My treatment regimen and coping skills have evolved over time. When 18-years-old I sought help at UCLA’s student health services. The cognitive therapy I got there helped me to identify my suicidal thoughts, stop them, and rewrite them into more rational thoughts. That skill stays with me to this day. Later in my twenties, I studied and sought therapy that explored the effects that alcoholism and family dynamics had on me.
Then at thirty, as a psychotherapist of severely emotionally disturbed teens, following the deaths of my grandmother and a friend from high school, I fell into a depression so deep that psychotherapy alone was not enough. From then on, I needed medication to maintain my mental health. Until I was thirty-nine, I remained stable on antidepressant medication and psychotherapy. At that point, experiencing elation and intrusive religious thoughts, I knew I was hypomanic and needed psychiatric treatment for bipolar disorder. From that point on, I’ve been treated by psychiatrists who have medicated me for bipolar disorder, a brain disorder which requires daily mood stabilizing medication. Medication treats, but does NOT cure, the underlying brain disorder. I still experience symptoms of bipolar disorder. Living well with bipolar means I must attend psychotherapy, use my hard-earned insight and arsenal of coping skills, and exercise self-care.
Honestly, it’s taken decades for me to develop excellent coping skills. I’ve always been good at asking for help and getting support from friends and family. My social skills have helped me to surround myself with loving and supportive friends and family. I’m honest and open about my symptoms and what support I need at the time.
That may mean that I have my husband get take-out or make dinner when I’m wiped out and not up to the task. I rely on my husband quite a bit. No doubt his role as my caregiver is tough. We are partners and help each other, but I make sure I express my gratitude for all he does.
I make sure I get a good night’s sleep every night. Regular sleep is essential to good mental health, especially when living with bipolar disorder. Every night before I go to bed to quiet my mind, I read on a tablet using a dark screen with warm tinted text. If racing thoughts keep me awake, I listen to a mindfulness app Sleep Story or two or three. If that doesn’t work, I take medications approved and/or prescribed by my psychiatrist. I MUST silence those hypomanic racing thoughts to sleep.
I do what I can when I can. I’ve learned to lower my expectations of myself. I change my mind. I cancel plans. I drop out of classes. I avoid commitments. “Failure” is always an option. I redefine what success looks like. I reject the need to be productive.
Some of the coping skills that work for me wouldn’t work for you. I avoid deadlines, for I ramp up to workaholic hypomania when faced with a deadline, especially when I’m working for someone else. You may have to meet deadlines for your job.
To manage my to do list, I use my cell phone’s calendar app. I schedule modest goals. If I can’t complete a task, I reschedule, revise, reconsider, or delete it.
Not only do deadlines trigger hypomania in me, so do crowds, conferences, and loud noise. I avoid overstimulating triggers. I keep all social media notifications off. I pop in and out as suits my needs.
At times, it may appear as if I’m isolating, but I prefer solitude and find cocooning peaceful. Besides, unless I leave my house, I’m never alone, for I’m married and have an nineteen-year old son living at home.
Years of therapy have given me insight. I’m aware of stressors that may make my mood to go up or down. I avoid caffeine after noon. Screen phone calls. Write out thoughts that clutter my mind. During the day I write, blog, and use social media to connect with others in the mental health community.
Humor is a fabulous coping skill both for me personally and for my husband and me in our marriage.
– Excerpt from Kitt O’Malley’s upcoming memoir Balancing Act: Writing Through a Bipolar Life