Reasons why people refuse to acknowledge and get help for Bipolar Disorder

in Ideas: Ways to Thrive / Information / Relationships Effected By Bipolar Disorder  by July 26, 2010 9 comments

Many people find it incredibly difficult to acknowledge and accept that they are living with bipolar disorder….let alone be willing to get help.  They have really good reasons.

Here are some perspectives people have shared with me as well as my own experience that I have overcome in order to get to be who I am.

I share this is so that people who want their loved one to admit they have diagnoses can understand where their loved one is coming from.

  • “This way of thinking and being is normal for me. I have always been this way. Why should I need a doctor, medication and therapy to feel “normal”. This is what I know. Nothing is wrong with me.”
  • “I’m not hurting anyone but myself. I don’t care what people think about me.”
  • “This is who I am. I don’t want to change.”
  • “I don’t want to be controlled by medication. I don’t want to be a robot……I am afraid that if I take medication, I will lose who I am.”
  • “Struggling with the ups and downs is something that I know how to do well. I don’t know what I would do with myself.”
  • “I am so scared of medication. I have heard stories of people not being able to feel and think. I have heard stories of people not able to be who they were. That really scares me.”
  • “I can’t believe that the most wonderful, beautiful, life changing experience didn’t come from God and is considered as a disorder…I can’t believe that it means there is something wrong with my brain.”
  • “I don’t want to be treated as though I am crazy.”
  • ” I don’t want to find out that there is something wrong with me.”
  • “Society has a problem for not valuing and putting to use your creativity, brilliance and energy. I have something to offer just the way I am.”
  • “Moses saw a burning bush and said God was talking to him…AND he’s a prophet. Why is it that when I see God and we talk that I am crazy?”
  • “I love mania.”
  • “I don’t see it as a problem.”

Underlying Fears:

  • “What if no matter how hard I try, I can’t be “normal”?”
  • “What if I can’t be fixed?”
  • “I am broken.”
  • “I don’t belong. No one will accept me.”
  • “My life feels over.”
  • “I don’t know who I am.”
  • “No one will love me.  I am not loveable.”
  • “I am so scared of myself.”

No one can be forced to see that they are living with bipolar disorder. No one can be forced to take action and receive treatment.

Have compassion and empathy.

People usually do not seek out treatment unless it affects their functioning on the following levels:

  • They feel out of control of their mind and body.
  • There loved ones do not feel safe being around them.
  • They are at risk for self-harm or a danger to others.
  • They are not able to function in their work.
  • They are not able to be the partner they want to be in their romantic relationship due to their behavior and emotion.
  • They are having difficulty maintaining friendships due to their behavior.

Sometimes people are not able to see that this is taking place.  They are so deep in the mania that they can’t see what is happening.

Therefore, it is important for loved one’s of a person who is allegedly experiencing bipolar disorder to share their concerns and help them develop their awareness.

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5 Ways to help someone who is manic or rapid cycling

in Actions / Ideas About Mania / Ideas: Ways to Thrive / Information / Relationships Effected By Bipolar Disorder  by July 21, 2010 3 comments

Before we get started, I want to help everyone understand why in my writing I use the terms “we” and “us”. The key reason for doing this is because stigmatization, judgment and the fear people have of people living with bipolar disorder can be very isolating and create a great deal of self-shame and self-fear. I use “we” and us” to remove stigma, judgment and fear in order to create belonging and acceptance. I also use “we” and “us” so it is very clear that I am writing about an experience that I belong to as well.

This blog is in response to someone asking for help to better be able to help her loved one who is struggling with rapid cycling…and I’m broadening this to include both rapid cycling and mania.

#1 Thing you can do to help the one you love is by taking really good care of yourself – emotionally, mentally, physically, your health etc.

It is incredibly hard to help someone who is experiencing mania or rapid cycling. The reason why hospitalization exists, besides being at harm to ourselves and others, is to slow us down. Hospitalization removes whatever supports mania and medically slows us down and forces our bodies and mind to stop running a million miles a minute and rest.  Being forced to slow down can feel like death or simply horrible.

The goal of this blog is to help intervene before hospitalization is needed.

This blog is about how to help someone you love slow down and gain some control during mania or mixed episodes without hospitalization. It is not easy.

A gem I have gained from my experience from experiencing mania is how powerful the mind-body connection really is. When my mind and emotions are going a million miles a minute there is no rational way to THINK myself out of this process. However, my body can only go so fast.  I learned that if I can slow down my body and gain awareness and control in my body that it has a profound affect on my mind.

What I hope to share are some tools that can be helpful to the ones you love that I have learned from experience and professional education that have been successful in slowing down mania or cycling and building awareness and control.

Help loved ones gain control of their mind through their bodies by:

  • Shifting our attention to our breath.

    When we focus on our breathing it brings our attention away from what is taking place around us and in our minds. Our attention goes directly to expanding and contracting our lungs.  Our attention goes to breathing as deeply into our bodies as we can and releasing our breath.

    By focusing on our breathing we experience control. Our awareness decides how deeply we breathe. We have the power to control our breath which can either slow down our body or speed it up.

    GOAL: Breathe deeply and slow down the breath which will regulate the rest of the body and the mind.

    How you can help:

    Don’t judge, label or say things like “You’re out of control. You’re manic. You’re crazy etc”

    Instead say something like, “I’m feeling scared/sad/down/lost/frustrated etc, will you hold my hand (or sit beside me) and breathe with me?”

    • Creating a safe place for us to contain ourselves

    When we feel out of control in our bodies, a long tight hug really helps.  There is something incredibly containing about a hug that is grounding for a person who feels out of control.

    The hug not only helps us stand, but it also helps us to emotionally center ourselves. We feel emotionally connected, present and a hug is an act of love.

    GOAL: Hug your loved one until they let go, don’t let them go. By hugging them they feel safe, wanted and loved. This containment creates self-control in both their body and mind.

    How you can help:

    Simply say, “I want to hug you, may I give you a hug?”

    • With your words

    When we are manic or rapid cycling we don’t respond well at all to words, we are not able to be rational…especially when sentences start with the word “You…”.

    GOAL: To not make us feel bad about ourselves, when we are manic or rapidly cycling and are out of control…we already feel bad about ourselves.

    How you can help:

    Make “I” statements. Start your sentences with the word “I”. For example, “I feel scared when…” “It concerns me when…” “It’s problematic for me when…” etc.

    • Giving us space.

    When you can’t express how you are feeling, it is incredibly frustrating when someone keeps asking you “What’s wrong?”, “How are you feeling?”, “Are you okay?” etc.

    GOAL: Give us space so we can ride out the emotional rollercoaster.

    How you can help:

    Help your loved one create a space when they are okay that feels safe to them. This space will be where they go when they experience an emotional rollercoaster.

    • Forgiveness

    Mania, depression and mixed episodes cause us to express ourselves and emotion in ways that are very hurtful.  We often feel ashamed of what we do and say. We are often not kind in how we treat the people we love during these times of incredibly emotional rollercoastering. We are so disappointed in ourselves and feel so much pain for how we treat those we love during an episode.  Forgiveness is a gift that we need to receive.

    GOAL: Help us heal and recover by forgiving us for the pain we cause.

    How you can help:

    If you remind your loved one that you know that how they are behaving is not who they are…that it is the mania or depression. Let them know that you love them and that the mania or depression is hurting you.

    Don’t let bipolar disorder be an excuse for bad behavior. Help your loved one see the difference. Therapy can be very useful to build this awareness.

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    Special for Moms: My Mother’s Story of Witnessing Me Experience Bipolar Disorder

    in My Stories / Relationships Effected By Bipolar Disorder  by July 17, 2010 3 comments

    I wrote this with my mom to be useful particularly for moms who are struggling with acceptance for their child struggling with bipolar disorder.

    My Mother’s Story

    Witnessing my child experience Bipolar Disorder


    Written By Robin Mohilner in collaboration with my Mother


    I never saw Bipolar Disorder coming into my daughter’s life. I believed I was seeing adolescence finally kick in as she began to be more moody, distant, and stay up late. She had the typical problems with boys, friends, and the freedoms that come with turning sixteen.

    “Bipolar Disorder? What’s that?”

    Robin was such a happy child. She was a very good student. She wasn’t angry. She wasn’t even rebellious. She never kept secrets from me. But in early adolescence she was wounded deeply by her peers and her relationship with her sister, watching me struggle with cancer, and her grandma’s death. She shut down and held everything in. There was nothing I could do to help her, except watch. We sent her to a therapist, but she impressed them with her self-awareness and maturity. She trusted no one with her pain.

    I didn’t know that she wasn’t sleeping at night. Once in a while I’d hear something or see her light on, but it wasn’t a big deal to me because I had difficulty sleeping at night, too.

    I once walked into her room and caught her with chemistry and physics books. I told her to go to sleep, but I was proud of her for studying. So I left her alone.

    A while after the diagnosis, she showed me what she was doing at night. She showed me her teaching bible. She had strategically highlighted it in four colors. She said each color represented a different voice in the bible. Each color had several meanings. If I remember right, in one case blue was acceptance, pink was love, green was responsibility, and purple was forgiveness. I thought nothing of it. It turns out she was doing this with Buddhist texts, the Koran, the Tanakh, any religious texts she could get her hands on. It was then that she shared with me that while she was manic she believed she was a prophet and was to be the mother of the messiah. I’m glad I didn’t know that at the time because I would never have known how to respond.

    One day, I looked through her school notebooks. She had taken notes and done work, yet the pages were covered with intricate and complex drawings that she had never drawn before. They were beautiful, yet strange. I didn’t want to comment on them since I felt it would hurt her. She said they help her focus in school for school was moving too slow. But I left it alone because she’s very bright and was doing well in school. Now I know that the work I saw was not school work at all. She was devising a plan to save the world. During that time period she wasn’t doing well in school at all. Her teachers thought something was wrong in her life and let her slide.

    I did know how badly she wanted to have sex. I even offered to take her to a sex toy store to keep her from acting on her urges, perhaps I should have left it alone a little and let her explore online stores, such as lovegasm or similar. She openly talked about masturbation at the kitchen table. This was alien to our family. She spoke about porn and how she visited https://www.tubev.sex/. But I didn’t know she was calling all the boys she knew to try to have sex. It was interesting that they all turned her down. They were either scared of how straight forward she was, or knew something was wrong because that just wasn’t her.

    I really started seeing the changes in my daughter when we went for a vacation. I was stuck in the car with her for nine hours. Right away I could see something was wrong. So I started a journal. She would go from so happy and fun, to attacking me verbally in the car, to crying about her pain. When we were pulled over for speeding, she yelled and cursed at the highway patrolman.

    When we got to our destination, I was walking on eggshells. She reacted to everything I said or did with intense emotion – intense joy, intense pain, intense rage, and intense guilt. I knew my daughter was sensitive, but this was beyond any level of emotion I had ever seen her experience. Her mood changed within the blink of an eye.

    I thought I knew her, but my child was a stranger to me and I didn’t like her. In fact, while she was manic, I couldn’t stand her. We’ve joked about this now. When she was manic I wanted to, as she puts it, “kick her ass”. I never laid my hands on her because I was afraid of her. She may have thought she was a prophet, but at times she acted like she was possessed by evil. I must admit, she did seem to possess certain super human qualities. But it is hard to see the good in the same behavior that is attacking you.

    One of the best things that happened to us is that I accidentally hit her with the phone. In response, she called the police to report child abuse while I was at the market. When authorities arrived, I told them about what had been going on and they wanted to arrest her for her own safety. But they didn’t because the sheriff knew her and decided to keep her safe and isolated at home.

    She calmed down, but then became more and more violent. She felt trapped and attacked a door with a hammer even though the door wasn’t locked. I was horrified by her behavior. She threatened to beat up a little boy for splashing water at her friend. She got into a fistfight with her friend who was with us. I must admit that I was rooting for the friend. She called her best guy friend and told him that they needed to have sex because she’d get pregnant and their child would be the messiah. She had visions of being raped earlier in her life. I didn’t know what to believe, but she needed help.

    I’d had it. I’d written down everything I knew at the time.

    So we drove for another nine hours being tortured by her until she fell asleep.

    It felt as though she didn’t wake up from that sleep. When we arrived at home she was a different person. There was an absence of emotion. She could hardly move or communicate. She’d get this look in her eyes of terror. She knew something was wrong with her. Sometimes she’d mumble, “I’m crazy.”

    When we had her diagnosed, she was unable to speak for herself. My journal told her story.

    When I looked into Robin’s eyes, I did not see her. Her eyes were vacant. There was nothing I could do to help her but pray that the medications work and that they work fast.

    The medications worked slowly. It was hard for me to be there for her after all the torture she put me through. But I found a way because I knew that everything I’d witnessed wasn’t really my daughter. I could clearly see the Bipolar Disorder. I was determined to be by her side and help her reclaim her life.

    I can’t tell anyone how to be a mother of a person living with Bipolar Disorder. I know I wasn’t perfect. But I can say that your child needs to know that you accept them and that you see them for who they are, and not define them by the disorder.


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    Part 2: Tearing Down Stima to Understand Diagnoses with Compassion – Behavior Perspective

    in Information  by July 14, 2010 1 comments

    In Part Two of this exploration of compassionately understanding diagnoses we will explore the perspective of behavior and changes in needs and interests.

    Behavior & Changes in Needs & Interests


    Bipolar Disorder – when experiencing mania

    • Decreased need for sleep

    In my opinion this is the number one detector that a person is experiencing mania. When we are having difficulty sleeping we are vulnerable to mania. This is a call to action for self-care or medical support.

    • More talkative than usual, rapid speech and a pressure to keep talking

    This is such an uncomfortable feeling to not be able to stop talking. When I talk about this with people we laugh about the endless times we’ve stuck our foot in our mouths because we talk way before thinking. Our words get so jumbled and we wonder if we are making sense. Nevertheless, we don’t dare ask anyone if we make sense, we just keep talking to fill the silence and hope they don’t notice.

    • Increase in goal directed activities, risk taking or pleasure-seeking behaviors. Ex. spending money, heightened sex drive and risky decisions

    This is where we really pay for our actions. No one cares if you spend way more money then you have when you are manic, the banks want their money back. When we invest all of our savings into everything from building a business/investments to saving the world and we fail…its gone. Our partners probably won’t mind if we spend more time on https://www.sexmature.xxx/ than usual, but I highly doubt they will be okay if we go and have sex with as many people as humanly possible. If we jump off of a cliff because we truly believe we can fly…we pay with our life or our quality of life.

    Then there are the consequences that often go not talked about…

    The loss of respect people have for us.

    The loss of trust and safety people hold for us.

    The loss of trust, safety and respect we feel for ourselves.

    We lose our dignity as a consequence to these behaviors and it is incredibly painful and so difficult to recover from.

    Schizoaffective Disorder

    Same as bipolar disorder or major depressive disorder or any other mood disorder, except that psychosis is experienced when not in a manic or depressive episode.

    I like to think of psychosis is similar to the “Telephone” game. When the message starts in the brain each time it gets passed along the message is changed so that when the message gets to the end of the line its a completely new and different message.

    When this “Telephone” game happens, the brain tells stories in the form of messages about things your eyes see, your ears hear, that you touch, smell and taste that you haven’t actually experienced. However, these experiences are very real to you because they are taking place in your brain.

    In many circumstances the experience of these messages wouldn’t be problematic for a person. We all have experiences where we think we see something and then realize it wasn’t there. What makes it problematic is when:

    • the message that we received is harmful in some way. It could cause us to be fearful, cause self-harm or harm to others, or be very painful.
    • We don’t have the ability to realize the difference between what we think we saw, heard, touched, smelled, or tasted from what is taking place around us. It puts us out of touch with our environment and that could be dangerous for our safety and survival.

    Borderline Personality Disorder

    • Frantic effort to avoid real or imagined abandonment

    I have so much compassion for this behavior when I am able to put in perspective everything a person would have to go through that could cause them to have this incredible fear. They are simply doing their best to be loved and there is no way to know how to do be loved when your primary caregivers didn’t provide consistent and predictable etc nurture.

    • Extreme idealization or devaluation treatment of interpersonal relationships

    I can only imagine this as a very painful and difficult behavior for all people affected by it to deal with. Based on observation, people affected by borderline personality disorder tend to idealize someone when they are experiencing forms of love such as kindness, acceptance, approval, affection etc and devalue a person when they make a mistake, disagree, aren’t fully available, don’t receive their needs when expected, aren’t 100% able to be supportive etc.

    No one will ever be perfect = 100% consistent in saying and doing the right thing and meeting your wants and needs. People are often not even be able to do that most of the time. This is painful for everyone. But I can imagine how deeply it would hurt for someone living with borderline personality disorder. I have so much compassion for the need to be loved and to have the fear at any moment the love that they receive will be abandoned. Therefore, the slightest change in the act of love could trigger that frantic fear of abandonment.

    • Impulsive actions that can be risky and cause self-harm

    I can’t say that I have an answer for this behavior. My curiosity looks at it from the perspective of attention seeking behavior to get needs met OR maybe a way to release emotion based fear and pain by causing physical pain. Either way, I believe these behaviors could be self-soothing in some way in an attempt to get needs met by the primary caregiver.

    Maybe it is a way to say, “Notice me! Love me! I need you! Take care of me! I’m so confused and scared and I don’t know what to do about it.” My heart goes out to people who weren’t able to receive the care that so many of us take for granted.

    • Recurrent suicidal behavior: threats, gestures, attempts or self-mutilation

    I wonder if this pattern is an attempt to get the attention, acceptance, approval, love and nurture that they deserve and need to receive…that we all need to receive. In many circumstances people do not want to die, but they may feel dead to the people they need to receive care from OR they may need to feel that their life is of worth to others. There is no right answer to explain this painful behavior.

    It is important to understand that not all of the characteristics or symptoms of borderline personality disorder will be experienced and expressed. These are tendencies that have been observed over periods of time.


    Part Three will explore these diagnoses from the perspective of Thought Processes and Sense of Self

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    Tearing Down Stigma To Understand Diagnoses With Compassion

    in Ideas: Ways to Thrive / Information  by July 12, 2010 2 comments

    In this blog I hope to create a better understanding and compassion for people living with the diagnoses bipolar disorder, schizoaffective disorder, and borderline personality disorder.

    Often times society sees people living with bipolar disorder as people to be feared and are seen as dangerous. Society has no clue as to what schizoaffective disorder is. And often when people think of borderline personality disorder there is so much judgment and rejection that it can feel incredibly hopeless to the person experiencing it.

    It’s important that I acknowledge that I do not have personal experience living with schizoaffective disorder or borderline personality disorder. I DO live with bipolar disorder and have a much greater understanding of how it affects people. Nonetheless, I hold a tremendous amount of compassion for anyone living with diagnoses that are incredibly stigmatized and misunderstood.

    What I hope to give you in this blog:

    1. Shine a light that empowers you to be proactive in how you choose to live with the challenges caused by whatever conditions and circumstances you are dealt.
    2. I hope to remove the judgment and stigma and instead invite you to have compassion and understanding for these experiences.
    3. An awareness that any diagnosis is NOT who we are. Diagnoses are something we live with, we are in relationship with it. This means that it has the power to affect us and we have the power to affect it.

    When professionals make a diagnosis we look at the following criteria and to what degree it affects one’s life:

    • Mood (defined as a temporary state of mind or feeling)
    • Behavior (defined as the way one acts or conducts one’s self, especially towards others) / Changes in Needs and Interests
    • Changes or Patterns in Thought Process
    • Sense of Self

    In today’s blog we will explore the diagnoses bipolar disorder, schizoaffective disorder and borderline personality disorder from the criteria of Mood with compassion. Following blogs will cover the other criteria.

    Mood

    Bipolar Disorder:

    It is important to note that bipolar disorder is defined by the presence of mania. The diagnosis is not dependent on the presence of depression. In this blog, we will only explore from the perspective of mania.

    The mood component of mania is defined as a temporary state (at least a week or can be less) in which mood is:

    • Unusually elevated, euphoric or expansive

    Experiencing these mood patterns can feel so incredibly good that it is hard to recognize that mania is present. They may be the superhero “I can fly” feelings that we dreamed about experiencing as children and now they are REAL feelings.

    • Unusually irritable

    No one usually wants to take responsibility for their irritability. Irritability is one of those things that just doesn’t make sense. It’s not usually based on what’s happening right now. It’s based on what happened in the past. And it usually is from things we don’t address.

    When irritability happens in the experience of mania in bipolar disorder it’s because bipolar disorder puts the pot of our emotions on a stove or in a pressure cooker. Our emotions boil over. Meanwhile, bipolar disorder is stirring the pot, mixing all of our emotions together without any regard to what’s taking place here and now. No matter what those emotions are, when this is happening to you, you’re going to be very irritable.

    • Often feels as though every possible human emotion is being expressed in the same time period.

    To make sense of this from a brain perspective, see my blogs on the bipolar brain.

    During this experience we are our most scared and at one of our most fragile times in which our life is at tremendous risk. This is a time when we feel completely out of control not only in our own minds, but also in our bodies. It is so hard to share that we are in danger with anyone because we are so afraid of what will happen to us. Often times its like we are having an out-of-body experience. We are watching ourselves be completely out of control, but there is nothing we can do about it. We know we are not crazy, but we are having a crazy experience and we can’t explain what’s happening and why.

    • Shifts in mood happen impulsively or swiftly with or without trigger

    This is so painful because there are so many consequences. During these temporary times, our family and friends don’t know how to be around us and are scared of us. They are walking on egg shells. It’s hard to be a friend when people can’t feel safe with us. We feel so alone and so isolated. We don’t know how to repair what was broken when we were out of control. It is very easy for shame, blame and guilt to set in.

    • There is a loss of control in the mood shift, yet there is an awareness of the shift in mood

    Often times people think that there is a lack of awareness when people are experiencing mania. I tend to disagree. I think people are so scared of what they are experiencing that there is an abundance of denial, fear and shame. I do not believe there is a lack of awareness. No one ever wants to feel completely out of control, let alone acknowledge it to other people who have no clue as to what its like.

    I have found people living with bipolar disorder to have incredible sensitivity and self-awareness.

    Note: If someone has lived with bipolar disorder untreated for a long time, it is possible for them to feel as though it is their personality. And maybe it is, I believe it is possible to have a manic personality and it is possible to have rapid and consistent temporary mood changes. Anything is possible.

    Schizoaffective Disorder:

    Same as bipolar disorder or major depressive disorder (depression without mania) or any other mood disorder.

    The key difference between schizoaffective disorder and other mood disorders is that the delusions and hallucinations take place during times when mania or depression are not taking place. This means that psychosis occurs beyond mood disorder episodes as well as during them. If you are suffering from something similar, then it might be a good idea for you to seek help. You could always check out an inpatient facility like Honey Lake Clinic that can help support you through this disorder. However, the decision is up to you.

    In my opinion, this may be the most difficult and painful mood disorder that people experience. I can only imagine how scary it would be to not only have to live with mania and depression, but to also experience delusions and hallucinations during the times when mania and depression are not present. Nonetheless, I am confident that there are gifts and beauty in every experience. I trust that we don’t get to hear about the goodness that comes through these experiences because as a society we silence that. (For example, prophetic wisdom and vision.)

    Borderline Personality Disorder:

    Here’s where people often get confused. It is quite confusing to recognize the difference between someone experiencing bipolar disorder and borderline personality disorder.

    People living with bipolar disorder can also live with borderline personality disorder.

    The reason why it is considered a personality disorder versus a mood disorder is because here mood shows up as character traits that are consistently unstable possibly on a daily basis that can last anywhere from a few hours to a few days. It gets very confusing with rapid cycling bipolar disorder. So keep reading to better understand.

    It is important to understand that borderline personality disorder appears to have a very strong nurture / environmental components that are often found to be passed on from one generation to another.

    Research has shown that people experiencing borderline personality disorder often did not grow up in an environment / family that offered them stability and predictability.

    Their environment may be one that lacked defined and consistent boundaries.

    In fact, people nurtured in this way often grow up in an environment where they never really know if and when they will have their needs met. This is incredibly traumatic to a person.

    A key component that people share with this diagnosis is the experience of emotional abandonment from their primary caregivers / parents. The response to these experiences are a persistent fear that they will be abandoned emotionally or physically in any relationship.

    Anyone living in these nurture / environmental conditions would experience tremendous pain and fear. When your primary caregivers abandoned you emotionally and/or physically or you lived with the fear that they would, relationships may be so difficult and frightening. It makes sense of how someone could live with such a deep need to belong, to be loved and to have their needs met.

    It has been described to me by a client in this way, “Its like going through life walking on glass and you get so used to it that it provides the comfort of a blanket.”

    This does not mean that all people living in this type of environment will grow up to live with borderline personality disorder, it simply makes them vulnerable to having the following response in life.

    These following MOOD characteristics are a response to growing up in this type of environment:

    • Intense dissatisfaction with life
    • Irritability or anxiety
    • Intense anger and/or difficulty controlling anger
    • Intense fear of abandonment
    • Consistent idealizing and devaluing of others
    • May have consistent suicidal ideation

    Note: We are only discussing characteristics of mood, this is not a complete diagnosis.

    A key difference from bipolar disorder is that people living with borderline personality disorder do not experience elevated, euphoric and expansive mood. They don’t feel invincible and on top of the world.

    In Part Two we will explore this from the perspective of Behavior and Changes in Needs and Interests.

    Part Three will cover Thought Processes and Sense of Self

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    Let’s Talk About Suicide & 5 Ways to Take Life Back

    in Actions / Ideas: Ways to Thrive  by June 27, 2010 0 comments

    When people have suicidal thoughts and desires, we so often dance around those thoughts and feelings.

    Instead, we go right into fix it mode. We write out a “no suicide contract”, assess, increase or change medication, develop a safety plan and support, assess for risk, intention, and a plan of action to carry suicide out successfully. When we’re done with all of that, we build hope.

    Rarely do we ever talk about what the thoughts and feelings that cause someone to really want to die.

    Here are some things that people have shared with me when I’ve listened to them when they really want to commit suicide:

    “I want the pain to end.”

    “I want the suffering to end.”

    “I want off of this emotional roller-coaster NOW.”

    “I want the feelings of being trapped in their body to end.”

    “I feel alone. I feel I don’t belong. I feel no sense of purpose and value.  I feel like a burden to others.”

    “I want to die because I can’t see my circumstances getting any better. I want my circumstances to end.

    I feel out of control in my own mind and body and ending my life is the only act of taking control that I feel I can do.”

    “I am carrying the burden or weight of not only my own life, but also the lives of so many other people and I can’t do it anymore.”

    “I want the numbness to end.”

    When I really listen, I am able to understand…

    They don’t want LIFE to end.

    They want these horrible feelings and thoughts to end.

    They want to be able to take their life back.


    5 Ways to Take Life Back

    1. We can’t always change the pain and suffering we feel. Nonetheless, we can change, influence and define the meaning we give pain and suffering and how we respond to it.
    2. We can learn how to identify what triggers our emotional roller-coasters and understand what fuels it. With this understanding we can intervene when triggered and remove the fuel of the roller-coaster before it takes control.
    3. When we feel trapped in our bodies or disconnected from our bodies, we can re-connect with our body by focusing on breathing deeply, feeling our lungs fill with air and our heart beat. We can notice the world through our senses – touch, taste, smell, sound, sight etc.
    4. We can recognize that everyone comes into life with a bucket of shit and a shovel. Our goal is to keep other people’s shit (ex. pain, negativity, judgment, criticism, issues, fears etc) out of our bucket. And we don’t have to let other people’s shit cause us to feel bad about ourselves and be isolated. We can stop carrying other people’s shit on our shoulders…and use our own shit to help us grow something beautiful.
    5. We can learn how to not use our thoughts and feelings to go against ourselves.  We can learn to think in ways that are not abusive of ourselves; that support us, nurture us and open our mind and heart to our own abilities, belonging, purpose and worth.

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    5 Sensitivities That Affect People Living With Bipolar Disorder

    in Information  by June 25, 2010 4 comments

    The earth & all life are sensitive to the moon

    Everyone living with bipolar disorder experiences and is affected by bipolar disorder differently.

    However, we all share specific sensitivities that can cause us to be more symptomatic or less symptomatic.

    1. We are all affected by changes in our circadian rhythms.

    Circadian rhythms are the natural rhythm that occurs in our body that tells us things like when its time to eat, sleep, when to wake-up, time to be active, have sex, rest etc.

    Everyone has these rhythms. With us living with bipolar disorder, our brains and bodies are more sensitive to changes in these rhythms.

    2. We are highly sensitive to changes in our quality and amount of sleep.

    When our bodies need less sleep we are highly vulnerable for mania or depression, possibly already in stages of mania or depression.

    Quality sleep, deep sleep, is very important in maintaining our stability.

    We ideally go through 4 cycles of sleep during the night. Our goal is to experience those complete cycles of sleep.

    During our REM sleep (deep sleep in which we dream and have rapid eye movement, increased heart rate and blood pressure etc) all brains are both organizing and processing emotion, retaining memories and managing stress. By not getting the proper amount of REM sleep (4-5 cycles) our brains cannot do what they need to do to maintain emotional and mental and emotional control and stability.

    3. We are very sensitive to light.

    Our bodies are so sensitive to light that even if we try to go to sleep with a mask on our bodies can still be affected by the light around us and this will affect our quality of sleep.

    We need our sleeping space to be as dark as possible to promote our best quality sleep.

    Sometimes things like watching candle-light can promote falling asleep. However, that same light will wake us up out of deep sleep once we have achieved it and completed a cycle of sleep.

    4. We are highly sensitive to our thoughts and emotions.

    What we focus on grows incredibly fast.

    Our sensitivity to our thoughts and emotions is so intense and rapid that we often do not have time to think about our thoughts and emotions to support them with evidence. Instead, we feel our thoughts and emotions incredibly deeply. We experience them in our mind and bodies in ways that cannot be put to words and easily understood from someone who is not living with bipolar disorder.

    We live our thoughts and emotions, instead of thinking them. They are real to us until we take control, set our boundaries and define or make sense of them.

    Our thoughts become feelings and actions impulsively. This process happens so fast that we often do not even think about it unless we know how. And even when we know how, it often will happen and we simply have to back-track and make corrections to our thinking and behavior.

    5.  We are highly sensitive to stress.

    We have the ability to face and conquer stress.  However, stress can easily throw us into an episode if we don’t know how to respond to it.

    If we respond to stress with a sense of urgency or panic we are in trouble. We are asking for a manic episode.

    Therefore, we need to learn and practice ways of responding to stress that do not invite the panic response.

    We need to have a plan for responding to stress. One way of doing this is to plan for the stress that you know you are going to have in your daily life due to your responsibilities.  If you know that there are certain things that you have to do, then you have control over that stress and are able to respond to it without urgency or panic.

    What tends to throw us through a loop are the stressors that we don’t plan for. When “shit happens” our goal is to plan that we’ll do the best we can with the resources we’ve got in that moment…and if it’s not perfect, so what!

    Everyone we are dealing with under circumstances of stress is human…they’re not perfect too.

    When you are living with bipolar disorder, it is not in your best interest to be a perfectionist. That’s just asking to be manic all the time.

    Make space in your life and your relationships to make mistakes and be willing to own it and do your best to do better.

    Take the stress off of yourself to be perfect.

    It is so important that you know your own limitations and are willing and able to communicate them during times of stress. Don’t be afraid to ask for help or support.

    There are some stressors like major loss, natural disasters, economic struggles etc that you just can’t plan for or do anything to control. During these times all you can do is grieve, feel a whole lot of pain, be angry, depressed…basically be just like everyone else during the worst times in their life…and get support, help and resources.

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    “To Thrive” or “To Struggle & Suffer” with Bipolar Disorder requires tremendous effort and energy

    in Actions / Activities / Ideas: Ways to Thrive  by June 12, 2010 2 comments

    It takes just as much energy and effort to struggle and suffer with bipolar disorder as it does to thrive with bipolar disorder.

    When I share this, often people’s first response is often disbelief.  They say to me, “Robin, how can that be, I don’t have to do anything to suffer and struggle with Bipolar Disorder. I’m not making the choice to struggle and suffer, it’s because of what happens to me everyday.”

    When people share this with me it makes me sad. People do not know how much power they have. Nevertheless, they give it away to forces that cause them to struggle and suffer.

    Our effort and energy is our power. What we do with them is the difference between thriving with bipolar disorder and struggling and suffering with it.

    Here’s one perspective I like to share and explore in response to feeling they have no choice in struggling and suffering:

    If we imagine a scale between 1-10 where 1 = no effort and energy at all and 10 = an exhausting amount of energy and effort…

    • How much effort and energy does it take to hide bipolar disorder and episodes from your family, friends and colleagues?
    • How much effort and energy does it take to try to control your mood and your feelings?
    • How much effort and energy does it take to resist how you are feeling?
    • How much effort and energy does it take to deny what you are feeling?
    • How much effort and energy does it take to try to break free from bipolar disorder?
    • How much effort and energy does it take to experience something beyond your control that is painful?

    Hiding, controlling, resisting, denying, breaking free, and being in pain take tremendous amounts of effort and energy.

    By investing our energy and effort into these ways of being, we maintain a lifestyle of suffering and struggling.

    We don’t have the ability to control what happens to us or within us, but we do have the ability to choose how we respond.

    We don’t have to hide bipolar disorder from our lives. That is a choice we make.

    We don’t have to control our feelings and moods. We have the ability to invest in developing an awareness of our feelings and moods which enables us to choose how we respond to feelings and mood.

    Just because we have a feeling does not mean that we have to believe it.

    We do not have to find evidence to support or justify our feelings.

    And we do not have to allow our feelings to control our thoughts.

    We can simply acknowledge how and what we are feeling and let it go.

    When we resist or deny how we are feeling, the feelings only become stronger.

    The act of resisting gives what we don’t want more power.

    Instead, if we acknowledge that we are experiencing something that we don’t want to experience, we get to develop our awareness of how it works and invest our effort and energy into intervening.

    For example, if we are experiencing depression, we have to identify what depression wants from us / Where is it getting its power?

    When you thrive with bipolar disorder you have the awareness:

    • Depression is…either simply like any other living thing trying to exist OR the consequence of mania in which the brain and body have exhausted itself of all resources.
    • Depression gets its power by isolating us so that it is the only voice we hear.
    • It gets its energy comes from the energy we give it by surrendering our interests, our appetite to eat, the will to shower, and ability to sleep well or sleep too much.
    • It develops strength by causing us to feel sadness, guilt, shame, blame, and any bad feelings about ourselves. It robs us of memories of happiness.

    We give depression our effort and energy by suffering and struggling to not be depressed.

    In the face of depression, we must use our energy and effort to not be isolated, be interested in something, eat, shower, and choose what and how we think and what we want to believe about ourselves, our lives and the world.

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    “You’re not bipolar enough…”

    in Ideas: Ways to Thrive  by June 5, 2010 0 comments

    Never in my life, until the privilege of writing this blog, has anyone ever told me, “Robin, you’re not Bipolar enough. You’re just like everyone else.”

    I took some time to explore what that means to me and came up with multiple perspectives that I’ll share with you. First, I noticed that it poked an old wound of mine. Growing up, I never felt like I belonged. I always felt different. So I gradually rejected the idea of being like everyone else in order to accept myself. Initially being told that I’m like everyone else or all the other psychotherapists/professionals didn’t feel good.

    When I received that message it hit me that maybe this person feels that because I’m not struggling or suffering enough with bipolar disorder that I can’t understand them or I can’t help them.

    I have so much empathy for these feelings. I too spent a lot of my life feeling that no one can understand me or help me, especially therapists. These are horrible feelings. When I had them, they made me feel so alone. These feelings make it so easy to give up.

    This awareness makes me wonder if other people feel this way – that I can’t help them because I’m not suffering or struggling enough with bipolar disorder.  I invite you to share your feedback and ideas.

    Another perspective that I explored is how bipolar disorder is so stigmatized that an unspoken identity and culture has developed around ideas of being “bipolar enough”.

    For instance, you’re not “real” or “bipolar enough” unless you’re struggling, suffering and angry with bipolar disorder.

    This way of thinking is bullshit.

    It is disempowering. And it is ineffectively manipulative.

    This way of thinking creates an identity that uses bipolar disorder as an excuse to place limitations on who you can be.  People will say or feel things like, “I can’t be / do….because I’m bipolar.” It is NOT true. You simply will have to work a lot harder for what you want, learn more than you ever knew you could and make sacrifices to achieve your goals.

    I ask you to please not fall into this trap. This way of thinking devalues us as human beings. It supports beliefs that we are not worthy of being loved, contributing to the community, being productive, having healthy relationships etc.

    There are people who are genuinely suffering and struggling with bipolar disorder. However, this is not who they desire to be. They desire to live their dreams and have healthy relationships. They want a good life. They do the best they can each day with the resources they’ve got. They don’t take pride in suffering and struggling.

    You are enough.

    May your identity be based on what you are able to be and do.

    Thrive with bipolar disorder.

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    Mood Tracking Tool: How to watch the roller coaster without getting on

    in Actions / Activities  by May 21, 2010 0 comments

    One way to track how bipolar disorder affects you is by using this tool.

    There four factors that I use to understand mood etc.:

    1. Consistency: ____

    (Scale it: 1 – 10…1=Almost Always; 2-3=Often; 4-5=Sometimes; 6-7=Less Frequent; 8-9=Rarely; 10=Never)

    Are you experiencing the same types of feelings and thinking in a similar way over a period of time?

    2. Predictability:____

    (Scale it: 1 – 10…1=Almost Always; 2-3=Often; 4-5=Sometimes; 6-7=Less Frequent; 8-9=Rarely; 10=Never)

    Can you and others predict how you will respond to external circumstances?

    This does not mean that you are boring or that people can read your mind.  It means that people have expectations for your personality and can count on you to respond in line with your personality.


    3. Appropriateness of the Response:____

    (Scale it: 1 – 10…1=Almost Always; 2-3=Often; 4-5=Sometimes; 6-7=Less Frequent; 8-9=Rarely; 10=Never)

    Is the response to the situation an appropriate response based on the degree of threat, urgency, or importance of the situation?

    One way to understand appropriateness it to ask yourself  these questions:

    • Would a person you respect, value and trust respond the same way?
    • Would someone who really cares about you and believes in you want you to respond that way?
    • Would you choose to be treated this way?

    4. Impulsivity:____

    (Scale it: 1 – 10…1=Almost Always; 2-3=Often; 4-5=Sometimes; 6-7=Less Frequent; 8-9=Rarely; 10=Never)

    How much thinking takes place before a response?

    Do you assess the cost, benefit and consequences of your actions?

    When assessing mood, notice things such as the time of day, how you slept, if you are hungry or tired, the temperature and weather. These all affect mood.

    Here is a tool for you to duplicate into a spreadsheet on your computer or use by hand:

    This tool will help you track your behavior, thought process, and emotional response or expression using the tool above.


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