10 Tips to help you understand, manage and thrive with a diagnosis of bipolar disorder

Whether you have no experience with mental illness or you have multiple family members who are struggling with it, hearing a medical provider tell you that you have bipolar disorder is disorienting at minimum, it may even feel devastating. What does it mean if you've been told you have bipolar disorder? Does this mean you have to quit your job or never have children? Does this mean you'll have to take medications for the rest of your life? How do I hide that I'm a "crazy person" from my family, friends, co-workers?

Ways to help you understand, manage, and thrive with a diagnosis of bipolar disorder.

1. Get educated about bipolar disorder.

Read reputable online resources and books that will tell you about the different kinds of bipolar disorder, various symptoms, types of treatments, and ways to help you manage it. Take notes about any questions to ask your treatment team. Be aware that many people who have bipolar disorder are misdiagnosed, there is no one test to take to give you a definitive diagnosis.

2. Have a good treatment team.

Finding a good psychiatrist and psychotherapist are arguably the most important tasks when you receive a diagnosis of bipolar disorder. If your primary care doctor is guessing at your diagnosis and can't answer your questions, or your therapist isn't too familiar with helping people manage symptoms of bipolar disorder, ask them to refer you to someone who specializes in treating bipolar disorder. There is often a huge disparity in the availability of mental health professionals. This is when advocating for yourself comes in, and if you're not functioning well, asserting yourself may be extremely difficult. Find a support person to help you (see #4) if you need to seek other providers. You need a treatment team that takes the time to answer your questions and treat you as a whole human being, not just a set of symptom check boxes.

3. Write down all your questions about bipolar disorder and get them answered by your doctor, psychotherapist or counselor.

You have the right to ask the professionals to explain bipolar disorder to you and your support person. Keep in mind that bipolar disorder is unique to every person, so if you are diagnosed with Bipolar II, it doesn't mean that your moods will follow the exact patterns out of the DSM (Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the most used guide book for mental health professionals for diagnosing mental illnesses. While you may or may not fit into the "textbook" definition of your diagnosis, you deserve to have all your questions answered by the professionals. If they won't take the time or don't know the answers, ask them for resources that will answer your questions.

4. Create a support network.

I mentioned above to bring a "support person" with you to doctor appointments, so let me explain more about why this is crucial. Often the diagnosis of bipolar disorder comes when you are severely depressed or struggling with racing thoughts and other manic symptoms that may be interfering with your ability to function. To help you process all the information needed to start appropriate treatment, find a support person to help you. Choose someone you trust, is reliable, and willing to be there for you to take notes, ask questions and even contact your treatment team when you aren't able to. Sign a release of information for your doctors and therapists so your support person can attend appointments and ask questions on your behalf.

In addition to a designated support person, do your best to build a network of people who know what it's like to deal with having bipolar disorder. Finding others who are struggling with some of the same issues as you helps to not feel so alone. Look up bipolar support groups in your community and attend a couple of different ones to see if you can find someone you relate to, even make some positive and supportive friends. Listen to guest speakers that can answer questions, and find group facilitators that can help you locate resources. The Depression and Bipolar Support Alliance (DBSA) offers in person and online groups, as well as National Alliance for Mental Illness (NAMI).



5. Learn about all of your medications.

Ask your doctor what symptoms each medication is targeting, the manner in which symptoms may be alleviated, most common side effects to watch for, dosages and time of day to take each one. Write all this information down, or have your support person do so because it's a lot to try to remember, especially if you're not functioning well.

6. Keep a log.

One of the most helpful tools to track mood changes is to keep a daily (or at least weekly) log of your mood ratings, hours of sleep, meals, activity level, medications, and other factors such as menstrual cycle or other stressors. There are many cool phone apps that have mood trackers, or you can find one online. Mood charting is very helpful for taking a look at what medications may be helping or exacerbating specific symptoms, as well as how sleep and nutrition habits and outside stressors are being managed. If you're feeling especially anxious or more depressed lately, you can take a look back at the last couple of weeks or months and see if there is a pattern of less sleep or more stressful events, and make a plan to get back on track to start feeling better.

7. Create a daily routine and follow it.

There are thousands of studies indicating that following a consistent healthy lifestyle routine can improve and maintain balance in people with bipolar disorder. Going to bed and getting up at the same time, eating healthy meals around the same time every day, getting regular exercise, and stress management skills are all emphasized in the majority of these studies. Terms like circadian rhythm and sleep hygiene may be included in many scholarly as well as casual articles about managing bipolar disorder. These are referring to regulating your body clock to help even out any other physiological changes that affect your overall health. This is a great place to start helping yourself by developing a routine that fits into your life. Ask your family, friends, and support network to help you stay on track with your daily routine.

8. Learn coping skills to manage depression, anxiety, mania and stress, and create balance.

Whether it's drawing pictures, listening to music, exercising, or keeping a daily log of negative thoughts using cognitive behavioral therapy, find a good therapist or counselor who is well versed in helping you create an individual treatment plan to address your symptoms. Stress is pretty much universal in today's multi-tasking world, but people with bipolar disorder may be more easily triggered by stressful events than others. Learn new ways to cope with daily stress as well as flare ups of symptoms that get in the way of living your life. Learn to create balance in your life by developing and practicing healthy boundaries and limiting the demands on you.

9. Addressing shame, embarrassment, guilt, stigma.

Feeling ashamed of having a mental illness, which is a brain disorder, is very common unfortunately. In addition to dealing with the symptoms of bipolar disorder, a flood of uncomfortable feelings may arrive including shame, embarrassment, and sometimes guilt for any disruptions the illness has created in our lives with families, friends, or co-workers. Working with a competent therapist or counselor who can help you peel away those negative feelings to uncover or rediscover your strengths and assets can be immensely helpful to your overall health. It's extremely difficult to manage symptoms and try to return to healthy functioning when we have poor self-esteem and low self-confidence. Feeling ashamed of who we are and hiding a part of ourselves usually results in feeling badly about ourselves. You deserve love, happiness, health, and are worthy just as you are.

10. Find hope with fun and laughter.

Don't give up hope when the latest medication gave you bad side effects or didn't work. Don't give up hope when your depression feels like it's smothering you. Don't give up hope if your support person bails on you and you have to find someone new. Hang on to the fact that there is a light at the end of the tunnel, even if you can't see it right now. Trust that it's around the bend, and find someone to hold that hope for you if you're struggling to hold it. Sometimes hope is found in laughter, even when you're depressed.

I try to find little ways to experience joy, have fun and laugh every single day. Whether it's watching a silly video, marveling at how little kids use their imagination, enjoying nature, or making fun of myself, smiling and a few giggles give me hope that things will get better. Let yourself play, find a slinky or get some crayons and a coloring book, or go on the swings at a local park and be goofy. Just changing your environment often helps to get out of a negative state and create a smile that can have a positive effect on you for the rest of the day.

How To Be Delighted With Your Compassionate Self

When you misplace your glasses for the 10th time this week, or agree to do something and then don't get to it, or the project you're working on doesn't look like you wanted it to, do you call yourself names that you wouldn't call your friends? When you go to bed too late and then regret it in the morning when the alarm goes off, is the first thing you say to yourself a curse word followed by calling yourself stupid?

Many people find that practicing compassion for themselves is much more difficult than having compassion for others.

Compassion is defined as "sympathetic consciousness of others' distress together with a desire to alleviate it" by Merriam-Webster's online dictionary. So if I'm trying to learn how to practice "sympathetic consciousness" of my distress and then "alleviate it," why is it so hard?

A common reason that having compassion for ourselves is difficult is because we are largely unaware of how often we are self-critical.

Self-compassion is can also be challenging because we're paying attention to others more than we are to ourselves. When we feel overwhelmed in our own lives, it's easier to try to fix others problems than focus on improving our situation. Sometimes people mistake self-compassion for self-pity or being selfish. But a healthy balance of practicing compassion for others as well as oneself usually creates kindness and happiness.

Many people tend to overlook self-compassion in their self-care routine.

Healthy diet, regular exercise, and fulfilling relationships are fabulous foundations for a balanced lifestyle, though many people who practice positive daily habits may leave out self-compassion. Scheduling exercise routines, a meal plan, and a weekly date night are great ways to keep goals on track and stay healthy, but don't forget to include some leeway into that schedule.

Do you find yourself metaphorically beating yourself up because you didn't follow through with your exercise plan or you ate something you decided is not allowed anymore?

What happens if you aren't able to stick to the timeline, or you grab a bite to eat out instead of making the healthy meal you had planned? Are you critical of yourself when you don't stick to your routine? Are you able to forgive yourself for being too physically tired to exercise yesterday? Begin one step at a time to cut yourself some slack but having compassion for yourself.

5 Ways to Practice Self-Compassion:

1. Pretend you are your best friend

Pretend you and a good friend are sitting and talking with each other, and your friend shares a very long list of negative, hurtful names she calls herself. You're surprised and ask what are the things she has done that make her so upset with herself. She reports the same things you are so critical of yourself about. If you can have compassion for your friend, i.e. feel "sympathy" and want to "alleviate her distress," then pretend you are your friend. It's often easier to forgive our loved ones than forgive ourselves.

2. Watch how children forgive themselves

If you have children or grandchildren, nieces or nephews, or even neighbor kids that you know, imagine them taking a baseball bat and hitting themselves in the head with it because they fell off their skateboard going downhill in the driveway. That's a pretty harsh reaction, right? That's what many adults do with severe judgments about themselves because they made a simple mistake. When you make a mistake and automatically reach for the metaphorical bat to hit yourself with, take a step back and look at the big picture. Often the mistake we are damaging ourselves over is only a piece of the bigger picture. We never need a bat when we make a mistake. We need a kind ear to listen and some encouragement. So put the bat down please.

3. Imagine yourself as a little kid

Go through some old pictures of yourself and find one you like, one that brings a smile to your face. I want you to imagine this little kid version of yourself sitting next to you. Start a conversation with your little kid self, pretending your little kid had a bad day at school and is calling himself names, saying a bunch of reasons he isn't a good student or likable as a friend. What would you tell yourself about what kind of person you are and why you are deserving of love and friendship? Tell yourself why you are worthy and valuable as a human being.

4. Crack a smile

Laughter is the best medicine, right? Frequent negative thoughts, being self-critical and having consistently high expectations for ourselves may lead to a pattern of taking ourselves too seriously. Sometimes the best thing to do when we make a mistake is to laugh at ourselves. We can even turn a frustrating situation or series of events into a goofy, fun-making giggle-fest by seeing the ridiculousness in our own negativity. Sharing our frustrations with others and having fun with our overly serious selves is a great way to embrace compassion for yourself.

5. Make a list

Increase your awareness by writing a list of every judgmental or critical thought, feeling or action toward yourself in a 24 hour period. Remember to include all the negative things you think to yourself, such as calling yourself mean names. Record all the feelings of disappointment, frustration, fear, etc, because you didn't live up to your own standards. Document your behaviors that were instigated by negative self-talk, such as drinking a bit too much wine, yelling at your kids or partner, or isolating yourself from friends or co-workers. When the day is over and you take a look at the list, you'll have a visual record of the frequency and manner in which you tend to NOT practice self-compassion. And you will have a road map of where to start being kind and forgiving to yourself.

Unfortunately, it's extremely common for people to feel bad about themselves because they didn't complete a goal, ate or drank something they weren't going to, or behaved in a way that they're trying to change. You are not alone in having low self-confidence or self-esteem.

Fortunately, there is something you can do about it to increase your sense of self-worth and learn to be loving, compassionate and encouraging to yourself!

Learning to forgive yourself for mistakes, having more realistic and healthy standards and expectations of self, and increasing your awareness of when the negative self-talk starts and interrupting it with positive and motivating words all lead to developing healthy habits that include daily self-compassion.

So, what is your first step toward feeling delighted with self-compassion going to be?

Women and Confidence: The First Step to Feeling "Good Enough"

I thought my confidence was intact and was actively working at building my career, enjoying a wonderful family and practicing self-care when I realized that there were more days than I wanted when I felt like I was swimming upstream. I paused and sat with that feeling, identified it, and decided I didn't like it. So I did something about it.

What can you do when you feel like you're hitting obstacles and can't seem to move forward in your career, have fulfilling relationships or find internal serenity?

Step one is to pause and take a look at what's stopping you from reaching your goals. I had many reasons that got in my way when I was trying to move forward, including: not enough time, too stressed, not having the resources to do what I wanted, needing help, and confused about what to do first. When I stopped and thought about those reasons they were mostly true and valid, but didn't include the whole picture.

Underneath the reasons were feelings of lingering fear and wobbly self-confidence.

Lacking self-confidence is often a result of trying to be something we're not. Comparing yourself to your peers or co-workers, focusing on doing things for others, or minimizing your needs are familiar behaviors for many women. When your confidence and worth are dependent on what you believe others are thinking of you, it's easy to start having self-doubts about your value.

Operating out of fear that you're not "good enough" to _____ (fill in the blank) is a common self-limiting belief that can keep you stuck and unhappy. What's worse is when you make decisions based on that negative belief, it may get reinforced through interactions with others. When we believe we aren't good enough, our behaviors often teach people what to expect from us and how to treat us. We inadvertently create this dynamic that keeps telling us we're not good enough.  (Insert negative thought here: See, I knew they wouldn't like my idea.)

We all struggle in various ways with learning new things or within our relationships, and that really is okay.

It's a typical human condition to feel challenged in things we care about, even though it may not feel good at the time. When you find yourself struggling and not liking it, pause. Acknowledge that you're feeling frustrated, disappointed or whatever emotions are present. Give yourself compassion in accepting that you're hesitant to do a project or that you're unsure how best to communicate with someone you love, and ask for help. Asking for help means you value yourself enough to get your needs met. And, you're still good enough. You are deserving, worthy and valuable.

Feeling self-confident can be a wonderful feeling of freedom, you are left with an awareness that you are capable and competent and good enough to know when to ask for help. You can relax into being who you really are and feel good about you!


Suicide Grief: Three ways to give and receive support for your loss

Suicide Grief: Three ways to give and receive support for your loss

Grief of any kind is often painful and life altering, however grieving the loss of a loved one who has died by suicide is unique in many ways.  Having lost my father and brother to suicide, I was asked to write a guest article for International Survivors of Suicide Loss Day to help dispel myths and increase understanding and compassion for people who have experienced a suicide loss.

Read More