Happiness, Excitement & Stress do NOT necessarily mean MANIA. Happiness & Bipolar Disorder.

One of the hardest challenges people living with bipolar disorder face is the fear that they cannot be happy, excited or experience stress in a normal way.

There is an assumption in our society that this is mania.

I believe it is NOT true.

The following article are simply my beliefs as a person who thrives with bipolar disorder and experiences a life full of happiness, excitement and stress.

HAPPINESS

Happiness that comes from feeling good about yourself…

self-esteem, self-worth, integrity, dignity, self-respect, what you’ve achieved, your family, how you treat people, give to people, gratitude for your life etc

….IS NOT MANIA…it is JOY.

Happiness and excitement that comes from what you plan to do in the FUTURE…

it is also JOY,

but because their is a GOAL that MAY invite the stressors of OVERWHELM or a drive of URGENCY…

the joy could lead to MANIA.

Therefore, happiness and excitement about what is current or in the past MAY be SAFE and not lead to mania at all.   It may be happiness and excitement about the future that may have the potential to welcome mania into our lives.

 

There is NOTHING WRONG with being happy and excited about the future.


We simply have to be more careful and pay attention to our sense of URGENCY and STOP when we feel URGENCY and /or OVERWHELM.

We must PAUSE…and take time to calm down and focus on one step at a time instead of the big OVERWHELMING picture.

The KEY here…is we have to be able to RECOGNIZE what URGENCY and OVERWHELM feel like in our bodies so we can respond to them RIGHT AWAY, before MANIA can kick in and we lose control.

On a different note:

Happiness or energy that feels excessive or strange to you could be mania.

The amount of happiness we feel, that is considered normal happiness, is often in proportion with the cause.

If we feel extremely happy and a burst of energy from experiencing something that is ordinary to us…

The chances are we may be experiencing mania.

 

STRESS

 

We cannot avoid STRESS in life.

There will ALWAYS be stress in our lives.

To believe that we cannot handle stress dis-empowers us.

We have to learn how to cope with STRESS and how to receive support when we are OVERWHELMED.

People living with bipolar disorder already have the tendency to hold everything in an be STRONG.

This way of being for us, holding everything in or hiding everything, IS NOT HEALTHY FOR US.

By telling us that we must maintain a stress-free life…it encourages us to hold everything in.

I believe we appear to NOT handle stress well because our whole lives we have held the pain, the suffering, the loss, the wounds and the damage INSIDE OURSELVES.

Therefore, when stress happens in our lives…coming from the outside of ourselves, it is too much, we have an episode.

Our own shame, guilt, internalized stigma, self-fear, lack of self-trust, low self-esteem and other self-destructive emotions and actions are enough stress to cause relapse without ANY external stress.

In fact, I believe that internalized stigma is more stress than any daily external stressor.

One reason why I believe I have not had a significant episode in 15 years…is because I don’t hold anything in.

I do not hide anything from anyone.

My transparency frees me from internal STRESS.

It does not mean that I don’t have stress, it means that when I have stress, I let it out.

I am not ashamed or disgraced to have bipolar disorder.


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How the stories we tell ourselves about ourselves get in our own way & Ways to do something about it. Strategies for thriving with bipolar disorder

 

The stories we tell ourselves about ourselves have so much power.

One of the great lessons I have learned in my life is that what happens to us matters far less than the stories we tell ourselves about it.

The stories we tell ourselves shape how we think, what we believe about ourselves, the choices we make and the actions we take.

 

When I was first diagnosed with bipolar disorder, I told myself the “I am crazy” story.  Here’s how it worked:

“I am crazy.” This is who I am.  It is my whole story.

How this story affected my thoughts: “It doesn’t matter what I think.  I am crazy.” and  “I am bad.”

How this story affected what I believed about myself : “I have no responsibility and no expectations for myself or from other people. I don’t have to do anything because I can’t.  I am crazy.”

How this story affected my choices: “I can’t do….”  “I can’t be…”  “I can’t try….”  “I can’t choose.”

How this story affected my actions: I stayed on the couch in a fetal position with my face buried in the corner.  I spoke to no one.

 

You can take out the word “crazy” from the “I am crazy” story and replace it with several other words and get the same exact effects and results.

 

This type of story drains away all self-esteem and self-worth.  It steals our ability to take responsibility for our lives and have expectations for ourselves. It robs us of qualities that give us strength and courage.  It does not allow space for resilience and persistence.  This type of story causes us to accept mediocrity.

If you have these kinds of stories in your life, I invite you to throw them away and re-author your stories.

 

On my Facebook page, Thrive With Bipolar Disorder, I shared an example of a form of storytelling that I do when I am feeling stuck, scared or judged.

 

Here, I will share some ideas for how to re-author the stories we tell ourselves about what happened to us and about ourselves.

 

Re-Authoring Stories

 

Part 1: Deconstructing the Problem Story

When I help people re-author stories the first thing I choose to do is listen to and understand the story they have been telling themselves.

I want to understand the role the story serves in their life and what makes the story a problem to them.

For instance, with the “I am crazy” story.  The role of this story in my life was that it defined my identity and who I could be.   What made it a problem was that it sucked the life out of me, as seen above.

I want to know how the story was invited into a person’s life.

In my “I am crazy” story, the story was invited by a medical expert putting a label on me and telling me that I had to take medication for the rest of my life in order to fit into society.

It is important to explore the effects a story has on a person.

The effects of the “I am crazy” story on me were:

  • I had no expectations for myself.
  • I took no personal responsibility for my choices and actions.
  • I had no self-esteem, self-worth and self-respect.
  • I felt useless and incapable of being anything.
  • I felt that I was bad.
  • I was afraid of myself.

 

 

I choose to know what the person does to support the story they tell themselves.  What actions and routines support the story.

In my “I am crazy” story, I refused to get off of the couch.  I did not want to go to school for the life of me, not because of what the kids would think,  but because I no longer believed I had a functioning brain and was capable of doing anything with my life.

My routine was to wake up, get on the couch and bury my face in the corner.

This carried over from my depression.  As I was coming out of the worst depression ever, I continued the behaviors that I had while I was experiencing full blown “I know longer feel alive” depression.

 

 

I explore what the problem story steals from peoples’ lives.

My “I am crazy” story stole my will to live.  It stole everything I believed about myself up to the point that I had my manic episode.  Until then, I believed I could be anything when I grew up and I was a great student and daughter.

This story stole my confidence, my courage, my intelligence, my creativity, my hope, my dreams….

Together we explore flaws in the problem story, times when the problem story is wrong about people and times when people have the upper hand.  We look at evidence that uncovers other possibilities and alternative ways of understanding the problem story.

When I explored this with myself, the problem story went from “I am crazy.” to “What I experienced during those handful of months in my life was beyond my control…it was crazy AND I have the ability to do something about it.”

Here was the evidence that I am not crazy.  For the entire fifteen years of my life (I was 15 soon to be 16 when full-blown mania came into my life) I was a very good student, I had friends and sort of the ideal teenager to my parents, I never got in trouble.

After the full-blown mania and depression and after I got stable on my Lithium…I still could read.  I still could write.  I still could speak my mind coherently and my thoughts were relevant and intelligent.  I still was a kind, warm, compassionate and loving person.  I still was playful, funny and loved to laugh.  I could still feel my feelings and was on a dosage of lithium that left me always slightly hypomanic (throughout much of my twenties).

Once we are able to identify the possibility that the problem story may no longer fit, I explore with people what gets in the way of letting the problem story go.  Together we slowly work on what hold’s people back.

In my case, I was afraid to let the problem story go because I did not trust myself.  I was scared of myself that at any point in time I could go into full-blown mania and crash into a lifeless depression.

 

One of the things that often keeps people stuck in their problem story is that they don’t have a different story to replace it with.  They don’t have a story that they want instead.  With this as a challenge our goal shifts from understanding the effects of the problem story to creating people’s preferred story.

 

In the Part 2 of this blog we will explore this process of creating a preferred story.

 

 

 

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How the stories we tell ourselves about ourselves get in our own way & Ways to do something about it (Part 1)

The stories we tell ourselves about ourselves have so much power.

One of the great lessons I have learned in my life is that what happens to us matters far less than the stories we tell ourselves about it.

The stories we tell ourselves shape how we think, what we believe about ourselves, the choices we make and the actions we take.

 

When I was first diagnosed with bipolar disorder, I told myself the “I am crazy” story.  Here’s how it worked:

“I am crazy.” This is who I am.  It is my whole story.

How this story affected my thoughts: “It doesn’t matter what I think.  I am crazy.” and  “I am bad.”

How this story affected what I believed about myself : “I have no responsibility and no expectations for myself or from other people. I don’t have to do anything because I can’t.  I am crazy.”

How this story affected my choices: “I can’t do….”  “I can’t be…”  “I can’t try….”  “I can’t choose.”

How this story affected my actions: I stayed on the couch in a fetal position with my face buried in the corner.  I spoke to no one.

 

You can take out the word “crazy” from the “I am crazy” story and replace it with several other words and get the same exact effects and results.

 

This type of story drains away all self-esteem and self-worth.  It steals our ability to take responsibility for our lives and have expectations for ourselves. It robs us of qualities that give us strength and courage.  It does not allow space for resilience and persistence.  This type of story causes us to accept mediocrity.

If you have these kinds of stories in your life, I invite you to throw them away and re-author your stories.

 

On my Facebook page, Thrive With Bipolar Disorder, I shared an example of a form of storytelling that I do when I am feeling stuck, scared or judged.

 

Here, I will share some ideas for how to re-author the stories we tell ourselves about what happened to us and about ourselves.

 

Re-Authoring Stories

 

Part 1: Deconstructing the Problem Story

When I help people re-author stories the first thing I choose to do is listen to and understand the story they have been telling themselves.

I want to understand the role the story serves in their life and what makes the story a problem to them.

For instance, with the “I am crazy” story.  The role of this story in my life was that it defined my identity and who I could be.   What made it a problem was that it sucked the life out of me, as seen above.

 

 

I want to know how the story was invited into a person’s life.

In my “I am crazy” story, the story was invited by a medical expert putting a label on me and telling me that I had to take medication for the rest of my life in order to fit into society.

 

 

It is important to explore the effects a story has on a person.

The effects of the “I am crazy” story on me were:

  • I had no expectations for myself.
  • I took no personal responsibility for my choices and actions.
  • I had no self-esteem, self-worth and self-respect.
  • I felt useless and incapable of being anything.
  • I felt that I was bad.
  • I was afraid of myself.

 

 

I choose to know what the person does to support the story they tell themselves.  What actions and routines support the story.

In my “I am crazy” story, I refused to get off of the couch.  I did not want to go to school for the life of me, not because of what the kids would think,  but because I no longer believed I had a functioning brain and was capable of doing anything with my life.

My routine was to wake up, get on the couch and bury my face in the corner.

This carried over from my depression.  As I was coming out of the worst depression ever, I continued the behaviors that I had while I was experiencing full blown “I know longer feel alive” depression.

 

 

I explore what the problem story steals from peoples’ lives.

My “I am crazy” story stole my will to live.  It stole everything I believed about myself up to the point that I had my manic episode.  Until then, I believed I could be anything when I grew up and I was a great student and daughter.

This story stole my confidence, my courage, my intelligence, my creativity, my hope, my dreams….

 

 

Together we explore flaws in the problem story, times when the problem story is wrong about people and times when people have the upper hand.  We look at evidence that uncovers other possibilities and alternative ways of understanding the problem story.

When I explored this with myself, the problem story went from “I am crazy.” to “What I experienced during those handful of months in my life was beyond my control…it was crazy AND I have the ability to do something about it.”

Here was the evidence that I am not crazy.  For the entire fifteen years of my life (I was 15 soon to be 16 when full-blown mania came into my life) I was a very good student, I had friends and sort of the ideal teenager to my parents, I never got in trouble.

After the full-blown mania and depression and after I got stable on my Lithium…I still could read.  I still could write.  I still could speak my mind coherently and my thoughts were relevant and intelligent.  I still was a kind, warm, compassionate and loving person.  I still was playful, funny and loved to laugh.  I could still feel my feelings and was on a dosage of lithium that left me always slightly hypomanic (throughout much of my twenties).

 

 

Once we are able to identify the possibility that the problem story may no longer fit, I explore with people what gets in the way of letting the problem story go.  Together we slowly work on what hold’s people back.

In my case, I was afraid to let the problem story go because I did not trust myself.  I was scared of myself that at any point in time I could go into full-blown mania and crash into a lifeless depression.

 

One of the things that often keeps people stuck in their problem story is that they don’t have a different story to replace it with.  They don’t have a story that they want instead.  With this as a challenge our goal shifts from understanding the effects of the problem story to creating people’s preferred story.

 

In the Part 2 of this blog we will explore this process of creating a preferred story.

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What medication does not improve with bipolar disorder

Many people believe that to treat bipolar disorder, you just have to get the right medication and the right balance.

That belief simply has never been true for me.

For me, medication prevents mania and prevents mania from getting worse…that is about it.

What follows is my experience of challenges that are consistently present when thriving with bipolar disorder.

Ruminating Thoughts

Ruminating thoughts are thoughts that repeat over and over again that are very difficult to stop.  Ruminating thoughts often occur during times of stress, excitement, uncertainty and insecurity.

When I have ruminating thoughts, not only can I not stop thinking about them, but it can be very hard to not stop talking about them as well.  The thoughts just sneak out of my mouth.  During these times, I do a lot more speaking before thinking.  When I experience ruminating thoughts, they often get expressed at inappropriate times, such as 5am or during a romantic dinner.

In all my years of struggling with ruminating thoughts, I cannot say I have “the solution”.  However, what helps me is the ability to recognize the “Aha!  I am having ruminating thoughts right now”.  By recognizing what I am experiencing, I may not be able to stop them, but I can contain them and better keep them from freely flowing out of my mouth.

Emotional Roller-Coasters

I get so sick and tired of emotional roller-coasters.  Preventing emotional roller-coasters is a consistent challenge that I face and manage.

I believe that I experience emotional roller-coasters during the same circumstances I experience ruminating thoughts – stress, excitement, uncertainty and insecurity.

What I’ve learned from emotional roller-coasters:

  • They start with a fantasy about what “could” happen or “may” be happening.
  • My imagination builds on that fantasy creating an entire story around what could happen.
  • My emotions don’t know or care what is real, they simply respond to my thoughts.
  • My emotions respond to my fantasy as though the story I am telling myself is actually happening right now.
  • The emotions then create their own thoughts based on how I am feeling about the fantasy.

As you can see, the journey of an emotional roller-coaster gets further and further from my reality with every thought.  Without this awareness of what my thoughts and emotions are doing to me, it is very easy to become delusional.

For many people living with bipolar disorder this can be so severe that they experience severe psychosis in the form of delusions and hallucinations.

Racing Thoughts

Even with medication, I still have difficulty expressing my thoughts at times.  Like with ruminating thoughts and emotional roller-coasters…when I am under stress, excitement, uncertainty or insecurity, my thoughts race or get jumbled.  During these times I have a difficult time expressing myself.  I have taught myself skills to cope with this, but those skills are effective maybe 50% of the time on a good day.

Following the Unspoken Social Rules

Unspoken social rules are my weakness. At times I feel like everyone except me has the “Social Rules Handbook” full of details of all the social rules full of boundaries and appropriateness when with acquaintances.  I do not naturally know what is appropriate dinner conversation. At times I feel like an alien watching people wondering “why don’t they just say what they mean or what they really feel?”

What comes naturally to me is to be honest about what I’m thinking and feeling. That does not work for people.  I’ve made plenty of people uncomfortable.  I truly believe that I am missing that part of my brain that just gets what is socially appropriate.

My research has taught me that my brain may have less mass (depletion) in the part of the brain responsible for picking up on and internalizing the unspoken social rules (anterior and posterior cingulates).

It takes effort to pay attention to how people interact to learn what is appropriate social behavior and what is not and no matter what I learn, it does not come naturally to me.

Thriving with bipolar disorder is not easy, but there is no other option.

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Good Stress vs. Bad Stress: How stress can trigger a bipolar episode

In the news lately,  Catherine Zeta Jones has openly shared her story of being treated for bipolar disorder that may have been caused by the stress of her husband, Michael Douglas, struggling with cancer.

People are wondering about stress and its relationship with bipolar disorder.  By no means do I believe I have “the answer”.  However, I do have a perspective that comes from my own experience that may shed some light on the types of stress that trigger an episode.

Good Stress vs. Bad Stress

Good stress comes from the combination of responsibility, goals and purpose with having a plan and structure to manage it.

Good stress is external, meaning it comes from doing something in the world.

Good stress may not cause a bipolar manic or depressive episode.

An example of good stress is, “I want to be successful in life.  In order to be successful I need to develop my abilities to do something that is meaningful to me.  In order to develop my abilities I need to learn information and develop the skills to apply them.  To learn information and develop skills I need experience.  In order to get experience, I need to get educated.  In order to get educated I need to study.  In order to study I need to pay attention in to my teachers and learn. etc…”

This example is full of stress and one that we all go through.  In my opinion, the stress of having to do these things is not what causes an episode for someone living with bipolar disorder.

This is productive stress that is goal oriented and task based.  This stress is emotion contained by a plan of action.

Bad stress is caused by internal pressures in response to overwhelm, urgency and fear.

It is caused by thoughts and feelings playing on each other without a plan of action.

Bad stress welcomes and ignites episodes of bipolar disorder.

BAD STRESS can take on multiple forms that build upon themselves:

  • Overwhelm

Overwhelm is a temporary state that occurs when we simply don’t have the interpersonal resources and information to achieve a goal.

In the example of good stress, there was a plan of how to reach a goal.  With bad stress there is no plan of how to achieve a goal.  As a result, a person may experience so much overwhelm that mania or depression gets invited as a coping mechanism.  Mania takes action or depression shuts you down.

Overwhelm is simply shouting, “I don’t know what I’m doing!” “This is too much!”  “I can’t handle this right now!”

So mania kicks in and the brain says, “Yay! I can do anything!” And it’s thoughts race a million miles a minute causing a person to focus on a goal for 20 hours straight using all of their brain power, even if the result makes no sense.

Or depression kicks in and the brain says, “I think and feel nothing.  I’m not getting out of bed. Lights are out, no one is home. Go away.”

  • Overwhelm + Urgency

Urgency is a real or imagined perception that something has to be done, RIGHT NOW.

This is a recipe for disaster for someone living with bipolar disorder because the imagined perception of urgency is a part of daily living.  Therefore, when it combines with overwhelm it can easily lead to mania or depression.

Overwhelm + Urgency are simply screaming, “I don’t know what I’m doing, but I have to do it RIGHT NOW!”

Mania kicks in and gets the job done or depression does nothing and simply shuts down.  Either way it is a coping mechanism to conquer overwhelm combined with urgency.

  • Overwhelm + Urgency + Fear

This is the worst.  Not only do you not know what you’re doing and it has to be done right now, but you have to deal with all of the “could’s”.

Example: “I could fail.”  “I could be humiliated.”  “I could disappoint everyone.”  “I could lose.” “I could lose the person I love the most in the world.”

When overwhelm, urgency and fear combine, which they tend to do eventually, you have the perfect storm for mania or depression.  It is a combination that is just asking for it in a person with bipolar disorder.

Bipolar disorder is interesting because it often causes many people to live with a sense of urgency regardless of an external source causing  urgency. 

In my own experience, I have to consciously remind myself that there is no external urgency in what I am doing.  I have to slow myself down.

The Hidden Stress

That doesn’t feel like stress at all

Excitement

When people think of excitement, they often don’t think of it as a stress response.  However, for a person living with bipolar disorder excitement is the match…or even easier a torch loaded with fuel.

People often ask me why that is…here’s what I believe.

We do not get excited about things that are familiar to us.

We do not get excited about things we know how to do well.

We do not get excited about things way off in the future.

Excitement is simply the really fun form of overwhelm and urgency.

Therefore, it is very common for people to experience excitement and have it lead to mania and possibly even depression.

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How to experience mania without it becoming a full on manic episode

This is a dangerous topic if misused that should be explored with caution and should not be attempted without the support and accessibility of psychiatric professionals.

By no means do I encourage any person living with bipolar disorder discontinue taking their medication or change their dosage in order to experience self-management (especially if you have not been medically treated and stable for several years).  To suddenly discontinue medication has the potential to be life threatening.

However, it is important that people living with bipolar disorder (and those treating it) know that contained mania can be a gift in a person’s life and permit them to continue to feel like they have not lost themselves.

There are some psychiatrists who prescribe so much medication that the experience of genuine emotion is not possible for a person. I take a stand against over-medication.

I have been stable with bipolar disorder for fifteen years and am in the process of becoming a licensed psychotherapist, what follows is how I experience mania without it becoming a manic episode.

Step 1: The Trigger

You must know your triggers.  You learn what they are by paying close attention to your episodes. Not all triggers will be able to be controlled and contained.

I have three types of triggers:

  1. Stress: that I’ve broken down to be defined as anything that I don’t have the interpersonal resources or ability to handle at the moment.  The lack of a plan of action.
  2. Excitement: Stress with a specific goal, yet I still don’t know what I’m doing, but it is so much fun figuring out how I will reach the goal and having the burst of excited energy.
  3. Urgency: When I feel the pressure to have or be something right now.

When either trigger combines with URGENCY that is a dangerous mania that I must contain as soon as possible. This form of mania could exacerbate rapidly into an out of control mania that could lead to full-blown mania if I am not paying attention.

The safest trigger for me hands down is EXCITEMENT. However, it’s a catch-22 because if I do not pay attention and respond carefully to the excitement, URGENCY will get involved and then I am in the danger zone.

My least favorite trigger is STRESS because I have no clear goal and no plan of action. I simply don’t know what I’m doing so I’m completely overwhelmed.

URGENCY is so dangerous because it causes us to ACT and those actions can change our lives permanently.  URGENCY also causes us to lose control on every level and mania takes over.

I cannot stress this enough.  The key is to pay attention. Keep an eye out for URGENCY.

Step 2: The Mania

I only allow myself to experience mania that comes from excitement.  Any form of mania that comes with URGENCY is dangerous to me and must be contained right away (see below).

My Actions of Mania:

I think about, research or work on a project or goal for several hours straight (significantly beyond 9 hours a day).  I become so obsessed on my goal that I can think about nothing else.  Key: I am unable to stop thinking about my project or goal and I cannot stop working towards my goal. I am obsessed.

How do I know when I am in trouble:

I am not able to sleep.  I stay up all night with both ruminating thoughts and new ideas.  I sneak out of bed to do research or keep working.  I do not disclose to people about what I’ve been doing all day because I don’t want them to know how obsessed I am.

How I keep URGENCY away:

Urgency is really hard to keep away.  It has taken me years of practice.  What it comes down to is throwing away the time-line for when my goal has to be achieved or the project I’m working on must be completed.  It requires the will and ability to put down and put away what ever it is that I am working on.

It was very easy to write those sentences, but very difficult to do in real life.  It takes me tremendous will power to prevent urgency.

Step 3: Containing Mania

I cannot say it enough how important learning how to pay attention is!

I allow myself usually only one day to experience mania because that is safest for me.  In the past I allowed myself a week and I really paid for it.  It took me months to recover and feel like myself again.

By giving myself only one day of mania, I notice that the recovery time only a few days and there are minimal consequences in my life.

Here is how I contain my mania:

  1. I get support.  I let everyone close to me in my life know that I am experiencing mania and ask for their support.
  2. I give myself permission to experience mania from when I wake up in the morning (which is really early since I was probably up all night being obsessed) until 5pm.
  3. I force myself to stop working on my goal in order to eat and shower.  This is not always easy to do.
  4. At 5pm, I have to completely remove myself from the situation.  I disconnect myself from whatever it is that was fueling my mania…the excitement. I do not give myself access to what excites me. If I am not able to do it, I ask for help from my support system.
  5. I eat dinner and usually with some form of prescribed sleeping aid, I take my lithium and go to sleep for about 10 hours.  Otherwise, my mind will not stop thinking.

When I wake up in the morning, often it is as though a reset button has been pushed; however, the manic energy is still somewhat present, but in a weakened form.

With the remaining mania, I do not allow myself to even get close to working on the goal that triggered the mania. Instead, I put it to work in some other productive way (like cleaning etc).

I spend the day doing self-care practices that include both exercise and repetition because it has a calming effect on me.

I continue my self-care practices until I notice that I am no longer triggered and that the fuel that fed the mania has been consumed.

I continue working on my project or goal once the excitement of it has worn off and it becomes “work” again.

This is my story for how to experience mania without it becoming a full on manic episode.  I hope this is useful to you.

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Answering Readers Questions: March 23, 2011

I highly value curiosity and welcome questions that can be generalized to be helpful to a lot of people.

Every thing that I write here is my opinion based on two things, my personal experience of living with bipolar disorder and my experience of helping people live with bipolar disorder both professionally and through out my life.

Here are the questions I have received recently:

  • What do you mean by “I am living with bipolar disorder”?

  • What are an M.A. and MFTi? (The letters that come after my name)

  • Can you treat bipolar disorder with just medicine or do you need therapy as well?

  • What does lithium do?

What do you mean by, “I am living with bipolar disorder”?

CLEARING UP CONFUSION: I, Robin Mohilner, was diagnosed with bipolar disorder as a teenager. I do not write from the perspective of living in a home with someone diagnosed with bipolar disorder.

I do not own “bipolar disorder” as my identity.  It is not who I am.  I try to refrain from saying, “I am bipolar.” That gives bipolar disorder the upper hand in my life.

By having the attitude and mindset that “I am living with bipolar disorder.”, I have the upper-hand.

I am in a relationship with bipolar disorder. I experience it as separate from me.  It affects me and I affect it (powerfully).

It does not control me, but when I’m not paying attention to our relationship, it temporarily gets the upper hand and I lose my power and control.

When I’m not paying attention, bipolar disorder loves to take me on emotional rollercoasters.  It loves when I am nervous or uncomfortable because it gets the upper hand and off I go unknowingly breaking unspoken social rules and impulsively speaking before I think or it makes me think so fast that it’s difficult to get words out of my mouth.

On the other hand, I have spent fifteen years developing a strong upper hand.  I get how bipolar disorder works.  I know how to prevent and contain my episodes.  I know what bipolar disorder needs and wants.  I am skilled in the art of stealing its power and fuel so that it cannot control my life.  My passion is to develop this in others.

The key is that I exercise my “paying attention” muscle everyday.  This keeps me living with bipolar disorder instead of being bipolar.

What are an M.A. and MFTi?

This question addresses my professional credentials.

M.A. refers to the Master’s Degree that I have earned in psychology, specifically in Marriage & Family Therapy, with eligible certification as an Art Therapist.

I earned my Bacherlors degree from U.C. Berkeley in Psychology and my Masters Degree from Phillips Graduate Institute in Marriage and Family Therapy.

However, earning degrees does not make me a therapist.  I have spent years paying my dues, which will explain the MFTi.

MFTi stands for Marriage and Family Therapist Intern. For the past five years I have practiced as a therapist under the license of supervising therapists.

I have successfully completed all of the hours of experience that I need to become a licensed therapist; however, I am currently patiently waiting (it’s a long wait) for the state of California’s Board of Behavioral Science to approve my hours of experience and grant me permission to take two challenging exams.  When I pass these exams, I will be officially a Licensed Marriage & Family Therapist (LMFT).

Can you treat bipolar disorder with just medicine or do you need therapy as well?

You CAN do anything you want. Nonetheless, bipolar disorder is complex and it affects a person’s complete way of being in the world.

Bipolar disorder is a reflection of the way the brain functions. It affects both how people think (very fast), feel (passionately) and how people respond to things that cause excitement, stress, fear and basically any human emotion.  There are both profound strengths (example, many experience high levels of intelligence and creativity) and weaknesses (example, having no intuitive clue about what is socially appropriate).

Bipolar disorder affects people’s self-esteem, relationships and quality of life.  Medicine does not change that.

Medication only reduces depression and mania.  Bipolar disorder is more than just an episode.

Therapy helps one navigate through the complexity and develop their awareness of how they are affected by bipolar disorder and utilize their own strengths, abilities and skills to construct their preferred way of being.

What does lithium do?

Scientists still do not know how lithium works.

Nonetheless, they do believe they have found two ways that lithium affects the brain.

One way they believe the brain is affected is at the level of the axon in neurons. Neurons are the brain’s cells that do all of the communicating.  Scientists believe that lithium affects the myelin sheath on the axon (the part of the neuron that message travels down). It is believed that brain’s affected by bipolar disorder have deteriorated myelin sheath and lithium may help reconstruct it.

Another more recent finding on the effect of lithium is that scientists have found that lithium may build  brain structures that are deteriorated in people living with bipolar disorder. Some of these early findings show that scientists witness change in areas such as the amygdala (seat of emotions in the brain) anterior and posterior cingulates (seat of impulsivity, awareness of unspoken social rules, center of inhibition that are all diminished in people with bipolar disorder).

If this was helpful, feel free to send me general questions and I will do this on a more regular basis.

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Lessons learned from UNCERTAINTY in the workplace

Have you ever felt like everyone else, but you, was given a guide-book for proper etiquette in various  work and social circumstances?

Some people just intuitively pick up on social rules and know how to behave or have an inner critic that keeps them from saying or doing something inappropriate.

Well, I don’t have that guide-book and I often speak before I think and lack a strong inner critic that inhibits me from speaking my mind or doing what I feel is right.

This is very common for people living with bipolar disorder.  Our brains have a unique design.

Not having these qualities has the tendency to get me in trouble, especially at work.  Here’s some of what I’ve learned from the challenges of not having an intuitive guide and inner critic.

This is the beginning of a series to explore challenges people living with bipolar disorder my experience in the workplace.

Challenge: Uncertainty

What makes it a problem:

In my experience of living with bipolar disorder I have discovered that uncertainty is a key ingredient in inviting mania into my life. Uncertainty by itself will not trigger mania for me; however, uncertainty combined with the other ingredients of excitement and a sense of urgency…and I have the recipe for a manic episode.  (It does not guarantee a manic episode, but it makes me vulnerable to mania.)

Uncertainty is a problem in itself because it has the power to trigger my fear of being out of control within myself. The fear of being out of control within myself is rightfully my deepest fear because of my experiences of mania and depression.

This is not true for everyone.  Everyone experiences bipolar disorder differently.  This is solely my insight into my experience of it.

Here’s how I believe uncertainty gets it’s power:

The FEAR of uncertainty ( fear of what could happen) triggers insecurity.

Insecurity happily welcomes ruminating thoughts.

Ruminating thoughts partner up with strong emotional responses.

And poof…an emotional rollercoaster takes off at high-speed.

In my mind, my emotions were in control and taking me for a ride, even though nothing in my circumstances had changed.

 

How to recognize when the problem is uncertainty:

I worked in an environment that lacked structure and expectations for what I was supposed to be doing in order to be useful and effective.

All people benefit from having structure and clear expectations; however, for people living with bipolar disorder it is a MUST.

Because I did not know what I was supposed to be doing, when I started, I dove in, got creative and tried to participate in any and everything that I could.  I did this because I needed to create structure and expectations for myself, so that I could function effectively.  The alternative, an emotional rollercoaster,  is not beneficial for me or for business.

Unfortunately my effort to create my own structure and expectations was not appreciated by my colleagues and supervisors.  My efforts possibly appeared to be a lack of respect and arrogance on my part to come in and try to change their system to fit me.

 

What to do about uncertainty:

No one can make uncertainty go away.  We will all live life “not knowing” something.  However, how we respond to uncertainty is crucial in how it affects us.

My greatest lesson in regards to how to effectively respond to uncertainty for me, was learning how to sit with uncertainty.  It was hard for me to learn because I used to normally respond to uncertainty with impulsivity (which got me in trouble.)

Therefore, I had to try a different response, on that was not impulsive.  So I chose patience. Patience was a tough choice.  Patience was something that I really wasn’t all that good at.  I didn’t even know what patience really looked like.  To me it was like sitting on my hands in front of the cookie jar…that’s sort of being mean to myself.

Since that wasn’t working for me, I chose a new response…“observation”.  This time, when I experienced uncertainty, I took the following steps:

 

Observed my thoughts

I simply noticed what I was thinking.  I wouldn’t run with any of my thoughts (add emotion to them) or take action.  (That is impulsivity.)

 

Observed the situation and environment

This was easy, all I had to do was pay attention.  I didn’t get involved in anything happening, I simply watched the interactions taking place and tried to notice patterns and rhythms in how everything worked together.

 

Identified needs, roles, weaknesses and strengths and what I could do that would be valued.

This helped me to give myself a structure and create expectations for my role in work. It also empowered me to be able to anticipate needs and opportunities to be effective.

 

The funny thing about learning how to observe is that it taught me how to be patient.

In the next post, we will explore lessons learned from OFFICE POLITICS in the workplace.

 

 

 

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