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 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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Why I’m Not Bipolar – and Neither Is Anyone Else

22 years ago, I was diagnosed with bipolar disorder (or manic depressive illness, as they called it back then) based on a set of symptoms, according to the DSM and failure to respond well to SSRI medication. My identity is not in my diagnosis, and neither is yours.

Imagine if we also said, “I am depression,” “I am anxiety,” “I am Hashimoto’s,” or “I am diabetes.” The phrasing doesn’t work for any other diagnosis. I’d also suggest that anytime we turn our diagnosis into an “I am” statement, we are attaching our unique identity to a set of symptoms, and putting our worth in our limitations.

22 years ago, I was suffering from the symptoms of bipolar disorder. I experienced bouts of glorious manic/hypomanic highs, where the world looked brighter and more alive, when I could stay up all night even with an illness like mono, when I felt charming and unstoppable and like the most brilliant person in the room. I also experienced waves of crushing depression, where I was unable to leave my bed, my body frozen, exhausted, and the world was a dark hole I couldn’t climb out of. It confused me because I was taking an anti-depressant at the time. So we upped the medication amount, and the highs got higher. I didn’t have any other tools for support (except my psychiatrist did mention there was emerging research on omega 3 supplements and brain health – too bad I hated burping up fish).

But here is the point I really want to get across:

Just because you were diagnosed with a mental illness by one person, based on a set of symptoms during one period of your life, doesn’t mean you will struggle with those symptoms for the rest of your life. That’s an archaic school of thought, and it doesn’t line up with newer research on brain health.

Often when we ONLY treat symptoms, instead of looking to the interconnecting root causes in each individual body, we don’t heal, and we limit the opportunity to find healing.

There are so many evidence-based tools to support mental WEALTH. Does rapid relief through medication possibly play a role? Sure! But remember, for some people, like me, it may exacerbate symptoms or make things worse, leading to new diagnoses and treatment cycle.

What are the puzzle pieces in my story that potentially led to a diagnosis of bipolar disorder? Some would say I have a genetic predisposition and leave it at that. But based on what we know of epigenetics, we know that our genes are only as influential in the way they express, and they express according to our environment.

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A Glimpse into the Mental Illness Memory Vault

“Sometimes I feel like being me takes up too much energy.” – me, 20 years ago.

In 2001, I started documenting my journey with what we then called “manic depressive illness,” after being unable to return to college with my friends due to my instability and frequent med changes. I forgot about the following journal pages, but they are so telling. I struggled with intense lows, wanting to leave this earth and end my pain, then I would experience shooting and soaring highs where I wanted to conquer every goal in a day.

Here are some of the entries:

8/27/01: “All I want to do is cry. I haven’t told my friends that I’m not coming back this quarter… What kind of trick are you playing on me, God? What lesson am I going to learn from this?“

9/5/01: “Sometimes I really do wonder if I should just end it all. I really do. Even when I’m stable, taking my 600 mg of Lithium, 100 mg of Topomax, and 25 mg and counting down of Zoloft (I’m hopeful that one day soon I’ll end this vicious charade with Zoloft).

What good am I doing here? What help am I to myself? Honestly? Why must I keep keeping on? Isn’t it ironic that the most inspiring thing I heard the other day came from the stupidest move, Joe Dirt. The main character, who lives a life of utter hopelessness, keeps quoting, ‘Life is a garden – dig it!’ I thought, that’s pretty inspiring. Unfortunately, I feel like any garden I’d be digging would only end up looking like weeds.“

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Freedom from the Mental Illness Shame Cycle

When I was 21, I made a suicide pact with myself. I felt the weight of the world on a consistent basis, as I struggled with depression, mania, and the chaos of jumping from one failed medication to the next. My mind was not my friend, and I didn’t feel safe in my body. At the young age of 21, I was fatigued from fighting the swirling thoughts and the heavy waves. I was burdened by being the only one who suffers from such a debilitating disorder.

I didn’t want to be on this exhausting earth any longer than necessary.

I decided that by my 41^st birthday, I would end it all.

Today I turn 39. I have been in a stable place mentally for over a decade. The giant roller coaster I used to ride with my moods is now just a soft swell, a gentle up and down of a kiddie coaster.

I have no intention of ending my life. Not now. Not ever.

My life is a gift. My illness is a gift. For so long I lived in shame about my diagnosis. I didn’t want to share about it, and I didn’t want to look “abnormal.” I knew I carried a stigma. Today I am learning that thanks to my moods, I get to see the world from a different lens. Colors are richer and brighter to me. The air is fresher. Sounds are more soothing and meaningful. Everything is vibrant and alive. And even when they are not, and I experience a drop in my mood, I see the dark side and feel more deeply than others… meaning I can empathize with others’ pain in a way I wouldn’t be able to otherwise.

I know now that my pain has a purpose. My pain showed me who I can be in spite of a broken brain.

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Being Bipolar in a Global Crisis

No amount of sugar or substance can make my brain buzz the way a dose of hypomania can. The ideas, the thoughts, and the LIFE that course through my head – all those are amplified in a time of crisis or extreme change. Being thrown off my daily routine or sleep schedule is a risk to my mental health. So throwing me into a global pandemic and giving me access to information 24/7 can really shake things up.

I find myself hopping around from medical research sites to conspiracy theory groups to political commentaries and read over all the comments and opinions. I am an excellent mimic. In order to manage my symptoms early on, I found a way to adapt to acceptable behavior and commentary, so I wouldn’t have to stand out any more than my buzzing brain could allow. I know what I shouldn’t voice in public or on social media, at risk of anyone thinking I am “crazy,” the C word accusation being one of my biggest threats. I fear other people’s opinions of me more than the average person, because deep down inside I know that my brain functions differently from everyone else’s, and that is scary. So I turn inward, and obsess, and research some more, and head down rabbit hole after rabbit hole, at the expense of my sanity.

At first the racing thoughts and buzz are a high, and they fuel me and energize me. At some point though, my brain reaches breaking point and I have to make it stop. I’ve been down these roads long enough to know where they end – in verbal explosions or in heavy medication to shut it all off.

ferris wheel and ship — The carousel ride that is bipolar disorder.

So I fight. I maintain my mind by shutting off my triggers. I stop researching, stop listening and reading to anything that will throw me into a black hole of information. I take naps, and I go to sleep early. I’m fortunate in that I’ve never struggled with sleep. I can always breathe myself to sleep. In for 4 seconds, hold for 7 seconds, out for 8 seconds. I burn off the energy through heavy exercise. I write, I dig into my feelings and name what is going on instead of escaping through obsessive behaviors.

The thing about bipolar disorder, is that it manifests differently in everyone. Everyone struggles in a unique way, and everyone has different triggers.

*To hear more details from others who suffer and how they manage, click to listen to Episode 29 of the podcast on my show page or subscribe on iTunes.

I’ve compiled a list of my favorite tools for finding stability during times of major stress or life change. Before I list them, here is the caveat – these tools aren’t always effective in the middle of a full-fledged episode. It is really hard to tell someone who cannot physically get out of bed due to depression, “You should just lace up your shoes and go outside. Why are you just laying there?” Or telling someone who’s manic, “Slow down and go to sleep.” It doesn’t work like that. These are physical illnesses that affect the physical function of our bodies. Our brains aren’t capable of telling our bodies to do what our bodies need to do. This is why we have to be on the offense and employ these tools REGULARLY, during times of stability, so that they are habitual and instinctual. The sooner we can tighten up these strategies at the beginning of the roller coaster climb or at the beginning of the dip downward, the better off we will be. Continue reading “Being Bipolar in a Global Crisis” →

Kanye, Bipolar Disorder, Religiosity, and My Thoughts

While my entire Facebook feed is filled with articles and comments about Kanye West’s new album and recent conversion, I have stayed silent. Why?

Because number one, I don’t really know anything about Kanye to begin with (other than the time he hijacked Taylor Swift’s speech on the VMAs and the famous rant about George Bush not caring about black people). He has kids with weird names and a wife with an awesome body. That’s about all I know. Superficial? Maybe. I can’t tell you the name of any of his songs. They’re not on my running playlist.

Number two, what he does or says doesn’t have any affect on me personally. If he wants to sing songs about being rich and famous or songs about Jesus – cool. I typically don’t speak up about issues in pop culture unless I feel they have some kind of heart-twisting impact on me and my life… or if they have some kind of mental health connection.

So when I heard he suffers from bipolar disorder, that’s when the light bulb turned on. How did I miss this? Talk about a plot twist! It led me to take an interest in all the Kanye news of the last year or so. While many out there are debating whether his conversion is real or a publicity stunt, my first thought upon learning this is – is this all a manic episode?

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