Dealing with the Problem Pileup
I recently attended a NAMI (National Alliance on Mental Illness) support group meeting that’s run as a problem-solving workshop. All attendees are sworn to confidentiality, so I won’t go into details, but as one of the attendees described her situation, I felt overwhelmed by what she perceived to be the problem. It was total chaos. What she described as one problem was actually a problem pileup – numerous problems all jammed together.
Problem pileups are common in bipolar disorder. Problems tend to come in waves making you feel confused and overwhelmed. When you’re in the midst of it, you may have trouble seeing what’s actually going on. As a first step, NAMI advises making a list.
For example, suppose you’re angry at your loved one because you feel she’s not doing enough to manage the illness. This sounds like one problem, but it may actually be several problems.
This particular observation is also very subjective; no evidence is provided to support the notion that the individual is not managing the illness – at this point, it’s just an opinion. To find out what’s really going on and present the problem more objectively, you might ask yourself, “What exactly is my loved one doing or not doing to manage the bipolar disorder that makes me feel concerned?” The answers may include any or all of the following:
- Not taking medications the doctor prescribed.
- Not getting enough sleep.
- Abusing alcohol or other substances.
- Not seeing her doctor or therapist.
- Not getting any better.
Each of these issues is a separate problem with its own list of possible causes and options for solving it. For example, if the problem is that your loved one isn’t taking the prescribed medications, you might ask, “Why aren’t you taking the medications?” and receive any of the following answers:
- They don’t work.
- They make me feel tired.
- They flatten my emotions.
- They make me gain weight.
Or your loved one may simply say it’s none of your business. Whatever the case, you now have more information to work with. (Even if your love one tells you it’s none of your business, at least you now know that he or she feels encroached upon, and you can start working on that particular issue.) By deconstructing the problem and making lists, you accomplish the following:
- Gain clearer insight into what’s going on.
- Shift the focus from the people to the problem. (This is perhaps the most important.)
- Make the problem smaller by narrowing it to a single issue.
Problem solving is like untangling a nest of fishing line. If you get frustrated and start tugging at it, the knots tighten up. You may even get new knots. A patient, steady approach is more effective. Identify one knot at a time and remove it.
The next time you’re facing a problem that seems overwhelming, take a few minutes to jot down a list of what you believe is bothering you and how you feel about each problem. Identify the one problem you deem most pressing, and make that your laser focus. List the possible causes and then team up with others to explore potential solutions. Save those other problems for later. If you’re lucky, solving one problem may make the others go away or at least make them easier to solve.
Class 5 of NAMI’s 12-week Family-to-Family course is a problem-solving skills workshop that provides a roadmap for identifying and solving problems and implementing solutions. I strongly encourage you to take the course. Check with your local NAMI affiliate to see if and when the course is offered in your area. NAMI also offers a Peer-to-Peer course for consumers.
Photo by Bart Everson, available under a Creative Commons attribution license.
Kraynak, J. (2011). Dealing with the Problem Pileup. Psych Central. Retrieved on October 28, 2016, from http://blogs.psychcentral.com/bipolar/2011/04/bipolar-disorder-problem-solving/