Bipolar-curious

Posted by fxckfeelings on March 17, 2011

Being diagnosed with mental illness won’t necessarily screw up your life, and screwing up your life doesn’t mean you have mental illness. In any case, people are most effective at managing screw-ups and mental illness when they’re ready to face the worst case scenario, assuming they can do so without letting it reflect on the quality of their management. Consider the worst, hope for the best, and don’t let your fears distort your perception of reality. In other words, don’t panic or feel that you’ve failed when somebody acts “crazy” or you’ll end up driving yourself nuts.
–Dr. Lastname

Are there varying degrees of bipolar? My son is 21 and just diagnosed in Sept 2010. He is a student, a swimmer with his university and a likeable, good-looking guy. He is medicated (lithium and Zyprexa) and is doing pretty well. He complains about concentration issues. I just feel sometimes like I need to be reassured that this is manageable and that there are positive stories of other people with bipolar. I hope and pray that he will lead a fulfilling life, marry and have a family. We are all just trying to adapt to this diagnosis.

Not only are there varying degrees of “bipolar,” there are probably various kinds as well, but we don’t know enough about what’s going on biologically to say. Like the Supreme Court once said of obscenity, you know it when you see it, but it takes many forms.

Basically, the word “bipolar” doesn’t have a lot of meaning other than as a description of someone who had an over-the-top episode of wild, excited, high-risk, inappropriately-undressed behavior that then, most probably, was calmed down by lithium.

Since we don’t have a biological definition of bipolar, we’re forced to use the word to describe the unluckiest cases, the ones who have the most severe symptoms that last the longest and come back the most often, simply because they’re the ones that are easiest to categorize.

There are probably lots of mild or brief cases that don’t get included in the definition, so the diagnosis seems to imply severe symptoms and a difficult future, when, actually, there are probably lots of mild cases. So yes, you’re right, he may not have it as bad as people think when they hear the word “bipolar” (which is to say, he will probably doing a lot better than Charlie Sheen).

In addition, whatever causes bipolar illness often seems to make people particularly creative and gives them a gift for communicating. It’s common among writers and actors, like Stephen Fry and Carrie Fisher, who have described working and enjoying life despite the disease.

Don’t pin all your hopes on his having a mild form of the illness, however, because that kind of hope guarantees despair if he’s one of the unlucky ones. Hope for the best, but reserve a good portion of your hope for the way that he responds to the worst, if that’s what happens.

He’s a good guy who may not be able to return to university until his concentration returns, so focus on his ability to cope with the waiting and frustration. Don’t see him as someone who dropped out of college, but as someone who enrolled in the course of “crippling illness 101.” Since you’ll be his professor, here’s your syllabus.

Praise his ability to bear pain and humiliation and still make the most of each day. Remind him that recovery and a normal life, however desirable, are beyond human control, and that what you care most about is how hard he works to deal with adversity.

For homework, encourage him to take his meds, see his friends, swim, and do everything normal that his brain will let him do. Tell him he is certain to get a good grade as long as he pushes himself to do his best, regardless of the limitations imposed by his concentration issues, as long as he keeps his clothes on.

STATEMENT:
“As much as I want my son to live a normal life after his bipolar episode—and he may very well—I will avoid pinning my hopes on a result we can’t control. I will stay positive about the way he deals with his recovery, particularly on those days when his condition is worse but he continues to be himself and do his best.”

I need to understand why my 18-year-old daughter dropped out of college without letting us know that she never attended classes and then, when we found her a job, she started out well and then started leaving early so she could go home and play videogames. I can understand that she’s not ready for college and was ashamed to let us know that she didn’t want to go, but I can’t understand why she flaked out on a job she likes. My goal is to get her into therapy so she can figure out what’s wrong and get started on her life.

It’s possible that your daughter’s flake-out behavior is due to a treatable cause, like anxiety or unexpressed feelings about her family or herself, and, if that’s true, psychotherapy with a good listener may well help. Or it’s possible she just flaked out.

The trouble is that kids with nice thoughtful parents who are good listeners have often had a chance to express their feelings and still find themselves avoiding situations they need to face. In that case, sensitive-listening therapy may have little to add.

Be prepared then for the possibility that her avoidant behavior doesn’t improve with sensitive listening, whether from you or a therapist, and that she has a bad habit that, regardless of its cause, is hard to stop. If so, you’ve got trouble and it will take more than talk therapy to get her on track.

Most of the therapy will need to come from you, and it will consist of good incentives for her to keep busy and meet her commitments. The good news is that, the better you do it, the more you’ll save on therapy fees. The bad news is that it takes time and training, particularly at first.

Learn how to identify and monitor the behaviors that matter most, including meeting her work commitments and doing chores that a reasonable roommate would do. Then apply your incentives while keeping discussion to a non-emotional minimum.

You can’t let her wear you down, and you can’t take it personally. As we’ve said before, you’ve become the supervisor for a very mellow half-way house. Your job is to keep your parolee on track so she can re-enter society, bleeding hearts need not apply.

So your goal, as usual, isn’t for her to be happy (though you wish she was happily working); it’s for her to do what’s good for herself, which may make her fairly unhappy in the short run.

In the worst case, she may always be prone to ducking out under stress and then ducking out more because of her shame at ducking out. Once you accept the fact that your daughter has ducking-out syndrome, however, you can help her accept herself, overcome stigma, and make use of the tools you’re offering.

Along the way, encourage her to make use of similar tools and advice from other sources, including therapists. Just remember—and this is coming from a costly therapist—that she’ll get more out of therapy when she’s ready to use it to help manage her negative behavior than to understand the cause or relieve the pain she’s trying to avoid.

STATEMENT:
“I hope therapy can help my daughter get a grip on her avoidant behavior but, if not, I’m prepared to accept the fact that her self-discipline is poor and provide her with strong management and supervision. My hope is that acceptance and incentives will get her going and that eventually she will make it her own business to improve her shaky self-control.”