Can You Learn to Limit the Impact of Your Next Break?

This post was inspired by a recent post at SpeakingBipolar.com.

About 30 years ago I met a psyche doctor who told me the more often you have a break, the greater the likelihood of having a break again. This was directed at the highs and lows, and this doctor requested me to go off alcohol which I have for 30 years and caffeine (which I did for 12 years and then stopped). Knowing this propensity was a great motivator in seeking and obtaining good self care including meds and other forms of care over the years. I tend to call this managing risk. If I manage or minimize the risk of one break, in theory I am (or am I?) managing or minimizing the risk of that or a similar break occurring again in the future.

This seeking good self care and med management and risk management did not start immediately for me but did begin once I was on Clozapine in 2008. This was my bottom out low is as far as it goes time.

Using this logic if it is accurate means that in some respects if I can “learn” from a prior episode, I am more likely to be successful in staving off or managing severe bipolar symptoms the next time. One success begets more success.

So how do you get to the place where you are learning not to break from current or on-going trauma? How can managing a current break help to minimize the risk of a future break? These are steps that I take. They don’t always work 100% of the time but they do help me learn to go around an episode and/or lessen its impacts and/or avoid another one head-on that is so severe that hospitalization is required. This has been the case since 2008 — fourteen years.

  1. I keep a journal of thoughts and self care and regular activities and feelings on a daily basis. A quick sentence or two for each day is all that is needed. I share the journal with my therapist.
  2. I get psyche meds prescribed from a psyche doctor and stay with the regimen. (In the past I have not done this.)
  3. If the regimen is not working I negotiate a change with the doctor.
  4. I keep in regular contact with my therapist. I seek to be as transparent as possible. Secrets tend to create a life of their own.
  5. I read my journal back to myself and see if I am acknowledging and managing triggers or not. This requires knowing what my triggers are like poor sleep, taking too much on in the day, talking down to myself, limiting that internal critic and so forth.
  6. Also I give myself credit for making baby steps in my journal. Perhaps I did not walk 2 miles every day for a week but did walk 2 miles for 4 days last week. Tell myself how much progress this is. Give myself credit for baby steps instead of listening to the critic talk that I am not doing enough.
  7. I get as much exercise as my mental health will allow. I start with small steps like a half mile walk and gradually build up to 2 miles plus. Or practice yoga with a class or on my own.
  8. Tire out my body in order to tire out that mind.
  9. I reach out to my support circle and let them know how I am feeling. Sometimes just acknowledging how I feel tends to diffuse the tension. It helps me to know others are aware I am having an off day.
  10. Eat well if and when I can. Avoiding empty calories. This includes accepting body image impacts of taking meds – ie. weight gain.
  11. Reach out to a friend I haven’t talked to in a while. Arrange a time to meet and walk or just enjoy talking with that person over the phone.
  12. Remind myself that there are always those who are struggling as much if not more than I am. This does require being part of a community. A church community, a mental health community, an on-line mental health community, a neighborhood community? A community hit by hurricane Ida? I seek to reach out and make some sort of contribution to the communit(ies)I am a part of. It helps me to know I can be of help to others even when I am not at the top of my game.
  13. Finally, be kind to myself. It is not my fault I have bipolar disorder. It is not my fault that certain consequences and behaviors trend to follow that diagnosis. I have to learn to forgive myself for sometimes “crazy” or ill-conceived acts. Ill-conceived acts here refers literally to acts I have taken while ill. I seek to forgive myself as readily for those acts as I seek to forgive others.

What do you think? Do you think we have any control over the propensity to have a full-fledged breakdown over time? If we cannot entirely steer clear of it can we at least learn to experience less dramatic highs or lows? Does this argument erroneously assume that the patient has the power to learn a better outcome or is the outcome already set in stone?

Safety, Society, Stigma, Stability: a “Me Too” Movement Moment (repost)

Names and places have been changed in order to maintain privacy in these discussions.

During the fall of 1984 I was working on my thesis with a professor named Professor Dean Flannigan.  My thesis topic was somewhat controversial as I was using Modern Fiction in my research and drawing conclusions from authors of the times like Alice Walker and Flannery O’Connor.  I was looking at the way family is portrayed in Modern Fiction as an indicator of the socio-political developments and historical dynamics of the time.  It felt like the English Department was not altogether in favor of such a modern approach to a thesis, yet approval for my thesis topic was provided by the relevant committee.  This was a couple of years after my approval of a major in American Studies. 

Professor Dean Flannigan is a story in and of itself and one which I will not detail right now except to say I now feel that Professor Flannigan was someone who needed to be revered and admired by his students yet also considered a peer.  This situation was associated with risky behavior including serving cocaine to students in his home and invitations to Chicago which may have triggered my illness.

For me at the time, this was a “me too movement” moment. While I was not physically abused by Professor Flannigan, I believe I was psychologically abused. Professor Flannigan without any training tried to psychoanalyze me through the thesis advisement process and perhaps even tried to make me feel unstable. This unwarranted psychoanalysis triggered the response of a six-year-old child within me that likely experienced child abuse. Professor Flannigan’s attempts to psychoanalyze me I call psycho-social or psycho-sexual abuse. They left me with exposure of this six-year-old child with no way to regain security.

Today, I continue have high disregard for this professor and for Ivy College given the behavior of Professor Flannigan.  I also readily agree now that I was not mature enough to distance myself from his later “come-ons” and “innuendos.”  While an excellent scholar, I was not mature enough to tell Professor Flannigan to go to hell when he started to make advances toward me.  I was confused with feelings of respect I held for him intellectually vying with feelings of confusion and paranoia at being asked to travel with him unaccompanied to Chicago. 

Immediately after my first breakdown, Professor Flannigan began to distance himself from me in an effort to secure tenure.  This effort to secure tenure was after he and I had several thesis review meetings, after he invited me to join him on a trip to Chicago, after he tried to analyze my childhood on several occasions and after he tried to seduce me into coming solo with him to Chicago and after making zodiac references to me like “Scorpio riseth…” I had no idea what that saying was supposed to mean.  I also had no idea how to establish a boundary with Professor Flannigan.  On the one-hand, I thought he was brilliant and a brilliant scholastic role model.  On the other hand, I felt his actions to seduce me (as I understood them) were highly inappropriate.  But I did not have the strength to articulate this to myself much less to him. If I had perhaps been more mature myself, I could have indicated to this Professor Flannigan that while I revered his intellect, I found great fault with his personal behavior.  Bottom line I was emotionally too immature to know how to say no to a trip to Chicago or to an invitation toward some sort of sexual interlude.  I was academically brilliant as a scholar but not so much so as a student to a professor who consistently pushed the boundaries of appropriate behavior.      

Since that time, Professor Flannigan has enjoyed getting tenure at Ivy College and has secured virtually unprecedented popularity on campus.  I, on the other hand, have not enjoyed similar successes particularly in my professional life which has been hampered over the years on numerous occasions by my illness.