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?

Thanks for Being Part of the Solution!

Recently I wrote a very long email to my high school peers and included a recounting of what I thought were mental health / addiction challenges affecting someone in that group who died suddenly. After reaching out to high school peers and receiving a full gamut of responses including both positive and negative, I want to say how much I value this on-line “community” at this blog site where people can talk freely about mental health and addiction full-throttle or head-on.

Over the past few years, I have grown accustomed to talking openly here at this blog and at others’ blogs about mental health challenges I experience that include the full gamut of symptoms including mania, depression, mixed states, sometimes crippling anxiety, body image challenges, hallucinations, hospitalizations and others.

I just want to say thank you to those of you who are in this on-line “community” for helping to provide an atmosphere that allows people with mental health and addiction issues to talk freely without a whole lot of push-back or stigma. Ten to fifteen years or so ago, such an online “community” possibly or probably did not exist? Not sure when people started blogging about mental health? For me, following posts and posting posts is an important part of my self-care. I thank you for your contributions even if you are in the “reader” versus “reply/writer” category. Everyone plays a part.

Finally, thank you again for participating in this “community.” I believe that stigma reduction is a crucial by-product of the collective posts here at these blogs about mental health and addiction. Thanks for being part of the solution!

Working for Myself as a Project Manager / Circumnavigating Stigma but Forfeiting Income

For two distinct periods in my career which includes the present day, I became a self-employed project manager so as to be able to manage both work and illness (bipolar illness).  During these times, I dedicated / have dedicated myself mostly to environmentally based volunteer work in my community.  In later years this often has translated to work in new measures for the environment and new measures in health.  Work also includes a period of service on the mayor’s environmental board in the town where I live.  In earlier years, I submitted grants for environmental development on behalf of my community.  In later years, I began to write papers that were accepted for presentation at the US government and at academic institutions in the US and abroad, including two acceptances from overseas groups.  This work includes being published by one overseas organization dedicated to sustainable development.

During both of these periods, I was able to put my health first and manage whatever bipolar symptoms or needs presented such as therapy appointments, psyche doctor appointments, meds management, or lab tests.  I also did not experience stigma in the workplace as I was working for myself. The first period was 1998 to 2001 and the second period was 2005 to the present with 5 plus jobs in the marketplace scattered among the second volunteer period and duration.  (I will recount the stories of these jobs at a later date.)  The downside of these two periods is that I was not able to make any income associated with these many accomplishments.  Work was volunteer in the community or involved publishing/posting papers that I developed on my own time. 

During this first juncture as a volunteer in my neighborhood, I was able to make important contributions to my community.  One effort resulted in a near million-dollar creek clean-up and naturalization effort about ten minutes from my house.  Another effort resulted in a survey-based community development plan for an in-town neighborhood including such priorities as walkability and economic development. I also developed three community-based sustainability grant applications to the United States Department of Agriculture recommending an environmental approach for managing agricultural waste and converting it into biofuels. 

During my later juncture of self-employment as a member of a city sustainability board, I worked on a variety of environmental agendae items including climate change.  I chaired one of the four subcommittees for a time.  This subcommittee worked on recommendations for the local tree ordinance, storm water management, and reforestation and trails development at a near-by park that was newly acquired by the city. 

Papers that I wrote and presented during the second timeframe focused on systems-based orientations to and measurements of environmental development.  The idea of much of the work at this time was that proposed adoption of systems-based measures in the Health, Energy and Food industries would correlate with simultaneous advances in all three industries.  Aligning measures for Health, Energy and Food advances means we can promote Energy work that allows for climate change concerns and we can promote Health work that allows for citizen well-being in the face of extreme weather events and the like.  This work and related work was presented and/or posted at a US government website in 2009, presented at a well-known public health university in the US in 2011, presented at a US academic non-profit geared to values in higher education (several submissions/presentations from 2010 forward), and submitted/presented/posted at two overseas non-profits dedicated to health economics and/or sustainability. 

Overall, my accomplishments during these two periods of self-employment are/were notable.  I am proud of these accomplishments, but I would not have been able to pursue this work if it had not been for support both financial and otherwise from my husband and my husband’s family.  Basically all this work in environmental development and new measures for the economy in terms of health economics and the like was financed by my family at that time.  This self-financing continues today with my blog writing and other work with which I am involved.