By Margarita Tartakovsky, M.S.
“The problem with bipolar disorder is that it takes away our ability to see ourselves,” said Julie A. Fast, a bestselling author of books on bipolar disorder, including Take Charge of Bipolar Disorder and Loving Someone with Bipolar Disorder.
For instance, you might question whether the feelings you’re feeling are really you or the illness, said Sheri Van Dijk, MSW, a psychotherapist and author of The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder.
Family and friends may add to the confusion. They may attribute “many normal emotional experiences to the person’s illness.” They might make remarks like “You’re really angry. Did you take your medication today?”
One step toward getting to know yourself is knowing your specific symptoms. “[I]n order to find out who you are, you have to figure out what’s bipolar first,” Fast said. “You have to be honest with yourself, and write down [your symptoms].”
Bipolar disorder affects everything from your relationships to your ability to work to how you sleep, she said. “When I’m stable, I really enjoy my work. When I’m sick it’s unbelievably difficult. It’s the same topic, the same work, the same deadlines, but it completely changes when I’m on a mood swing. I know who I am as a writer. Because I know who I am that’s how I know it’s an illness.”
Another step in getting to know yourself is sharpening your self-awareness about your thoughts and feelings. The below strategies can help you do just that, and distinguish between yourself and the illness.
1. Know your baseline.
“Make a list of what you’re like when you’re not in a mood swing,” said Fast, who also pens a blog on bipolar disorder and works with family members and partners of a loved one with bipolar disorder. Who are you when you’re well? What’s your personality like? What are your likes and dislikes? What kind of thoughts do you have? Do you talk slowly or quickly?
Fast knows she’s a cheerful optimist who loves to create. When she’s depressed and really sick, she tells herself: “Julie, this is the depression. The real you doesn’t think this way. This isn’t who you are.” When negative thoughts surface, Fast focuses on her treatment plan.
It’s also important to communicate your baseline to your loved ones, and let them know how to support you when symptoms return. For instance, Fast has taught her mom to inform her when she’s manic and that she’s worried about her.
“[Y]ou have to teach others what to say or what to do to help you.” Be specific about how you’d like them to help you, she said.
2. Explore your thoughts and feelings.
Buy a notebook, start a blog or email yourself “to begin documenting the textures of your thoughts and feelings,” said Deborah Serani, PsyD, a clinical psychologist who specializes in mood disorders and author of the book Living with Depression. “Research shows that using this ‘Dear Diary’ approach sharpens your self-reflection skills.”
Once you figure out a method that works for you, try to notice how you respond emotionally, she said. “For instance, do your feelings flow from one to another in a rapid fashion? Do you experience one big emotion that overwhelms you for a long time? If you look in the mirror, does your facial expression reveal what you’re feeling?” Write down what you learn.
3. Practice mindfulness.
Mindfulness “increases a person’s self-awareness, and over time many people are able to begin to distinguish small differences in the emotions that allow them to label the emotion as ‘normal’ or ‘illness,’” Van Dijk said.
Specifically, they’re able to become more aware of their emotions, the thoughts contributing to these emotions and the urges associated with the emotions, she said.
“I’ve had some clients with bipolar disorder [BD] who say that they can tell the difference between a ‘normal’ and a ‘BD,’ emotion because it physically feels different for them.”
Mindfulness also includes acceptance, which is key for bipolar disorder. Accepting what we’re feeling lets us focus on that emotion. When we don’t allow ourselves to feel an emotion, we usually trigger an onslaught of negative feelings. According to Van Dijk:
For example, if I feel angry at my mom and I then think “I shouldn’t feel angry with her, she’s my mom,” I might then feel angry at myself for feeling angry; or I might feel sadness or guilt or anxiety about feeling angry.
If, on the other hand, I can simply acknowledge my anger in a nonjudgmental way (“I feel angry at my mom” – period), we don’t trigger other emotions for ourselves. This means that we can think more logically about the emotion because we only have that one emotion to deal with instead of three or four.
Being able to think more logically about the emotion means we have more ability to consider: “Is this emotion a ‘normal’ emotional reaction, or is it part of my illness?”
4. Chart your moods.
Another way to become more aware of your specific symptoms is to chart your moods, Van Dijk said. You can use a paper chart, online trackers or even download an app. Serani mentioned this personal mood chart.
For instance, let’s say you notice that you haven’t needed that much sleep the last few nights. You’re feeling excited, but you’re not sure why. These might be signs of hypomania, she said.
Or you might notice that you’re feeling more irritable lately, have a shorter fuse and you’re upset “but can’t really connect it to a situation.” This might mean “the onset of depression.”
5. Consult others.
In the beginning, ask people who you trust how they’d react to the same situation, Van Dijk said. For instance, you might ask: “If this had happened to you, would you be feeling really sad right now?”
Also, ask others about who you are, Fast said. You might ask: “Who do you think I am as a person? What’s my regular behavior?”
6. Become an expert on bipolar disorder.
Make sure you have a deep understanding of your mood disorder, Serani said. She suggested everything from reading books to finding reputable articles to attending workshops to seeking out support groups.
“When you empower yourself with information about what symptoms are, how they present, and what to do, you give yourself the gift of enlightenment.”
Separating yourself from your illness can be difficult. But by sharpening your self-awareness and better understanding how your bipolar disorder manifests, you can get a solid grasp on the distinction.