Continued from part one of How to Tell Someone They Have a Mental Illness.
Thirdly, I recommend printing out information about the disorder for the person. There are plenty of resources online that will tell you the basics about a disorder and if you have this information ready, the person with the illness doesn’t have to go searching for it. Books are another good option. But know the person with the mental illness may use this information in dribs and drabs as information overload is a real possibility and will help no one.
Fourthly, look up places and ways the person can get help. There’s no point in pointing out a problem if you can’t offer a solution. In this case the solution is help. The easiest place to get help is your family doctor so maybe you could make an appointment for the person. You family doctor can do an initial assessment and refer the person to the appropriate person (probably a psychiatrist) for a full evaluation.
Additionally, there are all sorts of mental health and addiction related resources available and they are listed by location here.
When someone has a mental illness it can be very difficult for them to see it. The very nature of a brain illness is such that the brain itself has a hard time recognizing it. We are often so wrapped up in the symptoms that we can’t see that what we’re really suffering from is an illness and not just a bad day, bad week or bad month. This is to say nothing of anosognosia, the clinical condition wherein people don’t possess the insight necessary to understand that they are sick.
Sometimes Others Can See We Have a Mental Illness
So sometimes the people around us are the ones that realize we’re sick before we do. Sometimes it’s our loved ones that can clearly see a pattern of behavior that goes beyond unusual into pathological.
But if you know someone who you suspect has a mental illness, how do you tell them?
A pet peeve of mine is when people say, “normal is just a dryer setting.”
Um. No, it isn’t. Normal is a word that means “conforming to the standard or the common type; usual; not abnormal; regular; natural.”
Normal is not just a freaking dryer setting and pardon me for stating the obvious, but I am bipolar and I am not normal.
Every six weeks or so I like to do a quick round-up of writings I’ve done elsewhere, just in case you’ve missed them. This session’s round-up include subjects like assisted outpatient treatment, self-harm and mental health stigma. Here are some of the notable articles:
- Assisted Outpatient Treatment Thoughts – I’ve previously written here about assisted outpatient treatment (AOT; also known as Laura’s Law) and I’ve written two additional pieces on Human Rights and Assisted Outpatient Treatment and Does Assisted Outpatient Treatment Work?
- Self-Harm Thoughts – I’ve been on a bit of a self-harm jag recently and I’ve written about Stress Leading to Self-Harm, created a video on Stress, Anxiety and Self-Harm and whether or not to Hide Self-Harm Scars. I’ve received some amazing and touching comments on these pieces.
- Credibility and Mental Illness – ironically, by admitting I write under a nom de plume I seem to have lost credibility with some people on a very post talking about Losing Credibility Due to a Mental Illness.
- Acceptance and Mental Health – as I wrote about Acceptance of Bipolar Disorder Being a Process, acceptance of mental illness treatment is a process also, including the idea that Taking Medication Makes you Weak. This includes information on accepting the limitations placed on us by bipolar disorder.
- “Soft” Bipolar – information on what Bipolar Not Otherwise Specified (NOS) is. Indications you might be bipolar even if not traditionally so: Soft Signs of Bipolar Disorder.
- Drug-Free Treatments – Alternative Treatments for Bipolar disorder, Cognitive Behavioral Therapy (CBT) for Bipolar disorder and Drug-Free Products to Help you Sleep better.
- Understanding How Lithium Treats Bipolar Disorder – mice are helping us understand bipolar disorder and lithium.
The Bipolar Burble welcomes guest author Daniel Bader, Ph.D of Bipolar Today for today’s post on dealing with bipolar disorder in university. Bader proves again that you can do anything you want to do with bipolar disorder, you may just need a bit of help.
I was a student for a very long time, having just finished up my doctorate after nine years of study, not counting my two years of parental and medical leaves. It was quite a challenge, and most of those challenges came not from the program, but from my bipolar disorder.
However, having gone through it, I wanted to discuss some of the challenges of being a student with bipolar disorder and some of the tricks that I picked up along the way. Hopefully, it can help others who might be presently in university or considering going there.
Challenges as a Bipolar University Student
There were a lot of challenges with being bipolar as a university student, but there were definitely three issues that dogged me through most of my program:
- Isolation: Studying is an isolating experience. There’s endless research, reading and writing that is done entirely by myself. I found being alone with my moods was rarely a pleasant experience.
- Fluctuating Self-Esteem: It’s hard at the best of times to evaluate the quality of our writing. With bipolar disorder, my work would often seem incredible or terrible, making it hard to do revisions.
- Depression: Depression is awful, and it just crushed my ability to work efficiently. As a result, I often found myself falling behind.
My Strategies as a Bipolar University Student
Over time, however, I was better and better able to deal with these problems, ultimately finding my experience a satisfying one.
- Finding Ways To Be Social: For my entire university experience, I never once lived alone. I lived in residences with shared meals, with a good friend, with my parents and ultimately with my wife and children. This kept me from slipping into the infinite regress of self-reflecting moods that isolation brings.
- Finding Someone Whose Opinion I Trusted: I was able to develop a good rapport with my dissertation supervisor, who would help me see what was working and not working in what I was doing, when I wasn’t able to get the proper perspective. Before my dissertation, I would often show papers to friends to get their opinions.
- Getting Help: It took me a while to get proper help as a student, in part because I kept being put on the wrong medications (long story). However, once I had a proper regime of medication and therapy, I found that my depression improved significantly, and I was able to zip through the last few years of my doctorate, even while teaching half-time and starting a family.
Being a student with bipolar disorder, especially a graduate student, provides a lot of challenges. The isolation and fluctuating moods can wreak havoc. However, by figuring out what those challenges were and finding strategies to deal with them, I found I was able to complete and even often enjoy my experience.
Daniel Bader, Ph.D., is a recent graduate and works as a university instructor. He now runs his own website on bipolar disorder called Bipolar Today.
In the book I’m writing on electroconvulsive therapy (ECT) I’ve had to address the question as to how ECT works. However, in spite of the fact that ECT has been in use since the 1930s we really don’t know how ECT works.
But recently we may have gotten a bit closer to figuring it out.
[Note: I am running a survey on real patients’ experiences with, and perspectives on, electroconvulsive therapy (ECT). If you’ve had ECT and want your voice heard, please take the survey here. More detailed information on the ECT survey can be found here.]
Last week on HealthyPlace’s Breaking Bipolar I mentioned that I use a nom de plume. Yes, that’s right, Natasha Tracy is not my legal name. I don’t think this should come as a gigantic shock to anyone given as writers have been writing under pen names since the beginning of the written word.
But apparently it did come as a shock. And apparently people felt betrayed by this piece of information. And apparently some people felt like being rather nasty about it. And apparently some people felt like becoming ex-readers over it.
Well, OK, fine, that’s your prerogative. But I have my reasons for not using my real name. Here are a few.
I don’t want people knowing where I live. I don’t want stalkers.
Allow me to relay a short tale to you.
Writing and Death Threats
I have a good friend who is a writer. He writes on sensitive, emotionally-charged subjects similar to mental illness. And is the case with us online personalities, he got death threats. Horrible, but not something that isn’t expected in the world of the internet.
My friend was the kind of person who did share real details about his life and family and he did use his real name. So when it came time that a stalker really hated him, the stalker found out where his kids went to school and made threats against them.
Yes, that’s right, threats against his kids. Deplorable. Unthinkable. And illegal.
And if you think I’m going to facilitate that type of behavior where I’m involved you’re downright batty.
No, I’m not in the Book
The reason that I don’t use my real name and I don’t tell people exactly where I live is because I don’t want a real-life stalker. It’s because I don’t want someone to make death threats and easily have the capacity to follow them through. It’s because my privacy is important to me. It doesn’t mean I’m not open, or honest, or even make public appearances and videos, but it does mean that you don’t get to be able to easily find me. That is not your right.
I want to be hirable in fields other than mental health.
Again, a short story.
I was working for a very fancy software company. One that makes the software you’ve probably got on your computer right now. I worked among some of the smartest people you can imagine. Their big brains were barely contained in our building.
And while I was working there I had a vagul nerve stimulator implanted. The details aren’t important but suffice it to say that when it activates it cuts off my throat and makes it difficult to speak. So if I was in the middle of a conversation with a co-worker I would wave a magnet in front of the computer implanted in my chest to turn it off so I could continue speaking. I never told people what it was or why I did that, trying to make it as inconspicuous as possible.
However, my co-workers decided on their own that the device must have to do with my heart and that every time I waved something over that area of my body it must be because I was so stressed in the conversation that something was going wrong with my heart. My co-workers assumed that I couldn’t take the stress of the job due to something that had nothing to do with stress.
They just made a judgement without facts.
(I didn’t know this for a long time. Eventually one of my co-workers told me.)
And once I found this out I realized that’s why people had started treating me differently – not because there was anything wrong with me but simply because they perceived that something was.
Employees Judge You
And you can bet the judgements would have been worse if, heaven forbid, they thought I had a mental illness. People suggest that others don’t judge you for your differences when this blatantly isn’t true. I had a slight difference that produced no change in my behavior and yet it changed the way other people treated me. People can be biased and bigoted and small-minded. If nothing else, it’s a subconscious thing.
Employers Judge You
And even worse, in the same environment one of the employees was assumed to be bipolar. And he had to leave the country (and finally the company) to get a fresh start because of how it affected how people treated him.
These are not things I made up. These are things that I have witnessed, things that I have lived. If your experience has been different that is great, but I wouldn’t risk having that kind of experience again. I just wouldn’t.
(Keep in mind that I’ve work in very-corporate America where backstabbing and politics run extremely amok.)
Employers Google You
And let’s not forget that before any techie geek is hired the employer Googles the heck out of them and if they were to find my writings, judgements would run rampant.
Why I Use a Nom de Plume
So, quite frankly, death threats, stalkers, prejudice, hirability and other reasons are why I use a nom de plume.
And I will not apologize for that. You can judge me and feel it discredits me if you like, but I believe my work speaks for itself and your judgement speaks considerably more about you than it does about me.
One of the criticisms antipsychiatry folks like to make of psychiatry is its lack of objective diagnostic criteria. In other words, there’s no blood test that says you have bipolar disorder or schizophrenia.
And this is true. While today we do have blood tests for biological markers indicative of mental illness diagnosis, there is no hard and fast test that can diagnose a psychiatric disorder (except Huntington’s, for which we have discovered a gene).
The fact of the matter is no matter what is written in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or what blood we draw or which scans we do nothing diagnoses a person properly except a trained psychiatric professional.
But that doesn’t mean there’s nothing objective or meaningful about it.
In fact, using the diagnostic criteria from the DSM or even from a clinician’s clinical experience allows two experienced clinicians to arrive at the same diagnosis for a patient. (Is this always true? No, of course not. But there are second opinions in all of medicine so this is hardly rare.)
Psychiatric Diagnosis and Treatment
However, even if two clinicians were to arrive at slightly different conclusions, for example, one says unipolar depressive and the other says bipolar not otherwise specified, I would argue that it hardly matters as alleviating suffering is the goal and the diagnosis is only a way of getting to that end.
. . . clinicians do not in general fret over what does or does not constitute a disease. . . . If, for example, a patient’s arm is broken in a car accident, a doctor doesn’t lose sleep pondering whether this represents ‘broken bone disorder’ or simply an expected response to an environmental stressor—the bone is set and the arm is casted . . . mental disorder or not, clinicians working in ‘mental health’ see it as their calling to try to improve the lives of whomever walks through their office door seeking help.
Similarly, it is objective as to whether a person is suffering or not and thus it is obvious the person needs help regardless as to what the ultimate diagnosis is.
Do Psychiatric Diagnoses Matter?
Yes, of course psychiatric diagnoses matter as they direct treatment, however, just because there is no hard and fast test governing that diagnosis doesn’t make it any less valid nor does it mean that psychiatry doesn’t have a place in its healing.
After my recent post about stress leading to hypomania in bipolar, I’ve had a couple of questions about what tools I use to handle hypomania. I’m happy to share my experience with hypomania but I can’t promise it will agree with your own. (Remember, hypomania is not the same as mania. In bipolar I, mania can easily be life-threatening.)
Are You Hypomanic?
I know it’s tough to admit you’re hypomanic, which is a mood, which is a symptom of bipolar, because many of us enjoy parts of hypomania and we don’t want it to go away, especially considering some of the alternatives. We just want to believe we’re feeling “good.” Really good. Which would be nice.
Nevertheless, the first step in dealing with bipolar hypomania is realizing that you’re hypomanic. And, of course, there are various degrees of hypomania – the more hypomanic you are the more worried you probably should become. The more hypomanic you are the more you need to focus on dealing with it properly because the chances are greater are there’s a nasty depression waiting for you at the end. (See, Self-Diagnosing Hypomania.)
How to Handle Bipolar Hypomania – Self-Talk
The first step in dealing with hypomania is self-talk. If you know you are hypomanic then hopefully you can create the presence of mind to not make decisions based on your mood. Yes, I understand you feel like you’re the most brilliant person on Earth but the President probably doesn’t want to hear about it, k?
Self-talk is about your own awareness. Yes, I’m hypomanic, that’s why I’m feeling this way. Yes, I’m hypomanic, that’s why I want to act this way.
If you know that, and you can (probably) repeatedly tell yourself that, then you can start to correct some of the problems that are likely to happen when you’re hypomanic.
Dealing with Bipolar Hypomania
So to deal with bipolar hypomania:
- TAKE YOUR MEDS and see your doctor if the hypomania puts you or your life in jeopardy
- Don’t make any big decisions; don’t make any major purchases
- Don’t eat sugar or caffeine; don’t take drugs or drink alcohol
- Don’t skip meals – force yourself to eat good food
- Breathe – your hypomania is going to want to speed you up but purposeful, deep breathing will slow you down – but you have to do it for it to work
- Try meditation or yoga (if that’s your thing)
- Exercise to wear off the excess energy in a positive way (One commenter mentioned this can be activating for them so be careful about that.)
- Force yourself to sleep on schedule (I admit to using sleeping pills for this. I believe it’s much better to take pills and sleep than to not take pills and not sleep. I believe it is much better for mood and this one step can often right hypomania immediately.)
- Check in with yourself on your actions – before you go and sleep with that handsome stranger, check in with yourself and really see if it’s you that wants a one night stand or the illness. Are you really angry with your friend or is it the illness?
In short, whatever the hypomania wants you to do, do the opposite. That’s not a very fun rule but it is a generally true rule of thumb. Hypomania feeds on itself so the more you give into its behavior the stronger it will get (just like depression).
Self-Awareness and Bipolar Hypomania
Dealing with hypomania is like dealing with any other mood – you need to see the mood, analyze the mood and outthink the mood. It’s hard but that’s what self-awareness is about. And self-awareness is what’s going to get you out of the jams that hypomania has a tendency to put you into.
(This is not to suggest you can always do this on your own. Sometimes other people can be your saving grace as they can see your behavior and moods much more clearly than you can. It’s OK to lean on them for their insight too.)
How do you like to handle hypomania?
As many people know from my last post on hypomania, last week I was filmed for a documentary by Andy Fiore. The documentary is about bipolar disorder and I was one of three people interviewed. Michael Schratter of Ride Don’t Hide, an international tour and movement to battle mental illness stigma, was also interviewed.
What’s It Like to be in a Documentary?
So, what was filming the documentary like? Well, there was some talking and some acting, but mostly acting like a version of me, a version of me that walks in girl shoes, that is.
I met Andy at the Vancouver Central Library and we enjoyed a latte in the gorgeous, cobblestone courtyard. He’s a bright enough filmmaker to know that being on film requires the energy of caffeine (although truthfully I’d probably had enough already).
Then we began to shoot “b-roll” which is, “supplemental or alternate footage intercut with the main shot in an interview or documentary.” Alternate footage contains scenes of me walking on the stairs, walking across the courtyard, looking at flowers and so on. If you like watching Natasha Tracy walk up stairs, then this documentary is for you.
We then moved into one of the glass meeting rooms of the library where I checked my makeup before shooting, getting loose powder all over the table and floor (sorry janitorial staff). Andy then proceeded to ask me about two hours’ worth of questions. He asked and I answered while attempting to maintain good eye contact with the camera. A wandering gaze is bad in such scenarios.
Somewhere in the middle of the interview I found that all my happy energy from the hypomania had simply vanished. My brain slumped; I can only hope it wasn’t visible on film.
We then finished off with more coffee (thank-you Andy; thank-you caffeine) and a few more b-roll shots with me walking in downtown Vancouver.
Thoughts on the Bipolar Documentary
Overall I think the shoot was really positive and I hope Andy got everything he needs for his final cut. He’s deep into the editing of another film right now so I won’t be seeing a rough cut of the bipolar documentary for a couple of months.
While it’s nerve-wracking to have someone ask you questions for two hours while looking into the abyss of a camera lens, I will say it’s absolutely worth it. It’s a powerful way to get positive, real information about mental illness out and I’m honoured to be a part of Andy’s work.
Speaking out – it dispels fear and stigma.
PS: Pictures from the shoot are coming.
I’m not sure how your average person deals with stress. Bingeing? Talking? Ranting? Raging? Running? I just don’t know. As far as I can see, people do all those things when they’re stressed.
But for a person with bipolar disorder, stress can lead to hypomania. And one has to deal with the stress and deal with the hypomania combined – which is kind of stressful in and of itself.
Tomorrow I’m being filmed for a documentary by Andy Fiore of Fiore Films. It is for a documentary about people who have learned to successfully live with bipolar disorder. As many of us do, I successfully live with bipolar disorder type 2 even if it’s a rocky path much of the time. And one might argue, I have turned my bipolar disorder into a positive by becoming a mental health writer and helping create a positive path for others living with bipolar disorder.
OK. Fine. But I kind of can’t breathe.
But I admit, I’m nervous. Stressed. I’m stressed about appearing on camera. Even though I do a video spot for HealthyPlace once a month, I still don’t feel particularly comfortable looking into the black abyss of a camera lens.
What do I wear? What do I say? What do I not say? How do I not sound like a shmuck? I just don’t know these things. These are unanswered questions for me.
And they sure the heck are eating away at the back of my brain. And maybe the middle of my brain. And maybe the front. So sayeth the fragments of brain I can scrape together for a consensus anyway. Many other fragments are off doing random bits of flittery that keep distracting me from writing.
My brain is taking the stress, that would make an average person feel, well, stressed, and turning it into hypomania. A fast-thinking, fragmented-moving, cluttered, shaky world view.
Bipolar Hypomania is Useful?
And all this hypomania is kind of useful in that it’s helping me get a lot done before I’m off to do the filming (it’s going to eat a whole day). I appreciate that. But hypomania also seems to turn the stress volume up to 11, makes sleeping impossible and makes following through on a task extremely challenging. It’s like pumping 110 volts into a 100 volt socket. It’s powerful but one could argue the usefulness of lighting your wiring on fire.
Using and Not Abusing Hypomania
Hypomania then, is pretty dangerous. It’s a sharp knife, good for slicing carrots but deadly on the fingers. So I try to use it for what it’s good for – producing energy and getting things done – and yet try not to let it get out of control. I won’t drink coffee or eat a tonne of sugar and I’ll force sleep on myself through whatever means necessary tonight. I won’t encourage the hypomania, I’ll try to work with it accepting that I’m not going to be able to make it go away completely.
Hypomania Passes, and Not Usually in a Friendly Way
And if there’s one thing I think it’s quintessential to remember it’s that the higher you fly in hypomania the farther there is to fall when you’re done. A hypomanic Wednesday, due to excessive stressors will probably lead to one heck of a Thursday coming back from an impact crater.
So, wish me luck, deep breaths and good hair. I’ll let you know how it goes.