What Does It Look Like to Be in Mental Illness Maintenance Mode?

This is just a bit of musing on being in maintenance mode with bipolar illness. At times, I have called this maintenance mode being in mental illness remission. Due to the specifics about what is illness remission and what it is not, I am choosing today to talk about where I am in my history with bipolar illness as “maintenance.”

What does bipolar maintenance look like for me?

  1. Being on a largely functional cocktail of meds that are monitored by a psyche professional. I adjust these meds slightly with the help of my doctor when I am going through extra stress or when stress is more manageable. I have been on the same basic meds since about 2008.
  2. Seeing that psycho-pharmacologist about every three months with monthly trips to the lab for bloodwork. It is important to me to be honest with my doctor and to have the type of relationship where I can work with him to adjust med levels when needed.
  3. Seeing the therapist about every 2 to 8 weeks. Every two weeks is if I am in a rough patch. Every 8 weeks if all is progressing well. Back in 2008, this was weekly. Mostly now it’s every 4 to 8 weeks.
  4. Not having to be admitted to the hospital for 2 plus years. For me this has been since fall 2008. I have been informed that not being hospitalized for a period of time, in and of itself, does not qualify as remission. But the stats seem important to me to include as at least one barometer of remission and/or maintenance.
  5. Having several activities like blogging, care of pets, walking or yoga routines that are by and large fulfilling if not enjoyable. I find that with the anxiety and depression that I experience with bipolar illness, my activities are sometimes fulfilling and sometimes not. Getting them done is what I count most. There is “enjoyment” or “satisfaction” in getting them done even if at the time, the activities themselves are not particularly “joyous.”
  6. Being able to manage day to day activities in the household. These for me include being supportive to my teen-age daughter, keeping my relationship with my husband current and vibrant, running the household, going to the grocery on a regular basis, getting a healthy dinner on the table each night, doing basic laundry and clean-up, caring for a new puppy. This does not require me to hold down a job which has been a struggle for me since 2005 or so or perhaps earlier.
  7. Seeking out regular contact with friends and contacts who are supportive of bipolar illness. I have had a neighbor who is close to me move about an hour away from where I live, so I could make some improvements in this area. We used to talk openly about stress and anxiety on regular walks. It would be great to resume this activity virtually if possible. Blogging also does help create a sense of community support. I have been blogging regularly for a couple of years and this is very fulfilling — both the reading and the writing of various posts.
  8. Doing something tangible to reduce stigma about mental illness. Instead of being the victim of mental illness stigma, I have found it empowering to write about stigma in my journaling and in my blogging. It is important to get out in front of the stigma and try to tackle it and talk about it before it becomes a big deal with big deal consequences. I have found it difficult to address stigma, but I also have found that talking about it and educating people who have no prior exposure to mental illness is important. I have just written a series of blogs about mental illness stigma and working as a project manager. Hopefully that perspective when shared may mean people who have no prior connection with mental illness can at least read about what it’s like to experience that stigma.
  9. Talking and educating people who have no connection to mental illness seems to be at the top of the list for me for stigma reduction. Stigma reduction does not happen immediately or overnight, more like a small, small drip into a large, large pond. Very small change but change nonetheless. Also to note, there is real danger of preaching to the choir about mental illness stigma. Most people who might follow my blog probably already think stigma is an issue. In stigma reduction, it is important to find ways of reaching people who are not yet educated on mental illness and its challenges.
  10. Finally, being in maintenance mode for me means being able to be kind to myself. This means forgiving myself for mistakes no matter how large or small. This means giving myself credit for accomplishments achieved no matter how small they may seem – like going grocery shopping for healthy food that day. This also means not comparing myself to others in a way that makes me feel “less than” or “more than.” Maintenance mode means being willing to accept constructive criticism from my support team even when that criticism is difficult to hear. It also means standing up for myself when the criticism may not be “spot on.”

Does anyone else care to share what mental illness maintenance might look like to them?

Working with Bipolar Illness – Lessons Learned

All in all, my work experience has taught me several things about working with bipolar illness.  In no particular order they are here:

  1. Working in the public sector may be more forgiving than working in the private sector when it comes to stigma and access to short and long-term disability (in the US).
  2. People who have a family member with mental illness are 100% more likely to accept mental illness in an employee and be willing to work with that person toward mitigation strategies to help reduce stress and stigma in the workplace and help alleviate mental illness. 
  3. Most people in the workplace do not have a family member with mental illness and in general do not have a clue how to respond or how to be of help.  Generally these people consider you a danger to yourself and others.
  4. Keeping a presence in the workplace is very important if you are taking care of your own health insurance.  If you are blessed to be on a family member’s insurance plan and/or your home country has universal healthcare, be thankful.
  5. Meds are sometimes difficult – finding the right one or the right combination of drugs.  It is helpful if you feel you can work with a psyche doc about finding the right combination for you.  It is preferred if you can have a partnership and a doctor who listens to you as to what is working and what is not.  This can be a struggle particularly if you are going to work every day.
  6. I believe that mental illness like addiction has a bottom out effect.  You will not start thriving and responding to meds and other interventions until you have hit rock bottom.  This involves a sense of honesty about your symptoms and your challenges for yourself, your family, your support community and your medical team.   It also involves honesty with self about what kind of jobs you are best suited for.  For me project management work was not the best fit, but it took me a while to figure that out.
  7. Working for yourself, if you can afford it, allows you to explore your strengths without over-taxing your brain or your illness.  You can set your own schedule and allow yourself breaks for med checks, labs, psyche appointments and so forth.
  8. Blogging is a good way to keep honest within yourself and with other people in your blogging community.  You can learn a lot from telling your story and listening to other people’s stories as well.
  9. All in all, remember that you are more than your accomplishments.  If you spend most of your time on self-care rather than in a career, you are still doing a great job and you still have a huge contribution to make.  Being paid for what you do is not the tell-tale sign of success.  Define success based on your own goals that you reach and setbacks that you overcome. 
  10. Finally, don’t compare yourself to others especially those who don’t have a mental illness challenge or have very mild symptoms.  Judge your progress in the workplace and in your educational endeavors based on your own realistic goals.  Don’t be hard on yourself if it takes you longer than your peers or your siblings to reach your goals.  Or if you don’t reach them at all.  There are likely other strengths that you have that these people don’t have.

Does anyone care to add to the list of lessons they have learned about the workplace and mental illness? I am sure I have missed a bunch….

Worklife after Postpartum Depression

There are several stories to share about working as a project manager after the postpartum depression associated with the birth of my daughter.  Most are rather distressing to me as I was unable to hold down a job for any real length of time. 

 This includes work at:

               – a local planning and environmental company in 2004/2005

               – a major telecommunications company in 2007/2008

               – a non-profit environmental organization in 2010 and 2011

               – a health services company in 2013

               – a nonprofit management services company in 2014.    

Work at the local planning firm built upon prior work I did in the community for naturalizing the stream near my home. I served to facilitate the steering committee that was all-volunteer and dedicated to this stream restoration project.  My health at this time was still impacted by the postpartum depression.  The job was cut short when the principal developed lung cancer and retired and shortly after passed away. Generally speaking, working in the environmental sector proved less stressful than in telecommunications information technology.

A year or two after completing the job at the environmental planner and program manager job, I decided to go back into project management work at the telecommunications company.  This was a mistake.  The job was highly stressful.  At one point I was asked to work over a 70-hour workweek.  This was the death knell for my health.  Shortly after being up all night with a computer software launch, I began having break-through bipolar symptoms.  Within a day, this was full blown mania.  I wrote an incoherent email and forwarded it up the chain of command.  I was a contractor at the time.  My contract was immediately terminated and I was escorted from the building.  I was not even given the opportunity to retrieve my belongings.  The representative from the contracting agency retrieved my personal belongings and brought them to my house a few days later.  The treatment I received there made me feel like I was a criminal and/or dangerous to my colleagues.  There was absolutely no understanding of mental illness and/or bipolar symptoms.

Later that year, I was hospitalized for an extended period of time and started on a new regime of meds called Clozaril or Clozapine.  It was discussed at that hospitalization that I would perhaps not be able to work again.  After an extended stay in the hospital, I began weekly therapy visits and participated in CBT and other talk-therapy protocols.  My daughter by this time was almost five years old.

After a two-year stint away from the workplace, I landed a part-time job with a local environmental non-profit. I started working there 20 hours a week and eventually was promoted to 30 hours a week.  At this juncture, I was completely upfront with my boss about having bipolar illness.  My boss was more understanding than most people.  It appeared she was somewhat familiar with the illness.  During this time I made many contributions as project manager to this environmental start-up.  In addition to making strides on various environmental projects, I helped with the sale of one program to a national management non-profit organization.  I continued to work here for about two years but found that interpersonal relations with my boss were such that I wished to leave this place of work.  And I did.

From here the story tends to repeat itself.  I was hired in 2013 to do software development project management work. This contract lasted two months or less.  In 2014, I was hired to do project management in the certifications and educational departments for two non-profit agencies at a non-profit management company.  This job lasted about 6 months.

All in all, I found that project management work was too stressful for me.  I was not able to divide my time between two major projects I was asked to work on simultaneously.  I would tend to work on one major project and let the other slip.  Once in 2013 and then again in 2014, I resigned from each position in the project management information technology space within the period of several months.  Basically since I started on Clozaril or Clozapine in 2008, I have not been able to stay at a job for longer than two years.  And that was part-time work.

From here picking myself up in 2017, I resumed my work as a volunteer in the town where I live.  I was appointed to the local environmental sustainability board in the spring of 2017 and served on that board, chairing one committee for a time, until the end of 2020.

All in all, my work history after the extended postpartum period in 2004 has been very inconsistent.  I have had to re-orient myself as to what is productive behavior and what is not.  I have been very accomplished at volunteering locally and at researching and writing papers that were or have been presented in national and/or international settings.  But this work has not been “paid.”  I have had to re-direct feelings of being “less than” because I have been unable to keep a paying job. 

All in all, I feel like a major component of my checkered job history is due to the fact that bipolar illness carries such a stigma with it.  I either have been asked to leave employment because of it or I have left employment early because I was unable to manage bipolar symptoms and worklife at the same time.  If there had been some sort of support for mental illness like referring me to a less stressful job, perhaps I could have made a go of it.  As it stands now, I have basically given up working at a for-pay job.  I spend my time focused on managing homelife and illness and doing volunteer work including my blogging.  I also am striving to see if I can get published with my story of bipolar illness.  So far the only publishing options available to me are self-publishing.