Safeguards and Skills

I mentioned that my therapist said I had many effective safeguards and skills in place to manage my illness. I said I would explain some of them in greater detail. Here you go.

1. Spending: my wife and I have learned to recognize the early signs of a hypomanic or manic episode. These episodes often feature an urge to buy things and spend money. We have an agreement that when symptoms begin to appear and I am likely to make poor decisions about money, I have limited access to cash, and all of my credit cards are taken out of my wallet. This prevents me from spending insane amounts of money. This plan was put into place after I put our banks account balance in the negative several times, including the time that our balance was $1000 overdrawn.

2. Meds: one of the most common features of bipolar disorder is difficulty taking medications regularly. This also can be a feature of ADHD, as remembering to do things can be difficult when you are always distracted. To manage my medications and make sure I take them as prescribed, the first thing I do is set a week's worth of medication up in a "med minder" - those plastic med cases separated by day and time. I have a system, and I double check that all my meds are where they should be for the week. I then make sure I have alarms set. I set an alarm to take meds at each designated time, and if I know I am not going to be home at that time, I set a reminder to take the med with me. I also try to associate each time with a task, so I have a natural cue to remind me as well. For example, I currently use breakfast, leaving work, and my late-night snack as natural cues for my med times, and try to always do them at the same time.

3. Sleep: another common problem during both mania and depression is change in sleep patterns, and also disturbances. During mania, I can't sleep, and during depression, I don't want to do anything else. I have been forcing myself to remain in bed for at least seven hours when I am not able to sleep. I will not allow myself to get up, to read, or play on my phone until the seven hours are up. I toss and turn and try to rest for that time. During depression, I do the opposite. I try to limit my sleep, and go to bed and get up at reasonable hours. That can be a real struggle, but I make a real effort.

4. Social/Activities: when I am depressed, I don't want to do anything but sit home and mope. When I am manic, I want to do EXCITING, EXHILARATING things. I have a rule in place. If I have plans made to do something - I keep them. I don't stay home. I don't cancel then to do something more exciting. I keep my plans. My wife knows that this is what I want, and reminds me and pushes me to fight the urge to cancel plans, and we have a pretty good success rate.

5. Normal Functioning: sometimes I don't feel "normal" when I am experiencing symptoms, and may struggle or worry about my actions and behaviors around others. I have learned over the years to mask and hide mild symptoms. I never thought of this as a "skill" until my therapist talked to me about it. Acting "normal" and happy when I am depressed sometimes actually lifts my mood, at least temporarily. Trying to remain calm and in control may soothe me during mania or anxiety or frustration. Trying to not give in to my impulses and urges, and trying to behave normally, even if it is the complete opposite of my impulses, can help me maintain some control.

6. Breaks: sometimes, the only thing that can help is time alone to just deal with my symptoms and ride them out. I have learned to take regular breaks when I need them. I take breaks when I BEGIN to experience the symptoms, rather than waiting until they are nearly uncontrollable. Setting aside time to just sit and be calm and quiet and alone is really important and vital to managing my symptoms.

7. Directing Symptoms: my wife and I learned quickly that my symptoms during a hypomanic episode or mild manic episode can actually be useful. I have learned to direct the increased focus, drive and energy into productive things. I once painted nearly every room of the house in under a week. Directing symptoms into productive outlets allows me to deal with them in a healthy way. Many of the features of hypomania and mild manic episodes can be directed into useful and productive things, rather than acting in impulsive and destructive ways.

These are some of the things I use to manage my symptoms, and I try to use them regularly. I have the support of my wife when I need reminders to keep doing the things that keep my illness better under control. I stay on track.

Until I started listing off the things I do to keep my illness in check, I never really thought of these as "skills". I thought they were something that EVERYONE with my illness learned to do. I didn't give myself enough credit, apparently.

I hope these things give you some idea of how much Bipolar Disorder effects nearly everything I do, and the habits and behaviors I need to practice to maintain anything near stability.

These are some of the skills I already use. I will build on them. I am sure I will learn additional skills and strategies down the road.

It feels good to recognize that these are skills, and that my ability to maintain them is a sign that, even in my darkest hours, I try to remain at a high level of functioning. The reason I am so hard on myself sometimes is that I feel like these things aren't ENOUGH. I get frustrated with my symptoms. I get frustrated with myself, for allowing them to have any control over me. I am working on changing that destructive way of thinking. It will be a process, but I have confidence that I can do it.