Holistic Self-Management of Bipolar


My primary chronic illness is bipolar disorder. Most chronic illnesses, whether physical or mental, require the individual to take regular action to maintain the highest possible level of health. The illustration most commonly used is diabetes — people with diabetes must check their blood sugar regularly, follow a plan of diet and exercise, take oral or injectable medications, examine their feet often, and so forth. Failure to carry out any of these actions can lead to serious consequences including kidney failure, hypoglycemic coma, amputations, or even death.

Self-management of bipolar disorder also requires certain actions, but it is much more difficult to know just what these actions are when a mental illness is concerned than it is when it is a physical illness. The easiest action to discern is taking prescribed medications. Having gone off my meds several times in the past, including once for almost a year, I know very well what can happen. I know the insidious downward spiral of bipolar that can lead to the brink of death just as surely as a disease like diabetes can.

So taking meds is number one, but it is not the only habit I must develop. Here are some others that are equally important:

  1. Therapy — For some reason, I’m having a problem doing this often enough.
  2.  Eating properly — Research suggests that the Mediterranean diet is the best for bipolar.
  3.  Exercising regularly — I have a shirt my mom bought me that says “Exercise? I thought you said ‘Extra fries!'” That is my usual attitude towards exercising, but I know that regular exercise, outside when possible, is crucial.
  4.  Spiritual practices — This is one I have lacked for a long time, but I am beginning to realize (not for the first time!) that I have to depend on God to help me with the symptoms of bipolar, especially my bad temper.
  5.  Having a routine — Although I enjoy visiting my daughter and my mom, the break in my routine that results can be very disruptive to my mental health. I need to keep my routine as much as possible even when I am away.
  6.  Laughter and relaxation — Laughter can definitely be a powerful medicine! If I don’t practice relaxation, I develop excessive anxiety.

Of course, there are others, but at present, I will address these. Where does holism come in? Many of these issues overlap. For example, I can keep up with all of them better in the context of a routine. Prayer and meditation are spiritual practices that help me relax; yoga is a relaxing type of exercise. A healthy diet gives me the strength to exercise and to think rationally. These are not independent bits of my life that are related only because I am the one doing them. Rather, they are strands of activity that are woven together to create the fabric of my days

I shall go into each one in future posts and then revisit how they work together.

Dealing with Death


Yesterday my best friend’s dad passed away. We went to visit her family over Christmas, and it was clear that he would not live much longer. I am going with her to the funeral.

I’ve never been close to death — never wanted to be. I avoided being near my family members when they were dying. I guess it frightened me, or at least my emotions frightened me.

Sometimes it was due to an issue I had with the individual. For example, I had hard feelings towards my paternal grandmother due to a variety of seemingly small incidents (and a couple of big ones)
that had accumulated over the years. When she was close to dying, I was living in another city attending graduate school. I could have gone home sooner, but I waited, and by the time I reached home, she had already died. I was greatly relieved.

But that was 21 years ago, and I have changed in those years. Two years ago, my maternal grandmother passed. I am living in another city again, and I was not there when she died, but I had visited several times over the preceding year, and I had no issues with her. I wish I had been there. I don’t know if it would have made any difference to her, but it would have made a difference to me.


Word for 2017: Holistic

I just read a post on Colline’s Blog in which she discussed her word for 2017, discipline. This is her theme for the year. She described how the word discipline relates to her goals for the year.

The idea intrigued me, so I looked inside myself for a word that could be my theme for the year. I thought of spirituality at first,  but I finally decided on “holistic.”

I tend to focus on just one area of my life at a time, a habit which is probably related to my bipolar disorder. In spite of medication, I still have episodes of depression, hypomania, and mixed states. During these times I may obsess over my physical health, compulsively work on my writing, or ruminate about my relationships, to the exclusion of everything else.

In 2017, I want to keep in mind the “big picture.” All areas of my life are important: spirituality, physical and emotional health, family and friends, relaxation and leisure, writing, housework and cooking. I often feel overwhelmed when I think about doing all that! But part of the overwhelm is that I think of it as doing everything at once and doing it perfectly. I will need to remind myself that I am human and that’s okay. Trying to be aware of my whole self may feel like herding kittens sometimes, but I think it’s worth a try!

Baby Steps Part 2

by Emilio Garcia
Brainade! The Brain Grenade by Emilio Garcia

In the last post, I mentioned the poisonous thoughts that arise when I try to ask other people for help. I’ve been thinking about this idea. Are there Deadly Elements (e.g. grenades) in my brain that can get triggered by my thoughts, feelings, or actions? If so, how can I find and destroy those pockets while simultaneously employing the baby steps concept?

Clearly, this is an area in which I need help…. no irony intended! Where can I get it? Continue reading Baby Steps Part 2

Baby Steps? Part 1


Aren’t babies cute? There is nothing more adorable and exciting as watching babies take their first steps.

Twelve Step and other recovery groups often emphasize the need to take “baby steps” as we move along our journeys towards growth. But what does that even mean? When I think of baby steps, I see several crucial facets that can be applied to my personal journey.

First, no one expects a baby to run a marathon when she takes her first steps, yet I often expect too much of myself when I begin something new.  Continue reading Baby Steps? Part 1

Facing Fears


It is quite possible that I have social phobia or social anxiety disorder. On the other hand, maybe I am shy in a way that is completely normal. Either way, the difficulty I have being around people gets in the way of my enjoyment and happiness. Many days I don’t step foot outside of the house, even to get the mail. I just let my roommate get it when she comes home. I sometimes walk to the grocery store or the pharmacy where I get my meds (I don’t drive). I smile and say hello if someone speaks to me, but I am terrified that they might want to converse, so I leave as soon as possible. I don’t look over my grocery bill because if there is a wrong price I will have to take the item back. I would never ask a store worker where to find something, and I get embarrassed when they say, “Can I help you find something?”

You get the picture. Continue reading Facing Fears

Why Tolerate Distress?

Many people with mental health issues tend to go to extremes with their emotions because they are unable to regulate them successfully. When I go to extremes, I add another problem on top of the one I’m already dealing with. It’s not just the situation itself,  it’s also the fact that my extreme emotions are running the show.

I relate this to what happens in the body when something irritates it — a splinter, a “scratch” on the inside of an artery, a bacterium such as N. meningitidis (meningococcus). The irritating factor is bad enough, but what happens next can be worse, as the body’s inflammatory responses kick in. The use of immunosuppressants such as steroid to treat bacterial meningitis is counterintuitive, but it works, because inflammation is part of the problem.

Distress tolerance skills give me a way to handle inflamed emotions without hurting myself or other people (hopefully, I don’t destroy property either). Continue reading Why Tolerate Distress?

One Breath at a Time


I lost my temper today. It was primarily caused by my feelings of shame. I’m not sure why, but I’ve been having more trouble with shame lately. My therapist said that maybe I am moving to a new level of recovery and the “old me” is fighting back. The me that feels like a horrible person. The me that gets uncomfortable when my life is going too smoothly. The me that looks for a way to sabotage any success.

Regardless of the cause, I lost my temper. I felt like crying, screaming, banging the wall, and cursing. I actually did a bit of it.

But then I stopped myself. I was seriously white-knuckling it. All I could think of was “breathe in, breathe out, breathe in, breathe out.” If I tried to think of anything else my feelings started to take over again.

After awhile I was able to relax my muscles instead of being so tense. I still felt bad, and I knew I was still fragile. The smallest thing could knock me over the edge again. My stomach was still churning, my jaws were still clenching, but if I could just hang on long enough, I knew that the awful feelings would end.

Sometimes I forget that feelings change. Especially I forget that I can make an effort to change them. Sometimes the only effort needed is to NOT do things that will make the situation worst — to get quiet inside, focus on my breath, and let peace into my mind.