Bipolar Mood Swings and Shame: I Did a Lot of Foolish Things That I Really Didn’t Mean

 

Three Tips to Recognize, Feel and Ultimately Let Go of Shame Due to Mood Swing Behaviors

1. Recognize what was caused by a bipolar disorder mood swing. Remember that bipolar disorder is an illness that causes some pretty darn crazy behavior that you would never, ever do when well. It’s not like there is a choice in the matter to

  • Sleep with two people at once when full blown manic
  • Buy a car you can’t afford
  • Leave someone you love because you are so depressed you can’t see straight
  • Drop out of school because you can’t sit still.

Remember. If it happens because of bipolar- treat the bipolar and you won’t have to go through the shame… as much. For most people, mood swings come back and sneak up on you and even after years of management, you can still get sick. That is what happens to me. So I remind myself, if I’m feeling embarrassed and ashamed of something because I have bipolar and feel I should know better, that’s not realistic. I need to treat the bipolar and then deal with the shame.

Bipolar is a tricky illness. I must recognize that the shame I’m feeling is a result of something that happened during a mood swing, not a personal failing. I can prevent it from happening in the future. When something does sneak up on me, I say to myself, “Julie, you now prevent 90% of the mood swings that cause damage. Before, they all got through. I’m proud of you. Now deal with your feelings and move on.”

2. Feel the shame fully. Even if the reason you did what you did was bipolar, you still did it. It still had consequences. It still affected other people. Write it out.Talk about it. Here’s a very typical email I get all of the time:

“Julie, I’m so incredibly ashamed that I spend my daughter’s college fund on remodeling my kitchen. I didn’t listen to anymore- my partner was so upset that she threatened to leave. I didn’t feel that it was mania. I just felt invigorated and excited to FEEL something after being depressed for three months. I wish I had known that what I was feeling was mania. I understand the depression, but this mania kicks my ass sometimes. I need better meds I think. This was a $23,000 mistake. Julie, I’m going to do what you say. I’m open about my bipolar- first I need to apologize to my wife for not BEING ABLE to listen to her.I wasn’t in denial- we truly were having Bipolar Conversations. We will get Loving out again and strengthen our management plan. I need to tweak my meds- I’m not depressed like I use to be, but I forgot about the mania and how it feels so good.I wonder if my new meds let the mania back in? Julie, I’m so embarrassed. Maria’s college fund is gone. But, I love how you say Treat Bipolar First and things will work out. I make enough money to put that money back. Maria is only 11, it will work out. I forgive myself for what happened. It’s an illness. We are going to be OK.”  Jim

Yes, you are Jim and I am too!

3. Prepare for Breakthrough Episodes and Stop Them Before They Go too Far.  I told Jim that I also have break through episodes. A break though episode means you are taking meds if needed, working with a management plan- (Jim and his wife use the plan in Loving Someone with Bipolar Disorder), and yet the mood swing shows up anyway. His daughter Maria fully knows about the bipolar- but he had not been manic for so long that everyone missed the signs at first and by the time his wife noticed them, Jim was in MANIA LA LA LAND and couldn’t translate what she was saying.

If we constantly have destructive mood swings- then it’s up to us to do something about it. A new plan is needed- then the shame will be less because there are less mood swings. For people like Jim and myself and possibly yourself or someone you care about, we DO have a plan, but bipolar disorder can be stronger than anything we throw at it. My mom is my greatest support in the world- she says, “Julie, I tell you I think you’re manic and you blow me off.” I always remind her. “Mom, when I’m so manic that all I feel is a raging curiosity and a desire to help others- I’m only half on this planet! I do hear you, but it takes me awhile to react- so please just keep saying that I’m manic, get out my Health Cards- put them in my face and help me get out of the clutches of bipolar. I always hear you eventually!” Also, when we let go of our shame- it helps our immune system heal from the mood swing.

Embarrassment and shame, guilt and worry. These are often the emotional after effects of a rough episode. Here’s a script we can all use when this happens- and then we must strengthen our plans because serious mood swings simply can’t be allowed to go too far. They are too destructive. We can manage this illness!

***Script example of what to say to yourself- or to say to someone you care about. It’s also nice to send this in an email!***

Dear (your name here- or a loved one’s name) You are a loving, kind and normal human being. You do your best- love other people- help others in need and are a good friend. You are pretty good at managing your money and you always do you best to stay stable. If bipolar disorder simply went away and if the meds were full proof with no side effects, you would not have to go through the embarrassment of these mood swings. But you know what (your name here!) I’m so proud of you! This is a tough illness. It’s not like having the flu! It’s tough and you are tough. Feel any shame you need to feel- feel the embarrassment of what you did and starting right this minute, make your plan stronger so that you don’t have to go through this again any time soon! You are loved…. signed, ME.

 

We are not alone in doing foolish things in the name of bipolar disorder. Only we an stop it from happening again and again and again by having a plan in place.

Treating bipolar disorder first with a strong management plan that includes meds when needed, a filled out symptom list for each mood swing and the help from people around you prevents shameful episodes. It’s ok if you got sick and did something you regret. Let’s work together so it doesn’t happen again!

 

 

I would start with Take Charge of Bipolar Disorder and then move to the Health Cards if the mood swings are still causing problems.

Click here to watch the Stevie Wonder video that says- I did a lot of foolish things- that I really didn’t mean! Hey Hey Hey! 

Will This Relationship Survive? The Author of High Tide, Low Tide Helps Julie with a Friendship Question

I recently shared with Marty what happened when a very dear friend with bipolar disorder came to visit. She was in a manic episode that I found intensely stressful and upsetting.  After three days, I made a difficult decision and asked her to leave. I had to do this, but I am fearful that our friendship will not bounce back from this experience. I am not being judgmental. In fact, I 100% identify with what happened as I have been manic like this in front of my friends many times. They don’t like it either. My problem is the energy around the mania. I want to be stable and being around someone who is choosing behaviors that fuel the mania fire is not healthy for me. 

With his experience as a long-term support for his best friend Fran Houston who lives with bipolar disorder, and the insights they have shared in their book High Tide, Low Tide: The Caring Friend’s Guide to Bipolar Disorder, I asked Marty and Fran for guidance based off of the teachings in their book. Marty’s reply, in the form of an open letter, has been extremely helpful. I am sharing it in the hope it may be of value to others.

 

Dear Julie.

In the six years we’ve been friends, I have accompanied Fran through episodes of mania, depression, debilitating pain and fatigue. We discuss the key qualities of a successful caring friendship in our book.

Fran has bipolar disorder, chronic fatigue syndrome, and fibromyalgia. We live three thousand miles apart, and at the time of writing have only met once face-to-face. We nevertheless have a close, mutually supportive friendship. How have we done this? Is there a secret? No. There really is nothing special about us! We are friends, and like friends the world over we handle what comes up as best we can. But while there is no great secret to share, there are qualities which are crucial to our success as friends. We trust each other, we are open and honest, and we love to connect.

You and Melissa share these qualities. You were honest with each other through an intensely traumatic experience. You kept the channels of communication open when things got rough. Crucially, you took steps for your self-care. Where you need guidance is in what happens next. I asked Fran about how she manages her friendships.

A Note from Fran: I’m bipolar 2 and my illness has driven friends away due to lack of understanding. For me resonance is imperative. If I am resonating with friends then it works. If I am not then I need to be vigilant about how I manage that friendship. Healthy boundaries, honesty, compassion, and forgiveness are vital. It’s important for me to check in to see how I feel and to be present in the moment. I meditate a lot. It helps me be in touch with myself and handle things better than I would otherwise.

When Fran and I are stuck we turn to Nonviolent Communication (NVC). Also called Compassionate Communication, NVC is a technique developed by American psychologist Marshall Rosenberg to foster compassion and resolve conflicts peaceably. You can take classes in NVC and there is a wealth of material online, but you can use the approach without going too deeply into it.

Feelings and needs are at the heart of NVC. Fran and I begin by acknowledging our feelings, relating them to whatever needs are not being met for us. If other people are involved, we consider (or guess) what their feelings and unmet needs might be. From there, we think about what strategies could bring us closer to meeting our needs. This might involve making a request, of ourselves or the other person, in order to move things forward.

What I pick up most strongly from you Julie is that you felt overwhelmed, shocked, and stressed. Right now, you feel apprehensive and vulnerable about what to do next. My guess is that the following needs are not being met for you. The first is the need for closeness. This event has got in the way of your friendship and you don’t know how to bridge the gap. In your words, “How can a friend who has witnessed and been greatly affected by a person’s manic behaviour find a way back into the relationship?” Authenticity is very important to you. You need a way forward which resonates with your core values, including personal responsibility and honesty. You work hard to maintain a degree of safety and stability in your life, and are unwilling to put yourself at jeopardy. You also care about your friend’s wellbeing and that of your friendship. All this seems under threat. As you put it, “This is a situation where I truly don’t know what to do. I have to protect myself. I want to respect her. I am not being mean, but I cannot go through that ever again and since it’s [due to] bipolar, I know it’s very possible it will happen again.”

I don’t know your friend well,  but I would say she feels self-conscious and guilty about what happened; specifically that she didn’t identify what was going on for her and take steps to manage that effectively or communicate it to you in advance. On the positive side, she is appreciative of your honesty, and optimistic about finding a way forward. My needs guesses for your friend are the needs for awareness and clarity regarding her symptoms, also consideration and companionship in her relationships.

Let’s see how you might fulfil your key needs (closeness, authenticity, safety, and security) whilst also respecting your friend’s  needs. The good news is there is a lot of common ground. You both understand that a change of situation and environment can be a massive challenge when you live with bipolar disorder. You also know the impact bipolar behaviour—especially manic behaviour—can have on others. Most importantly, you both recognise the vital role vigilance plays in stability and wellbeing. Fran and I talk a lot about this in our book, including the role of friends.

No matter how effective Fran’s medications are, and no matter how diligently she works at her therapies and self-care, wellness can never be taken for granted. If life is a journey, illness is part of the landscape through which Fran travels. It is easy for her to inadvertently find herself in regions of mania, depression, insomnia, pain, or fatigue. Staying well requires Fran—and those who care for her—to be constantly vigilant. It is part of my role as her friend to watch for behaviours and situations which suggest she is becoming unwell.

You have your Health Cards System, Julie, which you have developed to help manage your symptoms. I don’t know if your friend uses your system or another tool such as the Wellness Recovery Action Plan (WRAP) developed by Mary Ellen Copeland. Fran has a number of strategies, central to which are her personal care manual and wellness plan. The latter is designed for friends, family, and others she trusts to help her stay as well as possible.

Fran’s wellness plan describes warning behaviours, and asks for help in identifying them should they occur. (“Let me know if you feel I am exhibiting any of these behaviours. I might not want to hear what you are saying, so remind me of this document and that I asked you to help me take care of myself.”) It also lists strategies Fran knows help keep her well. (“This is what I need to do to look after myself. Please remind me if it seems like I am not doing them.”) If people become concerned there is a list of contacts, including her doctor, psychiatrist, care coordinator, and a mental health crisis helpline. We update the plan from time to time and modify it for specific events such as trips abroad. It was invaluable a few years ago when Fran travelled in Europe, far from her usual support team and routines.

Such tools tend to focus on personal wellness, but the approach can be extended to support the stability of our key relationships. Julie, you might consider developing a wellness plan for when you have visitors to stay. It could include such things as how long you anticipate the visit lasting, what activities and strategies you need to stay healthy, and anything you need your visitor to be aware of such as behaviours you find especially difficult or triggering. For longer stays, it might include an agreement that you and your guest will check in with each other, say after the second day, in case either of you are having difficulties. The idea would be to share the plan ahead of time. It would have enabled you and your friend to share how you were feeling in the days leading up to her visit, so you could decide whether to go ahead or reschedule.

I hope this has been useful. I’m interested to know what you and your friend think of my suggestions. Best wishes to you both!

Marty

What is Rapid Cycling Bipolar Disorder?


The term rapid cycling can be very confusing. I recently asked my co-author Dr. John Preston for a clear explanation:
 
“Rapid cycling is at least four discrete episodes during a 12 month period (these can be mania, hypomania, or depression). The term ultra-rapid cycling is not precisely defined but many refer to this as having possibly monthly cycles (e.g. 12 per year)….
 
Ultradian cycling is where there are not really
discrete manic or depressive episodes, but the person is extremely emotionally labile, with chaotic and intense mood changes that occur every day or several times during a day.
 
One way to describe it is that they experience intense emotional instability….some mood shifts are in response to stressful events (e.g. an argument with a friend), but some are unprovoked- seem to come out of the blue and not associated with a specific trigger.”
 
I have ultradian rapid cycling, but my mood swings are often discreet. That shows how these categories are simply a guideline.
 
When I am very ill, I can have six or seven mood swings in a row between mania and depression and they are very obvious. This is usually a reaction to a drug, such as when I tried Ritalin for my ADD symptoms.
 
If you or a loved one are prone to rapid cycling, it’s likely you will not tolerate anti depressants, high THC pot, meth, coke, ADD meds, steroids or changes in sleep patterns due to work or travel.
 
I know. What a BummeR!
 

Julie

I recommend reading Take Charge of Bipolar Disorder in order to create plan to end rapid cycling. If you want something more intense in terms of a full symptom management plan,

Are You Manic?

 I hear stories all summer about people who go off their meds because they feel so GREAT and then the disasters that follow. It’s easy to think – the sun is just so WONDERUFL!!!!!! when the weather gets nice, you’re off school, you have a vacation, the kids are home, etc. 

There is no doubt that summer is wonderful if you were depressed in the winter- but this is just a friendly reminder that when things get WONDERFUL!!!!! it’s time to check for mania. Here are some questions to ask yourself – or ask the person you care about.

1. Are you sleeping a lot less than what is considered the norm- but are still filled with energy the next day? The norm is six to eight hours- mania sleep would be less than five hours for example- or sometimes not even sleeping at all.

2. Did what seemed truly hopeless just a few months ago suddenly become full of possibility and beauty?

3. Are the people in your life commenting on your energy level and that you need to cool it?

4. Are you more creative, but less functional?  

5. Do you have the thought that you don’t need your medications as you feel JUST FINE!

6. Are you acting ( or even thinking ) compulsively regarding spending, sexuality, travel, etc?

7. Are you filled with nervous and uncomfortable energy?  Is this energy painful and worrisome- but you can’t seem to calm down?

8. Is your mind racing, are you starting to see things and hear things, do you feel paranoid or agitated?

There are two levels of maniahypomania (bipolar II) and full blown mania (bipolar I). Mania can start slowly and stay at a low level. This is called hypomania.

Mania can also start really quickly and spin out of control and often into psychosis really quickly. This is called full blown mania.

Within the levels of mania- there is

Euphoric (happy! grandiose!)

Mania and dysphoric/mixed mania (agitation, racing thoughts, irritation, anger, feeling uncomfortable.)

I created the Health Cards Treatment System for Bipolar Disorder  to help my depression- but they have helped the most in terms of mania. It’s hard to catch lightening in a bottle- and mania is like lightening. The treatment window is SO short.

Please make sure you are ready for the absolutely first signs that mania is starting. Fill out or look at your mania Health Card. 

I want us all to have a wonderful summer- not a WONDERFUL!!!!! summer.

Julie

 

 

 

My book Take Charge of Bipolar Disorder has more information about mania symptoms as well. 

 

 

What is the difference between bipolar disorder and schizoaffective disorder? Parents want to know!

Julie, how do I know if my child has bipolar disorder or schizoaffective disorder?
 
I was diagnosed with rapid cycling bipolar two with psychotic features in 1995. This diagnosis was incorrect. I have schizoaffective disorder. Knowing this diagnosis has helped me manage my bipolar disorder and my psychosis successfully. Here is a deep dive into the question…….
 
What is Schizoaffective Disorder?
 
The answer has to do with mania, depression and psychosis.
 
Bipolar disorder is an episodic mood disorder that includes two mood swings: mania and depression. Within those mood swings, we can have a myriad of symptoms including anxiety, psychosis, irritation and anger, restlessness and attention and focus problems just to name a few.
 
Here is a deeper explanation of the above- people with bipolar disorder must have experiences mania or depression in order to have a bipolar diagnosis. A person cannot have bipolar disorder unless they have had a measurable manic episode.
 
All people with bipolar disorder experience their symptoms within either a depressive episode or a manic episode.
 
The episode has a beginning, middle and end. It can last a long time, but a person will come in and out of the episode. It is NOT a lifetime episode. It can be measured.
 
People with bipolar disorder only have anxiety, psychosis, attention and focus problems and irrigation and anger during a manic or depressed episode.
 
Please think about this sentence. It means that people with bipolar disorder are either manic, depressed or STABLE.
 
Our stable periods are called euthymia.
 
We all have them.
 
If a person with bipolar disorder has symptoms that are not mania or depression related, this is considered a separate disorder.
 
For example, if your son is stable over all, but still has panic attacks when going out on a date, this is a separate symptom from his bipolar disorder symptoms. This means he has bipolar disorder and a form of anxiety.
 
If your daughter is not depressed or manic, but consistency can’t add numbers together, read a list or get her homework done on time this is not bipolar disorder. It is a separate issue involving numbers and focus.
 
And finally, schizo affective disorder.
 
If your child, like myself has psychotic symptoms when she is NOT manic or depressed your child has a separate psychotic disorder.
 
Schizo means psychotic
 
Affective means mood (bipolar disorder in our case)
 
Schizoaffective disorder means that your child has full on bipolar one or bipolar two and a separate psychotic disorder.
 
It does NOT mean your child has schizophrenia. Schizophrenia is only one type of psychotic disorder. I for example have a ton of psychosis, but I do not have any symptoms of schizophrenia.
 
People can have bipolar disorder and schizophrenia. If anyone is in this situation, let me know and I will explain the difference between having two diagnose
s and having the combined diagnosis of schizoaffective disorder.
 
Please note that high THC marijuana CAN mimic a psychotic disorder. If your child has bipolar and is using marijuana and gets a schizoaffective diagnosis, this has to be revisited once your child stops using pot.
 
Thanks!
 
Julie
 
PS: As all of my clients know, the ONLY way to get clear on all of this is through a symptom list. The Health Cards and Take Charge of Bipolar Disorder will help with this process.
 

Bipolar? Feel Better Now. Here’s How:

1. Nothing is as bad as bipolar tells you.

2. Nothing is as hopeless as bipolar disorder tells you.

3. Nothing is as impossible as bipolar tells you.

When I am in a mood swing that is telling me all of the above- You’re in a hole Julie. You can’t get out, Julie. Nothing is going to work, Julie.

I consider the source.

Bipolar disorder thinking is not a reliable source.

I remind myself:

1. I am going to be fine. I always am. Mood swings are terrible things, but my life is not terrible. It never has been and it never will be. Life is simply life. I do not judge my life by my mood swings. Bipolar is an illness. It is not me.

2. I am a hopeful person when well. If I am hopeless about life in general, it is always bipolar disorder talking. If I can remember this, I will simply get on with my day and the mood swing will end.

3. Everything is possible if I stick to what I know I can do. It may be hard. It may take longer than I want and it may be very, very painful during the process, but all is possible.

Bipolar is a liar. It is not a reliable source. What is bipolar disorder telling you today that you need to push to the side?

What can you say out loud to remind yourself that life is life? It is not horrible or perfect. It is in the middle.

Bipolar paints the wrong picture.

I choose the middle path. I choose stability. I do not listen to bipolar disorder.

Join me.

Julie

 

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