A Life With Bipolar: Learning Coping Skills The Hard Way
Hello, my name is Natasha Tracy. I’m a writer. I’m a computer geek. My hair is not naturally red. I have done over 150 skydives. I have paraglided over the mountains of Venezuela. And I have bipolar disorder. Today, it is a big chunk of who I am, but thanks to my coping skills, I know it is not the only chunk.
A LIFE WITH BIPOLAR DISORDER
I can’t say when my bipolar symptoms first started. I suspect it was when I was a child. I distinctly remember something very akin to hypomania when my best friend would stay over and then something very near depression when she left. This basic pattern could be seen in any child, I suppose, but my swings were drastically more dramatic than that seen in other children. My mother did think this was odd, and certainly in retrospect, but, at the time, she never considered it a big deal.
When I was a teenager, I started displaying the signs of clinical depression. I think any psychiatrist worth his or her salt would have diagnosed me as such but I never saw one. In spite of crying through classes, bus rides, and after school, in spite of self-harming and crying out for help, in spite of seeing quite a few professional counsellors, no one ever suggested I might have a mental illness. These professional counsellors seemed to focus on my actions and feelings as a situational issue rather than a brain issue. I attribute this not to lack of symptoms but, rather, a lack of expertise in small town counsellors. Today, I could have spotted the need for a doctor at 100 paces, but these people just weren’t educated enough to see it.
If one had suggested I see a doctor, my mother would have likely rejected this notion out of hand as she didn’t really believe in Western medicine and she particularly didn’t believe in psychiatry. For my part, I attributed my wild mood swings to the horrible life I was living through and I have no doubt that contributed to the symptoms.
Removing my family from my life and moving to a new town had a very uplifting effect on my mood, as did starting university. But within about a year or so, my symptoms returned and I saw a downturn in my grades. I didn’t put these two things together; all I knew was that I was having “emotional problems,” would cry at the drop of a hat and, eventually, I would start self-harming again and obsess over my own death.
It was at this point that I saw a university counsellor who was considerably more savvy than those I had seen previously, and upon hearing my symptoms pretty much the first thing he said was, “Natasha, you need to see a doctor.” I had never even considered that. Really. I had grown up in a household that eschewed psychiatry and it never, ever, occurred to me to see a psychiatrist, as I mostly considered them to be drug-pushers.
But, at the time, I was in so much pain on a daily basis, so fatigued, so depressed, that I agreed to go. My ideas of what would lift my mood hadn’t worked and now I was placing my faith in that which I did not believe because I was desperate for things to get better.
As many people with bipolar will tell you, misdiagnosis is common and, as I have bipolar disorder type II, when I was first seen by a psychiatrist, he discounted my more mild hypomanias and diagnosed me with “minor depression.” At the time, I had done a lot of research online and I was pretty sure I had bipolar disorder; I also knew there was nothing “minor” about my depression, but when the psychiatrist disagreed, I just relented. At the time, all of my energy, every ounce, was being used just to keep me alive, and I had none left to disagree with this authority figure.
The medications he prescribed did not agree with me and, eventually, I changed psychiatrists and the diagnosis of bipolar disorder was correctly applied. So I tried all these drugs for depression with no success and then I tried the known drugs for bipolar (not many at the time) without success. For me, they were pretty much all the same. I would try them, get every side effect listed on the box, and could not tolerate them. Then we would have to try something new.
This went on for 18 months until, one day, I walked into my psychiatrist’s office for my appointment and he threw his hands in the air and he said, “I can’t help you. You’re no longer my patient.”
My psychiatrist had fired me.
I had no idea psychiatrists could do that, but it turns out they can. No referral to anyone else and no explanation other than the fact that he “couldn’t help me.” At a very sick, depressed, and suicidal time in my life, I found myself without medical help. It never occurred to me to seek out other help. I just figured that if he couldn’t help me, then no one could. Certainly, this increased my feelings of suicidality thanks to a distinct decrease in hope.
But I clung to the idea that my therapist could help me. I continued with therapy, as I had previously, and my therapist and I tried to work on coping skills to deal with the bipolar but to no avail. They hadn’t worked when I was trialing medications and they certainly didn’t work without them.
I continued to worsen until, one day, my therapist sat down and said, “Natasha, if you want to live, you have to go back to your doctor.”
Not surprisingly, going back to see the guy who had fired me wasn’t something I was so hot to do, but just as before, I saw no other option.
I went back to my doctor and, essentially, begged him to treat me; which he agreed to, but he still had no idea of what to do next. I had run the gamut of medications and I was still extremely sick. So he basically took a guess. He said that there was a medication that wasn’t being used to treat bipolar but looked like it had some promise so I should just try that. (The medication is now Food and Drug Administration approved to treat bipolar, by the way, but in 2000, it wasn’t.)
So I did. And, amazingly, it worked. I had never experienced a miracle before but that September I did. I saw the miracle of a smile reappearing on my face. I saw the miracle of not crying all the time. I saw the miracle of wanting to live. I couldn’t believe that after all this trying, a drug actually had made me better.
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LIFE WITH BIPOLAR SINCE THEN
That medication has since stopped being effective and I have been on every medication and more cocktails than I care to recall. I have tried vagus nerve stimulation, electroconvulsive therapy and almost every psychotherapy, mostly to no effect. I have seen many more doctors, many more therapists and have learned a lot more about the disease that plagues my waking existence. I have become a mental health writer, coach and subject matter expert. I now know more about bipolar than the vast majority of psychiatrists.
BIPOLAR COPING SKILLS
And through all of that, I have learned to manage my bipolar using various coping skills, as many medical treatments have failed. Coping skills, I feel, will never “treat” bipolar disorder but they can work to manage the havoc it wreaks on your life. Coping skills are the ways I get through a day, look back on it, and realize I’ve accomplished something. It likely isn’t all that I wanted, or as much as a person without bipolar disorder, but it is something, and that is progress that should be cherished daily. After all, it is all too tempting to stay in bed and not do a thing every single day, and every day I climb out of that warm, down-filled embrace is a win. I try to remember that.
BIPOLAR COPING SKILL #1: LOGIC
I am an intellectual. I was raised that way and I suspect I’m naturally inclined towards it so logic is second nature to me. But logic is also the biggest weapon I have against bipolar because bipolar disorder isn’t logical. So when I see things in my life that aren’t logical, I know they are likely coming from my bipolar brain and not coming from me.
For example, I don’t watch triggering television or movies as I get triggered enough without watching some starlet’s heart getting ripped out as the man of her dreams dies painfully of cancer. No thank you.
Nevertheless, watching even innocuous programming can still trigger me no matter how much I try to avoid it. I see someone win a cooking show and talk about doing it for his or her child, or a see someone simply talking, openly, about beating a disease and now having a wonderful life and I can end up bawling my eyes out. And I don’t mean merely crying. I mean wailing and sobbing and turning the sadness into a treatise about why I’m a failure.
This is not reasonable, normal or logical. And so I know it’s my bipolar disorder. I can see it coming and I can feel it when it jumps into my lap and starts to stab me with a dagger. It’s bipolar.
And so I use self-talk as early in the cycle as possible to try to avert the more substantial symptoms of depression. I say to myself that what I’m feeling isn’t real. This is a very convincing fake. This is a lie that my bipolar is telling me. And I don’t have to believe it. I don’t have to react to it. I don’t have to do what the bipolar wants me to do. I can fight back.
All that being said, like with most things, being too intellectual can hurt just as much as it can help. There are times, such as when someone dies, that you have to feel the feelings and not just intellectualize them away. Intellectualization is for when the feelings are incongruent with the situation, not for when the feelings do make honest-to-goodness sense.
BIPOLAR COPING SKILL #2: KNOWING YOUR BRAIN FROM YOUR MIND
People always say, “You are not your disorder.” This is true but far too simplified to be useful. What is, I feel, more helpful is understanding that you are not your brain any more than you are your pancreas or your spleen. And the bipolar disorder lives in your brain. It’s a brain disease. We know that. We can see it on various scans.
But you, your internal you-ness, your very self, lives elsewhere. I say I truly live in my mind. (You might call this a soul, but I don’t.) My Natasha-ness lives there. My brain sends out signals to my mind and my mind uses that information to act. My Natasha-ness, my mind, contains all the conscious thoughts and decisions that I make and my mind is distinctly separate from my brain.
So, in being forced to understand this absolutely critical difference, I can use my mind to fight my brain. I can keep my brain rational and logical and use it to fight the wacky nonsense that stems from the bipolar. I can use it to create self-talk cycles that will beat back what the bipolar is telling me. I can use it to create motivation where the bipolar has stolen all that my brain has to offer. It allows me to live in spite of the fact that my bipolar is trying to kill me.
BIPOLAR COPING SKILL #3: DOING WHAT YOU DON’T WANT TO DO
I’ve always known that I have to do what I don’t want to do with bipolar disorder. Bipolar disorder wants me to lie down and die, and I’m not doing that, no matter how much my brain wants me to.
But it’s more than that. It’s getting out of bed, even though I don’t want to. It’s making dinner, even though I’d rather eat ice cream. It’s writing, even though I want to nap. It’s taking what the bipolar wants and basically doing the opposite.
I have heard this called “the rule of opposites” and it’s not only me that has recognized this. Many people with bipolar know that the key to continuing to cope, succeed and thrive with bipolar is to do the opposite of what bipolar wants. Bipolar does not want what is good for you. You have to override that with your logical mind and do what you know is best rather than what you feel you want.
BIPOLAR COPING SKILLS WORK, SOMETIMES
While I use those three coping skills and many others every day, I’m the first one to admit that they don’t always work — nothing does. Medications don’t always work, therapy isn’t always beneficial, and coping skills sometimes just leave us high and dry. But, like psychiatric treatment, coping skills do work to some degree and I believe once you understand those top three, many other skills flow naturally. Things like sleep hygiene, circadian rhythm control, and daily routines all matter a great deal, but unless you’ve got those top three going for you, I don’t believe you’ll ever truly “get” bipolar disorder.
And an understanding of what a brain illness is and what this brain illness is, is critical. Because, as I tell audiences all the time: you can’t fight an enemy that you don’t understand.