Seven Solid and Surefire Ways to Manage Bipolar During the Holidays

It starts as early as September that my clients begin to express reservations about the upcoming holidays. They begin wondering and questioning how they can make this year better in a way that doesn’t include feelings of tension, fear, and dread.

Concerns about the holidays vary, and can be complex for some, or more straightforward for others. Common themes and experiences include:

  • Difficulties with relatives that may be more manageable throughout the rest of the year, but become much more intense at the holidays.

 

  • Expectations and pressure from family and friends to celebrate in ways that are no longer interesting and have become outdated.

 

  • Either too much forced closeness with family or too much distance, the latter of which could be from being too far away from one another in location or from lack of emotional connection.

 

  • Extra stress from trying to fit many activities into a short period of time such as decorating, buying and wrapping presents, sending holiday cards, planning meals, entertaining guests, and visiting others, all while continuing with job duties and other daily tasks.

 

  • High standards for trying to make the holidays “the best time of the year”, and feeling diminished if things do not seem magical and perfect.

 

  • Getting out of a healthy self-care routine such as with sleep, nutrition, exercise, and relaxation, and being tempted by excessive self-indulgence, particularly regarding food and drink.

 

  • Overspending and facing financial stress.

 

  • Fears of being swallowed up by a time of year that overshadows regular life, and seems to try to define how everyone should be feeling and celebrating.

 

  • Sadness from feeling left out, sometimes from wanting to decline invitations because of worries of becoming overextended, and sometimes from not being included enough and feeling alone.

 

  • After holiday “blahs” that can occur when everything winds down in January.

 

  • Symptoms of Seasonal Affective Disorder (SAD) that can hamper energy and increase depression.

 

  • Ramping up of enthusiasm that can exacerbate mania.

 

  • For parents of minors, navigating the highs and lows of their children’s excitement.

 

  • Wanting to hold on to favorite rituals that may no longer bring as much joy as in the past, and possibly exploring new options, which may or may not feel satisfying.

 

  • Life transitions, losses, and grief that occur at this time of year such as a layoff, divorce, or death of a loved one can seem much worse at the holiday season.

 

  • Questioning of religious and spiritual values, and the meaning and purpose of life may arise, and at a time when people are being encouraged to celebrate in a light-hearted way, and to not have deeper or more serious needs and concerns.

 

  • Memories of disappointments past, not only during the holidays, but perhaps also about another year that has passed, and tendency to regret what may have happened or what may not have happened that was hoped for.

 

From this list (and there can be many other variations on the above themes), it can be seen that the holiday season can become quite complicated. It is probably very “normal” to anticipate that the holiday season can carry with it reasons to view its approach with some trepidation and dismay.

It’s been found, though, that awareness and good preparation and planning can help people make the best of their circumstances. If any of the items mentioned about the potential effect of the holidays are areas you can relate to, taking steps to ensure you’ll fare well, and even thrive, during the holidays can serve you well.

Here are seven solid and surefire ways you can become aware of and plan to practice during the holiday season to keep your mood in a good place, and to keep you grounded and centered even when a flurry of activities and potentially stressful situations are occurring for you.

  1. Keep as much of your regular routine in place as possible. Consider your basic lifestyle as a base that you can vary a bit, but not abandon. Think of the things you do daily and/or weekly that are most vital to your good health and wellbeing and hold steady with them. You can add on other fun and joys, but don’t let go of what’s stable, and what keeps you grounded and centered. These hallmarks of good living could include your morning routine for getting started each day, your day-to-day flow of activities, special interests you embrace that give each day a boost, and evening rituals such as dinner with family and preparing for restful sleep.

 

  1. Determine what you will absolutely not give up in your self-care and stick to it. The holidays bring numerous temptations for going off course and overindulging. It can seem innocent at the time to think that some late nights out, drinking at a party, and eating too much and too many decadent foods won’t be harmful. The problem is that the holiday celebration season is so long that healthy habits can be lost within a few weeks, and poor habits developed, making recovery from getting off track difficult. An accumulation of too many missteps for too long can alter mood. Identify and make a pledge to stay within a predetermined framework of behaviors, which could include not ever staying out past a certain time, avoiding drinking, or selecting nutritious foods over unhealthy ones.

 

  1. Protect your sleep. Sleep is one of the top factors for managing mood with bipolar. As much as possible, allow for sufficient time to relax before bedtime, and sleep as closely as possible to your regular sleep hours. Try to select activities for socializing and celebrating that fall outside your sleep schedule such as going to a New Year’s Day brunch or lunch rather than a New Year’s Eve late-night party. If you do feel a special activity that might alter your sleep schedule would be worth it, plan for recovery. For example, if staying up to ring in the new year could be a worthwhile occasion for you, make plans to ensure you’ll return to your normal sleep patterns as quickly as possible by having the next few days and nights focus on a return to relaxation and restfulness.

 

  1. Limit as much other stress as possible. Along with sleep disturbances, an overload of stress can wreak havoc with bipolar. Stress inventories generally list the holidays as a source of stress. Anything that promotes change, whether it’s perceived as negative or positive, can aggravate stress responses. As it’s difficult to avoid some stress over the holidays, it is helpful to counterbalance the added stress with avoiding taking on other stressors during this time of year. Whatever you can control that would likely best be dealt with at another time of the year is advisable. For instance, this may not be the time to make a significant lifestyle change, go into debt for a major purchase, or take on a new challenge that requires much energy and focus.

 

  1. Examine what you would like from the holidays. So much of the time we aim to please and try to slot ourselves into others’ expectations for ways of celebrating. We forget that we can craft the holidays into something we can look forward to and that can meet our current needs in the moment. Ask yourself what you would like to do, what would make the holidays more joyful for you, and what would make it most meaningful for you. Sometimes we hold on to past ways of living that now seem lackluster, creating a sense of boredom or even depression that might prod us to make a radical change to promote excitement. Neither switching things up intensely nor living with dullness is necessary. Rather think of some healthy, doable things that could provide optimism and zest that you’d like to do for yourself this season. It might be as simple as going out for dinner and a movie on your holiday day rather than cooking all that day this year, or lighting candles and cultivating what you’re grateful for at this time. Promote your own rituals, and invite others to share in yours. Perhaps you can select how you might want to participate in others’ ideas, as well, that could benefit you. Either way, own the season for yourself, being flexible where you can, but making sure you don’t let go of what interests you for the sake of going along with doing things that don’t matter to you and are not valuable.

 

  1. Make good boundaries both for how much you want to take on this year, and for making plans with others. Remember to have limits. Know what is important and pursue those things, and let go of what doesn’t matter. So very often the phrase “less is more” can be beneficial. For example, it may not seem worthwhile to create a traditional feast this year. Maybe there are a few menu items you’d like to make, but you might prefer to order some things this year to try something different and to preserve your energy. Maybe fewer decorations or buying fewer presents could actually be enhancing rather than “not enough”. Adjust your priorities. Stay open-minded to new possibilities that can help keep you healthy while also allowing you to participate in special festivities that matter to you.

 

  1. Balance your relationships. Think about difficult social mixes that could occur, and plan accordingly. Maybe you’d prefer to skip the big, loud parties, and entertain with smaller, quieter, more intimate gatherings. Or just attend one big party, and focus on other types of get-togethers for balance. Be selective about what will most work for you. Put your health first. If you have difficult people in your life, limit your time with them. Keep those interactions as simple and light-hearted as possible, and focus on being with people who can be healing and rejuvenating. Make sure not to isolate, which is the worst thing for depression. You may not feel like being jovial at all, and may find it hard to force a smile and create enthusiastic words; however, being too alone is a recipe for worsening of mood. If generalized holiday socializing seems trivial for you, there might be more meaningful activities you can participate in that meet your needs such as volunteer work and church functions. Gravitate towards what can brighten your soul, help you maintain a positive mood, and contribute towards your having a rewarding holiday season.

 

© by Annette Houghtling, MA, LPC, NCC, Psychotherapist and Counselor Specialist for Bipolar and Depression Help for Individuals, Couples, and Families

 

 

 

 

 

Conquering Fear

We were given fear to protect ourselves. Healthy fears can help keep you safe, such as making sure to drive carefully. Non-useful fears, however, such as worry that you’ll never feel better again, are not reality; those fears are perceptions that can get you locked in your fear, and you can become deeply trapped. Unhealthy fear often runs the whole engine behind persistent anxiety, depression, and many bipolar spikes and lows.

As uncomfortable as it is to do, fear needs to be faced. The more fear you conquer, the less prone you will be to anxiety, depression, and mania. You will be more likely to develop confidence, to have less racing thoughts and rumination, and to reduce feelings of hopelessness and helplessness. Here are some guidelines to help you challenge fear:

  1. Ask yourself what you’re afraid of, and dissect what underlies the fear. Some common underlying fears include the fear of loss, and the fear of not being accepted by others. Fear can also supplant other emotions that need to be addressed. For example, with fear-based anger, the anger is coming from being afraid of something, with the anger masking the fear. Consider what emotions your fear may be about. Practice mastering the understanding of your emotions and what’s underlying your fears to help you overcome them. This process can be done through writing and journaling, self-talk, or mental health therapy.
  2. Fear can be about what we can’t control. Your fear could be lessened by accepting that the only person you can control is yourself, and that you can’t control others or most situations. Ask yourself what you’re most likely better off accepting that you can’t control. Define what a helpful level of control might be. Pour your emotions out with some reframing. Ask yourself, “What control do I really have?” or “What does control mean to me today than in the past?” Re-author your life to choose what you believe is helpful to your overall good mental health and functioning.
  3. Fear often emanates from past experiences. Examine if you’re giving the past too much power. The experiences that may be leading to our fear today are in the past; nothing bad may happen along those same lines again. The past, in terms of negative emotions and memories, is only important for what you can learn from it that you don’t want to repeat. Try to reorient towards the positive and the present. Otherwise, too much of a focus on the fears and problems of the past will get in your way. This also includes forgiveness, which is ultimately about forgetting because the issue has been resolved internally and doesn’t dominate your thoughts anymore.
  4. Change the way you think, and redefine your emotions. Take every little thought and feeling and challenge the negative. It’s a choice to start changing, to start seeing your fears differently. This commitment can help you pull the fear out by its roots, and not let it grow back. Consider if you may be holding to on your pain because it’s a comfort zone that’s scary to leave. But it you want to conquer your fear, you may be motivated to work through the painful emotions that lead to success. It’s important to tell yourself, “I’ll beat this, I’m going forward, and I’m not going back.” Remember that whatever you tell yourself, you’re going to be 100% correct.

© by Annette Houghtling & Brandon McNeil

The Steps of Recovery

Recovery from bipolar, depression, and anxiety is the process of moving towards a healthier condition. It is a very deliberate choice. Essentially, recovery is about taking responsibility for making the healthier choices that can lead to achieving and sustaining quality-of-life improvements.

The first step is to believe in recovery. Truly believing in recovery gives you more and more good days, and helps you stay stable through the so-so days and the bad days. However old you are today, you can change – it won’t be overnight, but it can happen step-by-step. Celebrate every gain, even the gains that seem very small, as recovery can be done in very small pieces that accumulate to major achievements.

The second step is to see yourself as more than your bipolar, depression, or anxiety. If you’re depressed, tell yourself, “I am not my depression.” Circumstances may pop-up that produce symptoms, but you are you, not your depression. Don’t live the label of depression, bipolar, or anxiety. Accept and live who you are – and who you are is who you decide you want to be – don’t let anyone push a label on you. Don’t tell yourself you “should” be or do anything. Accept that it’s okay for you to feel like you do, and to be who you are. And then ask yourself how you’d like to move forward in recovery and how you can do so.

The third step is to develop positive and helpful expectations. Don’t try to be perfect; try to live fully. Much stress comes from trying to meet too-high expectations. Take control of what you think is good enough by challenging if your expectations are helpful or hurtful for you. Drop your unreasonable expectations, as they build guilt and shame. Redefine who you are and accept who you are. Know your limits. Everyone has them. Yet, sometimes people with bipolar, depression and anxiety sacrifice their mental health by overextending themselves. It’s beneficial to pace yourself to reach your goals. Remember you will always have some bad days; no one’s life is perfect.

The fourth step is to build skills through changing your thoughts, how you deal with your feelings, and what behaviors you select. If you change the way you think, feel, and behave, you change the chemistry of your mind, as medication is not the only path to changing brain chemistry. Developing new positive-oriented thinking, feeling, and behavioral skills leads to recovery. Build your skills until they become strengths, and then continue to build on those strengths until they become your resilient attributes.

© by Annette Houghtling & Brandon McNeil

Bipolar Recovery Includes Skills

Brandon Writes:

I felt so depressed one day at the age of 26 that my head literally hit my work desk, and I couldn’t even begin to lift my head back up. That episode of deep and debilitating depression led me to a psychiatrist’s office a few days later, where I was diagnosed with bipolar disorder. At that point I had no idea what bipolar was, but I would learn quickly that it explained my continual up-and-down mood patterns.

Learning about bipolar and how it affected my moods was quick, but managing the bipolar effectively was not a simple process. From the time I was 26 until I was 36, I was given many medications to try to control my bipolar. Yet there were times when I was flipping out so badly that I was getting different medications every couple of days to try and control my manic episodes.

Extreme mood patterns persisted during those 10 years. For instance, I would start getting manic each year at the first part of February, and the mania continued until October. The mania did allow me to get a lot of work done, as I would be flying around to make every deal possible. However, my work was not always productive. Sometimes when I had more work than I could handle, I would get so overwhelmed that I would shred half of my files and never call the clients back. It made sense to me back then when flooded by mania. Now looking back on it from a perspective of largely prevailing moderate mood, there was no logic to it at all.

There was also the angry side of mania. For example, if someone would cut me off when I was driving, I would fly up next to them and start throwing all the loose change I had at them. It made sense at the time during my mania that this was a valid response to rude drivers.

“…there were times when I was flipping out so badly that I was getting different medications every couple of days to try and control my manic episodes.”

In addition to the mania, I would fall into a period of depression verging on suicide from October through January. And throughout all these lows of depression and highs of mania, the focus of treatment was on changing my medication. I had not yet been taught recovery skills to manage the bipolar day-to-day, as my psychotherapy sessions focused on my talking about my past.

Finally, after 10 years of medication, and no skills for dealing with bipolar, I had reached my bottom. I was in a crazy manic episode on August 6, 2008. My plan was to take my own life that day, but somehow instead I chose to drive myself to a hospital. This was to be my time of rejuvenation, as the hospital program introduced me to recovery skills, and I took these recovery skills very seriously.

My first major skills practice involved my writing about my different emotions. I would take an emotion and write about it the way I was thinking about it, and then reprogram the emotion in a way that I should think about it in order for the emotion to be helpful. I learned many Cognitive-Behavioral Therapy skills during these years, as well; and recently have begun practicing Dialectical Behavior Therapy skills.

With the combination of these skills and medication, the last seven years of my life, from ages 36 to 43, have been much better than the first 10 years of my diagnosis. Of paramount importance for me is that I have found and maintained the best love relationship I have ever had, in which I have become successful as a husband and as a father. Those roles were very difficult for me before I was introduced to recovery on August 6, 2008. That day saved my life, and gave me my new and very welcomed beginning.

© by Brandon McNeil, Professional Peer Specialist & Annette Houghtling, Psychotherapist in Private Practice

Medication Will Only Take You So Far

For bipolar, depression and anxiety, the right combination of medication can help keep you stable. But what Brandon and I have learned through our experience helping our group therapy participants, and what Brandon has learned through his 22-year-long battle with bipolar, is that medication will only take you so far. What’s more important is to use medication to give you the focus to learn the skills that will help you through your rough times.

No one medication or combination of medications will take away all of your symptoms. Instead, recovery comes from daily management of your bipolar, depression and/or anxiety, which constitutes making a lifetime commitment to good practices of health and well-being. Brandon’s personal experience is that medication contributes about 40% to recovery – the other 60% is what you do everyday to make a difference.

With bipolar, depression, and anxiety, of utmost importance is learning to monitor your moods and triggers. For instance, regarding bipolar, Brandon has learned over the years to watch for the signs of any upcoming mania or depression. If he can pick up on the signs, he can get ahead of an episode. A major sign of mania for him is extreme irritability, especially when things that usually don’t bug him are starting to become a serious bother. He writes about a recent incident that showed him the need to get ahead of a flare-up:

“The other day my kids were bouncing a basketball. The sound of that basketball made me want to crawl out of my skin. Picking up on that, I immediately went upstairs to my room, and started a Dialectical Behavior Therapy (DBT) exercise to start centering myself, which worked to pull me out of a downward spiral.”

Another of Brandon’s signs that he is approaching mania is if he starts wanting to argue with everyone. He calls it the, “I want to hate the world syndrome”. In this mode, Brandon starts to believe that everything is everyone else’s fault. During this heightening period towards mania, he works to get himself re-centered through the use of skills, such as the DBT techniques. He describes one re-centering skill-set that is particularly helpful for him: “I mentally start focusing on my awareness of myself, focusing on my toes and working my way up my body, acknowledging what each function of my body is doing.”

Medication does help in the management of bipolar, depression and anxiety. However, once that foundation is laid, the next most major successes come from learning and utilizing as many research-backed skills as possible. These methods can take you further than you could ever imagine.

© by Annette Houghtling & Brandon McNeil