Archives for Relationships
My sister died in my arms last June in the middle of one of the deepest impressions of my life. The fact that I understand depression and I have learned to live with it instead of against it made my depression an asset for my entire family instead of the burden that my depression once was. This election-infused depression was not normal for me. Because of the prevalent election anxiety among so many people on the left and the right, I was experiencing levels of anxiety that I never had before. I also got the chance to explore my fears in a way that has led to a better understanding of both anxiety and fear along with the positive outcomes that are available to all of us.
A common refrain in the bipolar disorder community is "I'm doing the best I can.” Every time I hear this or a similar phrase my heart weeps. I know all too well the feeling of despair and hopelessness that comes with it. There were so many times, while in tears, I used the exact same phrase. Whenever I hear it now, I want to reach out and empathize with the person so she does not feel alone. But at the same time I find myself conflicted. I know from my own experience, and from helping so many others, that the results we based the statement on was not the best we could do. Not by a long shot. That part of me wants to say, "you are stigmatizing yourself into accepting a life that is far less fulfilling than what you're capable of." I have struggled with this conflict for many years and I'm finally ready to go public with it. Allowing such statements to go unchallenged not only harms the person saying them but also stigmatizes everyone else into believing that the best we can do is to continue to suffer with a dis-ordered relationship to the bipolar condition. I wonder if my first compassionate inclination is not really compassionate at all when we consider it prolongs suffering in anyone who buys into the sentiment. The most compassionate thing is to help everyone create better outcomes so that bipolar is no longer a disordered condition and instead becomes an advantage in their lives. It is especially disconcerting when I hear such statements from people claiming to be "experts" who are giving advice about how to deal with bipolar disorder. I know it gets them sympathetic comments and the feeling that they are relating to their audience, but aren't they just telling their audience to accept the same limitations that they have accepted?
Bipolar in disorder combined with anger is a very dangerous mix. The disordered person tends to become very volatile and can explode into a rage with little provocation. It is best for the person to avoid anything that might trigger anger until the disorder is in remission, but even then an angering stimulus can trigger another manic or depressive episode with anger as one of the troubling elements. Bipolar people who have their condition in order have learned important lessons that can be applied to most of our experiences. For example, since we understand bipolar so well that we can function highly during depression and mania, we can also handle more intense states of anger without losing control. As with every experience, most people can usually function fine when anger is at a very low intensity, but when the intensity of anger increases beyond their comfort zone they begin to lose the ability to choose their response to it. They act in ways that are less than optimal. They may even become a danger to themselves and others if the anger becomes too intense.
We get a lot of calls from parents who are looking for help with their bipolar children. We make great progress within the first few visits, but too often run into an underlying issue that needs to be addressed. While the bipolar issues are certainly part of the problem, the family dynamics are a bigger issue. Since the child has usually been diagnosed before contacting us, the parents assume all conflicts will be resolved as soon as the child is no longer in disorder. All issues are seen as being caused by bipolar disorder and the rest of the family is completely innocent; it is as if the diagnosis suddenly made everyone else perfect. This does not happen when the parents have been diagnosed with any psychological issues. The parents recognize their own issues that need to be addressed and how those issues play a role in the conflicts. Even if the diagnosis is completely different from bipolar disorder, there is a recognition that nobody is perfect and we all have room for improvement.
Many bipolar people say they are "high-functioning," but most of them mean they function OK when in remission and cannot function when things get too intense. How well one functions DURING depression or mania defines the difference between Bipolar Disorder and Bipolar IN Order. At every intensity, functionality influences the comfort of everyone involved and whether they see value in the experience. Functionality should be the central focus of any approach to bipolar instead of simply trying to make it go away. Many think intensity of depressive or manic episodes is the determining factor in functionality, but evidence contradicts such belief. Far more important are awareness and right understanding as outlined in the previous articles in this series. With enough education and practice, intensity becomes far less relevant to functionality than most people believe. Functionality does not mean driving as fast as your car will go or talking so much you take over the conversation. It must include the ability to do the things necessary to function in society. Measurements for physical, mental, emotional, spiritual, social, and career/financial productivity need to be part of the analysis. Real functionality includes the ability to get along with others and for them to be comfortable with your behavior. The functionality scale, like the other items in the graph, runs from zero to one hundred percent in increments of ten. Fifty is a normal person during normal times. Less than fifty means that depression or mania is causing one to function less well than normal, whereas above fifty means functionality is enhanced.
I have discussed bipolar with thousands of people over the last 10 years and would guesstimate that being hypomanic without losing control is the Holy Grail for 75% or 80% of them. Most say their goal is "permanent hypomania and to never be depressed again." If you ask their parents, though, they will say "I don't mind him being a little depressed, but could you make the mania and deep depression go away forever?" There is good reason for the discrepancy between parents and bipolars. Bipolar people may like being manic, but their behaviors are so often out-of-control that they become a problem for those around them. Bipolars and non-bipolars alike are justifiably afraid of mania because of past history with manic episodes. It is commonly believed that it is impossible to even be hypomanic without rapidly escalating to an out-of-control state. The belief is so prevalent that the standard of care for mania according to the National Institute of Mental Health is to make it go away entirely. On the other hand, there are many people who advocate that bipolar is a dangerous gift. Some take it too far and say we should allow all states no matter the consequences. While I fully agree with the dangerous gift idea, we must learn to take responsibility for our states and keep them from getting to places that we cannot control.
I noticed it when I was first diagnosed, but have been watching the phenomenon ever since. I have seen it happen in so many people that it might be true in three quarters of the cases. What is even more amazing is how fast it happens. Bipolar may be the fastest path to perfection known to man! I have been working on more thorough assessment programs for my new book and think that I have found a breakthrough. Through the assessments I have it traced to the exact moment that it happens. I wonder if you can help me verify my research with your own experiences and share your ideas on how to improve upon it?
One of my earliest memories is of learning to ride a bike. I remember the fear, exhilaration, and hyper-awareness, along with the tension in my body and how my breath became both more rapid and shorter. I was outside of my comfort zone and challenging myself to grow. It was also a blast! My father had a wisdom common with most dads. He didn’t push me down a steep hill and hope I survived; he ran along next to me making sure I was not too far outside of my comfort zone as to be incapable of handling it. He taught me one of the most important lessons that day about what it is to be human. We need to challenge ourselves to grow, while at the same time making sure we don’t go too far outside of our comfort zone. The thrill of learning something new and challenging myself to grow has been a constant companion ever since my first bike ride. On too many occasions, I took on challenges far outside of my comfort zone and was either debilitated by the fear and lack of skills, or took risks that caused more harm than the potential reward from succeeding.
Every single day I think about the time I tried to kill myself. It is one of my strongest and most detailed memories. I mention it in passing in my talks as if it is just a point of reference, but it has a profound impact on my every thought. I have not heard the bipolar or depression world debating pro-choice vs. pro-life suicide, but it is an internal debate that I often have myself. I wonder if others have had similar thoughts? My debate is further colored by the suicide of my best friend Santiago. I think about his hanging himself every day, and the effect it had on everyone around him. It is another memory that is so strong it could have just happened. It too has a profound effect on my every thought. The other day I was showing a visitor around San Francisco and he brought up suicide when we drove by the Golden Gate Bridge. He asked how many people have jumped off (over 1,200 so far) and whether they have put up a barrier yet. I found myself sharing my internal debate and chose to take the pro-choice side.
I have finally settled on a motto that says it all for me - I Want To Be A Better Person. For me, that simple phrase addresses many of my issues; my arrogance, my bad behavior, my admission of having done wrong, my acceptance of who I really am, and most of all, my need for hope. I Want To Be A Better Person reflects my belief that in spite of my bipolar condition, I can overcome my bad tendencies and become someone to admire, instead of someone to fear or feel sorry for. My journey to wanting to be a better person was long and convoluted, painful, yet even funny at times. My hope is that by sharing it with you, I will have an even greater desire to live up to my dreams and give someone else hope as well. There are countless details left out and many details may be wrong, but I hope to paint a picture of how I got to this point. Long before my diagnosis of Bipolar, I exhibited behaviors that were considered horrible, to put it mildly. Thinking I was smarter and better than anyone, I would justify my behavior as the fault of whoever was my victim. It was always “your” fault that I was acting so horribly, and if it weren’t for you, I would be a saint. My extreme rages were outdone by my delusions, my denial that I was responsible for my behavior, or even believing that my behavior was perfectly justified. After getting sick of my own behavior, I bought an estate that was next to the monastery that I once lived in. I volunteered to manage the computer systems department and was put under the direction of Lee, a senior monk who I have known for over 20 years. One day, I had a falling out with a friend of mine that I had hired to do some work for the monastery. We ended up in a heated email exchange that was rapidly escalating to the point that it was harming the monastery. Because I was representing the monastery, Lee insisted that all emails that I sent be approved by him. It has been almost five years now, but that experience is one that I have finally grasped.