Awareness is crucial in managing bipolar disorder off meds

Our circumstances can make us depressed. Seems like a fairly obvious statement, yes?

Sadly though, this fact is overlooked in the mental health field a lot, and even in our own personal lives. I know after being diagnosed with bipolar, I started to buy into all the messages out there – I NEEDED meds, it was bipolar that was making me depressed, I should monitor my moods so that I could alter my meds, etc. Sure, I had counseling but it mainly focused on – bipolar! Everything in a round about way came back to bipolar. I thought I was gaining clarity by listening to these messages. After all, these doctors and nurses and counselors were the experts, right?

During that time I was making videos a lot and still journaling so I have a lot of detailed accounts of how I was feeling and what was going on in my life. It is amazing to me looking back how unaware I was the vast majority of my life! I had a great deal of INSIGHT into my FEELINGS but very little AWARENESS of WHY I felt that way. I made one video about depression in 2010 and how nothing was going on in my life to make me depressed, and that it must have been bipolar. Yet, I was completely unaware of my surroundings and how they were affecting me.

During that particular time I made that video, I recall exactly what was going on, and my life was NOT going great at all. My husband and I were having major conflicts. It had been going on for months though so I think I just discounted it as having an effect on me, when I now see it was one of the main causes of my depression. Also, we were living with relatives at the time which was becoming stressful. We were looking for our own house, also stressful. I was taking care of twin 2 year olds, stressful. I can’t believe I didn’t take all that into account when looking at my mental state and the way it would fluctuate!!! I just thought, ohhhh, it’s bipolar…that stinks…maybe tomorrow would be better. In a way it kept me from addressing things in my life that were affecting me, because I was putting too much emphasis on the wrong things (bipolar/biological/medical problem) and not enough on other things (relationships/family life/stress level).

I guess I felt compelled to make this blog today because I think the current message in the mental health field is doing a disservice to those diagnosed with depression or bipolar. Here is my 2 cents…

I believe that many mental illnesses (including depression and bipolar) begin with an inherent sensitivity. This is something currently being researched in the mental health field and I do believe this is barking up the right tree, so to speak. I believe this sensitivity makes a person more likely to be affected by external stimuli. This can then manifest as many different things – anxiety, depression, mania.

For example – take an average person and a person with bipolar. Put them in a situation where they are going through a break-up. The average person will feel sad and maybe even depressed. The bipolar person may dwell on it incessantly, feel suicidal, perhaps even attempt suicide. The same stimuli but much more intense emotions related to that stimuli. (Keep in mind this is just a random example, of course this isn’t true of every average person or bipolar person! I’m just making a generalization.)

So, if I were to go to my psychiatrist and tell them all this, (in my fictional example) one of the first things they would be concerned with is: medication! Upping meds, changing meds, etc. They have the viewpoint that these things must be dealt with by pharmaceuticals. I used to believe that and I went along with it all. Now, I feel differently.

So many times over the course of my treatment, everything got lumped under the category “It’s because you have bipolar.” Is it? Well, no not really. Does being depressed because I have marital conflict mean it’s related to bipolar? Hardly. If I addressed the bigger issue (marital problems) could I help mediate the effects on my “illness”? I say yes.

Bipolar or not, we are all human beings. We feel low when we get divorced, lose a friend, have a family member that dies, lose a pet. Now, those are BIG things. But even little things affect us too. Having a stressful day at work. A sick child. An upcoming deadline. Interpersonal conflict. Too often, these things are not addressed in psychiatry or in counseling as far as ways to cope with these issues in healthy, non-medical means. Somehow, everything always comes back to an illness, even if it is a legitimate problem. To this day, within the bipolar community, whenever I say things that others view as extreme, they caution me that I must be having an episode. I deeply appreciate the care and concern. But it really goes to show just how ingrained the idea has become even within OURSELVES and TO ourselves that mental illness is WHAT we are. That we are helpless. That we cannot change or improve without meds. That any sort of variation means we better get some new meds, pronto, and that will help our situation.

Now, I think at times, medication plays a role but that often, when we learn to be aware of ourselves, our moods, our surroundings and WHAT is causing these feelings we can address them in a more pro-active way. Many people in the mental health system (including myself) did everything “right”. We went to counseling, we took the meds, we followed the regime for YEARS. But that is only addressing one small piece of the puzzle. We are multi-faceted individuals and must deal with our lives in a holistic manner, instead of focusing everything on ONE THING – our illness. That doesn’t help us, but instead keeps us trapped in a cycle we can never get out of. I often wondered WHY I wasn’t getting better despite doing all the “right” things (and believe me, I have heard the same thing from others about a million times! People want to know WHY these meds aren’t fixing their depression or their mood swings, WHY they aren’t getting better. Ultimately it can lead to a worse feeling of depression, because on top of the initial depression, there is depression for having “failed” to get better.)

I am now almost a year off meds and am so much more aware of myself than I was at the beginning of my mental health journey almost 5 years ago, and I am so thankful for that. Like I said, I could identify my feelings but not WHY I felt that way. I now understand: all the variation of mood, how various social cues trigger my moods or affect them (positive or negative), how the behaviors I engage in affect me, how all of this affects others. It’s not something that occurs overnight but is a learning process that occurs over time and with observation. Does that mean I’m now “fixed”? No. But it puts me ahead of the game because I can anticipate things before they happen. I can be prepared. I minimize the chances of being caught off guard. When bad things do happen, I can learn from them and try to adjust things/situations in the future. I know my weaknesses and limitations and try to take those into account when making plans or scheduling particular outings or things of that nature. For example, I now know that working hard on something can trigger elevated mood or “mania” for me. So, I don’t avoid working hard, but if I notice signs, I can either enjoy the ride or if it becomes extreme, back off and try to do calming activities to mediate the excitation happening in my brain. If I start feeling depressed and notice I’m ruminating on negative thoughts, I can purposely cut off the train of thought and engage in something more uplifting – some happy music, or watching a funny video, or talking to a close friend. If I weren’t aware of the effects of my environment on me, I couldn’t do any of these things! Awareness is SO important. I think it is THE most important thing in dealing with mental illness, period.

So my advice to anyone new to the mental health system or newly diagnosed is this – FIRST, take stock of your own life. No one knows you like YOU. You are the best advocate for yourself. We may like the idea of a fairy godmother or white knight swooping in and fixing us or fixing our lives but that isn’t reality. We must be our own advocates in life. Understanding yourself better can help you understand your moods and ways of coping or self-medicating (drugs/alcohol/self-injury/bingeing/social withdrawal, etc.) that are unique to you. You can in turn begin to address these things. SECOND – Don’t believe the hype. Even if you’ve been diagnosed with bipolar (or even if you just think you may have it) not everything about you is “because you have bipolar”! Bipolar in itself doesn’t make a person inherently – quiet, loud, obnoxious, generous, loving, selfish or any other thing. We all have to accept that we have our own traits regardless of bipolar. Don’t fall into the trap of believing “I’m a thrill seeker…it’s because I have bipolar!” or “I don’t like people. It’s because I have bipolar.” Not only is that boxing yourself in, but some of it isn’t even true (bipolar is simply a tendency for extreme mood experiences and shifts.) While you may be able to say you’re a thrill seeker while in an elevated mood state, if you’re like that all the time, it’s just your personality. (I’m going to go ahead and say that most people realize a lot of their own personality traits, good or bad. We don’t all admit them openly to others though!) Lumping all these things under the heading of “bipolar” may make you feel better for a while and you may feel validated that it’s not all in your head, (I know I did) but eventually it will consume you. Bipolar will become the only thing you see about yourself and in a weird way, it becomes a self-fulfilling prophecy. You believe you’re nuts and so you act nuts, so people treat you nuts and so you believe you’re nuts…It will make you feel worse and not better. And that isn’t what any of us want, bipolar or not.

LASTLY, Many times, bipolar or not, addressing the true issues in life can bring more happiness than simply relying on a pill. There is no miracle pill to cure bipolar or depression. But healing starts with AWARENESS. A person can never change something they are unaware of. If you walked around with spinach in your teeth all day and never looked in a mirror, would you think to floss your teeth right away? Probably not. You wouldn’t even be aware of it. But if you thought to yourself while you were eating your salad that you better head to the bathroom after you eat and make sure your pearly whites were white instead of green, you’d head off any unforeseen embarrassment. Point is, be aware. Aware of YOURSELF, aware of what is AROUND you. Notice how things affect you, what your particular “weaknesses” are, what triggers your moods (both down and up). Is it having too much to do in a short time? Is it dealing with money troubles? Relationship troubles? Is it being involved in a cool class? Experiencing something new? Really take a step back and assess your own life. You can be your own best friend or your own worst enemy. Only by truly looking at yourself as a whole can you begin to understand how to take steps that will bring the improvements you seek.