Keeping Bipolar Disorder in Remission

Twenty-five and a half years ago I was diagnosed with bipolar disorder. I’ve been living symptom-free for over a decade. I consider myself to be in “remission” from my mental illness, because I no longer have symptoms that plague me, so I no longer fit the diagnostic criteria for bipolar disorder.

Bipolar disorder comes with a heavy stigma and is often confused with a personality disorder. For me, it meant I had seasons of depression (lasting weeks) or seasons of hypomania/mania (that didn’t last as long). Hypomania was “fun” and led to productivity, but mania was dangerous. If I didn’t sleep, it got worse.

People frequently message me, wanting me to know what I did to become symptom-free. Concerned parents reach out to me, asking me to help their child heal. I think it’s important to note that there is no one-size-fits-all approach. Everyone’s illness affects them differently, and every diagnosis has a different cluster of root causes. My root causes were trauma-based and psychoneuroimmunological (I was diagnosed with mono the same month I was diagnosed with bipolar disorder, and I had immune challenges all throughout childhood).

Another factor that is important in my story is personality. I’m a go-getter and a very determined, curious, research-driven person. When I was first told I would always struggle, I believed what I was told. When I began to see research that indicated otherwise, I dug deeper. I realized that I wasn’t as powerless as I once thought. That brought out a “fighter mentality” in me, and I refused to let my label limit me from living out my purpose.

I understand that for many people struggling for years, the exhaustion of fighting with symptoms can leave you hopeless, and that feeling is paralyzing. I hope the information I share next doesn’t fill you with a greater sense of hopelessness. Instead, I want to spark your inner curiosity to dig into what may be helpful for you to incorporate.

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You Are Not Your Diagnosis

As a mental health advocate, functional medicine practitioner, and someone who was diagnosed with bipolar disorder at 18, there is a frequently used phrase about bipolar that makes me crazy.

When someone says, “he is bipolar” or “she is bipolar” or “she’s acting bipolar,” I’ll likely get pretty defensive pretty fast. Bipolar disorder is NOT a personality trait.

Mental health awareness is important, but current awareness and discourse sometimes comes at the expense of the over-identification of our personality with symptoms of an illness.

You don’t say “she IS diabetes” or “she IS depression” or “she IS rheumatoid arthritis.” For some reason, bipolar disorder is the only diagnosis and physical illness that becomes an identity statement and personality trait.

A lot of people who use that phrasing don’t understand that for most people with bipolar disorder, they’re not having constant mood swings. They may have one or two mood episodes a year. For example, in the past, I tended to get depressed in the late fall and winter and then I would head into hypomania/mania in the spring/summer. Some of that was triggered by trauma, diet, poor lifestyle choices, and substances. Even the wrong medication caused psychosis and hallucinations in me. (Yes, prescribed medication made my symptoms worse, which isn’t discussed enough.)

Bipolar disorder is a mood disorder rooted in many physiological issues that causes fluctuating episodes of mania or hypomania (which is milder than mania) and depression. Episodes can last several days to weeks, and between episodes there may be seasons of stability. Mania and depression are broken down by the following symptoms below.

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Do We Need More Mental Health Awareness?

May is Mental Health Awareness Month. Here’s my controversial opinion: we don’t need more mental health awareness. We need more tools to get well and stay well. We need practitioners willing to think outside the box, beyond the checklists and low-efficacy treatments.

At 18, I met the criteria for a diagnosis of bipolar disorder.

When I was diagnosed, I experienced symptoms of hypomania and mania that impaired functioning for weeks at a time, such as:

racing thoughts
lack of sleep
grandiosity
heightened energy
impulsivity
increased risk-taking

I also experienced symptoms of depression that impaired functioning, for weeks at a time, such as:

low mood
inability to get out of bed
sleeping too much
no joy in previously joyful activities
no motivation
fatigue
hopelessness

BUT there were many other things going on in my physical body that were not addressed. Nobody blinked at chronic antibiotic use, chronic strep infections, or mononucleosis occurring at the same time. Nobody looked at trauma, hormones, or cortisol. Nobody looked at lab data at all.

Getting a diagnosis to match my symptoms didn’t give me information about the cause of the disorder or a solution to manage it.

I had to figure that out on my own.

I was very aware that my mental health wasn’t okay.

I didn’t need “mental health awareness.” I needed tools. I needed to process what a diagnosis would look like for my future. I got a label and meds that came with terrible side effects (and did little to tame my symptoms or treat the root).

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Mental Health Awareness Month – What I Learned About My Mental Health This Year

Breaking news for myself: I don’t need to pathologize my feelings. I can experience Big Feelings without having a mental health crisis. Experiencing feelings does not make me mentally unstable.

For so long, my feelings were scary. It wasn’t safe to feel them. While I have always enjoyed experiencing a wide range of emotions, from high school on, they met a list of symptoms on someone’s checklist. Hypomania? Categorized by racing thoughts, pressured speech, elation, high energy, increased goal-directed activity, distractibility, or talkativeness. Check. Depression? Categorized by fatigue, sadness, hopelessness, lethargy, too much sleep, tearfulness, feelings of worthlessness. Check. My real human emotions were analyzed and over-pathologized for so long–by me, by my parents, by the experts. It disrupted my life, and it made me feel shame for experiencing a wide range of emotions. So at some point, I stopped letting myself feel them. You know why? It’s easier not to feel than be worried your feelings are at the mercy of a brain, diagnosis, and prescriptions that are out of your control.

I created a disconnect between my body and brain. In some ways, I checked out of the experience of life. I activated autopilot mode. I cruised. This looked like packing my schedule and hyper-controlling my environment. I had routines that were predictable. I said yes to too much, so there was no room for thinking or feeling for too long. I planned for downtime, in case the overwhelm hit me. I stayed away from dramatic movies, series, or books. I didn’t want to be caught off guard. Sleep was a savior when life became too heavy.

I questioned every mood shift. Thankfully, my husband Richard pushed back on my questions. He reminded me, over and over again, that experiencing a wide range of emotions is okay–and is very human. It took me a long time to believe him.

Today, almost thirty years after I first experienced the darkness, I can use my feelings as a navigation system. They tell me where I need to re-adjust. They are alerts on the dashboard, indicating that it’s time to check in with myself.

If I’m feeling sad, overwhelmed, scattered, distracted, TOO energetic, or any other emotion that feels extreme, I ask myself what I need to feel regulated again. Sometimes, I check in with a feelings wheel (see below or click here). Simply identifying a feeling, naming it out loud, is like taking a big deep breath that’s been constricted in my chest for hours.

I do this often at the end of the day, usually as I verbally process with Richard, but sometimes as I pray myself to sleep. Saying the feeling normalizes the emotional wave driving the feeling, and then I can move on. When I don’t identify them, they build up. That’s when the dysregulation happens.

Now, hear me clearly: I’m not saying every time a person is experiencing depression or anxiety or a manic episode, it’s due to the fact that they can’t name their feelings. I get anxious when I eat a large cookie. My brain gets buzzed if I drink a too-sugary coffee drink. Alcoholic beverages can make me feel depressed and poorly impact my sleep. Skipping yoga too many times in a week can make me restless. There are very real physical triggers to my mood shifts, and I am constantly monitoring my responses to mood-altering substances like sugar, alcohol, gluten, dairy, and any overly processed standard American food.

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Putting My Mental Illness into Remission

I was medicated for bipolar disorder for 18 years. Ten years ago, I went off anti-psychotic medication. Eight years ago, I weaned off my remaining medication, an SSRI antidepressant.

Today, I am mentally healthier than I’ve ever been, particularly in the last five years, since I have been (mostly) gluten free and eat a lower carbohydrate diet. In fact, my husband would agree that since I changed my eating habits, there has been more of an increase in my mental stability. The times that I consume a bit of gluten here and there, and eat a little more carbs than usual, I typically start to sense some mental instability creep up. The connection between gluten, carbohydrate content, and psychiatric disorders has much clinical evidence behind it, but I’ll get to that in a bit.

I always feel the need to offer a few disclaimers before I share more of my story. Number one, I never encourage anyone to go off medication cold turkey or without the support of a medical professional. Unfortunately, many medical professionals don’t offer much caution in the tapering of medication, so there must be more of a support team in place, in my opinion. Going off medication cold turkey can lead to many unfavorable side effects and can often lead to a person feeling worse than they did BEFORE medication, so it is a very bad idea. When I weaned off my last med, I had a support team in place, and I had established many health practices that had me in the best physical shape possible. It wasn’t a quick decision; it took a lot of detailed planning and prayer.

Number two, every mental illness manifests differently in every individual who experiences symptoms. I was diagnosed with bipolar disorder in 1999, back when they still called it manic-depressive illness and didn’t distinguish between bipolar 1 or 2 as they do now. The symptoms I experienced at the time met the diagnostic criteria. Unlike most clinical diagnoses, diagnosing a mental illness means checking boxes on a list of symptoms, not looking at a blood test – and definitely not a brain scan. Because of that, and because I no longer experience the same symptoms, I consider myself to be in remission from this illness.

Here are the symptoms I experienced at the time that categorized me with bipolar disorder: periods of depression, lasting longer than a week where I felt fatigue, loss of interest in regular activities, sadness, apathy, worthlessness, and an inability to get out of bed at all. I also experienced symptoms of mania and hypomania, which meant that for short periods of time I felt increased energy, euphoria, an inability to sleep or slow down, racing thoughts, distractibility, and an increase in risky behavior and impulsivity.

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What to Do When Psych Meds Aren’t Working

More people are prescribed psychiatric medication than ever before, so why are we seeing mental health issues continue to climb? How can we support our loved ones when the traditional treatments aren’t working for them?

Dr. Julia Britz specializes in supporting people who are struggling with mental health issues such as OCD, disorders eating and psychiatric medication tapering. Her passion for working with individuals suffering from these lonely conditions is that she too was a “hopeless case”, but got better. Dismissed by doctors, she was told over and over there was nothing else she could try beyond pharmacotherapy, and so was inspired to create myocddiary.com, a site dedicated to documenting the daily life of OCD and related disorders. Through this project and holistic therapies, she found new levels of wellness, and in 2014 did a TED talk called “MyOCDdiary: an imperfect story.”

She utilizes natural and integrative modalities including targeted amino acid therapy, peptide therapy, micronutrient therapy, bioresonance, botanical medicine and epigenetic analysis, many of which are discussed in this episode.

Download this episode here or find wherever you get podcasts.

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Mental Health Awareness Month: Special Podcast Episodes

This month, I’m taking a break from the regular podcast content to bring episodes focused on bringing awareness to all the tools that support our mental health. Contrary to what the media may tell you, you can change your brain. You can heal from mental illness. You can access resources beyond medication and more sleep, and many of those resources are free, like these episodes.

In Episode 135, I share my story of overcoming PTSD, depression, and bipolar disorder in a way I haven’t shared before.

Key Topics:

The growing epidemic of mental health issues in teens
The root causes to my own mental health issues and how I struggled to find treatment that supported my mental well-being
The medication weaning process and how I was able to get off medication I had been on for 18 years
The tools I used to support healing and how I continue to prioritize my mental health to prevent recurring issues

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Mental Health Awareness Month: What it Means to Be a Survivor

Someone recently asked me, “What do you mean when you say you are a survivor of bipolar disorder?” I paused for a second. What does it mean?

I ended up responding with this, “I no longer exhibit the symptoms of bipolar disorder.“

I’ve been thinking about this conversation ever since.

Does not exhibiting symptoms of bipolar disorder mean that I no longer suffer from this illness?

Did my diagnosis match my symptomology in the first place?

This caused me to reflect back on the symptoms of bipolar disorder, which consists of fluctuation between a depressed state and a manic state.

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Identifying Root Causes of Bipolar Disorder

I was diagnosed with bipolar disorder (what they then called “manic depressive illness”) in 1999. While the diagnosis matched the symptoms I was experiencing, the treatment I received never seemed to make things better… and they never treated the root of why I was struggling.

While I have shared about my personal experience with bipolar disorder, PTSD, and depression and I have interviewed many different experts who share ways to treat the root of chronic disease, I have never devoted the majority of an episode to bipolar disorder and its root causes.

Ellen Vora, MD received her B.A. from Yale University and attended Columbia University medical school. She’s a board-certified psychiatrist, medical acupuncturist, and yoga teacher. Dr. Vora takes a functional medicine approach to mental health—considering the whole person and addressing imbalance at the root, rather than reflexively prescribing medication. Dr. Vora’s book, The Anatomy of Anxiety, comes out in March 2022.

Recording this episode was personal for me. It helped me put together the puzzle pieces of my health even further. Download here or listen wherever you get podcasts.

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How to Survive Stress Without Burning Out

It is well-known that chronic stress contributes to chronic disease. Research shows that as much as 90% of illness is attributed to the impact of stress. Finding a way to manage stress in our very busy world of constant notifications is a challenge. So I was excited to connect with Erica Cuni for this recent podcast episode. Spoiler: multiple listeners have written in to tell me that this is their favorite one!

Erica Cuni, known as “The Burnout Professor,” is a stress and burnout expert. She teaches high-achievers how to consciously thrive through an integrative approach. Erica is the founder of “The C.U.N.I. Method” – which stands for Create Undeniable Natural Impact. She is a former Trauma Psychotherapist, Clinical Director, and Adjunct Lecturer and Clinical Professor at Central Connecticut State University. Her mission is to help make the mental health field more effective, accessible, decolonized, and non-stigmatizing.

Download this episode here or listen wherever you get podcasts.

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