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Archive for the ‘Bipolar’ Category

Trigger Unhappy

Tuesday, September 25th, 2007

This is the third post by Anna on being a carer. Earlier posts are The Depression Dialog and Know the Enemy.

I used to get so mad with James when he had major mood changes. Trivial little things seemed to set him off, but I saw no rhyme or reason to the whole mess. I staggered from one day to the next, not knowing what was coming, feeling like a punching bag.

In my last post I wrote about the diary I kept for 2 years; it was the key to working out what caused James’ mood swings. We made some breakthroughs just by reading it back from time to time, but most progress came from charting the data in an Excel spreadsheet. This gave us a clear, visual way to see the relationships between triggers and symptoms. We discovered a couple of major depression triggers this way, and also found that small things that were minor irritations would snowball with other events added in.

The trick for us was to discover which triggers were the most important ones, where the threshold was before they would have an impact, and what we could do to reduce their effects.

Here’s an example. We used to have a busy social life. Through my diary, I began to notice that 2 days after a meal out, James would spiral downwards very quickly and experience a period of depression for 5 or 6 days. It was a very strange, but consistent pattern. We eventually discovered that certain food additives were a trigger; things like preservatives, artificial colors and artificial flavors. Adjusting our lifestyles and upending our diets was difficult, but by doing so we pretty much eliminated one of his major triggers.

Another example is our “feral hour”, around dinner time when the kids are tired, hungry and cranky. Very loud noise is another trigger, since it causes James to become very irritable. If it becomes all too much he will disappear until the kids are calm again. He can now recognize when his irritability is rising, and so takes preventative action. The key is that we have agreed that he can do this when needed, so I don’t feel resentful for lack of help. Leaving me to handle “feral hour” alone is better than suffering another bout of depression.

This knowledge continues to be very helpful to us. We know the little things that can snowball, and we take action when, or before, these little things happen. It’s a preemptive strike, so to speak. Whenever a trigger or potential trigger comes along we have a specific plan to remove its effects. As a result James’ depressive and manic episodes have become more intermittent.

Bipolar, Carers, Depression, Staying Well

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Revolution Health Podcast

Saturday, September 22nd, 2007

A conference call focusing on bipolar disorder was held during the week, hosted by Tim McCann from Revolution Health. It is available as a podcast from the Revolution Health website.

It is an interesting, wide-ranging discussion on bipolar disorder, that touches on many subjects that are worth pursuing. There is a small section at about the 45 minute mark, on being a carer of someone with a mental illness, which ties in nicely with our current series of posts.

In response to a question by Therese Borchard about being a carer, Stephen Propst from the Depression and Bipolar Support Alliance made some excellent points.

There is no substitute for education about the illness. This is critical for the carer, in order for their subjectivity about the person to be replaced by objectivity about the illness. Understanding the illness and the behavior it causes helps the carer to separate it from the person.
Mental illnesses are not solved in the short term; they present a long term problem. A carer has to have patience to stay with it over the long term.
Carers need to look after their own well-being, to remain effective and minimize their own difficulties. They need to set boundaries with the ill person, and enforce them.
Carers should never give up hope.

Anna’s next post is on recognizing and reducing the triggers that affect the person you are caring for.

Bipolar, Carers, Depression, Depression Treatment, manic depression

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Know the Enemy

Thursday, September 20th, 2007

This is the second post by Anna on being a carer. Click here for the first post, The Depression Dialog.

Know the enemy. Sounds awful, doesn’t it? But I’m talking about the illness, not the person who is sick. When that dawned on me, that the illness is the enemy, I started to have more control over my anger and resentment. Why? Because I had something I could fight, and yet still love my husband James. I’m not saying that he isn’t responsible for his behavior; but I could now explain it, or most of it, by his illness.

Our third child was born in 2003 just as things were at their worst. James had left another job, he had a go at crashing his car, and our other kids were showing signs of distress. I had to think about leaving him for a while to protect myself and the kids emotionally. I felt alone, scared for our future and worried sick.

It was at about that time that he was diagnosed with bipolar, which prompted me to thoroughly research depression and bipolar. There is an awful lot of junk out there, so I sifted through until I found some great sources. Then I learned as much as I could. The best thing about this learning process was a much better understanding of the illness, so I was less frightened and more assertive in handling his behavior.

The resources that I relied on most are:

Loving Someone with Bipolar Disorder by Julie Fast
This book helped me more than any other. It is written for carers and has great, practical solutions, especially in the area of talking to each other. James was on board with the idea of trying the suggestions in the book so that helped. Most of the content is readily applicable to depression.

It’s a love it or hate it book. I love it. I’ll write a review as the last post in this series.

Dealing with Depression by Gordon Parker
I continue to rely on this book for my medical understanding of mood disorders. James reviewed the book in an earlier post.

Black Dog Institute
I use this website for finding all kinds of reliable information on mood disorders. The Black Dog Institute is headed by Gordon Parker (above).

The next break through was keeping a diary of James’ moods and things that happened each day. I did this every night for almost 2 years. It sounds a bit keen I know, but it was also therapeutic. After only 3 months or so, I was able to see patterns of behavior emerging. His illness was looking somewhat predictable! The progress over those 2 years was very slow, but just having some noticeable improvements gave me hope. I could stop living from day to day, wondering what would hit next. Also, and even better, I was able to see what was triggering his mood swings. Things like certain foods, certain people, and certain social situations.

Armed with this knowledge we started changing our lives to avoid triggers. This is an ongoing process, but James continues to get better. We completely removed some problem triggers so they no longer have an impact, and he also copes better with the triggers that remain. I hope that we don’t sound perfect. The process is ongoing, and there are still many times when bipolar ruins things. But now that I know my enemy I can “attack” it, and get on with being James’ wife.

Bipolar, carer, Carers, Depression, Mental Health

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With Dignity…………by David

Wednesday, September 19th, 2007

I guess my biggest resentment in all of my life has been how the world is full of people who basically care only for themselves. They are incapable of, or won't treat others with respect.

First of all, there were clicks when we were in school. You may have been in one or you may not have had quite the social skills, looked the part or your parents were not financially solvent enough to belong to a click.

Next are people who treat you one way when it is just you and them and they treat you another way when the two of you are around someone else. I really could go on and on about examples but I won't. It is a very special person that knows (deeply feels) that it is truly a joy to give more than it is to receive and it is a shame that these people usually get taken advantage of, used and sometimes abused.

My doctor has helped me over the years to expect something in return, that's a very difficult thing to learn. It is a very, very rare person who can see the beauty of a child or man or lady who has a very big heart. You become bubbling with joy if you act like you need them, or you need them to do something for you, or if you just want to be around them. It is sad that so many people just don't understand the concept of giving of themselves instead of all the time taking, being a friend to someone at all times and not letting that change because they are in the company of the "select" few.

It's a long old journey this thing called life and we don't need to be settling for just any kind of treatment from people. If nothing else, stay away from people like I do. I was not put on this planet to baby sit grown adults who do not know how to behave! It is all I can do just to take care of myself. My emotional energies are spent on my daughters and my sister.

If you can't distance yourself emotionally from people who are no good for you then you are better off alone. You do not need the abuse, you are a much better person than that! There should be a special, few people in your life who treat you with dignity, and I do mean it would be a few because now-a-days, they are few and far between, but you do have a choice. Make your choice and stick with it.

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The Depression Dialog

Tuesday, September 18th, 2007

I’ve noticed from feedback that I’ve received, from two posts in particular (12 Ways to Care for Someone with Depression and Things to Say to Someone with Depression), that issues and worries facing carers are a major concern.

In response, my wife Anna will be writing 4 or 5 posts about these issues, spread over the coming 3 to 4 weeks, to relate how she has coped as a carer.

It’s really hard being a carer when all you want to be is a wife, husband, partner, or friend. It’s important to have strategies to deal with different situations and remain in your normal relationship as much as possible. This is what I want to work through in these posts.

I’ve learned over time that James and I can relate to each other in a rational manner even when he is ill. This has been a learning process; it hasn’t always been the case. And I still often feel like I’m walking on egg shells depending on the severity of the episode.

The key strategy that I’ve learned is how to talk to James when he is sick, either high or low. When he becomes ill he turns into a different person. I say goodbye to my husband, so to speak, and hello to bipolar James. In a depressive episode he becomes highly irritable and usually itches for a fight. Early on he will often make comments to bait me. “All I do is work, work, work, to support your lifestyle and your precious social group.” You can imagine what a red rag to a bull that comment is.

At this point I have 2 options:
1. Take the bait, have a messy fight and accelerate his downswing, or
2. Grit my teeth and say “it’s the illness speaking”. If I can do that then I have a much better chance of diffusing the situation. A comment like “You sound stressed about work – let’s talk” has better results and sometimes can even stop the mood swing.

Lately I’ve also been able to say “Let’s talk before you get stuck in a negative cycle of thinking.” This is huge progress for us. It usually results in a fairly sensible conversation.

James says some very hurtful things to me when he’s depressed, but I only tell him how he’s hurt me when he’s better. I wait until he is rational and can deal with it, rather than inflame the situation further when he is ill. I’ve also learned not to take his bait so personally, as I’ve come to recognize it for what it is.

It’s important to know that I couldn’t do this if I didn’t recognize the start of a mood swing. You need to listen to what is really being said before you reply to comments. Is the person sick? Are they really asking for help? Is this a normally held opinion? A few seconds of thought can save a lot of heartbreak.

Next time I can get on the computer I’ll write on learning about the illness and recognizing early symptoms.

Click here for the second post in this series.

Bipolar, carer, Carers, Depression, Mental Health, Stay Well Plans, Staying Well

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Stigma is shame, disgrace, discrimination

Sunday, September 16th, 2007

Stigma is shame, disgrace, discrimination. So begins “Crying Shame“, a report by the Priory Group in the UK, written to increase awareness of the stigma surrounding mental illness, and encourage people to be more accepting of sufferers.

“Stigma” is a catch-all kind of word. It’s a group of negative attitudes and beliefs that motivate people to fear, reject, and discriminate against those with mental illnesses. They avoid living, socializing or working with, renting to, or employing them.

I have never suffered from this stigma. I’ve rarely felt it, and when I have, I’ve chosen to ignore it. But as the comments on this blog have increased and I’ve received more email, I’ve come to realize that the stigma surrounding mental illness is, unbelievably, alive and very well. And widespread. Many readers here are feeling its effects.

The “Crying Shame” report reveals that 72% of adults in the UK believe that there is a stigma attached to mental illness, and that people with a mental illness are unpredictable (79%), dangerous (50%) and scary (49%). Only 45 per cent think that people with long-term mental illnesses can live independent, fulfilled lives. Hmmm…excuse me? It is ironic that mental illness touches just about everyone, in one way or another, over the course of their lifetime.

Stigma is borne out of fear and ignorance, so a good way to counter it is to replace the preconceptions and misinformation with better understanding and knowledge.

It’s a start, but at a personal level it’s much easier said than done.

Bipolar, Depression, stigma, Uncategorized