BeyondBipolar Newsletter html version July 2007
ItÕs been a long wait, but itÕs here at last! My new book, Beyond Bipolar — 7 Steps to Wellness, is finally in print and available on my website (www.BeyondBipolar.com). This is a new book Òhot off the pressÓ. You can buy it now on my website or at selected conferences. In October it will also be available through Amazon and at your local bookstore.
So what have I been doing all this time? Writing and rewriting, attending conferences and speaking. And I am happy to report that Beyond Bipolar — 7 Steps to Wellness was a great hit at the NAMI National Conference in San Diego, recognized as an excellent complement to my first book, Bipolar Disorder — Insights for Recovery.
To celebrate, both are offered this month without a shipping charge. And if you buy them both you get $5.00 off the cover price.
This monthÕs BeyondBipolar Newsletter includes an excerpt from Beyond Bipolar — 7 Steps to Wellness.
Beyond Bipolar —
7 Steps to Wellness
Jane Mountain, MD
veryoneÕs life is full of challenges. For those of us with bipolar disorder, even ordinary challenges can become complicated, because bipolar disorder can unexpectedly throw us off balance from the normal flow of life. Episodes can be small or can take titanic bites from our lives. They can overwhelm not only us, but our family and friends as well. When overwhelmed we often cope rather than manage. Management drives resiliency.
The Difference Between Managing
The verb Òto copeÓ has its root in words that mean to slash, to deal with and attempt to overcome problems and difficulties. Coping carries us through difficult times, especially if we have learned skillful tactics to approach problems. However, when bipolar disorder has us in its grip, fluctuating moods can leave us fragile and undermine our ability to cope.
Sometimes we cope by working or playing harder, sometimes by debating with ourselves whether or not we want to live. But all too often we hack away without really weighing the results. It is better that we slash wildly (cope) at our challenges rather than ignore them or passively give in to them. In our fierce slashing we sometimes forget to ask questions like these:
¥ What actually works?
¥ What works when bipolar disorder isnÕt complicating things?
¥ What doesnÕt work at all?
¥ What has worked in the past?
Next consider the root of the word ÒmanageÓ. Manage comes from a Latin word meaning ÒhandÓ, as in handling a horse: to put it through its paces, to direct it with a degree of skill, to guide its tremendous power and potential into something useful and beautiful. An alternative to stormy coping is to go beyond bipolar by learning to manage its power and potential. This is important because our goal is not just existing through bipolar disorder but achieving mental wellness. In the long run, our dealings with bipolar disorder need to focus on learning to manage. Management drives resiliency.
Coping Leaves Us Stuck
The process of moving from coping to managing is a vital step in learning resiliency in the face of bipolar disorder. It can take us from being very ill to being able to live a resilient life in spite of having a recurrent challenge. With patience we can hone our skills as we learn to manage bipolar disorder.
Sometimes misdirected coping skills (slashing) are enough to get us through immediate challenges. But they donÕt always work well in the long term. Coping without managing can lead us to a place where we feel stuck, unable to step back or go forward. Clearly, using management skills works better than coping and helps us have more success facing the challenges of bipolar disorder. Management drives resiliency.
HereÕs an example in which coping got me through a difficult time yet, in the end, left me stuck. At one of the worst times in my illness, I was suicidal. I wasnÕt just thinking about suicide — I was planning. Soon my plans were complete and I was just waiting for the right opportunity. My plans included having to walk a distance in the dark. One part of me didnÕt want to carry out my plans and that part kept reminding me that since childhood I had been afraid of the dark. But most of me longed to be out of my misery. Still there was a small, buried part that hoped I would feel better some day.
Whenever I felt like acting on my plans, I coped by recalling my fear of the dark. I convinced myself that I couldnÕt act because my plan required me to endure the dreaded darkness. My plan did not include management skills, and it didnÕt help me recover from this threat to my life.
This rather ineffective coping kept me alive, but it might not have. At any point, my desire to be rid of the intense pain may have become stronger than my fear of the dark, and I even thought of changing my plan to remove the requirement of darkness from the scheme. Although this method of coping helped keep me alive, it didnÕt allow me the resiliency to put suicidal thoughts behind me and make progress toward recovery.
Then I began to manage instead of cope. I decided not to act on suicidal urges. I put a note in my wallet that said, ÒI need help. I feel suicidal.Ó I showed the note to a few trusted friends, and I taught them what to do if ever I showed them the note. I resolved to call a friend when I needed support. When suicidal thoughts came, I told those thoughts, ÒNo! Go away! Get out of my head — leave my thinking alone!Ó Finally, I considered a short hospital stay to give me a break from the strong suicidal urges. Although I didnÕt have to use this latter plan, it helped to see it as an option.
Adding management skills to treatment takes you beyond bipolar and to a new place. When you move beyond bipolar you can draw from your positive attributes rather than bogging down in the challenges of this illness. Management drives resiliency.
Management is a process that occurs in several stages. When we manage something, we first learn as much as we can about it. Then we identify goals and challenges to reaching those goals. Next we propose plans and solutions. We then chose a plan and try it out. Finally we evaluate the effectiveness of our plan and tweak it to make it better — or change to a new plan that has greater possibilities. Sometimes we need to retrace our steps, perhaps to choose a more appropriate goal, or to continue learning.
We know this process of problem solving from other parts of our lives. We may be expert at solving math problems, doing crossword puzzles or balancing our checkbooks. For others, planning a garden seems effortless. As we do these activities, we hardly realize that we are following a management procedure. But the strong moods of bipolar disorder may kidnap us to a place where problem solving is thrown out the window. Moods may be so strong we think we have to act on them unquestioningly instead of stopping to identify problems and solve them.
Some of us may not be experienced with following a problem solving process. Or perhaps our process lacks a crucial step. Perhaps we educate ourselves well about a challenge and set goals easily but then fail to follow through. Or we are in the middle of our plan but doggedly slash forward without evaluating if our plan accomplishes our goals. Management drives resiliency.
Managers learn the steps of problem solving and use them regularly. This can be applied to the challenges of bipolar disorder, and with practice, can take us forward in recovery. Here are the steps again:
¥ Identify one or two goals and the challenges you will have in reaching them.
¥ Propose possible plans to meet your goal or goals.
¥ Choose a plan and try it out.
¥ Evaluate the effectiveness of your plan. If it isnÕt working well, ask yourself whether you need to give it more time, or to go back to one of the earlier steps in the process to try a different plan.
1. Stop — just stop your thoughts for a few minutes.
2. Write down the problem you are trying to solve and define it as well as you can.
3. Brainstorm some solutions and write each one down no matter whether or not it seems possible.
4. Choose two or three of the best solutions you have written down.
5. Take a piece of paper and draw two columns. On one side put the positive consequences of a potential solution. On the other side put the negative consequences.
6. Choose one plan on which to focus.
7. Try your plan for a couple of days.
8. Evaluate your actions. What worked? What didnÕt?
9. Decide to continue your plan, tweak it or choose a different plan.
10. Persist in looking for solutions.