I want to start this blog post by informing you all that I am NOT in any way affiliated, receiving compensation for, or have any connection at all to GoodRX.com. I am writing this blog post because medication is a pretty major part of managing and maintaining Bipolar Disorder, so finding ways to cut costs on medications is generally a good thing.
What is GoodRX.com?
GoodRX.com is a search engine, of sorts, that compiles and compares pharmacy pricing information to help you find the lowest cost on your prescriptions. Their service offers different coupons as they come available to further help the user cut their cost. They do not require a sign up or a credit card, in fact, their service and app are both free. If you create an account, you get a few additional benefits such as: price alerts, new coupons, finding the lowest average price to get all your prescriptions at a single pharmacy, as well as updates sent to your email.
As of this writing (7/8/2016), they currently have 27,000 reviews and a 4.7 rating on the Google Play Store for their app.
So, what’s the catch?
GoodRX.com is not forthcoming about how they are actually making their money. In the research I conducted, I mostly agree with this write up by Ejovi Nuwere, as well as his concerns. Namely, that they have partnered with Pharmacy Benefit Managers to generate sales. The PBMs earn a transaction fee in exchange for driving customer traffic to certain pharmacies. The marketer (GoodRX.com) is then paid a transaction fee from the PBMs. Essentially, a type of internet affiliate marketing.
The other concern is information. Data is king in marketing. Users of this service are essentially providing “free” data to GoodRX.com on their prescriptions and whatever other personal information they provide. It is written into into their Terms of Service that they will not sell that information. However, if GoodRX.com was created and funded by another company, that information will go to that company. So, for example, if Pfizer is the one that paid for it, then Pfizer would have access to those assets because it’s not “selling” the information.
A concern that Nuwere puts forward is the sale and acquisition of the company. If the company is sold, any data collected would go with it as part of the company’s assets, because it is not technically a sale of the data. It would be a sale of the company.
Should you use GoodRX.com?
It depends on how you feel about providing information to a third party. You can use their website and service without actually signing up, thus you can avoid providing any directly linked personal information; but they are still collecting data, even if it’s not directly attached to a name.
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You’ve met an awesome new person, you feel an immediate click with them, you feel amazing, everything is great! If you have Bipolar Disorder, that can potentially be very bad. That click and the honeymoon feeling of meeting an awesome new person is the result of a flood of endorphins that your brain produces in response. That endorphin flood can kick off an escalated cycle and send your mind running into hypomania or mania.
Probably 80% of the correspondence I receive is from people asking questions about this. They meet an awesome person, things are amazing for anywhere from a couple months to a year, and then it all comes crashing down in a storm of chaos, confusion, and depression. In the course of that year, both parties may end up making life-altering decisions as a result of the escalation.
There is a very common theme in this correspondence. The passion can be overwhelming and exciting, but it’s the conviction that really cements the idea that this it is all real. It’s very common for a person with Bipolar Disorder in a dominant escalated cycle to be absolutely certain of what they feel without zero doubt or any reservations.
I rarely make absolute statements because there are so many gray areas, but I am willing to here. If you are Bipolar or love a Bipolar person, doubt is a good thing. A typical mind is supposed to have doubt at times. A lack of doubt, or one of my loved ones pointing out that I’m having no doubts, would be an immediate reason for me to start scrutinizing my mental state to ensure I am not escalated. A lack of doubt leads to scenarios like this:
“Of course it’s a good idea I move to another country to marry you even if I’ve only known you for six months! It’s ridiculous for you to suggest otherwise! Look at what we have! How special it is! I’m going to quit my job/school, sell my car, and buy a plane ticket! I can’t wait to start this new chapter of my life with you!”
To expand on that, many people with Depression and Bipolar Disorder subconsciously chase new relationships as a result. The endorphin flood is powerful, it can knock out depression in many people for a little while. As a result, the Depressed or Bipolar often incorrectly conclude that the key to their happiness is finding the right person and relationship.
They then attain it, that honeymoon feeling eventually wears off as time goes on, the depression sets back in, and then they conclude that they aren’t really in love because the depression swallows it up. Then the mentally ill person either leaves or feels that spark with someone else, which causes them to pick up and move on.
“This person is the wrong person because I don’t feel good or feel good about the relationship.” That is incorrect. The depression is just doing what depression does; depressing our ability to experience emotions correctly. Sooner or later, it will overwhelm the endorphin flood as it trickles off.
Love is a product of the mind, and therefore, is very vulnerable to mental illness.
When You Feel That Spark or Click
For people with Bipolar Disorder: Be wary, even if you’re well-medicated. Your body does increase its tolerance to meds and the endorphin flood can tip you into escalation even if you are medicated. If you start getting ideas of drastically changing your life within the first six months, go through whatever processes you have on confirming whether or not you are escalated. Talk to your support network or mental health professionals. If you’re not or poorly medicated, you should plan for an escalated cycle because it’s probably going to happen. Listen to the people around you if they are expressing reservations. It can save you the pain of blowing up your family or relationship.
For people with Depression: That honeymoon feeling is going to eventually go away, one way or another. A relationship will not fix the problem. It is only a temporary reprieve in the overall storm if you’re not treated. Talk to your doctor. If you are correctly treated or recovered, there shouldn’t be an issue or it should be manageable.
For the partners of the mentally ill: Be wary. If your new partner mentions they have Bipolar Disorder, it always pays to be wary lest you make life changing decisions because you get swept up in the intensity of it all. The biggest tell is a lack of doubt or any fear from the other person. A person in a reasonable mentality is definitely going to have some doubts about moving to another country or spending the rest of their life with someone they just met. A lack of doubt or fear is quite likely a symptom of Bipolar escalation. My general rule of thumb is not to make any major life-changing decisions unless you’ve known the person well for at least two years.
The key phrase there is “known the person well” not necessarily “been in a relationship with”. Two years will give you a pretty good view of the ups and downs. It will also give you time to see how the person approaches their mental health and management as well.
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I was recently asked if I could find a decent article on the Depression one can experience after a person with Bipolar Disorder crashes out of an escalation. I couldn’t find one that I was satisfied with or that addressed this matter specifically, so here we are.
About the Post-Escalation Crash
Bipolar Disorder is characterized by the mood cycles it gives us. We go up, we go down. Right? Right.
An escalated cycle (mania or hypomania) is like putting our mind into overdrive for as long as we are escalated. Sooner or later, that cycle will end. The Bipolar mind typically snaps back hard into Depression because it has been in such a severe state of overdrive for the duration of that cycle.
How severe is it? Typically, it will be a far worse and deeper depression than we normally experience. In my case specifically, I go from being reasonably intelligent to not being able to do basic math in my head. The thoughts just aren’t there. I never drive in a post-escalation crash period because my mind won’t connect thoughts and actions. As an example…
My mind crashed out of an escalated cycle while driving once. I was escalated one minute and cratered into severe depression the next. I almost ended up rear-ending someone because my brain ceased to do what it is supposed to do. Consider the process required for braking.
1. The person ahead applies brakes and their brake lights come on.
2. Your brain sees the brake lights.
3. Your brain associates the brake lights of the car ahead with a need to stop.
4. Your brain sends the signal to your legs to apply the brake pedal.
That all happens in the span of a second or two. It’s just habit for people that drive on a regular basis.
Now consider what might happen if you insert 3-15 seconds of brain lag between each of those steps with no guarantee that your brain will connect the dots properly. Consider what might happen if your brain doesn’t pull the correct information about the scenario. “What are those lights for?” “I can’t remember which one is the brake pedal!” “That car is slowing down! What do I do?!”
The Difference Between a Crash and a Depressive Cycle
I want to preface this section by noting that this is heavily opinion and theory based on my interpretation of facts. Take it with a grain of salt.
I’ve met many people who feel that this deep crash is another type of cycle. I don’t believe this to be the case and there’s no real support for that belief, that I know of, other than the person having Bipolar Disorder and the low being depression. I don’t believe it to be a cycle of its own because it is often temporary. In most of the examples I’ve seen in myself and in the several people with Bipolar Disorder I interact with on a regular basis, it’s not unusual for the person to crash hard and then float back to their normal.
The crash is just different. It just feels and functions different than what my depression normally gives me. And it does the same thing in numerous other Bipolar people that I’ve been around. It can be frightening and intimidating, which is made worse by the depression, because we’re not used to it.
The other problem is that people who have been dealing with this for a long time often get used to how Bipolar Disorder affects them. “Well, my depression has done this for 30 years. Why would it change now?” It changes because Bipolar Disorder often gets worse with age, so it changes the way things can happen in your brain in addition to whatever other influences are at work such as stress, medication, general life situations, and more.
So, if you haven’t ever experienced it before and you suddenly are, it’s not unusual.
How do we deal with it?
As always, talk to your mental health professionals first and foremost. Communicate with them about what is going on, particularly if it persists for longer than a few weeks. In my personal experience and with other Bipolar people I’ve been around, it usually doesn’t take longer than 2 or 3 weeks to recover. If it takes longer than that, it’s very likely that a medication may need adjusted or added.
The “natural control” crowd often doesn’t want to hear that, particularly if they are in the camp of Bipolar people who aren’t so severe that they can manage with very little medical oversight. But the fallout from this type of cycle can be far, far more severe than what natural management practices can handle.
First, I would recommend revisiting the way that you look at a dominant escalated cycle. A lot of people look at it like this…
When really it looks more like this…
We need to account for he possibility of that extremely deep crash. We need to have a strategy for dealing with that as well.
Rest is an important part of recovery, in my personal experience and with many of the people I interact with on a regular basis. A lot of times I’ll sleep 12-16 hours a day for about a week after I crash and then my brain will rebalance.
Sometimes, patience is the only way you can handle these things.
But, as previously mentioned, involve your mental health professionals as much as possible so they can look at your situation specifically. If it’s lasting more than a couple weeks, we may need a medication adjustment to pull us back towards our normal baseline.
A Theory About Post-Crash Depression and Suicide
Again, pointing out that this is just a theory based on my interpretation of facts and I have no way to substantiate it. I strongly suspect that a post-manic crash is when a majority of suicide attempts driven by Bipolar Disorder occur.
Consider the following.
Ben is well and balanced for years. His body becomes acclimated to the medication and he triggers into a manic cycle that he doesn’t identify because he doesn’t realize that medication efficiency doesn’t last forever. He goes from loving husband and father to manic monster over the course of a couple weeks, unloading verbal and emotional abuse on his family until he finally decides that his family is the source of all of his misery and walks out.
He quits his career, something he went to college for, to pursue his “lifelong dream” of being a rock star even though he hasn’t picked up an instrument in 20 years, shacks up with some random woman he met, files for a divorce, and tears his life to pieces as his brain is screaming through mania.
About a year later, the manic cycle comes screeching to a halt. Ben crashes hard into depression. His mind is no longer plagued by the delusional emotions and thoughts of mania. The love for his family is back, in full force, with the knowledge of what he did to them. Everything he’s built in his career is in shambles. None of the emotions he had for this random woman are present anymore. She becomes collateral damage in the cycle because Ben probably related his delusional thoughts and feelings about his family to her. And many people in her position are convinced by the “passion” and emotional instability a person like Ben is projecting; when in reality he’s just projecting manic delusion.
And he’s in the process of being divorced from the woman he wanted to spend his life with.
On top of all of that, now he has a severe, deep depression which is an entirely new experience; a depression that he is not used to navigating. And Bipolar Disorder, Bipolar-depression, is whispering in his mind on a nearly constant basis about how badly he fucked up. Delusional, incorrect thoughts and feelings plague his mind while he is drowning in the depression with all of the lies it likes to tell us. “It’s hopeless, it’s pointless. You’ve lost everything. You’ll never be able to fix this.”
What’s left for Ben? He’s burned the bridges to the people he cares about. Hopefully, he would reach out to an emergency service or his doctor. But I’m certain plenty of people do not. I think that this time period, when a Bipolar person swaps from the “invincibility” of mania to the most fragile emotional state we will ever experience, is the most likely time that we will decide we’re done with this ride.
What can we do about it?
The only solution I can think of is to plant a seed that will hopefully blossom after they crash. I would say something to the effect of, “If ever there comes a time when you realize how awful you’ve been acting, please reach out to me so we can get you help.” And that may be a real hard thing to do with someone whose brain is screaming through insanity with all of the chaos and misery that goes along with it. Hopefully, they will remember that when their brain finally crashes out and know that they can reach out instead of seeing suicide as the only option left.
That does not mean you make them promises or welcome them back with open arms or anything. Every situation is different. Every person has limits on what they are able to deal with. But, many of the people that are faced with this decision are sons, daughters, mothers, fathers, spouses; and so on. It could be the difference between just a serious life change versus needing to explain to the kids why their parent is gone. And if they do reach out, get them in touch with an organization that can help at-risk, in-crisis people that serves your area. In the United States that would be the National Suicide Crisis LifeLine 800-273-TALK (8255) and their site also has a chat contact option, which may be good for some.
How will I know if a toxic person is just trying to manipulate me?
Given that most of the people dealing with this will know the Bipolar person very well personally, you’ll know. It’s a night and day difference. Just pay attention to ensure they are acting on trying to get help. Don’t promise that they can come home or that there won’t be repercussions. Don’t promise to forgive and definitely don’t forget. Just focus on getting that person in contact with people that can help them.
And finally…
I want to take a final moment to point out that this article specifically points at a dominant escalated cycle and the subsequent ending of it, not general instability or Rapid Cycling. I’ve known Bipolar people who never really had extremely deep lows and highs. This information may not be 100% applicable to each of us specifically. Nothing is when you’re dealing with mental illness. If you’re in doubt, talk to your mental health professional. If this resonates with you, feel free to let your professional read this, get their thoughts on it, and develop a strategy for dealing with it that makes sense for YOU.
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In my last blog post, I discussed some future plans I had for wanting to push my body of advocacy work to a new level. The type of feedback I received on that post could be neatly fit into two categories; encouragement and “are you manic?” On the first point, I appreciate the kind words and encouragement that many people gave me.
On the second point, I’m a Type 2 Bipolar. I don’t experience mania, I experience hypomania. I realize that most people use the two interchangeably, but they are different things. Mania requires psychosis. Hypomania does not. Technically, I’m not manic. Also technically, I’m not hypomanic either.
How do I know that? Doubt and self-doubt.
Understanding the way unwellness manifests gives us a great tool for identifying when Bipolar Disorder or Depression is trying to drive our thought processes. In my case, hypomania brings with it arrogance, impatience, and anger. The thought that I could be making a bad decision never crosses my mind because Bipolar Disorder just shoves my brain ahead at 1000 miles an hour without any consideration for consequences.
The ideas and thoughts I shared on pushing towards forming a venture of my own are not an overnight creation. It’s something I’ve been thinking about for the past two years, off and on. The list of doubts and cons is about the same length as the list of ideas and pros.
That is a good thing, because it heavily infers that I’m not now or have been escalated. A major decision like that is an almost guaranteed unwell cycle trigger. That doesn’t mean that I will or have triggered, it’s just that the potential is there. Anything that can bring major stress or incite passionate emotion should be counted as a potential trigger. That means increasing the amount of self-assessment that I would normally do to ensure that I pick up on any shift towards unwellness before it becomes a major problem.
Awareness gives me the power to unwind the unwell cycle before it really gets going. My methods of management are derived from personal reflection and strategy learned through Cognitive Behavioral Therapy.
These points are something that anyone can learn to be aware of. It may sound exhausting to need to think about mental state on a daily basis, but it really is the best way to keep a firm grasp on potential unwellness. Though it is kind of annoying at the start, regular practice and effort turned it into a thing that I just do without actively thinking about it.
That leads me to one of the more common misconceptions about Bipolar Disorder. Just because we’re not unwell at the moment does not mean that Bipolar Disorder is not lurking, waiting. An unwell cycle can trigger from anything and come out of nowhere.
The only way to head those unwell cycles off is to treat Bipolar Disorder like it is a companion that is always walking beside us: not behind us, not sitting at home on the couch, not as that thing in our past. Even when we’re medicated we need to keep a close eye on it to make sure it does not run ahead and away.
Even though my doubts have been strong, I view them as a good thing. Doubt means I’m sane and balanced. Doubt means I’m thinking critically of my choices. Doubt means I’m still in control of the Disorder, it is not in control of me.
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This is pretty much just going to be an update post on the direction I’ve been contemplating for myself and body of work.
It’s coming up on the four years anniversary since I launched my website and began my advocacy work. Every year, around this time, I contemplate the past year and how I want to advance my missions in the coming year. I used year too many times in that sentence, but screw it I’m leaving it.
The first point is a slight change in the way I deliver my message. The only real critical criticism I’ve ever received on my body of work is my casual swearing. I opted to preserve that tone of speech in the hopes of breaking through to other people like me who are turned off by the sterile nature of a lot of mental health material. I felt that preserving my authentic language of anger and frustration would help others who are of similar mentality to identify and hopefully take action.
I’ve finally decided to change that, except when I’m writing examples of unwellness. I feel it is super important to preserve the tone and feeling of what unwellness cycles can look like, because they can be very brutal.
Simply put, I feel the decision is hurting more than helping. While I, personally, think the idea of bad words is stupid and ridiculous. My opinion isn’t the one that really matters here. Writers and other artists often push the importance of staying true to your own voice of expression. My voice of expression isn’t what’s important to me. What’s important to me is reaching people and ensuring they are receiving quality, actionable information. If that takes a hard approach, that’s what I use. If it takes a soft approach, that’s what I use.
It really doesn’t matter to me either way because my work isn’t really about what I need to express about myself. I don’t NEED to express any of this really. I’m expressing it solely for the benefit of other people. But I’ve come to find that there are several regular or high-functioning people who just see it as a demonstration of undirected anger and instability. I’m not either of those things, but that really doesn’t mean squat if that’s how I’m being perceived.
It would be really stupid for me to hamstring my efforts just because I feel like that particular social standard is idiotic. (So, you were half-right, mom. Half a point to you on this issue.) I mean, it’s not exceptionally hard to make “good” words bite the same way. You just have to know your audience and which buttons to push. But, I feel like I’m never going to push to the next tier of scope unless I do it in a more socially acceptable way.
The next announcement is a change in how I do what I do. I have decided to pursue the angle of establishing a one man limited liability corporation, branding myself as a “Bipolar Coach”, and pushing towards a profitable model that will allow me to turn this passion into my career and discontinue the need for donations. This seems to be the best path for legal, personal, and profit driven reasons.
It’s been challenging trying to find a model that will work for me. I’ve read hundreds of page on Coaching models in the past six months and none of them really fit what I do and want to accomplish. I believe I will be creating some form of priority-based model. I am still clinging very tightly to a promise I made myself when I first started writing my Bipolar Manifesto.
That promise was to ensure that anyone, regardless of economic situation or belief, could have equal access to quality, actionable information to better understand and deal with their mental illness.
This is a contributing reason to why I utilize Amazon for distribution of my ebooks. Amazon allows me to offer them for free, periodically. And it’s the reason I’m heavily considering a priority-driven model.
So, what do I mean by priority? Well, A LOT of people send me emails and leave me blog comments. As anyone that has ever written to me will know, I make it a point to write meaningful answers to each and every one that does. That takes a fair amount of time.
At this point, when I take a day off from it I fall behind. A priority-driven model will simply allow me to slide the people who are willing to pay for my services to the front, rather than just saying “Oh, you can’t pay? Well, bye.” I’ve been regularly told that my service was well worth paying for; so I think this will let me whether or not that is true and still help people of very limited resources.
The other challenge is finding an appropriate price point. I looked at several other life coach-type service providers to see what they did. There is absolutely zero chance that I am going to charge people $50 for an email, $150 for a 30 minute phone consultation, or $400+ dollars for a monthly retainer. My target demographic are not primarily businesses and people with tons of disposable income.
My target demographic are regular people dealing with difficult circumstances; many of whom have very limited resources. I can’t imagine asking for more than a $100 a month retainer for unlimited emails and a Skype conversation.
Frankly, I didn’t even like a majority of the life coaches I looked at. “Unlock your inner potential!” “Attain spiritual peace!” “Heal your mental pains!” With their fake, plastic marketing-friendly smiles. (You can insert some expletives here, from me, if you’d like.) You know, this should really tell you something – doing marketing work has jaded me more than being mentally ill has. What’s up with that?
Anywho…
A further addition that will soon be coming to my website is a t-shirt shop that I intend to populate with funny and inspirational shirts. That will hopefully bring in a few additional dollars on top of services provided and ebook sales.
That provides another unique problem. When you think, “t-shirt from a business” you usually expect it to be branded with that business’s logo and be a marketing vehicle. I can’t do that with my offering because branding “Bipolar” on them could most certainly prevent people from buying them or causing customers uncomfortable conversations that they don’t want to have with relative strangers; or strange relatives, as the case may be.
I will offer a few, I think. And some awareness oriented shirts. But by and large, I can’t see actually branding them in a traditional way being good for my customers and followers.
Anyway. It’s been a couple of years since I’ve actually done a focused fund drive. I believe I will be running a GoFundMe campaign within the next couple of weeks to defray some of the costs associated with the direction I want to take my work. I hope you will consider contributing if it is within your means.
Thank you all for your support and for reading my work. I’m excited for this new direction and hope it will provide me the means, resources, and time to help more people understand, cope with, and overcome mental illness.
I know there are many people out there from a lot of different backgrounds and professions; so if you have any thoughts or suggestions, please feel free to drop me a comment or message.
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I would like to share with you the worst couple of weeks I have had in years and their impact on my mental state.
It started about the second week of December when I interviewed at a local store for a part-time job. Everything seemed awesome. My store manager was a direct, no bullshit kind of guy who had overcome some mental health issues of his own. The job hours were perfectly suited to what I was looking towards. It would have had me in and outside on a regular basis, so no stagnation in four walls constantly. Rather easy going environment so long as you got your work done. Seemed great! Super stoked and happy about the prospect.
I’m offered a job. I go through my self-management practices that I learned in Cognitive Behavioral Therapy. Being Bipolar, I know from previous experiences that I would often escalate when offered a new job. I would rocket up, be super excited, happy to get going, and then either get myself fired for saying inappropriate things thanks to hypomania removing the filter between my mouth and brain or crash into a mind numbing depression and be unable to function for a few days.
I purposefully avoid thinking about it for about the first 12 hours after I find out. Every time it comes to mind, I push it back out with something else that requires a lot of thought. Reading about economics and finance are my general haven for that. You don’t have to do anything that boring; but having a difficult subject to try and focus on can help derail the thought processes.
Make it through the job offer with no hints of an escalation! Success!
On Monday, December 21st, I go in for my orientation at about 9 A.M. At about 8 or 9 P.M. that night, I start feeling very off. By about two in the morning, my body is violently rejecting anything I had put into it that day. I am forced to call off of work my first scheduled day because my body is expelling everything from it, from both ends, with the force of a geyser.
I’m hoping this turns out to be a 24 hour bug. NOPE! I’m repeating this process for a good 48 hours until I am finally able to eat and actually keep things in my stomach. Though my stomach seems to be settled, my intestines weren’t quite finished with me. I tried to go into work that day. I was there for an hour going through training before I realized, “If I bend over or try to pick up something heavy, I’m going to shit myself.”
I get sent home because I can’t do my job. This goes on for about 5 more days. Maximum dosages of anti-diarrhea medicine don’t touch what’s going on in my intestines.
So, let’s rewind for a minute.
The day of my work orientation, I’m driving home and my engine makes three hard fires and then starts driving like a tank. I’m like, okay, I have a misfire. I get in to a mechanic some days later to find out that one of my cylinders has no compression and is scored severely. Diagnosis of trashed engine. $4500 that I don’t have for a remanufactured engine and installation or shop for a different used car. Only reason I’m not going to be driving a $500 beater is my folks were willing to help me with it.
On Day 2 of this ordeal, I get a call from Social Security. “We never received paperwork for reexamining your Disability case. You are going to lose your benefits if we don’t hear from you.” I immediately call and find out they sent me paperwork in JULY that I don’t remember ever seeing. The social worker I’m dealing with gives me until January 12th to file a new set of paperwork. (Seriously, be nice to these people. They are there to help you, even when they are giving you news you don’t want to hear.)
At this point; I’m stressed out about being sick, figuring I’ll lose my job for missing so much work in my probationary period, figuring out what I’m going to do about a vehicle with no credit and the couple hundred bucks I have, and the potential for losing Social Security and medical insurance.
I’m proactive about communicating with my work to show that I want to be there, that I want to work. My Store Manager decides he doesn’t want to fire me if I have a legitimate medical excuse (good guy, boss) even though I should be let go. Unfortunately, I can’t get in to get cleared to return to work, per company policy, until January 4th. I get cleared, I go in January 6th.
I’m like awesome, came out of this with my job intact! I go in, work on January 6th. January 7th, I report for work. I ended up losing the job anyways. Fun stuff.
The only response I could muster was laughter…for about five straight minutes. It was one of the deepest belly laughs I’ve had in years. Why?
No unwell cycle. Because of medication, the practices I learned through Cognitive Behavioral Therapy, and the things I’ve come up with for myself – no unwell cycle. Some depression, sure. But my brain isn’t screaming at me to kill myself nor is it running unchecked into mania. Ten years ago, the circumstances like this would have rocketed my brain into a severe unwell cycle and screwed me up for months; just like I’m sure it would for many of my readers out there.
Bipolar Disorder can be a daunting, intimidating illness. It is especially scary for people who are newly diagnosed or do not know much about their mental illness. The more you learn, the smaller the teeth on the monster become. It will always have some teeth. There is a possibility that I could have triggered and had an unwell cycle because of this no matter what I did. No one should be complacent in the management of the Disorder and making sure they keep it controlled. I identified that I was entering a turbulent time and responded with my contingency plans for dealing with my brain during them.
Knowledge, planning, and tools from the mental health industry are why I’m not out of my fucking mind right now. Anyone can learn to do these things. It’s a lot of work and it’s not easy. I don’t always get it right and neither will you. Derailing just one unwell cycle can greatly reduce the overall chaos in the life of a Bipolar person and their loved ones.
In other news, I’ll be using the time I have between applying for new jobs to begin working on my third e-book in earnest. The next to come will deal with my observations and suggestions in creating more harmonious Bipolar relationships (friends, family, love), identifying toxic situations and when it is time to let go, common mistakes I see people make regularly, strategies for dealing with different situations, and more! Like all my work, it will be written to be equally useful for mentally ill people and the people that love them.
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Image courtesy of Supertrooper at FreeDigitalPhotos.net
Awhile back, someone asked me “how did you manage to find peace with being Bipolar?” It’s a question I’ve thought about a lot. Not only did I not have an answer, but I felt like it was something that could potentially be very useful for other people. I think that I may have narrowed it down to a few important points that may be useful for others.So let’s have a look…
Dispel Fear and Uncertainty with Knowledge
Many fears that are not the result of atypical processes come from a lack of information. After my diagnosis, I began to read and absorb as much information as I could on Bipolar Disorder and the way it is treated. I quickly realized that a lot of the information that I was taking in really did not relate to how I experienced the Disorder. So, one of my early goals was to figure out how my mental illness affected me specifically.
There is a lot of chaos and shittiness that goes along with being Bipolar. It is pretty difficult to predict what the results of an unwell cycle may be. Will we run screaming into chaos or crash into suicidal depression? I have no idea what tomorrow will bring in that regard. However, Bipolar Disorder is an illness. There are threads of order in the way it functions. I may not know what this escalated cycle will bring; but I can at least start planning for the fact I will soon be unbalanced by identifying the symptoms that point to it.
Understanding how the Disorder affects me, specifically, removed a lot of the anxiety about what my brain was doing.
Figure out how Bipolar Disorder functions and affects you.
My clearest indicators of escalation are an inability to sleep more than 4 hours at a time while not being tired, racing thoughts, and pressured speech. There are other symptoms but they are things I experience in times other than when I’m escalated. The pressured thoughts, speech, and inability to sleep are things that ONLY manifest when I’m escalating. They are also things that a third party can point out to me. I may not know what the cycle will bring, but I at least know I’m heading into choppy waters and can start planning accordingly.
I feel that the easiest way to go about doing this is to read as much as possible about the Disorder and eliminate that which does not apply to you.
Let Go Of What You Can’t Control
I’m pretty sure I could hear everyone out there with Anxiety scream out all at once as I was writing that. “But Dennis! It’s not that simple!” No, it isn’t that simple. I never said or would say it is. It takes practice and work to learn to let go of things and accept them for what they are. It takes effort to change thought processes. And it is much harder if you also happen to have an unchecked mood disorder or problems with Anxiety.
A technique that I learned awhile ago involves distraction. This is particularly true for Bipolar unwell cycles. The more you dwell on a point of information, the further it is going to drive you into unwellness. When I trigger, I do my best to separate myself from that situation as much as I possibly can until my brain has had a chance to move past that time period where it is just fueling the start of the unwell cycle. Within a day or two, my brain will reach whatever new level it was going to advance to and then I can address the situation more effectively.
“But I have to address this situation now!” I know. Some things you can’t just set aside and ignore. What you can do is force yourself to not dwell on it when you aren’t attempting to get anything productive done about it. Let me use a hypothetical example.
Dad has a heart attack. It is clearly a serious situation that needs attention and focus that will most likely trigger an unwell cycle. However, there’s only so much you can do that in that situation. You’re going to spend a lot of time waiting. And the more time you spend sitting around thinking about the situation and every potential “What If” scenario, the further your brain is going to escalate. So you don’t want to spend every hour in the waiting room, agonizing over what could happen.
My choice for distraction are Sudoku puzzles. They are a grid with numbers where you use logical reasoning to figure out what numbers go where. Don’t be afraid, it’s not math! It’s logical thinking – if this number is here, it can’t go there – and so on. I throw myself into working through these puzzles because I have to actively think about them. And I time myself on seeing how long it takes to solve them. So instead of spending hours agonizing in the waiting room, I’m still present but my mind is focused on something else instead of what could happen. In doing so, I reduce the extreme to which my brain is trying to run away.
You can use anything that requires active thinking. Mindless is bad. It still leaves room for the circumstance to force its way back into your thoughts on a regular basis. When it does creep into your thoughts, you just have to push it back out unless it is necessary for you to deal with at the time.
Find a way to distract yourself from dwelling on circumstances out of your control.
Meditation, puzzle solving, really anything that will put your thoughts elsewhere can help. You’re not avoiding the problem. You’re just minimizing the amount of attention you give it while your brain shifts from the trigger point to wherever it’s going to land in unwellness. The more you dwell on the trigger in that period of time, the worse it’s going to be.
Create Positive Out of Negative
Bipolar Disorder is the best and worst thing about me. I would not be sitting here writing this had the Disorder not caused the problems I faced while I was undiagnosed. I was able to really see and understand these things because of that perspective. It taught me important lessons – like the need for humility, patience, and asking questions.
On the other hand, I fucking hate the fact that I can’t trust my own brain. Is what I feel real? Or is it my brain just fucking with me at the moment? I know I have to be vigilant about watching out for potential triggers, which can be exhausting at times. Any time I have a “really great” idea, I need to run it past people I trust to make sure it actually is a good idea and not just my Bipolar brain spinning it that way to me. Plus all of the chaos, bullshit, and depression that goes with it. It sucks ass. And I really hate it.
I don’t know if I would go so far as to choose to not be that way though. I know I’ve helped a number of people because I’ve had the perspective that I do. In my mind, suggesting that I would choose to have never been Bipolar means those people may have never had a perspective to benefit from. And my pains and challenges are no more important than those of anyone else.
I remind myself of that fact when I start slipping into depression or feeling overwhelmed. This negativity and shittiness may bear positive circumstances later on. Don’t get lost or dwell too much in the moment. Just get through it and add it to the body of knowledge I’ve already accrued.
Advocacy work is how I turned my negative into a positive. Respecting the trials and tribulations that the Disorder threw into my life as a means of learning and challenges to overcome keeps me from feeling overwhelmed by them. They are just problems to find solutions to and learn from. Everyone has challenges and difficulties in life. Changing the way you view those challenges and difficulties makes it much easier to deal with them.
Find a way to turn negative circumstances into something positive.
There are many ways you can accomplish this, as varied as our individual lives. Probably the easiest route is to volunteer for some non-profit work. There are many avenues where people that have experienced hardships can use them to help someone else. Even if you decide to just go bang some nails in for Habitat for Humanity, you can take some pride in knowing that you made a positive contribution. That can do wonders for your own mentality and feelings of self-worth.
The obvious leap, in this circumstance, would be to try and get involved in non-profit work or get a job helping people with problems like yours. That will not be a great solution for everyone. You need to have a good control over your own problems and your ability to stay balanced when immersed in the pain of someone else. I’ve met a couple of people who could not maintain a healthy separation and it spurred on their own unwellness.
I strive to maintain a healthy, reasonable perspective. My goal is to not “save the world”; it’s to leave people better than I found them and encourage them to do the same. I can’t force people to make the right or better decisions for themselves; I can only present them with information that I hope will help them make a better decision. The only problems I own are my mine, because those are the only ones I can meaningfully affect.
I feel like these three points were the main foundation of finding peace and acceptance with the Disorder. Point 1 gave me understanding. Point 2 reduces the chaos and makes unwellness more manageable. And Point 3 helps me keep a positive perspective if things aren’t going smoothly.
Things aren’t perfect, they never will be. But they sure as hell are better than they were ten years ago.
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The following post was written as a response to another half-informed comment thread in my post “Bipolar Disorder: A Reason Or An Excuse?”. The comment about Downs stems from another comment where the original author weakly related the two.
At any rate, I decided to turn this into a post, primarily so I would have some place to point people instead of needing to repeat my response on a continued and regular basis. Enjoy!
As posted by Sandi:
“People with Down Syndrome, on average, aren’t as likely as bipolar people to gaslight, cheat on, manipulate, squeal at, violently attack, or play mindgames with people they claim to love as Bipolar people are.
Yes, they ARE different.
I know an individual who has bipolar and his behaviour is ABHORRENT, and I’ve mostly only talked to him on the phone so far. Lying to me (mixing up details, having a “poor memory”, denying having said things, usually negative ones, gaslighting me and shitting on my self esteem, telling me I overanalyze him when I’m just asking a simple question or mistaking what he says for something else (not necessarily anything “deeper” or more psychological like he says I’m doing), using his mother’s sickness as an excuse for not answering valid and gently phrased questions while MY mother was DYING)
Oh, you know, little things like that.
Bipolar people absolutely do know the way their behavior effects others because even though a good percentage of them are little glops of horse jizz who have no empathy, empathy is not necessary to be aware of the fact that others are hurt, just to CARE that they are hurting them. And sadly many of them don’t care. But they know.
And don’t listen to dopes like Natasha Tracy who write Bipolar apology articles, which trick normal humans into dating these (likely to be- not all, but likely to be) uncompassoinate freaks of nature instead of being responsible and warning others that they have higher rates of narcissism and destructive behaviour. Apparently, their “rights” to not be “stereotyped” are more important than keeping the rest of us normies safe.
I am so sick of apolgizing for mentally ill behavior (some of it is stuff like losing temper and control of one’s body, but other stuff, especially the verbal stuff like the pathological lying and the purposeful confusing of the other person for NO reason even of self defense, is on purpose by default).
We have become a society that talks too much about psychology and too little of morals, and sometimes there is such thing as a moral illness.”
At first, I was tempted to sluice this post into the spam heap; but I decided against it.
The similarity that Bipolar Disorder shares with Downs (and many other mental illnesses) is the physical difference of the brain. Some people are born with defective livers, kidneys, lungs; some people are born with defective brains. Many mental illnesses (such as Bipolar Disorder) are genetic. My family has a history of Bipolar Disorder, as do many others. So behavior-wise, no, they are not the same. They are the same in that they are the result of physical problems with the brain that impact functionality in a negative way.
In regards to the individual you know – why are you still talking to them if they are so awful to you? How about not letting them do it? How about distancing yourself from the person? How about minimizing the damage the person can do to you?
Time and time again, people lament on how awful they are treated by a Bipolar person, never once considering that they simply don’t have to be involved.
I regularly see people complain that Bipolar Disorder is used an excuse. My question is – what difference does it make? The only thing stopping you from standing up for yourself is you. Would it make you feel better if the person would just say “hey, I’m an asshole!” How many terrible people have you known to do that, who were not just seeking attention? How many dozens of times have you heard “he seemed so nice” or “I’ve known him all my life” right after some horror came to light?
“Blah blah blah. They use it an excuse.” No. People that whine about it being used as an excuse are the ones using it as an excuse. NOTHING is stopping you from standing up for yourself and saying “You can’t do this, this is wrong.” and taking steps to remove yourself from that situation.
So let’s talk about a problem of society; a society that values opinions and feelings more than facts. I’m sick of people acting like they’re entirely helpless and putting the responsibility on someone who is KNOWN TO BE MENTALLY ILL to make good, rational decisions. That seems like a fantastic idea! Let’s also walk out into the middle of a highway blindfolded. I’m sure that will work out great too.
I’m sick of people thinking their feelings and opinions are a replacement for fact. It’s clear that you’re angry and upset about being treated badly; as you should be. That is fair and valid. Making sweeping statements about the Disorder and the people suffering from it based on those feelings? Not so much.
I’m sick of ignorant people thinking that Bipolar Disorder is some new or made up mental illness. The oldest surviving mention of the Disorder is from one thousand years ago in The Canon of Medicine, written by the Persian doctor Avicenna. Early on it was known as the Circular Illness, then it became Manic-Depression, now it’s Bipolar Disorder. Bipolar Disorder has a long and storied history; ranging from the pens of the Persian physician to Chinese doctors of the 1500s to the European developments of the 1800’s and 1900’s that paved the understanding we have today.
We have become a society that talks too much about psychology and too little of morals, huh? There’s another argument I’m sick of hearing. Humanity is no different today than it has ever been. People pine for the alleged golden age; a time when racism and sexism were fine. A time when mentally ill people were locked away in asylums in conditions worse than prisons with even less rights. Humanity has always been awful and always will be.
And some people are just toxic people who also happen to be mentally ill. Some people are mentally ill and able to maintain some sense of normalcy with the assistance of meds, self-management, and support from friends and family. Some people cannot be helped. Some people can.
You always have a choice. You can choose who you let into your life and how you let them affect you. It may not always be a good choice, but at least you have one.
We, on the other hand, have to spend the rest of our lives dealing and managing this mental illness – 24/7/365 – while being bombarded by the unfounded, asinine opinions of people who seem to think that “oh, it’s just a matter of making better decisions” or “be a better person”.
And no matter how awful you think you’ve been treated – I can guarantee you that person has done just as bad to themselves; oftentimes without even realizing the destruction and chaos they create. People like you act like being mentally ill is a get out of jail free card, like the crap we do in our lives doesn’t have repercussions. It ALL does. It’s miserable, horrible, and painful; and that’s part of the reason why untreated Bipolars have a 20%+ suicide rate.
But hey! I guess I could have easily avoided those 7 suicide attempts, drug abuse, alcohol abuse, dozens of lost jobs, two broken engagements, ruined relationships, homelessness, and screwing up college if I was just a more moral, better person!
I’m kind of confused though. I mean, I’ve sunk hundreds of hours into helping inform people, helping them find local services, being a shoulder, pulling them out of depression, tempering their escalations, and calming their fears. I’ve helped a few people leave abusive relationships. I’ve helped a vet past his hurdles to seek care for his PTSD. I’ve been a friend to people who felt like they had no one in this world; listening to their darkest pains and thoughts. I’ve encouraged at least a couple dozen people back into therapist and doctor’s offices, helped them communicate with their professionals better, and push towards wellness.
Yet here I am, still Bipolar! I must not be moral enough? I must not care enough? Is that right?
I have ALWAYS been capable of empathy and care. However, this little glop of horse jizz spent years full of hate, anger, and self-loathing; unable to keep anything together because of the physically rooted mental illness I inherited. I was able to attain a large degree of perspective and understanding by educating myself on the Disorder, how it’s treated, how it affects me, and medication.
I do agree with you on one point though; caring and empathy are woefully rare in this world. Particularly from people who stand behind their “morals” to pass judgment on people and things they know nothing about.
And despite our “disagreement” on the basic facts of mental illness, I am very sorry to hear about what you went through with your mother. That must have been extremely painful and difficult for you. My condolences to you and your family.
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The whole #TheDress thing is a pretty awesome example of how a person’s perception shapes the way they look at the world around them. One’s initial perception may show it as white and gold, but if you look at it long enough, your brain corrects it to the blue and black dress it actually is. It’s the same sort of thing as magic eye puzzles where an image would jump out of the noise at you.
It is an apt demonstration of the way perceptions stained by mood disorder can function as well.
As an example:
I step around a corner and see my partner hugging some guy I don’t know.
Manic: Rage. I knew she was cheating on me. Confrontation, yelling, and general shittiness. (White and Gold Dress)
Depression: I knew it. I’m no good for her or anyone else. Of course she would want to throw me aside. I’m going to lose her. I’m going to lose everything I care about. Self-loathing, maybe self-harm or suicide attempts. (White and Gold Dress)
Truth: Blind accusations are damaging no matter what they are. Even if I don’t necessarily “trust” her; I ask who he is. Maybe he’s a friend from college I had previously met but entirely forgot about. Maybe he’s a cousin I haven’t met. The point is, a hug is no indicator of unfaithfulness. (Blue and Black Dress)
And that is why it is a good example. So many people are looking at this picture of #TheDress and see two different things. When it comes to being bipolar or depressed, we have something similar going on with our feelings and emotions. Except for us, it’s whatever unwell thinking our brain funnels us about our loved ones or today being the day to commit suicide.
The fact of the matter is – the truth is buried in there underneath the emotional instability and unwellness. That’s why I do not trust my emotions when I’m trying to interpret something that is going on in my life. I work to cut through how I feel and push towards the reality of the situation.
I always strive to react without anger or emotion clouding me so the hypomania or depression does not have a chance to creep in and fuck things up by seeding disastrous thoughts in my mind.
So the next time you are looking at a loved one with a mood disorder, wondering what the hell is going on in their head, try and remember that they are seeing the white and gold dress at the moment. Their emotions and perception is clouded by the unstable, often irrational thoughts. Counter their emotions by pointing out facts and adhering tightly to them.
And if you suffer from a mood disorder – be it Anxiety, Depression, or Bipolar Disorder – drastic emotion paves the way for instability. That does not mean you strive not to feel or numb everything. It does mean we should all strive to not respond or react out of emotion. Identify the facts about the situation and address it after you have had a little time to really look at what you’re faced with.
I find myself constantly reminding myself of facts and reality if I am pushing back against unwell thinking. You can envision it like two people arguing in my head. The unwell side is trying to introduce chaotic thoughts and feelings. The other side of my brain is shouting it down with the facts about the situation. I may even write out a list of all of the facts of the situation so when the unwell thoughts start creeping in, I can just go back and read the list I wrote for myself to KNOW what the reality is before my unwellness really starts to take hold.
Unwell cycles typically take a little time to fully get rolling. Not dwelling on the emotions and reminding ourselves that we are actually looking at a blue and black dress, instead of a white and gold dress, can go a long way towards minimizing the total impact of an unwell cycle.
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Image courtesy of www.freedigitalphotos.net and by the artist David Castillo Dominici.
Spend any amount of time on social media and you will see proclamations about how there is no “normal” being thrown around. “There is no such thing as normal.” “Normal is just a setting on a washing machine.” Blah blah blah.
There is a normal. I believe that normal is at the most basic level of human existence. My regular readers will know that I have a severe Bipolar-Depression component of Bipolar Disorder. I’ve spent about 80% of my teenage to adult life mired in mild to suicidal Bipolar-Depression ranging from just “fuck it all” to “put a 9mm to my head and pull the trigger on a dud round” suicidal. Though many people equate depression to sadness; it is really more like your feelings are muted (or “depressed”).
The analogy I use to describe it is that of a stained glass window. A stained glass window is alive and vibrant with color when light pours through it. Consider that to be life and normal emotion. Depression is layer after layer after layer of wax paper put over that stained glass window. It diffuses the color, the light, the vibrancy. The wax paper mutes the light and makes it hard to perceive. You look at it, and you know it’s supposed to be bright and vibrant; but all you can perceive is the muted colors trying to get through. At least, until there is so much wax paper on the window that it is all gray.
By and large, that was my normal for a majority of my adult life. Day in, day out. Wake up in the morning, curse silently to myself that I woke up again. Look in the mirror, hate what I see. Grind through another meaningless, pointless day to when I can go back to sleep. Avoid human contact, put on the plastic smile so people will stop asking what’s wrong because I had no idea what’s wrong. And when I dipped far and low enough- contemplate killing myself. Should I unsnap my seat belt, punch it to 100, and hit that bridge support? Should I slit my wrist and step off of the local bridge to ensure I don’t survive this time? Should I drink tonight? Get high? Make it all go away for awhile?
That was my normal, but that is not normal.
Humans are not meant to function in that kind of emotional wasteland. We are social, emotional creatures; even the introverts out there. We are supposed to have feelings; including happiness from time to time! I know it exists. I felt it once, in what I suspect was the window between a dosage increase and my body getting acclimated to it. I felt sad. There was no numbness, no void, no emptiness. I just felt sad and I had that feeling you get behind your eyes when you’re about to cry; but no tears came. Then, I realize I had felt sad without depression and that made me happy and excited. There was no stain of hypomania, no accelerated thinking, no erratic behavior, no unreasonable emotions; just warm and positive even though the overall circumstances were sad.
That’s the only time I remember feeling genuinely happy or sad in probably 20 years. It stands out so starkly in my mind because of how different it felt. The rest of the time? Barring hypomania, I’m standing below that stained glass window, waiting for any kind of light to get through and show me something beautiful. I want it, even if it is something just as simple as feeling good about stepping out into a sunshiny day and listening to birds sing.
I know a lot of people that are depressed who do not realize they are depressed. No, I’m not a doctor or therapist. I am someone who has lived with severe Bipolar-Depression for a long time. I know what it is for the same reason I know what a chair is. It has four legs, a back, sometimes arms, and you sit in it. It’s a common and consistent part of my life. Just as common to me as the void that is depression, if not more so. After all, when I wake up in the middle of the night and stare at the ceiling, I’m not looking at a chair; but my old friend Bipolar-Depression is typically there to greet me.
Anyway, I regularly see the depressed tell themselves that it’s normal to feel placid or nothing constantly. That life is hard. There are wars and famine and cruel injustices in the world; and they should just be thankful for what they have in life instead of striving for better. Depression is incredibly common because of this.
But therein is the problem. Even people in terrible circumstances are able to find a piece of happiness once in awhile. Maybe it’s their child’s smile. Maybe it’s a delicious meal. It doesn’t have to be complicated or grandiose. The point is, they feel something other than emptiness, numbness, and misery. Something other than another gray day to grind through until they can go back to sleep.
The mocking humor in this? Depression is relatively easy to treat. No, it doesn’t necessarily mean shoveling meds down your throat. A change in sleeping and living habits can potentially provide relief. Exercise and dieting can help. There are many routes that could have a beneficial impact on the person that should be explored with a general practitioner.
But they don’t, because it’s “normal” to be gray, miserable, and feel little to nothing.
Normal is being able to conduct your life in a meaningful way. It’s being able to function appropriately in a healthy way. You can be rich, poor, goth, punk, hip-rop, city, country, conservative, liberal; whatever. The unifying factor is the ability to conduct your life in a meaningful way; regardless of how you choose to pursue your existence. THAT is normal.
As for me? I’m a Type 2 Bipolar with a severe Bipolar-Depression component. I’m still staring at that stained glass window, waiting for an antidepressant to cut through the wax paper and let the light flood back in. I catch it in glimpses here and there. I can see it trying. Just going to take some more time and some more work to get to the real normal.
The grayness and chaos of Bipolar-normal for me is not normal for all; even other Bipolars.
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