Bipolar Disorder and Irritability

Everyone gets irritated at times especially if they are hungry or tired. People with bipolar disorder are often more sensitive to fluctuations in their internal and external environment and can become more agitated, anxious, sad, or angry than the situation would warrant for those without bipolar disorder. Examples of these fluctuations include:

Internal triggers

  • Hunger
  • Anger
  • Loneliness
  • Fatigue
  • Being cold or hot
  • Pain

External triggers

  • Noises
  • Lights
  • Other people’s emotions or moods
  • Tactile input such as touch by clothing or other people
  • Smells

Some ideas to help combat these triggers

  • Eat at regular intervals and always carry snacks and water with you when you leave the house.
  • Talk to others, journal or exercise when angry or if you are in a 12-step program work the steps on it.
  • Make contact with people in real life on a regular basis.
  • Go to bed and get up around the same time everyday.
  • Dress in layers and always keep a jacket or coat in the car. You never know when a restaurant or store will be extra cold. Keep a cold wet cloth in a small cooler during hot weather to place on your forehead or the back of your neck.
  • Always carry pain reliever with you when you leave the house.
  • Use ear plugs that cut down on the decibel level of the environmental noise.
  • Wear a hat or sun glasses to shade the light.
  • Practice setting boundaries and blocking out other people’s emotions.
  • Remove yourself from situations where other people’s emotions and behaviors cause you distress.
  • Cut the tags out of clothing.
  • Wear comfortable clothing like loose shirts and elastic waist pants.
  • Remove yourself from noxious orders or keep a cloth with you that has a scent you like on it to bring to your nose when you can’t get away from a smell.

What are some of your triggers and how do you deal with them?

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Bipolar Disorder and Grief

Everyone has the potential to grieve losses in their life. Those with bipolar disorder don’t have a right to say they grieve more than others. However, they are at risk for extreme mood episodes as a result of a significant loss in their life, making their grief dangerous and potentially life threatening.

The loss doesn’t have to be a death. It can be a job, a relationship, or a tragedy without death like a severe illness or injury. It doesn’t have to involve someone who is personally known but can be related to a collective loss or tragedy of a famous person or someone in their community.

When a person with bipolar disorder experiences a loss, at a minimum, daily tasks may fall by the wayside. Worst case scenario the person becomes completely immobilized, ignores their most basic tasks such as hygiene and nutrition and starts having thoughts of harming him or herself.

  • Some ways to cope with a loss if you have bipolar disorder is to make sure you keep taking your medicine as prescribed.
  • Stay away from alcohol and recreational drugs which can bring you down even further and lower your inhibition when trying to stay safe.
  • Talk to someone about your feelings.
  • Journal about your thoughts and feelings.
  • Go to a support group.
  • Talk to your doctor.
  • Go to a therapist or counselor.
  • Get outside.
  • Go for a walk.
  • Spend time with animals or children.
  • Take a hot bath.
  • Take the time and care you need to ride out the emotions knowing they will pass.
  • Do not “should” yourself or judge or talk negatively to yourself about anything you’re not able to do while going through this time. This is the way your brain was made and it is not something you chose. Acceptance and self compassion are key to experiencing less suffering during these times.

What are some other ways you can or have coped with loss in your life?

Irritability and Bipolar Disorder

Everyone has bad days, but when yours start to negatively affect your relationships it may be a sign of bipolar disorder. I can be irritated for no apparent reason for days at a time and this is often a symptom of mixed mania for me where I am hypomanic and depressed at the same time. My baseline is low depression so when I get a burst of creativity or energy that I have trouble acting on I get irritable quickly.

If this happens to you, learning mindfulness and anger management techniques might be helpful. It also might be a good idea to discuss it with your doctor.

Inability to Complete Tasks and Bipolar Disorder

Nine months ago I posted an article on Dialectic Behavior Therapy (DBT) and I ended it with “More to come…” Well, more never came. I had started reading a DBT workbook around this time and joining in on a weekly DBT Twitter space as well, which is what inspired me to write about the topic. I quickly got bored with the book and as a result also lost interest in the space on Twitter and didn’t give the article or topic a second thought.

Having grandiose ideas and abandoning them before they are finished is a common symptom in people with bipolar disorder.

“Having a house full of half-completed projects is a hallmark of bipolar disorder. People who can harness their energy when they are in a hypomanic phase can be really productive. Those who can’t often go from task to task, planning grand, unrealistic projects that are never finished before moving on to something else.

“They can be quite distractible and may start a million things and never finish them,” says Dr. Don Malone, the director of the Center for Behavioral Health and chair of the Department of Psychiatry at Cleveland Clinic, in Ohio.” https://www.cbsnews.com/pictures/bipolar-disorder-10-subtle-signs/

Do you experience this problem? I always have plans to post a blog every week and my last one was seven months ago so you can see how well it works out for me.

New 988 number in the US for Crisis

988 is now available in the United States to contact if you are in a mental health, substance use, or suicide crisis! Please pass this information along.

What Bipolar Disorder Has Given to and Taken Away From Me

In honor of World Bipolar Disorder Day I am going to discuss numerous things bipolar disorder has given to and taken away from me. I was diagnosed with rapid cycling bipolar type 2 disorder 15 years ago. I knew nothing about the disorder or how it would affect my life for the next 15 years. While there are positives that have come about due to having bipolar, the negatives far outweigh them.

What Bipolar Disorder Has Taken From Me

The ability to work a paying job

Since being diagnosed with bipolar disorder, I have tried various ways of staying gainfully employed. I have worked full-time outside of the home and part time from home for a healthcare employer, as well as part time outside of the home and from home for myself. In each situation my bipolar symptoms, especially anxiety (social, general and panic), anger/irritability, and depression, have left me unable to cope with the demands.

I even started a photography business since photography is my favorite hobby, but the business side of it and dealing with people was more than I could handle and bipolar symptoms were triggered. So, I had to quit or continue to suffer the negative health consequences.

My ideal body weight

Bipolar medications have caused me to gain at least 20 pounds over the last 10 years. Couple that with the fact that my previous career involved a lot of exercise that I no longer get and the weight keeps piling on. My rapid cycling moods make sticking to an at-home exercise routine or diet regimen nearly impossible.

The ability to be a stable parent

Unfortunately, my bipolar disorder has negatively affected my children. There have been times where, because of anxiety and depression, I have been unable to get out of bed to be there for them or to attend their activities, and even worse, times where I have been hurtful with my words to them due to hypomanic irritability. I worry that they have picked up their own anxieties from growing up in a household filled with mine.

The ability to socialize and be in public places without extra medication

Bipolar anxiety has left me with an extremely sensitive nervous system that becomes overstimulated with what is typical input for most people. For me, the noises are always too loud, lights too bright, smells too strong, and people too close. I have to take one or two additional medications to cope with all of these stimuli.

Spontaneous changes in my routine

Maintaining mood stability requires that I adhere to fairly strict schedules with my sleep, medications, food intake, and social calendar. I go to bed at the same time each night. A rare late night out can wreak havoc on my mood for days afterwards.

I take my medications on a strict schedule. Forgetting a dose can cause troubling side effects such as light-headedness and nausea.

I eat three meals a day because going too long without eating can affect my moods greatly.

Finally, I have to plan ahead for social events. Any last minute plans or changes to plans can send me into a tailspin.

Parts of my creativity

Before going on certain bipolar medications, I was prolific at writing, especially poetry and mental health blogs. I also painted a lot. I believe antipsychotics dried up those creative wells for me. I just don’t have the same drive and imagination for it anymore.

The ability to stick with something long term

I will often enthusiastically start projects such as writing a book, starting a new blog, beginning an exercise program, creating a house cleaning schedule, starting a new diet, reading a book, or learning a new skill, but after a few weeks my mood will shift and I will abandon whatever it is I began. It’s a pattern I’ve had for nearly my whole life, starting long before I even knew I had bipolar disorder.

Outdoor summer fun

Some of the bipolar medications I take make it difficult for my body to regulate its temperature. Therefore, I’ve had to give up many once enjoyed outdoor activities when the weather is too hot, such as spending the day on the lake with friends, watching the kids’ baseball games, lounging for hours at the pool, going for walks, and doing yard work.

Friends

The irritability that comes along with bipolar mood fluctuations has caused me to do or say things that most people might think but never act on and this has caused rifts in some of my friendships.

I also think that because of bipolar disorder my inhibitions can be lower at times in a way that makes it feel like I can’t control what comes out of my mouth and I find myself blurting out comments or answers that are inappropriate.

Paranoia has also caused me to embarrassingly ask friends if they are mad at me or don’t like me anymore which is just awkward for everyone.

Peace of mind

With bipolar disorder’s mood changes and the secondary emotions that can come with it, such as anger, irritability, and anxiety, I am always on edge and wondering what is coming next. Everything internally feels so unpredictable that I can barely ever relax and feel secure about my health. Even when things are going well I’m always waiting for the other shoe to drop. Lasting peace of mind seems to forever elude me.

What Bipolar Disorder Has Given to Me

An opportunity to stay home full time and work on my physical, mental, and spiritual health

Because I am home most days by myself, I am able to spend a lot of time learning, reading, writing, reflecting on things, and participating in hobbies, support groups, spiritual groups, and going to as many doctors’ appointments as I need to to reach towards my fullest potential in all areas of my health. If I did not have bipolar disorder, I would be working full time and not have the time to do all of these things.

The ability to truly help my children, who also suffer from mental illnesses

My kids have had multiple physical and mental issues over the years that have required many daytime doctor and therapy visits that I would have not been able to do if I was working a full-time job. Bipolar disorder has forced me out of the work place thereby allowing me to be home for them during some of the most critical and crucial times of their lives.

The ability to support others with mental health issues in real life and online with greater compassion and open-mindedness

Sometimes you can’t imagine what others are going through unless you’ve been through it yourself. I have been through a lot of trauma and heartache including hospitalizations due to suicidal behavior thanks to bipolar disorder. You just can’t help others in the same way when you haven’t experienced these depths of despair as you can when you have. I have something valuable to offer others because of my trials.

What About You and Bipolar Disorder?

What are some things bipolar disorder has taken from you and/or given to you? Share your experiences in the comments.

DBT Distress Tolerance Skills

What is DBT?

Dialectical Behavior Therapy’s (DBT) premise is that two seemingly opposite things can be true at the same time. For example, my parents did the best they knew how when raising me and they negatively affected my emotional development.  

DBT trains the mind to think with a good balance between reason and emotion, calling this the “wise mind.” It also can keep you out of all or nothing or black and white thinking. There are many shades of grey with everything in life. 

There are four main tenets of DBT. They are Distress Tolerance, Mindfulness, Emotional Regulation, and Interpersonal Skills. 

Distress Tolerance and Radical Acceptance

Distress Tolerance includes an idea called “Radical Acceptance” where you fully acknowledge the present moment reality. This does not equal condonement. Radical acceptance places you in a position of being able to make a plan to elicit changes in your life because you cannot change anything if you aren’t fully engaged in the acceptance of what currently is. 

Distress Tolerance skills include distraction and self-soothing. Distract by engaging in pleasurable, non-destructive activities, focusing on helping others, doing chores, counting breaths or anything you can see, or distract by removing yourself from the situation.

Self-soothe any of your senses: smell, sight, sound, taste and touch. Use any input that makes you feel good that is non-destructive and not harmful to you or anyone else. 

R.E.S.T.

Above all, make sure to use the “Rest” technique in any situation that is upsetting to you at the start. Relax (R), Evaluate the facts (E), Set an intention (S), Take action (T).  The intention and take action steps could include some ideas from the distress tolerance skills.

More to come on DBT skills…

Differences Between Depression and Sadness

Everyone feels sad at some point in their life but not everyone gets depressed. Usually sadness is a result of some specific external event or reason going on in someone’s life from something as serious as the death of a loved one to something less serious like failing an important exam. This is not to say that some things that cause sadness such as these cannot lead into depression if it goes on for a long period of time.

Main Differences Between Sadness and Depression

  • A person with sadness can usually find some relief from crying, venting, or talking out frustrations. Those with depression can do the same thing but often don’t find the same kind of relief. They continue to feel very sad with the added symptoms of hopelessness, lack of motivation, and loss of interest in activities that they once found enjoyable.
  • Sadness usually passes with time. Depression tends to last weeks or months and may lead to those with it thinking about or attempting suicide. They may also no longer feel like spending time with family or friends and might become disinterested in their usual hobbies and feel unable to attend work or school.
  • Sadness is just one part of depression. Other symptoms of depression that aren’t necessarily seen in sadness include a daily depressed mood that lasts for most of the day, nearly every day, with signs of hopelessness and sadness. There’s also a loss of interest in normal activities for an extended amount of time, significant and unintentional weight loss or gain, insomnia, sleepiness, or increased amounts of sleep that affect normal schedules, tiredness and low energy, feelings of worthlessness or excessive guilt on a daily basis, inability to concentrate or make decisions, and recurrent thoughts of death, suicidal thoughts, or suicidal attempts or plans. A person who experiences any five of these symptoms for longer than two weeks would probably be diagnosed as having depression rather than a prolonged experience of sadness.

If you feel like you are experiencing depression rather than sadness, contact your medical professional as soon as possible. There are many treatment options available for people with depression including medications and psychotherapy and counseling.