dropping even further and I meet people to reduce the possibility of self isolating.

Medication plays a crucial role in managing bipolar disorder. Without it I could become acutely ill on a regular basis which could potentially be fatal. There is no imaging device or blood test that a psychiatrist can use to assess the symptoms of someone who has bipolar disorder. They rely on their observations and our report on what is happening in our life. To make this process more effective you can use mood charts that rate your mood daily to learn about patterns that may exist. Also, Crest.bd has a Quality of Life Tool that asks you a series of questions and produces a report that can help you understand how you are doing in the context of your illness.  Providing this information to your psychiatrist can improve your treatment.

When you have bipolar disorder, creating a routine that includes consistent opportunities for joy and fulfillment requires learning as much as possible about your illness. Over time, this knowledge can empower you to lead your best life. While it is not a guarantee that your symptoms will never become acute it gives us the best chance to lead a rewarding life long-term.  

A couple of months ago, I had little energy, my thoughts were negative, and I felt sad. I thought it might be the start of a depressive episode, but my psychiatrist told me I was suffering from “Covid Fatigue.” She explained the cumulative effect of the isolation and reduced interaction with people has led to people feeling down but she assured me I was not suffering from the physical symptoms of a bipolar depressive episode.

Had it been a bipolar depressive episode, I would have exercised a little more and made sure I kept eating to combat the poor appetite I experience. Implementing these two strategies prevents my depressive episodes from getting worse and they do not last as long. Although “Covid Fatigue” could lead to poor life choices that could trigger a depressive episode it is a psychological problem which requires a different type of intervention.

The main issue for me has been the impact Covid-I9 has had on my routine. I volunteer at the Kerby Centre, a centre that supports seniors. I find helping seniors rewarding and working with the positive staff fills my emotional need for positive interactions with people. The Kerby Centre is still providing important support to seniors via the phone, online and food delivery but the building is closed which means I am not needed at the moment.

My psychiatrist said we needed to add some activities to my life to help me stay psychologically healthy during the pandemic. After doing some brainstorming we decided that crochet and baking bread would be the answer. It is no coincident that these are two of her favourite activities. I am glad she is not into skeet shooting and gymnastics because I do not think those activities would be a fit for me.  

Learning to crochet was frustrating at first but, now I find it relaxing and rewarding. I have made gifts for people which makes me feel good and it is helping me stay positive because my thoughts are occupied by making stitches. When I start to have negative thoughts, I make mistakes which take awhile to fix. Crochet is helping me train myself to focus on the present moment.

In the last few weeks, I have been attempting to make bread and it has been a challenge. My first attempt was edible but very dense. When I added all the flour that the recipe called for the dough became dry and the bread came out crumbly. I talked to a friend who bakes and she told me she just adds flour until the dough ” feels right.” I had no idea how to make dough that “feels right” but after watching a YouTube video I managed to make a loaf of bread I enjoyed eating.

The brain power I used to figure out how to bake bread was a nice break from thinking about life during Covid-l9 and I am still doing crochet. I am grateful that this trying time has given me these two new skills that I will be able to use for the rest of my life. If you would like to add bread making to your repertoire of life skills, I have included the instructions and recipe that I used below.