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What are some tips for living with bipolar 2?
I’m bipolar II, rapid cycling mixed state with psychotic features. There are two sets of things to learn. The first is the “business” side of being mentally ill. There are a multitude of things I had to learn to manage when I got sick. There are lots of practical, everyday tasks that must be fulfilled in order to stay in the game. In all of my trial and error learning, I’ve figured out some very crucial things. If you’re mentally ill, I hope you learn to do all of these things too.The first and biggest is managing medicine. You have to take every dose at the right time every day, or it’s not going to work for you. If you feel like your medicine isn’t helping, this is probably the culprit. It only works if you put it in your body on time, every single day, and that is a much bigger ask than one would assume. I strongly recommend putting alarms on your phone for every dose. When I started, I had to put a backup alarm on, too, for ten minutes after my dose time, because I got used to hearing the alarm, turning it off, and then forgetting and not taking my medicine. If your memory is impaired (as mine is), this will be even more challenging, but if you stick to this routine, you will eventually build the healthy habit of taking pills on time, and that habit will aid you for the rest of your life. It’s a skill worth building.Pharmacies are crucial. Try to use a 24 hour facility if you can, like CVS or Walgreens. The benefit of having access to your prescriptions on weekends is not missing any doses. Federally scheduled medicine like Xanax, Ativan, klonopin, and temazepam are written out to last exactly 30 days, and you if you run out at the end of the week, you could miss two whole days of medicine if your pharmacy is closed on weekends. There is also great value in pharmacies that are open late, because missing that 6 o’ clock deadline can be damaging if it makes you miss a dose or more.The doctors that help you are so, so important. You are your only advocate in a doctor’s appointment, so you need to go in knowing what information to give and what questions you need answered. The solution is very simple: write it down. As you move through life and questions arise about the meds or you have mysterious side effects, take a minute to write down your questions and symptoms on a running list, so you have them all when you get to see your doctor. It’s also a very good idea to keep a mood chart. If you google “mood chart, you can find a printable mood chart. I’ve used for 10 years. I make a bound booklet with 24 sheets at kinkos once a year, a mood chart and a comments page for every month. I keep track of my symptoms so that I can report them to my doctor. Without my information, the doctor has nothing to go on and I cannot be properly medicated, so it’s crucial that I have accurate information to give, and trusting my memory is never a good option. The doctor cannot read your life unless you present it, and memory is fickle, so keep track of your moods, symptoms, and side effects on paper.The practical aspects of mood disorders are what’s going to make your treatment effective. Without these building blocks, you’re just pushing a boulder up a hill. It’s way less difficult to thrive when you’re doing the boring legwork of taking medicine on time every day, not letting prescriptions run out, going to all your appointments and reporting your health accurately. You can do this, and it will help you.The second part of living successfully with bipolar is learning coping skills. Everyone struggles sometimes, and often they feel alone; only you see through your eyes. Feeling alone can be very hard. For whatever kind of pain you have, you’ll need tools to cope with it. Family and friends are a good place to start, but for many that’s not an option. Instead you have to rely on yourself to get through your rough times. The biggest benefit of therapy I’ve gained is learning the things I can do to help myself. I’m going to share with you some of the tools that have collectively saved my life.Mindfulness. Mindfulness means mentally being completely aware of the present moment. It’s the most beautiful feeling I’ve ever had. It feels sacred. I don’t believe in god, but I do feel the feeling that people associate with a higher power. My supposition is that we have a natural chemical in the brain that produces a sensation to which we ascribe the presence of god. That god-feeling is in the moment every time I go there. I say I go because it feels like a transition into another place. It can be difficult to reach that place sometimes. There are several things I do to get to a mindful state. One is to pick an object and examine it thoroughly. Think of the fact that it’s made up of atoms and is actually mostly empty space. Or think of where it came from, who or what made it, who has touched it, what may have happened to it in the course of its existence. Expand that awareness and sense of wonder slowly outward, until the whole universe is dancing for you and with you. There are exercises you can do to practice mindfulness. It is a tool; you have to practice it. My favorite two are washing dishes slowly, as if they are sacred, or taking a very slow shower and trying to be mindful of all the things you feel, see, and smell.EMDR (Eye Movement Desensitization and Reprocessing). Unfortunately, you’ll need a trained professional who knows how to do this work, so it’s not available to everyone. If you have access to a therapist or psychologist, ask if they know how to guide you through EMDR. You do most of the work by yourself in your head. There is very little guidance by the professional, which is why I’m bending definitions and putting this in the category of self-care. You can read more about EMDR here.Safe Place. Establishing a safe and happy place in your head can provide relief in situations where you feel overstimulated, like in a loud or crowded place. Pick a safe and happy memory or imagine a peaceful place where you can relax and feel safe and comforted. Practice meditating on this place in peaceful and quiet times so that you can use it later on when you really need it. If you get into a situation where you feel your anxiety is getting out of control, take a bathroom break and sit in a stall, close your eyes, and concentrate on your safe place until you relax. Don’t stop when you relax just a bit, because if you give yourself as little as one or two more minutes, you might feel a lot better instead of just somewhat. Continue to practice this skill in your naturally peaceful times to strengthen your ability to combat your anxiety the next time it starts its nasty tirade of awful sensations.Write yourself a love letter and keep it with you. Sometimes other people telling you comforting things doesn’t feel like the truth, especially if it’s a compliment. During a time when you feel happy or even just calm (happiness can be hard to access), sit down and write yourself a letter about all the good things you know about yourself. If you’ve dealt with depressive episodes or panic attacks and really needed to hear someone tell you something like “I love you” or “You’re a good and beautiful human being” or “You are worthy”, write it down. You’re more likely to believe yourself than someone else when you feel awful. If your healthy self tells your sick self that you are loved, that alone can move you enough to cry with relief. A whole love letter to yourself, detailing all your positive attributes and filled with affirmations that you are worthy and will survive your pain, can make a tremendous difference in an episode. I keep mine in my wallet. Right now I have two. I’ve got a lot of trouble spots in my mind, and different kinds of episodes call for different kinds of comfort.Be stubborn. If you’re having deep depression with suicidal ideation, get angry at those thoughts. How dare they try to take your life. Fuck them. All you have to do is be stubborn enough to not let them win. I’m much better at being stubborn than I am at feeling strong. But I don’t have to be strong: just stubborn.Remember that this will pass. The hard thing about this is that many people have conditions that will never go away, and that makes the idea that this will pass seem pretty unrealistic. While it’s true that some conditions are life long, “this will pass” means that not every day will be as bad as today. There will be light and laughter again in your future. It won’t be all day every day, but the color in the world doesn’t go away just because you can’t see it. It will still be there when you come out of your dark place.Remember that you are enough. You are more than enough. It is unbelievable how enough you are. That is not my quote, but my mother sent it to me once and I cried for an hour because I had been feeling like I contributed nothing to the world or my family and that I was a burden on everyone I loved. I thought they would all be better off if I killed myself. I thought they’d be sad for a while, but they would move on and be much happier without me. The idea of being enough still gets me choked up when I feel worthless.Meditation. There are lots of meditations on the internet that you can read how to do, or you can try a guided meditation on youtube. I like this one. There is no wrong way to meditate, so please don’t put pressure on yourself to do it the right way. Try putting a hand on your chest and a hand on your belly and focus on your breathing. Imagine a balloon in your chest connected to a bigger balloon in your belly, and notice how they expand and deflate. Breathe slowly, but naturally. If any troubling thoughts come to mind, name what kind of thought they are and then let them go. In my head, I often have to say “That’s an anxious thought.” or “That’s a distracted thought.” and then go back to my breathing. Notice any sounds inside your body. After a few minutes you’ll probably find more sounds in your body than you expected. I am always surprised at how loud my breath seems after a minute or two of meditation. It’s okay to let your mind do what it wants to with the space you give it. Continue to name and dismiss bad or intrusive thoughts, but the mind wants to play, so let it be as creative as it wants when it comes to the images you see in your head.Netflix has gotten me though some hard times. It helps me turn my brain off, or at least turn down the volume of my thoughts. I like to pick something I’ve seen before so that I know it won’t be triggering, and I can take comfort in the normalcy I felt (hopefully) when I last watched it. It helps me remember that not every day is a bad day.Build your toolbox. I made a physical tool box out of a shoe box that I filled with index cards that each have a coping skill or a personal affirmation on them, and when I’m in crisis I rummage through them until I find some that appeal to me in whatever state I’m in that day. My tools are something I write down to keep for myself and to give to loved ones for reference. That way they know they need to tell me I’m safe, I’m loved and this will pass. They remind me to take my as-needed anxiety meds and check that I’ve eaten (low blood sugar is a trigger). My list can also remind me of the things I can do for myself in episodes. Push-ups are very helpful because they engage the muscles in the chest, which is calming. Pressure on your chest has the same calming effect. If you’re panicking and have a significant other or close friend handy, get them to lay on top of you and try to match your breathing to theirs. Reading helps me slow down my thoughts during mania. Doing things that incite flow-state help me, like singing, playing guitar, coloring, walking, or painting. Any time you discover something that helps you, write it down.Know your limits. When I’m in an episode, I’m not in top form mentally or physically. I’ve made rules for myself to keep me safe. No driving, no cooking on the stove or in the oven, no fire, and no knives. Figure out if there’s anything that could be unsafe for you to do when you’re dealing with whatever pain you’ve been dealt, and make a rule for yourself not to do those things when you’re at half capacity.These coping skills and tools have indeed saved my life many times. Mental illness is often overwhelming, and it’s not always enough to wait for someone to try to comfort you. Even when they do, it’s often not enough to make you feel better. If you’re in an episode, you can probably only ameliorate your pain and wait for it to work itself out. My world gets very dark sometimes, and I go far away, but so far I’ve always come back. I can take some solace in that.If you want to read more like this, check out my site at goldfishpainter.com
How do I dig myself out of the hole that my bipolar w/ psychosis has me in? I can't deal with stresses of any kind without developing psychotic symptoms. Medications have been ineffective at best and ECT worked but only for days per treatment.
I’m bipolar II, rapid cycling mixed state with psychotic features. There are two sets of things to learn. The first is the “business” side of being mentally ill. There are a multitude of things I had to learn to manage when I got sick. There are lots of practical, everyday tasks that must be fulfilled in order to stay in the game. In all of my trial and error learning, I’ve figured out some very crucial things. If you’re mentally ill, I hope you learn to do all of these things too.The first and biggest is managing medicine. You have to take every dose at the right time every day, or it’s not going to work for you. If you feel like your medicine isn’t helping, this is probably the culprit. It only works if you put it in your body on time, every single day, and that is a much bigger ask than one would assume. I strongly recommend putting alarms on your phone for every dose. When I started, I had to put a backup alarm on, too, for ten minutes after my dose time, because I got used to hearing the alarm, turning it off, and then forgetting and not taking my medicine. If your memory is impaired (as mine is), this will be even more challenging, but if you stick to this routine, you will eventually build the healthy habit of taking pills on time, and that habit will aid you for the rest of your life. It’s a skill worth building.Pharmacies are crucial. Try to use a 24 hour facility if you can, like CVS or Walgreens. The benefit of having access to your prescriptions on weekends is not missing any doses. Federally scheduled medicine like Xanax, Ativan, klonopin, and temazepam are written out to last exactly 30 days, and you if you run out at the end of the week, you could miss two whole days of medicine if your pharmacy is closed on weekends. There is also great value in pharmacies that are open late, because missing that 6 o’ clock deadline can be damaging if it makes you miss a dose or more.The doctors that help you are so, so important. You are your only advocate in a doctor’s appointment, so you need to go in knowing what information to give and what questions you need answered. The solution is very simple: write it down. As you move through life and questions arise about the meds or you have mysterious side effects, take a minute to write down your questions and symptoms on a running list, so you have them all when you get to see your doctor. It’s also a very good idea to keep a mood chart. If you google “mood chart, you can find a printable mood chart. I’ve used for 10 years. I make a bound booklet with 24 sheets at kinkos once a year, a mood chart and a comments page for every month. I keep track of my symptoms so that I can report them to my doctor. Without my information, the doctor has nothing to go on and I cannot be properly medicated, so it’s crucial that I have accurate information to give, and trusting my memory is never a good option. The doctor cannot read your life unless you present it, and memory is fickle, so keep track of your moods, symptoms, and side effects on paper.The practical aspects of mood disorders are what’s going to make your treatment effective. Without these building blocks, you’re just pushing a boulder up a hill. It’s way less difficult to thrive when you’re doing the boring legwork of taking medicine on time every day, not letting prescriptions run out, going to all your appointments and reporting your health accurately. You can do this, and it will help you.The second part of living successfully with bipolar is learning coping skills. Everyone struggles sometimes, and often they feel alone; only you see through your eyes. Feeling alone can be very hard. For whatever kind of pain you have, you’ll need tools to cope with it. Family and friends are a good place to start, but for many that’s not an option. Instead you have to rely on yourself to get through your rough times. The biggest benefit of therapy I’ve gained is learning the things I can do to help myself. I’m going to share with you some of the tools that have collectively saved my life.Mindfulness. Mindfulness means mentally being completely aware of the present moment. It’s the most beautiful feeling I’ve ever had. It feels sacred. I don’t believe in god, but I do feel the feeling that people associate with a higher power. My supposition is that we have a natural chemical in the brain that produces a sensation to which we ascribe the presence of god. That god-feeling is in the moment every time I go there. I say I go because it feels like a transition into another place. It can be difficult to reach that place sometimes. There are several things I do to get to a mindful state. One is to pick an object and examine it thoroughly. Think of the fact that it’s made up of atoms and is actually mostly empty space. Or think of where it came from, who or what made it, who has touched it, what may have happened to it in the course of its existence. Expand that awareness and sense of wonder slowly outward, until the whole universe is dancing for you and with you. There are exercises you can do to practice mindfulness. It is a tool; you have to practice it. My favorite two are washing dishes slowly, as if they are sacred, or taking a very slow shower and trying to be mindful of all the things you feel, see, and smell.EMDR (Eye Movement Desensitization and Reprocessing). Unfortunately, you’ll need a trained professional who knows how to do this work, so it’s not available to everyone. If you have access to a therapist or psychologist, ask if they know how to guide you through EMDR. You do most of the work by yourself in your head. There is very little guidance by the professional, which is why I’m bending definitions and putting this in the category of self-care. You can read more about EMDR here.Safe Place. Establishing a safe and happy place in your head can provide relief in situations where you feel overstimulated, like in a loud or crowded place. Pick a safe and happy memory or imagine a peaceful place where you can relax and feel safe and comforted. Practice meditating on this place in peaceful and quiet times so that you can use it later on when you really need it. If you get into a situation where you feel your anxiety is getting out of control, take a bathroom break and sit in a stall, close your eyes, and concentrate on your safe place until you relax. Don’t stop when you relax just a bit, because if you give yourself as little as one or two more minutes, you might feel a lot better instead of just somewhat. Continue to practice this skill in your naturally peaceful times to strengthen your ability to combat your anxiety the next time it starts its nasty tirade of awful sensations.Write yourself a love letter and keep it with you. Sometimes other people telling you comforting things doesn’t feel like the truth, especially if it’s a compliment. During a time when you feel happy or even just calm (happiness can be hard to access), sit down and write yourself a letter about all the good things you know about yourself. If you’ve dealt with depressive episodes or panic attacks and really needed to hear someone tell you something like “I love you” or “You’re a good and beautiful human being” or “You are worthy”, write it down. You’re more likely to believe yourself than someone else when you feel awful. If your healthy self tells your sick self that you are loved, that alone can move you enough to cry with relief. A whole love letter to yourself, detailing all your positive attributes and filled with affirmations that you are worthy and will survive your pain, can make a tremendous difference in an episode. I keep mine in my wallet. Right now I have two. I’ve got a lot of trouble spots in my mind, and different kinds of episodes call for different kinds of comfort.Be stubborn. If you’re having deep depression with suicidal ideation, get angry at those thoughts. How dare they try to take your life. Fuck them. All you have to do is be stubborn enough to not let them win. I’m much better at being stubborn than I am at feeling strong. But I don’t have to be strong: just stubborn.Remember that this will pass. The hard thing about this is that many people have conditions that will never go away, and that makes the idea that this will pass seem pretty unrealistic. While it’s true that some conditions are life long, “this will pass” means that not every day will be as bad as today. There will be light and laughter again in your future. It won’t be all day every day, but the color in the world doesn’t go away just because you can’t see it. It will still be there when you come out of your dark place.Remember that you are enough. You are more than enough. It is unbelievable how enough you are. That is not my quote, but my mother sent it to me once and I cried for an hour because I had been feeling like I contributed nothing to the world or my family and that I was a burden on everyone I loved. I thought they would all be better off if I killed myself. I thought they’d be sad for a while, but they would move on and be much happier without me. The idea of being enough still gets me choked up when I feel worthless.Meditation. There are lots of meditations on the internet that you can read how to do, or you can try a guided meditation on youtube. I like this one. There is no wrong way to meditate, so please don’t put pressure on yourself to do it the right way. Try putting a hand on your chest and a hand on your belly and focus on your breathing. Imagine a balloon in your chest connected to a bigger balloon in your belly, and notice how they expand and deflate. Breathe slowly, but naturally. If any troubling thoughts come to mind, name what kind of thought they are and then let them go. In my head, I often have to say “That’s an anxious thought.” or “That’s a distracted thought.” and then go back to my breathing. Notice any sounds inside your body. After a few minutes you’ll probably find more sounds in your body than you expected. I am always surprised at how loud my breath seems after a minute or two of meditation. It’s okay to let your mind do what it wants to with the space you give it. Continue to name and dismiss bad or intrusive thoughts, but the mind wants to play, so let it be as creative as it wants when it comes to the images you see in your head.Netflix has gotten me though some hard times. It helps me turn my brain off, or at least turn down the volume of my thoughts. I like to pick something I’ve seen before so that I know it won’t be triggering, and I can take comfort in the normalcy I felt (hopefully) when I last watched it. It helps me remember that not every day is a bad day.Build your toolbox. I made a physical tool box out of a shoe box that I filled with index cards that each have a coping skill or a personal affirmation on them, and when I’m in crisis I rummage through them until I find some that appeal to me in whatever state I’m in that day. My tools are something I write down to keep for myself and to give to loved ones for reference. That way they know they need to tell me I’m safe, I’m loved and this will pass. They remind me to take my as-needed anxiety meds and check that I’ve eaten (low blood sugar is a trigger). My list can also remind me of the things I can do for myself in episodes. Push-ups are very helpful because they engage the muscles in the chest, which is calming. Pressure on your chest has the same calming effect. If you’re panicking and have a significant other or close friend handy, get them to lay on top of you and try to match your breathing to theirs. Reading helps me slow down my thoughts during mania. Doing things that incite flow-state help me, like singing, playing guitar, coloring, walking, or painting. Any time you discover something that helps you, write it down.Know your limits. When I’m in an episode, I’m not in top form mentally or physically. I’ve made rules for myself to keep me safe. No driving, no cooking on the stove or in the oven, no fire, and no knives. Figure out if there’s anything that could be unsafe for you to do when you’re dealing with whatever pain you’ve been dealt, and make a rule for yourself not to do those things when you’re at half capacity.These coping skills and tools have indeed saved my life many times. Mental illness is often overwhelming, and it’s not always enough to wait for someone to try to comfort you. Even when they do, it’s often not enough to make you feel better. If you’re in an episode, you can probably only ameliorate your pain and wait for it to work itself out. My world gets very dark sometimes, and I go far away, but so far I’ve always come back. I can take some solace in that.If you want to read more like this, check out my site at goldfishpainter.com
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