Bipolar Rage

Sometimes, we want to do the right thing, but don’t know how. Sometimes, not knowing alternatives keeps us engaged in unhealthy behaviors. The list below is a collection of possibilities how to redirect behavior when an outburst of anger looms imminent. These ideas are a jumping off point for you to release angry energy. Can you think of others? Share your knowledge. I will print your suggestions on my blog, if you would care to pass them along my way.

1. Decrease stress: Learn your limits:
   When you become aware of what sets you off, you can avoid those circumstances which result in losing your temper and create a breakdown in understanding.


2. Journal the outburst, write it out:
   When you feel yourself beginning to lose control, being able to channel your frustration into words on paper (or electronically) can reduce the emotional charge and help to regain your calm. Reading something, writing it down, is a cooler means of communication and helps maintain composure.


3. Keep a rubber band around your wrist:
   Snapping a rubber band whenever you feel anger rising can be a good preventative, a reminder to maintain your cool in avoiding an anger outburst. 


4. Learn your physiological cues of anger to avoid outbursts before they occur:
   We don’t exist in a vacuum. Long before we have an outburst of anger, our bodies register the rising tides, of frustration and temper. Studying our responses to anger will help head off dangerous emotions before they occur. Whether it is an increase in heartbeat, sweat breaking out on your forehead, or a rush of heat, these and other physical sensations can offer a clue to what’s coming before you lose control.


5. Take time out:
   Removing yourself from the presence of agitation can go a long way in helping yourself regain a sense of calm. Whenever you find the sense your rational mind is slipping into emotional excess, step away from the source of your mounting rage until a cooler mind returns.


6. Calm yourself through exercise:
   One way to get your mind off a troubling encounter is to shift attention. Doing so with exercise can cut through a potential outburst. Moving the mind off its mental focus by physical demand moves concentration onto our bodies, relieving tension and releasing endorphins, the body’s natural tranquilizers. Triggering a mind-body relaxation response by exercising re-establishes clarity and calm.

These are some thoughts to keep you cool in the fray when you find yourself losing control to manic excess. Use these feelings as an opportunity to make a fresh start. As is true of any technique or strategy, it is only as good as what you actually put into practice. It takes work to take back your calm. but you need not be controlled by bipolar rage. Choose wisely, choose health.

Manic Depression - Renewing Courage

Manic Depression affects its victims in insidious ways. It weakens resolve and undermines the spirit. It agitates the ability to concentrate and focuses the individual afflicted on the edge of social norms, a place where he is vulnerable to the loss of mental health. This is not particularly unique as many illnesses follow a similar course. So it is that many bouts with illness are universal. It is from this perspective that I offer the following: the struggle to maintain stability, the sensitivity of human dignity, and the drive for courage.

Courage, which is about living dreams daily, is not just about physical courage, but mental courage as well. It is about persistence, not taking no for an answer. Reaching a goal is a daily decision to pursue that goal. It is resisting intimidation and focusing quietly without fanfare.

We all hear stories of tenacity in the face of odds. They speak to us everyday: the businessman who strives to improve his business, the worker who works three jobs to support his family; the individuals with a serious illness who focus on life and refuse to be victims. They all display examples of courage.

Dana was deemed mentally retarded at a young age, five years old. His reactions were slower then other children his age. While being termed slow, he was not without grace. He had a way about him. He found comedy in everyday activities. When he made a mistake, he would laugh at himself. Though pensive about his performance at school or in a group activity, he would look back at the milestones in his life with a sense of wonderment: graduating high school or working his first job. While some collect stamps or baseball cards, Dana collected people, those who had helped him overcome the obstacles of life. Though he wouldn’t be able to define the word, Dana had gratitude. As an adult, he recollected stories of the help he received: the third grade teacher who taught him how to read, the coach who encouraged him to swim, the counselor who helped him choose a vocation, his parents who never let him feel disabled.

Today, Dana works at a major metropolitan hospital as an x-ray technician, a job he has held for over 20 years. He has also had a long-term relationship with a woman for twenty-six years. But Dana is not without his fears. A recent bout with anxiety had him question his ability to continue in his job. Over time this receded. Like all of us, his relationship sometimes has discord, which offers challenges to overcome. In spite of it all, Dana displays a resilience which could make all of us envious. He shows courage in the everyday sense of the word, perhaps not the physical heroics of the battlefield, but the daily struggle to fulfill a promise to himself to be the best at whatever he does, living out his goals one day at a time. Dana should be a lesson to us all. Life is a drama lived out on a stage.

For those with bipolar disorder, like many of my psychotherapy clients, Dana’s story is instructive. Never miss a chance to do your best. As for those out there who have never experienced a manic episode or a clinical depression, but struggle daily with their loved ones who have, take heart at the dramatic unfolding of a life lived and the small but not inconsequential victories achieved. What is already stated for a friend or loved applies to us all. Courage is about the attitude we bring to the things we do. It would seem that at some point we find common ground, both client and family alike. Sometimes, what is true for one is true for all.

Bipolar Disorder: Not Letting Yourself Down

Recently I was watching a 10-part TV series about World War II, called, “Band of Brothers.” The series documented the experience of one company as it fought in the European Theatre of the war. At the beginning of each one-hour segment, there would be commentary by real-life veterans about different aspects of being a soldier in battle.

In one segment these veterans talked about fear and the various ways they dealt with it. Many spoke to the issue of not letting their comrades down. There was one sentiment that struck me. It was the statement, “I didn’t want to let myself down.” Not only was this man being loyal to his fellow soldiers, he was being loyal to himself.

This struck me as a stance one can take in any struggle, including recovery from mental illness. It was certainly true of mine. Though fearful at times when doing new things and facing down hospitalization, medication, and the anxiety and stress of the work world, I willed myself to move forward because I didn’t want to let myself down. Though filled with trepidation, I would not allow myself to settle for a limited existence. I couldn’t let go of myself as a whole, healthy person, despite the knowledge I have a disability that brings darkness which sows seeds of confusion and doubt.

For a long time I was uncertain which way to turn at various crossroads of my life. I made decisions I could not be sure were the right ones. Often, there was no clear marker to base a decision on. So, I proceeded into the unknown, fear of failing at life my constant companion. Over time my road became a little clearer until the time when I began to feel a small amount of confidence.

I was doing helpful things to recover. Little by little my terror subsided, and as I constantly pushed myself to be true to myself, I succeeded.

Many may now be in the same place I was when I began my recovery. Instead of recovering for the sake of those who hope for your return to mental health, do it for yourself. Believe in yourself and have faith in your ability to do the right thing. Like the soldier in E Company of “The Band of Brothers,” do something because you don’t want to let yourself down. It’s a value and ethic to live by. To address life’s struggles straight on is difficult, but to be true to oneself is its own reward. It also goes by the name of “having character,” and who can say, “ those with mental illness can’t have character.”

From the Wife of One Who is Bipolar

Aesop once said, “United we stand; Divided we fall.” I keep this quote in mind as I live each day with my spouse, who is bipolar. From the very beginning of our relationship, I knew he had a mental illness, which could manifest itself at any moment and yet; I took a chance. I have no regrets. There have been those times when I thought, “What have I gotten myself into,” but I made a commitment, and that commitment still stands.

I am fortunate; I have never seen my husband in a manic mode, although I have seen him depressed. We met after he began the meds that have kept him sane for the last 25 years. There have been those times when I have had to distinguish between what is normal and what is not. This has been difficult for me to determine. I have only witnessed a mild down period or extreme enthusiasm, which I have come to realize as his normal way of expressing heartfelt emotions. He is a sensitive soul. These feelings alert me, put me on notice and cause a fear of relapse despite 25 years of recovery. To counter this, I continuously educate myself on bipolar disorder, trying to read and learn as much as I can about this illness. Support groups such as National Alliance for the Mentally Ill have been a help, along with books and blogs on the subject.

There have been those unfortunate times I have lost my temper with my husband, usually over petty things and have been tempted to shout, “You’re nuts,” or “Stop acting crazy.” It is then I catch myself and refrain from saying words I will regret; words that are cruel and hurtful. It is very easy to blame his actions or moods on his illness. I have to remember that he has the same moods and emotions I do and that it is unkind to remind him of an illness, which is chemical and through no fault of his own. Because we are both totally open in our communication with one another, we are able to discuss our feelings about mental health issues.

Wanting to introduce myself as the wife of someone with bipolar illness, I am writing this article for my husband’s blog. I hope it will be helpful to readers.

Linda Kern – wife of Donald Kern

Ways to Work Together When One Spouse has Bipolar Disorder

• Develop good sleep habits.
• Help reduce stressor & triggers
• Learn to forgive
• Communicate your feelings
• Educate yourself about the illness
• Work together to promote health.
• Promote a calm environment.

Mental Illness - Living with Consequences

Recently, I was part of a panel of consumers of mental health services and family members, talking about their firsthand experiences with mental illness. Speaking about both my past manias and subsequent work with the mentally ill, I sat raptly at attention and listened to a couple who were sharing their experience dealing with a mentally ill son. They told their story of a son who had turned mean, threatened physical violence, and spent days locked in his room This couple was on the verge of being terrified in their own home, even to the point of putting a lock on their bedroom door. As I listened, I was filled with concern and dismay. “My gosh,” I thought. “They’re prisoners in their own home. They have to take back their lives.”

As I reflected on their plight, I was drawn to speak to them and repeated my thought of their need to take back their lives. Their response was one of agreement. I went on to suggest a disciplined, tough-love stance. They responded in a murmuring tone, of past attempts to set boundaries gone astray. They were clearly overwhelmed, feeling defeated, and my suggestions of resolute sternness brought out hopeless irritation on their part. They’d been there and were loath to return to that place of helplessness. They were not ready to put their son out, despite their struggle. I recognized a lack of positive response to my counsel as parental regard, mixed with frustration and defeat. I thought to regroup my remarks and was about to speak when a family caregiver next to me on the panel interjected. What she said was concise and to the point.

“Despite suggestions of tough love, you have to be able to live with yourself. No matter how difficult it may be to live with your son, and while it’s true you have to find some way to intercede with him, you have to be ready to accept the consequences.”

Because I knew this family caregiver and her story, I knew what she was saying was true. She’d lost a bipolar young adult son to suicide and another to paralysis after an unsuccessful suicide attempt. She’d been ready to put her son out of the home if he wouldn’t stay compliant with medication. Now, she was caring for a quadriplegic who was mentally ill. She had been ready to follow through with tough love and expressed no regrets. But, she was able to reach out to that couple with wise counsel in a way that I could not. She taught me something. You have to be able to live with your decisions, and when you are ready, you will do the right thing.

Bipolar Bereavement

Although my father died in 1979, he still lives on in my memory. Our relationship has survived across the years. Often a stormy, resistant interplay between us when he was alive, has given way to an understanding I could only have gained over time. My strongest regret is that he never saw me recover from a florid manic depression. He never saw me recover my sanity, go to graduate school, get married, or start a successful private practice as a psychotherapist. I have much to mourn.

Though I have much to mourn, I also have much to celebrate. One of my memories of my father is that of a father proud of a son seeking to find his place in the world. A stern man at times, he dealt with my mental illness with persistence in seeing me get into treatment. We both, at times, grew impatient with my inability to return to a traditional, middle-class way of life.

It is a fitting tribute to him that he was a frequent character in my psychotic delusions when I was still in the grip of manic episodes. My wish to control his obstinate urge to get me into treatment had me cast him in my delusion as the leader of a group of seniors I had put him in charge of. He was to organize the use of their soul energy for telepathic, peaceful use.

How do you deal with the loss of a loved one who was unable to experience your wellness when alive, and is now unable to join with you when you are better? There are no easy answers. For me, I imagine his joy at my attainment of the lifestyle he wanted for me, even when in the past, I didn’t always share his dream.

When recovery meant returning to the middle-class values I had rejected earlier in my life, I grew to appreciate the life he had created for himself in his own struggles. We then had a common bond, normalcy. When treatment dictated the need for structure and stability, it was to the model he had raised me with that I returned. It has been a bountiful fulfillment I later arrived at.

My father’s death before my recovery has now come to mean the continuation of that relationship through insight and aging. I don’t try to bring him back. I just recognize the universal truths of living in the modern era. I have finally let go of the judgments I made of him; the attitude that I would somehow surpass him in understanding my life. Instead, I have learned how much he had to teach me. We have much in common. So it is, he continues to inspire.

Five Ways to Deal with Bipolar Bereavement

1. Embrace a loving attitude.
2. Recognize your differences have ended with the passing of a loved one.
3. Remain open to understanding their hope for your recovery.
4. Maintain a spiritual frame of mind.
5. Allow your loved one to live on in your memory.

How have your dealt with bipolar bereavement of a loved one?

Learning to Find Creativity After Medication for Bipolar

There are some creative individuals who are burdened by a mental disorder. For many, the issue of creativity is tied to mania. They deal with their finest displays of artistic fervor and accomplishment in their manic phase of a bipolar diagnosis. The flame of original thinking combined with an expansive self-confidence propels them into a productive frenzy. At these times, artistic, bipolar types revel in the quantity and endurance one needs to take on a project.

Mania is tied to the creative impulse. While prolific as one can be in mania, a mood shift dispels original thinking. When an episode has run its course, the artist finds himself in an odd position, yearning for creative release, but too depressed to reclaim it. The artist gives way to the patient. Medication comes with normalcy and life takes on a drab, passionless existence. The artistic, bipolar patient decries his situation, but inspiration is nowhere to be found.

A common complaint of bipolar clients is their level of creative expression. It comes as no surprise that many such persons choose their creative manias over medicated normalcy, while others give up, take their pills, and make the best out of a stale existence. When mania is suppressed, boredom steps in; or so goes the given wisdom. This is true in the short term, but not necessarily the long.

In the immediate, medication locks down the fountain of creative urge. The switch is flipped off abruptly as a fantasy life is replaced by the more immediate needs of everyday. Often there is the sense that life has been drained of its essence, and this state is all there is, a spiritual wasteland governed by the pills one must take for stability.

My experience of 35 years says otherwise. There is a creative life after medication. It just takes time and persistence to resurface. Inspiration reasserts itself a bit at a time and needs to be nurtured. Once a stable platform is rebuilt, thoughts turn from the mundane. While initially stability struggles with staleness, appreciation of the commonplace spawns shoots of possibility. This takes time, and patience is of primary value. One reacquaints oneself with a creative vision a piece at a time. Eventually, hope for the ridiculous and the sublime re-emerge. Medication cannot hold back the urge to a larger view of life.

Thirty five years of living with manic depression has taught me that even when I give up in despair, I keep on growing, although I am unaware of this at the time. Life grows at its own pace. Becoming aware and being thankful are accomplished in small steps.

Twenty five years ago when I was newly recovering, there was no urge to write, sing, make music, or shape metal. At the time, I simply wanted to get back my life. I wasn’t interested in anything else. It was difficult enough to discipline myself to get up and go to work everyday. Eventually, that learned, I progressed to venturing out to meet others, to engage in uncomfortable but pursuant conversation. It was five years before I picked up a pen to write. I had nothing to say before that. Eventually my ear for music returned, and learning to share myself with others began. All of this led to a vitality in my everyday life.

During this time, I was, as I still am, on medication. It’s about a regrowth of spirit that helps us reclaim our lives. Life is a verb. It’s about doing. Medication cannot teach us this, only a life lived can do that. It’s like being in a dark closet. You keep bumping into walls whichever way you turn as you feel the bruises form. Eventually, the pain goes away and some light creeps in. You find that the walls you bumped into were actually mirrors. The longer you look, the more light seeps in. You see yourself again and again, always in a new and different way. And so, creative endeavor emerges over time. Medication can’t take that away. In fact, it can help.

USING BIPOLAR AS AN EXCUSE Taking Responsibility for Your Actions

Joshua sat on the couch opposite me, the tension in the room growing by the moment. “I don’t owe her an apology; I was in the midst of a manic episode at the time. They told me when I was in impatient treatment that I have a chemical imbalance; so it’s not my fault I slapped her, and now she’s exaggerating the injury.”

Joshua by this time was angry, plenty angry. He couldn’t see the point I was making that while a chemical imbalance may have influenced his actions, his actions were regrettable, and he should acknowledge this. He finally agreed in a statement to me that his actions were, indeed, regrettable, and a reflex reaction to his ex-spouse’s provocative statement still carried the sting of unresolved anger. The trust between them, already strained, had grown worse.

In treating bipolar disorder, this situation is not rare. Often, when volatile, those with a major mental illness diagnosis are confused and troubled by mild messages they receive from others. If a lack of knowing right from wrong at the time of a mental breakdown has been established, there is diminished capacity according to the law. What is lost in this logic is the damage done to the victims of angry outbursts. That is not to say a victim may not have fanned the flames of anger and has some responsibility for the eruption of verbal or physical attack. We do not live in such a pristine world of black and white, or all or none thinking. In the case of my client, his ex-spouse was not the perfect victim. But, in the aftermath of harsh words and/or physical assault, is clinging to the notion that a chemical imbalance is the culprit a fair release from culpability?

There is much work in healing the breakdown of civility which goes on with those in stressful situations. Even though you may be delusional, your actions may result in pain to another. Aren’t you then responsible for their pain? Too often one is loath to apologize, feeling it will only supply ammunition to an opponent and will weaken a claim to be the righteous one, the one wronged. This does not lead to understanding. It only increases the gulf already formed.

Setting the record straight implies acknowledging the damage done and can result in the beginning of a dialogue. “I’m sorry you were injured by my actions, or, what occurred between us is regrettable; let’s strive for a better understanding.”

But, the argument that a chemical imbalance is at the heart of a divide is an over-simplification and an easy way out. If you make a mess, then you have to clean it up. Sometimes it’s just what is needed.

Ten Ways to Take Responsibility

1. Be honest with yourself; admit your limitations.
2. Acknowledge your contribution to the misunderstanding.
3. Mentally exchange places with those you’ve harmed and
4. see the situation from their view.
5. See an outsider to mediate a dialogue.
6. Cool down before reacting.
7. Take time before trying to resolve an issue.
8. Recognize the futility of all or none thinking.
9. Seek understanding with goodwill.
10. Educate yourself on the difference between being reactive in the face of an altercation and looking at the aftermath for your opportunity to set things right.
11. Remain open.

Coming to Terms with Bipolar Disorder

I sit in my office, the pause in conversation becoming brittle. My client, settling into the silence, is a study in frustration. Sitting next to him, his young wife stares pensively. “The diagnosis isn’t an end; it’s a beginning,” I hear myself say. The words, Bipolar Disorder, hang languidly over the room.

I recall my own diagnosis and manic episodes. Education comes to mind. I must help this couple understand this illness. A label means little without explanation. These young people have just received the diagnosis of bipolar disorder by a psychiatrist whose perspective is to somehow rebalance this young father’s biochemistry.

Defenses have been moved into place. As much as this patient wants relief, he doesn’t feel ready and is ambivalent when venturing further into the treatment of mental illness, a dreaded explanation of his bizarre thoughts and strange behavior. To educate is to enlighten this family. Yet, there is resistance. Later, this couple will go home to try to pick up the pieces of what had been an idyllic life: family, children, and connection to others. What I have to say is splintered by denial and fear, or just plain unfocused thoughts that will inhibit taking in what I am trying to present to them. How you educate people about mental illness is stymied by shock and ignorance as much as fatigue, anger, and the desire by some to be anywhere but in this room at this time.

I proceed with explanations, recognizing the limitations I am up against. No doubt, this couple will not remember what I have said. “Why didn’t you tell me?” they will say. “What is this thing called bipolar disorder? I was never told.” And so, we’ll begin again, the clients’ defenses lowered by painful acceptance this mind disorder is not going to go away.

Patience, I think, be patient. It took me 12 years to understand my mental illness. Can it be any different for my clients? Can my presence make a difference? Patience, my mantra; “So, let me tell you about my experience,” I hear myself say. And so, on it goes.