Living with bipolar disorder isn't easy. I have ten rules that I have to keep me going when I'm struggling with bipolar depression, but there are times when those ten rules are not enough to keep you afloat.
I recently discovered that, since I had an epic relapse and had a rather serious near miss with a suicide attempt, and scared the numerous people who care so much about me. I realized that my original ten rules are great, but they are truly lacking when I start to go downhill and find myself in a crisis situation. So I have discovered that I have a new set of rules for crisis management, and I think they are also great for preventing crises as well.
1. Don't stop taking your meds! I think this could be my only rule and the end of this article, honestly, because if I hadn't quit my meds, the rest of these rules probably wouldn't be necessary. This is a common problem for many people with bipolar disorder usually because of side effects, or because people feel better and think they don't need the medication anymore. This was my first mistake. I stopped taking my best line of defense because I was feeling insecure about my weight, even though I was doing phenomenally mood-wise. I know not to quit my meds usually, but I was just so tired of feeling hopeless about my size. This leads me to rule number two.
2. If you are going to quit your meds, at least do it with the doctor's blessing. I saw my doctor and talked to him a couple weeks before my attempt, and he understood my frustration with my medication side effects, and was supportive of me doing a trial run of being off my meds as long as I had a game plan in place if I became unstable. The problem was, I'd been off my meds for several weeks before I got my doctor's blessing, and was already spiraling downhill, only I didn't see the signs in myself. I couldn't be honest with my doctor because I wasn't seeing the signs in myself.
3. Utilize your support system! I did not utilize my support system at all correctly during the last 6 weeks leading up to my attempt. I talked to my therapist about quitting my meds, so she knew, but my husband didn't know I'd quit them until the week I started to really go downhill. I think if he'd known earlier, he could have pointed out the warning signs of my instability to me sooner, and I probably would have never pushed my doctor so hard to stay off my meds even longer. My husband is the one who encouraged me to go back on them ASAP, thankfully, but by then it was just too late for much to be done. I didn't call my doctor when I started spiraling downhill to see what he could suggest as emergency options. I didn't reach out to my friends for support, I just isolated myself more and more and got worse and worse.
4. Don't shut your therapist out. I shut down and stopped working with my therapist for a couple weeks before my attempt. I knew something was getting to me, and I was feeling more and more down, but I couldn't express what it was exactly, and instead of telling her that, I just put on a show and pretended everything was fine. Part of my biggest problem the last couple of weeks beforehand was that we were going to start a new therapy approach that I was absolutely terrified of doing, and I didn't voice just how scared of it I was, and it was stressing me right out. That, mixed with work stresses, and home life, really got me down. I did try reaching out a couple of times in the days leading up to my attempt, but I denied feeling suicidal right up until I sent her my final text saying goodbye. Not such a smart idea.
5. Accept that if you send goodbye texts to people, you're probably going to be admitted to a psych ward, and embrace it for what it is; an opportunity to get help. There's no shame in getting treatment. Repeat that mantra over and over to yourself, especially if you're having a hard time coming to terms with possibly being 'labeled'. Labels aren't always a bad thing. I'm lots of labels. Mom, Wife. Teacher. Advocate. Writer. Storyteller. Bipolar. Unfortunately, I didn't use my first three days there to my advantage, I was too angry at the world, and too despondent about my life to really appreciate the therapy groups available to me. It took a lot of patience on the nurses' and therapists' part for me to come out of that bitter shell and start working on me to get myself in a good place and feeling better.
6. Recognize that treatment doesn't end after the crisis has passed and you're relatively stable again. You're going to need aftercare. A good doctor and a therapist is going to be crucial to keeping you stable. You might even need more than just a good therapist and doctor (preferably a psychiatrist if you've got a serious mental illness, in my humble opinion). Using me as an example, this has been my fourth hospital stay in the last 2 years. I've made lots of progress, but I've finally realized that I'm not progressing enough with what I'm doing when I get out of the hospital. I've decided to do IOP, which is intensive outpatient treatment, meaning I'll be doing group therapy as well as a education group 3 times a week for 3 hours a day for 6 weeks, in addition to meeting with my individual counselor once a week.
7. Practice self compassion. This is so important. I made a lot of mistakes. I burned some bridges with this last crisis. Thankfully those bridges were built with something stronger than wood, and I was able to extinguish the fires rather quickly, but I hate letting people down. I broke a lot of my original rules for staying stable that could have probably kept me out of the hospital in the first place, like getting enough sleep, leaning on my support system, doing the have to's, not the want to's, among others. That all being said, I'm still trying really hard to tell myself that I'm good enough. Eleanor Roosevelt once said "No one can make you feel inferior without your consent", and that includes yourself. I'm not giving myself permission to beat myself up.
I wish I had a silver bullet for dealing with bipolar disorder. I wish I could say that doing all of this is cake, and since I could say ' Since I can do it, you can too'! No one in their right mind is going to say that to someone living with bipolar disorder though. It is truly hard on everyone involved. Everyone who cares about you doesn't want to see you suffering, they want to see you thriving. And if even one of these rules I have for myself can help just one person, then I'll have not suffered all this for naught, and I'll have considered my time spent learning these rules the hard way time well spent.