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Tuesday, May 17, 2016

My Battle with Bipolar---4 Simple Strategies for Recurring Problems





Reprint: Permission of BP Hope Magazine

My Battle with Bipolar—4 Simple Strategies for Recurring Problems
You can take charge of your recovery on a regular basis, one day at a time, by using these simple strategies.

bipolar-recovery-stategies

By Stephen Propst



He’s too smart to have bipolar. I’m glad he found the right medication and is back to normal. He’s got things under control now. These are among the many comments I’ve heard over the years. Unfortunately, statements like these trivialize what, for me, has been an ongoing and occasionally overwhelming battle with bipolar.

The truth is that intelligence alone does not solve a sometimes life-threatening condition. A pill doesn’t magically make all the symptoms go away. And when you have bipolar, even with treatment you can remain vulnerable to episodes of debilitating depression or major mania, sometimes for life.

While I don’t have as many major crisis moments these days, I still face four factors on a recurring basis. The chronic nature of these issues is particularly problematic. To maintain my recovery, I try to take things in stride and employ some simple concepts— and you can too!



CONTINUITY

At one time, my life seemed to have a natural flow. But ever since I was diagnosed with a mood disorder, my days seem disconnected. It’s like having a series of mini-lives. To maintain some sense of connectivity, I’ve learned to never go to bed before deciding on a reason to get up the next morning.

To further confront this challenge, I set goals and stick to a schedule. For example, when I decided to get myself into better shape, I started working out with a trainer. We established specific expectations, and I rarely leave one appointment without setting the next.



ENERGY

My energy level can feel depleted one day and elevated the next. My brain vacillates from slow, confused, and worried to excited, impulsive, and hurried. This ever-changing mental climate can wear me out.

To overcome this obstacle, I have to manage both ends of the energy scale. When I’m feeling low, I take time to rest my body and restore my mind, by meditating or doing something relaxing. When my spirits are high, I try to focus my energy on something constructive, like working on a project I’ve been delaying.



DECISIONS

Making routine decisions can cause my mind to take flight and my recovery to suffer. To deal with this dilemma, I try to simplify my life. For example, I shop at stores that offer fewer choices, perhaps four varieties of a product versus 30. Interestingly, American psychologist Barry Schwartz has studied this very phenomenon. His “paradox of choice” research suggests that limiting consumer options reduces stress. I’ve certainly found that to be true.



SELF-ESTEEM

To manage this menace, therapy has really helped me transform my thinking. I have to be diligent about not downplaying my worth as a human being. I’ve found it helpful to be with positive people and engage in activities that give me a sense of purpose, like volunteering.

Perhaps the most effective strategy I’ve learned is to stop all the sabotaging self-talk. Whenever I start to condemn myself, I pause and take time to rethink what I’m saying. I then restate my thoughts in a more self-affirming manner.



In the more than 25 years that I’ve lived with bipolar, I’ve had my share of dealing with the full-blown symptoms that are characteristic of the condition. But continuously coping with the daily factors, like the four discussed here, is an equally formidable task. It’s a never-ending cycle, but there is hope!

Whether you’re dealing with day-today discontinuity, enduring erratic energy, confronting countless choices, or suffering subpar self-esteem, being patient and persistent pays off. Despite the daily demands of bipolar—which can be extremely tiring and taxing—you can take charge of your recovery on a regular basis, one day at a time, by using these simple strategies.



Thursday, May 12, 2016

Better Then The Med's I Take




Better then the Med's I Take

Like the Title of his Blog, "the Peers Life" Please welcome a fellow Peer, a reader and new friend whom met while reading my Op-Ed re-print in the National Alliance on Mental Illness this past December 1st, 2015, Worlds AIDS Day.

Like I say when I receive emails from readers, "Better than the Medications I take," is why I'm a Consumer Advocate for mental health, HIV and substance abuse, raising awareness and eliminate the STIGMA of all three.
A tease from his Blog. "I’m an American/Australian man who has relocated from Lismore NSW Australia, a regional city centre to Tucson Arizona. I’m a recently Certified Peer Support Specialist. I volunteer at NAMI Southern Arizona providing NAMI program and information regarding mental health held at various resource fairs throughout Tucson. Prior to living in Tucson I left a wonderful mob of people called Grower’s. With the help of the GROW program I changed my life and I haven’t looked back yet. Thanks mates!"

Please welcome James Chapman, "The Peers Life"











Tuesday, May 10, 2016

Living, Coping, Aging with HIV among People over 50

Living, Coping, Aging with HIV among People over 50
by James Chapman, Southern Arizona Certified Peer Specialist

How aging with HIV affects our brain function, our social support
networks and mental health

For people living over 50 with HIV, whether you are a long-term
survivor or recently diagnosed, we are the first group of people who
live with HIV/AIDS and many co-morbidities as we age which are being
studied and given considerate thought in accessing what our needs are
both physically, mentally and socially.  It’s ongoing.  It would be
helpful to them if we give them the opportunity to understand us
better.  The more we can share the more they have to work with.
Living with HIV in later life presents the opportunity for doctors,
psychiatrists, psychologists, neurologists and social workers to
better understand how they can best serve us.  We are the first
amongst people living with HIV/AIDS to be studied.  We can experience
changes in our mental health, our neurocognitive abilities can change
and our fine motor skills could become affected.

HAND or HIV AIDS Neurocognitive Disorder has 3 disorders with
different degrees of impairment. We could have trouble with attention,
memory, language, problem solving, decision making.  We will
experience none, some or many of the known symptoms which can and does
affect our lives, emotional and spiritual well-being, our social
support network, and family.  It can come all at once or slowly.
There is no set way for HAND to occur.

Symptoms of HAND can include confusion, forgetfulness, headaches,
changes in the way you behave, problems with cognition or movement,
pain due to nerve damage, and a gradual weakening and loss of feeling
in the arms and legs.  The only way to be sure is to seek an
experienced neurologist who can eliminate other possibilities or
causes.  They may conduct neurological exams, perform brain MRI scan,
possibly a lumbar puncture to analyze the cerebrospinal fluid (CSF).
Depending upon the results a change may be needed in the type of HIV
drugs prescribed.  Please speak/consult with your doctor about changes
to drug treatments.

There are other areas of our lives that it can impact.  It can affect
our ability to seek enjoyment being with people and lead us to isolate
out of the stigma and discrimination we may face, how well we continue
to stick to drug treatments and following our doctor’s advice.   Our
family and community support is important to maintaining physical and
emotional wellness and connection to others.  Finding people who can
see past what we are experiencing and to focus on what our needs are.
Having a good spiritual or religious belief(s) has a known positive
affect on our well-being.  Learning mindfulness and applying it into
your daily life as a way to focus on activities we are able to do, not
focusing on what we cannot.

So you think you may be experiencing HAND or is it just depression?
You may or may not be aware of it happening.  This is where your
doctor may wish for you to be assessed through neuropsych testing.  It
will provide the psychologist with a detailed assessment of your brain
function/capacity.  It can be followed up with time if your symptoms
are remaining or have progressed.  It’s an important tool to have in
allowing people who treat us to have a bigger picture of where we are
at.  Because we are entering into uncharted waters there are no easy
answers or that they have figured out how to treat us.  All of us can
experience similar symptoms with different needs.  No two people are
alike.

I would like to share with you my personal experience as a way to help
you understand this important topic that is affecting people living
with HIV/AIDS over 50.  I have lived with HIV/AIDS for 33 years this
past March.  In early 2007 I was diagnosed with AIDS (HIV
Encephalopathy).

In late 2006 I was working in a high stress job as a receptionist at a
company who processes insurance claims.  I talked on the phone every
day, initiated new claims for the assessors to inspect damage claims.
I was the beginning contact point, follow-up progress of claims, and
filing of claims once completed.  6 months into my job I began to
notice small things.  Dismissible things like not remembering how to
spell someone’s name while on the phone with a customer.  I would lose
track of my thoughts and keeping all of daily tasks in order.  I live
with a spinal injury and my left foot began to drag on the floor while
I was walking across the floor.  Over time I was finding it difficult
to talk on the phone either losing track of what I was talking about
or who I was talking to.  My speech became noticeable to other people.
They could see that I was changing from the person they recognized but
not being able to put a finger on what it might be.  My employer was
unaware of HIV status.  I hadn’t disclosed my status.
I stopped working abruptly.  I wasn’t able to function.  I was finding
everything too hard.  I didn’t understand what was happening to me.  I
knew I lived with depression and this was way different.  I felt like
a shell of the man I was.  No self-esteem, a good support system and
medical team.

After consulting with neurosurgeons for possible neurological problems
due to my spinal surgery, I was assessed by Professor Bruce Brew
Director of Neurology St. Vincent’s Hospital in Sydney Australia.
Based on his assessment I was advised that I had HIV Brain disease
(HIV Encephalopathy) and spinal cord involvement.  He gave my HIV Dr.
a list of new drug treatment options and offered this as a way to
begin my treatment.  I was given all of the known HIV medications at
that time (2007) that would stop the virus from crossing the blood
brain barrier.

I began to see a psychologist who gave me ways in coping and learning
new strategies to deal with such a radical change in my life.  I
learned mindfulness.  I practiced it every day.   My ability to think
had stopped.  I was losing the ability to say what I was thinking.  It
would get on the tip of my tongue and then disappear.  I spoke with a
slur/slowness.   I began to use a walking frame.  My cerebellum had
been affected.  It’s the part of the brain that affects walking,
talking, thinking and speaking had been affected.
My whole world changed overnight.

I currently live with peripheral neuropathy of my hands and feet with
an unknown cause.  Possibly HIV, drug medications, or long term nerve
damage.  I manage through diet, exercise, mindfulness and being gentle
on myself.  I had a counselor available to talk about what I was going
through.  It helped me overcome what I was living with.  Emotion can
both lift us up and also create for tense feelings which can increase
pain, increase Blood Pressure and Depression.

One of the reason’s we are on disability is so that we have the time
and ability to educate ourselves on our disability(s).  Learn to take
care of us so we can begin to lead a self-directed life.  I have spent
many years learning how the body functions because of my disabilities
(physical, mental).  When we know what is happening to us it can help
reduce our fears of the unknown.  Reducing our stress and anxiety
about the unknown.  Take one step at a time.

It was hard living with HIV Encephalopathy and thought I was going to
die.  My doctors hadn’t seen this before and were at a loss of what
could be done.  I took my meds and did the best I could each day
trying not to fall apart emotionally.  My relationship with my partner
began to change.  Our communication was difficult.  I was reliant upon
him to take me to doctors’ appointments, picking up my meds from the
pharmacy, nearly for everything.  I was given a visit by an
occupational therapist to review what could improve my daily routine
in my home making changes that were necessary.  I learned a whole new
way to live by dealing with the physical problems I was experiencing.
Allowing for change is hard and so worth it for me.  It brought me new
insights and possibilities.

When we come face to face with death we find out what we are made of.
In time I was able to change my HIV drug treatment.  I had a new HIV
doctor who had a different approach to how I was being treated and
with a reduction in the number of HIV meds, I improved.  My new HIV
drug treatment consists of 2 pills taken once a day.  It was a huge
psychological change from taking my meds 2x day every 12 hours for
many years.  It was a godsend and welcomed.  How something so small
could create a big impact just by switching my HIV meds.  I’m glad I
made that change.

As I get older living with HIV/AIDS I am well informed about my
disease(s) and how to stay well by being proactive about my life.  I
am concerned primarily about the normal old age problems.  Each day I
take steps that will help me further down the road to stay well.  Part
of going through horrific medical experiences for me is to learn from
them.  By taking steps in making good food choices & plenty of water
each day, taking my medications each day as directed, going for walks
staying active, having family in my life, connecting with people by
volunteering and being a part of the community, whilst maintaining a
good working relationship with my medical team gives me peace of mind
that I am doing what I need to do to stay happy & healthy.

For me with all that I do for myself each day, allows me to know that
I am doing the best that I can, to enjoy each day as it comes, dealing
with my life’s problems using the coping skills I have learned along
the way.  I smile from knowing I’ve done what I can and accept that
which I can’t.  I am optimistic about the future.  I have already come
through the eye of the storm.  You CAN too!

Tuesday, May 3, 2016

May is Mental Health Awareness Month

courtesy  of Tumblr 
snapped by me:  05-02-16 

"Mental Health Awareness Month has been observed in May in the United States since 1949, reaching millions of people in the United States through the media, local events, and screenings.[1]
Mental Health Awareness Month also comes to the United States via the Mental Health America organization. During the month, National Health America runs a number of activities which are based on a different theme each year.
In 2010, the theme was 'Live Your Life Well'. [2] 'Live Your Life Well' was a theme designed to encourage people to take responsibility for the prevention of mental health issues during times of personal challenge and stress. The message was to inform the public that many mental health problems could be avoided by striving toward and making positive lifestyle choices in the ways we act and think.[2]
The theme for the 2014 Mental Health Awareness month was “Mind Your Health”. A focus of that year's theme was to create a motivational effort that will put toward the goal of building public recognition in regards to the importance of mental health and to the overall health and wellness of those around us. The association hopes to inform United States citizens of the connection between the mind and body; and intends to provide advice, tips and strategies that will encourage people to take positive actions and protective measures for one’s own mental health, and whole-body health.[1]
Mental Health America is not the only organization to run campaigns throughout May. Many other similar organizations choose to coincide with Mental Health Awareness month. National Children's Mental Health Awareness Day is one such campaign. This event is sponsored by the American Psychological Association (APA).[3]
Many other months are also recognized for similar mental health awareness programs. For a list of some in America, see: http://www.whathealth.com/awareness/event/nationalmentalhealthmonth.html
Its purpose is to raise awareness about mental illnesses, such as depressionschizophrenia, and bipolar disorder. It also aims to draw attention to suicide, which can be precipitated by some mental illnesses. Mental Health Awareness Month also aims to educate communities about psychological disorders, while reducing the stigma that surrounds them. The month came about by presidential proclamation.[4]"

Source: Wikipedia  


Sunday, April 24, 2016

Out of the Blue - Into the Green.

GUEST POST BY PERMISSION OF THE WRITER.

IF YOU WOULD LIKE TO POST A STORY, CONTACT ME AT SHAREYOURSTORY@BIPOLARBEAR.US


Out of the Blue - Into the Green
By: James Chapman, Arizona Certified Peer Specialist

In a recent article in POZ Magazine April 4, 2016 - Out of the Blue
authored by Mark Leydorf shares recent findings by Mary Ann Cohen, MD,
a clinical professor of psychiatry at Mount Sinai Hospital in New York
who identifies that people living with Depression, Substance Use and
Violence can lead to higher possibilities of contracting HIV/AIDS.

First let us break a few things down to make it easier for us to
understand what is known.

Mental Health as defined by the World Health Organization (WHO) as of
April 2016 is a state of well-being in which an individual realizes
his or her own abilities, can cope with the normal stresses of life,
can work productively and is able to make a contribution to his or her
community.

Depression is the single leading cause of disability worldwide (WHO).
WHO has identified Depression as the single most Mental Illness
diagnosed.  It costs the economy of the United States approximately
100 billion dollars a year.

For people aged 18-35 which includes high school students and college
students, during the course of 12 months 25% will have a diagnosable
mental health condition of depression or anxiety disorder.  10% will
be diagnosed with substance abuse.  75-80% of people that experience a
mental illness and substance abuse will never get any form of
treatment as stated by Michael Schafer of Arizona State University.

I have lived with HIV/AIDS since I was diagnosed in 1983.  I have
lived with Depression for over 2 decades which later in my life
(August 2013) was re-diagnosed with Major Depression.  It can be a
very disabling, difficult, chronic condition which limits our daily
life, work, and well-being.  It is treatable and manageable with
medication and used in conjunction with therapy(s).

We have come very far in how we treat depression.  The biggest
obstacle can be ourselves in not wanting change, not believing we are
depressed, feeling hopeless in knowing I have HIV and all of the
things I have to do to stay well is overwhelming to say the least.  It
all can seem too much.

Living with HIV, Depression, and Substance Use leads to a revolving
door I have gone through.  For me living with HIV/AIDS & Substance Use
was a way of coping through adversity and for many people in the LGBTI
community, a norm.  Everyone does it, it must be okay.  When I was
able to step out of the revolving door and decide to make change for
myself, by myself with the help of others, I learned to understand
depression by identifying my life stressors or feelings of
hopelessness, loneliness and began to put in place ways of changing to
overcoming my depressed state into one of empowering myself to do what
I need to do to stay well.

It was hard work and for me a new lease on life.  A chance to live.  A
chance to participate in life.  To consider going back to work.  To
have new friends in my life.  To finding happiness in my daily life.
To love myself.

I have said over and over to myself and to others who would listen,
until I am able to understand mental illness myself it’s difficult to
address other physical/sexual/emotional problems that occur.  If I am
mentally unwell it’s difficult to have the insight needed to deal with
other issues that affect my daily life.  Exercise, diet, well-being,
employment, volunteerism, being part of family or community.  Being
mentally unwell excludes those opportunities.



RESOURCES:

Eight Dimensions of Wellness

Wearing Red & Green, Statistics on HIV/AIDS and Mental Illness

Working While Disabled, How Can We Help

Tuesday, March 8, 2016

HIV and Depression




So what's the importance of a brochure you may find in the waiting room while you wait to see your HIV specialist and if necessary while you are waiting to see Psychotherapist and Psychiatrist .

From my home page www.bipolarbear.us  you will read that not so far back 2004, you couldn't find brochures discussing the two.  It wasn't until 2005 - 2011 that more and more scientific studies were being published.  

One quote also from my homepage, "Dr. Glenn J. Treisman, MD, Ph.D., who is Director of the AIDS Psychiatry services at John Hopkins Hospital estimates that at any given time 1 in 5 HIV'ers is suffering from a major depression and require psychiatric treatment." (HIV Plus Magazine March/April 2009).

So what does that mean for you?  Well possible you been diagnosed HIV, like any diagnoses like Cancer or some other illness where you became depressed.  Depression is a natural experience, but long periods of depression is not, possible you are like me, 1 out oft he 5 HIV'ers suffering from a major depression that requires psychiatric treatment, why to get better, to go on living a productive life, to be able to return to work, even if it's a part-time job as you may require going on Social Security Disability Insurance because you are overwhelmed, or experience side effects from your medications.  Some of these are sleepiness, unable to focus long periods, there are many others (please check the resources at the bottom of this blog entry) that make it hard for you to work a full time job, but you can work part-time, another topic down the road.

So if you are reading this, you are not alone, it's not just you and that means others are out there and in GLBT community, that there are resources that can help you both at a doctors office, and in the form of self-help, peer to peer support groups.  
Please visit my website which lists 49 centers through out  the United States where you can get assistance, also visit the the home page for some valuable links.

IF YOU FEELING SUICIDAL CALL 911, I did, there is no shame, I'm here to tell you this and to tell you that it does get better.

Get involved, one organization which I've been on the GLBT Leadership Group as a Consumer Advocate.  Consumer = Someone like yourself living with an illness in recovery.  Advocate = an activist, some one who is pro-active in helping others by blogging, sharing my experiences, so that again I can't say it enough you are not alone. 


Other Resouces:

living well with HIV and Depression

AIDSinfonet.org , reliable up to date treatment news

http://www.thetrevorproject.org/    "The Trevor Project is the leading national
organization providing crisis intervention and suicide prevention services to lesbian, gay,
bisexual, transgender, and questioning youth." 

www.NAMI.org/glbt  National Association on Mental Illness, Gay, Lesbian, Bisexual and Transgender (GLBT) Mental Health Resources page.

Tip of the day 

Now two hours of sunlight left, this blogger like to ride his bike, take a bottle of water and get some excerise.  Go for a walk--find that boring, help an elderly neighbor and offer to walk to the grocery store for her--turn it into both exercise and a good deed, from the heart that's X two feel good and good for you..

Tuesday, February 9, 2016

Mending Relationships



REPRINTED with Permission:


Mending relationships.

Relationships strained to the breaking point are the trailing ghosts of bp. But that doesn’t mean repair is out of reach.


By Elizabeth Forbes



mend-relationships If only life came with a reset button. One push and voilĂ : Relationships unraveled by the behaviors of bipolar disorder would knit themselves back together.

Of course, it’s not that easy to mend what’s broken—but it’s not impossible, either. What bipolar symptoms put asunder, effort and understanding may repair.

Not all rifts can be mended, and sometimes letting go of the relationship is the best way to move forward. Yet healing can happen through a commitment to self-care on one side, education and acceptance on the other, and lots of communication to work through hurt, anger and fear.

When Barbara B., 53, and her husband, Gary, 57, separated after nearly 15 years of marriage, she was pretty sure the split would be permanent. Gary’s escalating bursts of rage, coupled with a growing emotional distance felt by both partners, had eroded the El Cerrito, California couple’s bond to a thread.

Both mania and depression often leave those with bipolar “unable to interact with the people around them,” explains Mamdouh El-Adl, MD, MRCPsych, an assistant professor in the Psychiatry Department at Queen’s University in Kingston, Ontario, and a clinician and researcher at the Providence Care Mood Disorder Research and Treatment Service.

“They don’t seem interested in maintaining the relationship, and this can be misperceived by other people,” he says.

Before Gary got his diagnosis of rapid-cycling bipolar I, Barbara interpreted his out-of-touch reactions to her problems as impatience and lack of sympathy, especially after her father died in 2003. When Barbara had to store boxes of her father’s belongings in the garage, for example, Gary complained there was no room for his car.

Bipolar-Depression-2That sense of disconnection deepened in the months that followed, just as the angry tirades Gary directed at Barbara were getting more frequent and more extreme. Looking back, Gary sees a combination of causes: extreme stress at work; disturbed rest from untreated sleep apnea; and antidepressants he was taking for unipolar depression, diagnosed a few years earlier. Getting an accurate diagnosis, which happened shortly after they separated in 2004, opened the door for real improvement—and for the couple’s reconciliation two years later.

As someone with a mood disorder herself—she was diagnosed with depression and anxiety in her 20s—and with a background in psychology through her work as a medical writer, Barbara didn’t see the bipolar diagnosis itself as a deal-breaker. The key for her was whether Gary was getting treated for the illness.

“I was really impressed with how Gary made a lot of effort to get better,” she recalls. “He was really good about medication. If any symptoms cropped up, like depression, he would talk to his psychiatrist about it. He became much more emotionally engaged once he was treated.”



Committed to Care
Experts agree that a relationship frayed or fractured by the fallout of mood swings can’t really be repaired until the ill person commits to recovery.

“In order to have a healthy relationship, you have to take care of yourself,” says clinical psychologist Cynthia G. Last, PhD, author of When Someone You Love is Bipolar: Help and Support for You and Your Partner (Guilford Press, 2009). “It’s not your fault that you’ve got the illness, but it is your responsibility to take care of it.”

Mamdouh El-Adl lays out three steps to mending relationships. First is getting treatment, with medication as the cornerstone upholding therapy and lifestyle changes. Second, those involved with the ill person should also learn about bipolar. Third, once a stable mood state is achieved, issues in the relationship must be resolved, perhaps in counseling.

“It is a long-standing process,” he says, “and requires a lot of work.”

During their separation, Barbara and Gary began seeing a couples counselor weekly. In the year before they reunited, they tested the waters by going on dates—“gradually learning to trust that things had gotten better,” as Gary puts it. Still, it was hard when both of them were depressed.

“At times we felt almost hostile toward each other,” he says.

“The only thing that could keep us going was knowing from experience that we would feel different later,” he adds.

Barbara says there are still times when it feels as if Gary’s not fully present in conversation, or seems depressed and unresponsive, but now they’re careful not to let such situations fester.

“We are very honest with each other,” she says. “That’s one thing we fall back on. We’re open about talking about our issues, whether in therapy or other ways.”



Reaching out
Time and talking is what brought Sheryl, 37, and her best friend back together. The two women have lived across the street from each other in rural Minnesota for more than a decade, but between 2004 and 2007 they didn’t speak.

Sheryl was diagnosed with bipolar II in 2001, but it took six years before she got serious about managing the illness. Meanwhile, as Sheryl found out later, her friend had also been diagnosed with bipolar and pulled back from Sheryl’s manic whirl for her own health.

“She never came out and said, ‘I have to cut it off,’” Davidson says about her friend. “She just stopped [being around]. And mania is such an egotistical thing, I never noticed.”

Bipolar-Marriage Sheryl managed to carry on her nursing career despite rapid-cycling mood swings, but by 2006 she faced losing her home to foreclosure and her kids to conservatorship. (She has a son, now 17, and a daughter, 10). That’s when she finally embraced her medication regimen, began weekly visits to her counselor, and learned all she could about her illness and coping strategies. At that point, she was ready to reach out to her neighbor. It took months, she says, to re-establish their friendship.

“It was baby steps,” Sheryl explains. “A five-minute phone call here, touching base, ‘How was your day?’ … building up a rapport again, and finally sitting down and asking, ‘What happened?’”

Now the pair have become a support group of two, running depression interventions if the mail piles up or watching each other’s daughters if one of them needs some quiet time to head off hypomania.

“To think I almost lost the one person I can sit and talk to for an hour,” Sheryl muses. “I almost lost that good friendship because of not taking care of myself.”



Hope for the best
There is another relationship Sheryl hasn’t been able to repair. At 13, her son moved to Nevada to live with his father, far from the drama and unpredictability of Sheryl’s unmanaged bipolar. Trying to work things out with him has been difficult because of the distance, she says, but he’s also made it clear that he’s not interested in bridging the gap.

Totting up the relationships lost to bipolar can unleash withering emotions like grief, regret, guilt, even self-hatred. Sheryl says that for her own mental health, she’s learned not to think about what her illness has cost her.

“I can’t dwell,” she says. “It was a good few years of torturing myself over it until I said, ‘I can’t.’”

Instead, she works to forgive herself for the hurt she’s caused, acknowledge that damage was done, and accept that some breaks can’t be healed no matter how sorry she is about what happened.

“I do believe in a sincere apology, and in some relationships it will go a long way to repairing things,” she says. “In others, maybe not so much.… But if an apology is not accepted you need to be able to walk away for the moment and not let it hinder your progress.”

What bipolar symptoms put asunder, effort, and understanding may repair.
The sad truth is, people with bipolar can extend an olive branch to those who’ve turned away, “but they’re not really the one that does the mending,” says Cynthia.

It’s up to the other party to decide whether or not to trust and try again—and the outcome often depends on how open friends and family members are to learning about and understanding the illness.

Kansas-resident, Charlie, need only compare the mothers of his two children. The women’s different attitudes toward his bipolar disorder have shaped his relationships with their children, leading to an ongoing estrangement from his daughter and a continuing connection with his son.

The 61-year-old was incorrectly diagnosed with depression in 1983, shortly after his daughter was born. By then, however, his marriage to her mother was deeply troubled. It didn’t help that he had walked out a few weeks before the birth, a move triggered in part by the stress of impending fatherhood. Although he moved back in briefly, the couple was divorced within months.

He had married again by the time his diagnosis was changed to bipolar II, in 1984. Learning about the illness and how to manage it was a joint project—until he ended that relationship six years later, when his son was two, due to the misguided promptings of manic euphoria.

Although Charlie had visitation rights with his daughter, he says her mother shut down any communication about his bipolar and how it affected his behavior. He sees the same unyielding mindset carried down to his daughter, now 28, who rarely communicates with him.

By contrast, his son’s mother managed to get past her bitterness after their divorce —though it took two years and her remarriage to a mutual friend—and proved a supportive partner during their shared custody.

Bipolar-Forgiveness“It’s not so much that I did great things,” reflects Charlie. “I apologized, but it really happened because of who she was and what she wanted as much as me trying to make things better. You can’t repair a relationship if the other side doesn’t want to.

“The fact that she lived with me and had gone through all that stuff … she understood once she got through the anger,” Charlie adds. “Whereas with my daughter’s mother, she never, never did.”

He says that tolerance—shared by her new husband, who had also been through the diagnosis and early recovery process with Charlie—made it possible to reestablish a respectful relationship, speak openly about the persisting ups and downs of his illness, and nourish the connection with his son, now 22.

It’s up to the [injured] party to decide whether or not to trust and try again.
If Charlie was immobilized by depression, she was flexible about putting off custody visits. If Charlie disappeared on an impulsive jaunt, she would explain to their son that it was part of the illness.

Charlie stays in regular contact with his son, but he’s learned to shield their relationship from the depression and impulsively that still beset him despite the best efforts of medication and therapy. At those times, he says, “I tend to stay away. I’ll have just brief contacts, keep it simple and uninvolved.”



Prevention’s best
Learning how to safeguard a connection from the troughs and tempests of bipolar, as Charlie does with his son, may be the most important part of reweaving relationships. In some cases, an ounce of prevention can head off a break in the first place.

After all, it’s not always the other person who severs a bond: The person with bipolar may be the one who turns away from a relationship. In toxic or overly stressful situations, that’s a healthy move.

Sheryl, for example, ended one romantic relationship that she felt was an “energy suck,” with nothing left over for the other people in her life or for her own needs.
“It’s a matter of measuring how much stress you can take in a relationship,” she explains. “Every relationship has stress, whether it’s with a parent, a friend, a child, a lover. It’s how much stress versus the benefits.”

Then there are situations where misunderstood or unmastered emotions play a role. That’s what happened when Charlie left his son’s mother: He says he interpreted the self-absorbed rush of euphoria as lack of love for his wife. And that’s what happened when Annette of Nova Scotia, stopped speaking to the sister she’d felt closest to.

Annette, 41, says her volatility damaged a lot of relationships before she was diagnosed with bipolar II in 2005. Even at her job as an administrative assistant, she would lay into co-workers and superiors without thought of the repercussions.

What soured things with her sister, however, was Annette’s reputation for blowing things out of proportion rather than an actual blowup between them.

When a friend of the family began behaving nastily to Annette, she started telling others that the woman was not as nice as she seemed. Her sister assumed Annette was overreacting as she’d done so many times before, and Annette angrily broke off their connection.

In the three years they weren’t speaking, Annette got her diagnosis and started cognitive behavioral therapy. She learned a great deal about her emotions and reactions.

“Before, the only feelings I knew were mad, upset or OK,” she says. “I didn’t know all the levels of hurt and anger. If I was mad, I couldn’t realize it was really because I was hurt. I just let things build up until I was angry.”

Annette says that when she decided to reach out to her sister, they rebuilt their relationship even stronger than before through “communication, forgiveness and understanding.”

Treatment has also given Sullivan tools to resist her rages. Deep breathing often helps. So does getting away from the situation, perhaps by going for a brisk walk. “Then, when I’m alone, I type,” she says. “I type my little heart out until all the rage is out.”

None of that would be possible without her medication, though. Now, she says, “when I feel that rage burning, I can at least see through the haze a little bit and realize, ‘This is what’s going to happen if you do this.’ I’m more aware of the consequences of yelling at my boss.

“Prevention,” she adds, “is much easier than damage control.”



Picking Up The Pieces
Cynthia G. Last, PhD, a clinical psychologist in Boca Raton, Florida, has both personal and professional experience with the strains bipolar disorder can put on relationships.

Last has bipolar II. At 54, she’s been managing the illness successfully for two decades. In her mid-30s, though, before she was correctly diagnosed and fully engaged in treatment, she “made a bad judgment” and left her husband for a year.

When something of that magnitude occurs, she says, the person who’s been wronged has some work to do if the relationship is to survive. Last gives her husband’s understanding attitude and nurturing spirit a great deal of credit for their marriage’s longevity.

Bipolar-Relationships About serious transgressions, she notes, “[The injured party] is not going to forget it, but they need to get past it. And the only way to get past it is [to find] a solution so it doesn’t happen again.”

The person with bipolar must address the root cause of damaging behaviors by managing the illness, she says, while the other partner must put safety measures in place.

That might mean cutting off credit cards and PayPal accounts for someone who tends to run up debt during a manic episode, Last explains, or “maybe writing a contract that the [person with bipolar] will stick to this, this and this treatment.”

Finally, to get past lingering hurt, anger and mistrust, “the well partner may need some support from a pastor or a therapist or a support group,” Last says. “And it will take time to heal.”