Functionality-Based Understanding For Depression and Bipolar Disorder
When I first started putting together the protocol for assessing depression and bipolar disorder, I was working with a professor of Psychiatry to make sure the ideas were sound. His advice was to combine both awareness and understanding in the graph to keep it simpler. I am glad that I did not take the advice.
Awareness and understanding are different in ways that matter. Expertise might help someone understand why things happen, but does not necessarily lead to increased awareness. An expert on sex, for example, may be totally unaware that his wife is having an affair. It takes awareness (covered in the first article of the series) to know what is going on whether you understand the phenomenon or not.
It turns out that understanding is more related to functionality (covered in the next article) than awareness. You may be completely aware that you are sitting in a car, but unless you understand how to operate it you cannot drive.
Understanding is not just about knowing the physical, mental, emotional, spiritual, social, and career/financial aspects and their implications, it also includes knowing about the tools. You need to know how the tools work, have proficiency in using them, and understand which ones to use at each stage of bipolar – the disordered stages of Crisis, Managed, and Recovery, and the IN Order stages of Freedom, Stability, and Self-Mastery. I call this functionality-based understanding.
Too many people are holding out those who cannot function as the ones we should be listening to. Those who only know bipolar disorder and have not created Bipolar IN Order in themselves or others have no understanding of what it takes to make it happen. They can learn, but many times their beliefs limit their willingness to do so. They keep insisting it is not possible to be highly functional with bipolar and refuse to consider the evidence that contradicts such beliefs.
Functionality-based understanding has a tremendous influence on awareness. Knowing what to focus on tends to make people more aware of the important details mentioned in the previous article. Such awareness leads to greater understanding. The combination tends to create a feedback loop where both awareness and understanding increase together. But, as in any field, it generally does not happen without lessons from someone who has already created success and knows how to point you in the right direction.
This awareness/understanding combination has a major affect on our ability to function at any intensity of depression or mania. It helps us recognize the level of intensity where we begin to lose functionality and provides the tools to lower the intensity when it gets outside of the high-functioning range. It also helps us to expand the range to one guided by wisdom instead of ignorance and fear. In time we become highly functional at intensities that were previously the cause of crisis in our lives. Mastering the combination of awareness and understanding is the difference between disorder and In Order when it comes to functioning during depression and bipolar (and most other things).
I have had the honor of helping many people graph out their levels of awareness, understanding, functionality, comfort, and value at various levels of intensity. It is a great privilege to learn from them in the process. While we do not have enough data to make definitive conclusions, some interesting observations are clear.
When first asked about lower levels of intensity, the majority of people thought they had a much deeper understanding and were more functional during states than was the case. This may be related to the observation in the assessment article where we found that most people are not aware of levels of intensity until they have already lost functionality. They recognize their lack of functionality in the more extreme states, but during lower intensities they mistake the hypo-manic highs they enjoy with actual functionality.
Interestingly, they often equate the feelings they do not like during depression with a misperceived lack of functionality. It is generally believed that it is harder to function during depressive states than manic ones. We have more often found the opposite to be true. Those who understand depression find that it enhances their ability to function and doing so is far easier at any given intensity than the same intensity of mania.
At higher intensities, it is generally believed impossible to function. That may be true for some people, but when intense states do happen, their increased awareness/understanding measurably opens the window of time that they have to take effective steps to lower the intensity to a more functional level (I will cover time later in the series).
Those with Bipolar IN Order find a range of intensity where they benefit from the increased functionality that awareness and understanding affords them. They previously felt something was missing in their lives and they now understand that they can have some of the highs they were missing if they take responsibility for how they function, for example. They have been able to increase functionality in both depression and mania at all levels of intensity. They also know when to bring in someone with specialized knowledge appropriate for the needs at hand.
Defining functionality, of course, is critical to the entire concept. I will be doing that in the next article. Deeper understanding, along with the increase in functionality that comes with it, leads to more comfort and perceived value in both depression and mania (at least hypo-mania). I will be covering these concepts later in the series.
In the mean time, please share your questions and insights in the comments or contact me through our Facebook page at https://www.facebook.com/bipolaradvantage if you prefer.
Discussion photo available from Shutterstock
Wootton, T. (2013). Functionality-Based Understanding For Depression and Bipolar Disorder. Psych Central. Retrieved on August 27, 2015, from http://blogs.psychcentral.com/bipolar-advantage/2012/12/functionality-based-understanding-for-depression-and-bipolar-disorder/