DBSA Ask a Young Adult

Q&A

Members of the DBSA Young Adult Council offer their perspectives on questions posed by young adults about living with a mood disorder. Submit your question.


Q: I'm a student doing my engineering and I'm a person who portrays easy mood swings and is sensitive and emotionally attached to dear persons or situations. For the past 3 years, my mind displays the movements of a pendulum oscillating from emotion to emotion and is unsteady like hell. This situation of mine lead to suicidal thoughts but the thing that there is no reason or nothing wrong going on in my life is the one thing that is stopping me from taking any step.Sometimes i feel so powerful as I'm a reasonably godly person and participate in social welfare activities and feel I possess blessings what millions out there cannot even think of. But the weakness strikes again to kill me from within and break me down into tears. What do I do further to maintain a stable positive mind so that I lead a normal life ?
Answered by: Danyelle 

A: From my experience as a high-function individual living with a co-occurring mood disorder and a personality disorder, I can understand the complexities of your experience. Even though I always did well enough to get by and it seemed like I had everything, I was screaming inside. I normalized my feelings and fears and stuffed them deep inside. I hid them very well (on the outside), but they never went away and eventually got worse. I knew something was wrong, but I was scared to face it. I was afraid of ‘being different,’ afraid of the possibility of having a mental health condition, afraid of what others would think, afraid of stigma and stereotypes, everything. But I knew I couldn’t live like that anymore. I realized that I can and should be happy-and that it’s up to me to make that happen.

They always say that ‘better the devil you know than the devil you don’t.’ This is far from true. Facing our fears is scary and difficult, but facing ourselves is even more overwhelming. It’s so daunting to take that first step-to start a journey to discover yourself and be the best you can be, regardless if an individual has a mental health condition or not. I used to think that if I was function, then I was fine, but I wasn’t. I had to acknowledge that something wasn’t okay. I wasn’t alright and I deserved better. I matter and my life matter and, more importantly, it was okay not to be okay and it was okay to get help.

I struggled for so many more years than I needed to because of fear. I’ve learned a lot along the way, but I wish I got help sooner. Looking back, I was always struggling and I didn’t know where or how to get help. Once I started reaching out to people I trusted and allowed myself to be vulnerable, I learned where and who to turn to. Even though I lost some friendships along the way, I gained real relationships and I uncovered a beautiful me I never knew existed.

As much as I wanted/want to believe I can do everything on my own, I’ve accepted that it’s okay to need other people and things. What is important that you never stop trying and utilize your resources. There’s always hope. There’s always help. There’s family, friends, counselors, school nurses, social workers, so many people that can and want to be there. I surround myself with positive people and things, take my medications, and visit my therapist regularly. I exercise frequently, eat healthy, and follow a routine. I set boundaries and say ‘no’ when I need to so I don’t get overwhelmed. Even though sometimes I don’t like having to do these things, I have learned that taking care of myself allows me to be the best me I can be. It took time to find what worked for me. Running away from everything was exhausting, but it’s okay to be me. No one is perfect, but we all deserve to be happy. There’s no such thing as ‘normal;’ there’s only what works for you to find stability and serenity in yourself. Don’t give up. DBSA has great information and resources to finding support.

Q: I am the mother of a beautiful 21 year old daughter who is struggling with rapid cycling bipolar disorder. We have been working with great doctors and counselor for about 4 years. My daughter has never had more that 5 weeks of stability. Is this what she will live with forever? She always takes her meds and follows dr's orders. She totally gets that she has bipolar 1, but there is not a lot of info out there about rapid cycling. Any info others can share would be helpful.
Answered by: Marty 

A: Living with a mood disorder requires one to think proactively and act preemptively. Although mood changes are difficult to anticipate, it is important to have a plan of action or specific behaviors that can help mediate the symptoms of bipolar disorder. Bipolar disorder is complicated and varies for each person. Finding the right treatment can be difficult and frustrating at times, but it is crucial to not lose hope. For me, it took some time to figure out which medications were able to stabilize my moods. Finding the right medication and dosage are very important, but there are also other things that one can do to relieve some of the negative effects of bipolar disorder.

Once I had my first manic episode, I went through a considerable amount of emotional turmoil. As I regained control of my mind-state and life, I had to take an honest look at my lifestyle habits and sacrifice things that were inhibiting my well-being. I found that when I wasn’t on effective medication, my moods would swing from something as little as a cup of coffee. I had never experienced such a depressing after effect of caffeine in my life before, but that experience taught me how little things can affect my mood throughout the day. I am now more aware of what I put into my body and the consequences of those things, both good and bad. I know that working out, meditating, and being active in general helps lift my mood, and also helps me to maintain a healthy balance internally.

I don’t have much experience with rapid cycling, however, I’ve talked to a few people that do. One person told me that each day was unpredictable with regard to how she would be feeling. She said that she would use the swings in mood to her advantage and make the most of an upswing in productivity. It might have taken her a few years to learn how to manage and control the symptoms, but she had certain people in place to let her know when she might be slipping a bit. For example, she has a person that monitors her spending habits to help her avoid any relapse into impulsive spending sprees. She is also very active in the community and lives to help others with mood disorders and promote awareness to remove the stigma surrounding mental illness. I have found it extremely valuable to get out and speak with other individuals who live with mental health complications. I have learned a lot from listening to other people share their stories. It is cathartic to both hear how others cope with their disorders and to share one’s own feelings and experiences with a group of people that truly understand what it is like to live with a mood disorder.  It can be disconcerting when it feels like I might have to take medication and live with a mental disorder for my whole life, but I find it easier when I focus on the short term future. On a positive note, I believe there is hope for those who are still searching for successful treatment. Recent advances in brain research have enabled the medical community to find new ways to treat bipolar disorder. Modern technology and research has led to tremendous progress in our understanding of the chemicals involved in mood disorders. Who knows when the next breakthrough will be, but I am confident that there will be many. DBSA has a brochure that helped educate me about rapid cycling, and I think it is a great place to start. You can read more here.

Q:  Why can't I express my emotions or thoughts to anyone?  I want the help, but I don't know what it is that's holding me back. The thoughts seem to be becoming overpowering, and it is making things worse.
Answered by: Adam 

A:  Being vulnerable and putting yourself out there especially in the context of needing help can create feelings of intimidation, nervousness and anxiety. However, I can assure you that if you are feeling this way, you are not alone. It is important to first find someone to talk to that you feel will not judge you, will be ready to listen to you and will be open to trying to understand what you are feeling. Taking the first step can oftentimes be the most difficult, and while it may be uncomfortable at first, the connection and support that can be created as a result can be worth it. If you still are having trouble finding someone to talk to, DBSA does have some local chapters that have peer-led support groups. You can go to our Support Group Locator on our website, find your state, put in your zip code and it will show you the group that is closest to you. You can find that at www.DBSAlliance.org/FindSupport. We also offer an online young adult support group which you can access by going to: www.DBSAlliance.org/OSG

Q: The issue I'm having is that I'm not incapable of laughing, performing, or distracting myself (not in a manic/hypomanic way), but rather I'm incapable of letting this sad, lingering depression completely go. These 'low' feelings are not exactly too threatening (like hospitalization needed), but strong and unexpected enough that I'm alarmed later on. I don't understand how I can be moving forward in life and happy for the most part, but still feel unnervingly depressed, too.

What's the longest a recovery period can be after a depressive episode? And, is it possible to exist in a state where depression kind of hovers over you constantly?
Answered by: Greg Simon, MD, PhD 

A: Unfortunately, the situation you describe is fairly common.  Medications for treatment of bipolar disorder are often more effective for controlling or preventing symptoms of mania than for controlling or preventing depression.  So, many people experience continued or residual depression after a major episode has passed.

If you're experiencing continued or residual depression, adjustment in medication may help.  But specific kinds of counseling or psychotherapy, such as cognitive behavioral therapy, probably have a better track record for helping with depression.  Those kinds of therapy emphasize the things we know help with depression: recognizing and taming negative thoughts, increasing involvement in positive or rewarding activities, and developing skills to manage stressful or challenging interpersonal situations.

Q:  I struggle with finding a therapist that I feel like I can truly open up to and trust. How can I overcome this and connect with a professional that can help me?
Answered by: Adam 

A:  Finding and then developing a sense of trust with a mental health professional to confide in with very personal information can be a difficult thing to do. However, one thing to remember is that they are, in fact, professionals. It is their job to listen, to respond, to observe, to ask questions, to try to understand and to work with you on your personal issues. Therapists keep your conversations confidential, and what they care about is your safety and wellbeing. If you think there is some kind of issue or you are not making progress, a good place to start is to discuss it with the therapist. He or she may not know how you feel or what exactly you want to work on in therapy, and divulging that information to them could improve the quality of your sessions as well and could improve your trust and relationship. Ultimately, if you find after giving your therapist an honest chance that there is continuous disconnect and lack of personal growth, you may want to seek a different therapist that might be able to better help with your specific needs.

Q:  What is the significance of creating a relationship between your therapist and your doctor and/or psychiatrist who prescribes you medication?
Answered by: Adam 

A:  Most would recommend that there should be some sort of line of communication between your therapist and other mental health professional(s) that you see. As a whole, all of those different professionals play important but very different parts in improving or assisting with your mental health needs. Therefore, it is helpful for all sides to be on the same page, up to date and aware of your mental health needs, diagnoses, medications, etc. so that each individual can help you by tailoring what they do to your needs and providing the best quality care that they possibly can.

Q:  My medication oftentimes makes it difficult for me to get up in the morning because it makes me tired. As both a college student and a working young professional, I have recently been missing classes, I have been late to work, and I have been missing assignments and falling behind. What should I do?
Answered by: Adam 

A:  One thing to do to start is to communicate. Discuss what is going on in your life with your teachers, professors and/or supervisors. You do not necessarily have to tell them everything about your condition or personal issues, but it is helpful to provide them with enough information for them to get a basic understanding of what is going on that is affecting your performance. That way, your honesty is something that they can hopefully appreciate and possibly work with you on making a plan together. Concurrently, you should work on a plan with your doctor and/or other mental health professionals to discuss and resolve your medication issues.

Q: If I am depressed, how can I find motivation to get up each day?
Answered by: Keith

A: When you are depressed, it’s like you don’t care about anything. You can’t seem to find the energy to do simple tasks, and you may feel hopeless about the way your life is going. Motivation is a rare source of empowerment that depressed individuals struggle to have enough of. One thing that helps me is to simplifying the demands of my day. Rather than try to accomplish a large agenda, you can fix your goals to 1-2 things you can accomplish. If I finish those 1-2 tasks, I can feel satisfied and content. For example, if I’m a student experiencing depression living on my own, I may decide if I just finish one homework assignment and do the laundry, I can choose to accept that day as a success. Little tasks completed can build momentum for you to get things done, slowly but surely. Another way to motivate yourself to get up and get going is to focus both on one thing you like about yourself and one thing you look forward to each day. Reflect on that in the morning and throughout your day. An intentional mind-set on a positive trait about yourself and a positive expectation can keep your depressed thoughts at bay and enable you to set out with enough vigor.

Q: How can I best support someone who has depression or bipolar disorder?
Answered by: Keith

A: It is difficult, to say the least, to be around someone who is experiencing depression or bipolar. The first thing you can do is to be present and willing to listen to their cries of hurt and confusion. They may not always acknowledge it, but having someone who listens to them nonjudgmentally is like a breath of fresh air. A second thing you can do is to remind them regularly of happy memories they’ve had, particularly ones where they felt loved and significant to others. You can also find stories of others, particularly more famous people, who have had to live with mood disorders and have still found success in managing them, and share those stories. A third thing one can do to support someone is to keep them accountable to taking medication and going to therapy. There will be times a friend or loved one will spontaneously decide they no longer need medication or counseling. You should always encourage them to stay on their treatment plan until they have discussed a change with their doctor or therapist.

Q: What makes a good support system? As a person with a mood disorder, how can those around me understand how to help me?
Answered by: Megan 

A: After an episode or period of uncertainty, your loved ones want a way to help you. There are plenty of professional resources available now for your family and friends. But I think another important resource for your loved ones is yourself! 

I believe there are important details that only YOU can communicate with your support system. For example, I tend to feel more depressed on the weekends when I’m not busy keeping up my school and work schedule. I’ve identified my own mood trends and began to tell my closest friends and family. When I’m feeling better during the week, I can make plans to go to brunch Saturday morning. Having something to look forward to makes all the difference. Even if I’m still feeling down come Saturday morning, I’ll still have someone in place to talk to. By tracking your moods to identify your own patterns and keeping an open line of communication with your supporters, you can avoid some of your triggers and feel that support.

After a rough patch, hearing that you’re still worthy and that you’re still loved helps. Mood disorders can be very alienating.  It can be uncomfortable to rehash your episode with others. Having a conversation and adding perspective can guide you on your way to wellness. The ultimate goal is to keep you safe! Your support system should help you feel less alone in your struggles and celebrate the daily triumphs with you. The first step is to open up just a little bit, and let those that love you the most help you.

Q: I often struggle with the feeling that I have no control over my body because of my bipolar disorder. How can I conquer this?
Answered by: Taylor 

A: It’s easy to allow something as serious as bipolar disorder or depression take over many facets of your life- but that does not mean that it’s all you are. During the aftermath of a manic episode or as you’re climbing out of a debilitating depressive episode, you can find yourself wondering how you can still grasp onto some sort of control of your body. I like to think of a roller coaster; it can go up and down without notice but it regains equilibrium without fail. Sure, you can’t control necessarily when that will be but there are definitely things you can do to help yourself.

First, of course, is to talk to your doctor- Or establish a relationship with a good one if you have not done this yet. They will be extremely helpful in working with you to find a good treatment plan to manage your symptoms. This could look like a mix of medication, therapy or one of the many other options out there.

Another strategy that I’ve found really helpful is yoga or any other type of mindfulness practice. When I am overwhelmed with chaos or feel as though I have no say in what my body does next, I recognize that I need to take time to be with myself and go for a run, do some meditation or even just sit down and put on some music. These techniques work well for me to remind myself that I am still here and that I still have a choice in who I am- my mental health condition does NOT define me. I challenge you to come up with other techniques that allow you to briefly remind yourself that your condition does not define who you are. 

Q: How can you make your way in the world in light of a diagnosis?
Answered by: Chelsea 

A: Personally for me, and luckily for me; being diagnosed with Bipolar Disorder II was a blessing in disguise. For me it meant that now I could and would be properly treated and had hope now for being able to control my illness to a certain extent. I know for some people it can be a scary time, but I think that most people who are diagnosed with a mental illness might be more afraid of what lies ahead; the possible stigma from loved ones, trying and changing medications, new types of therapy treatment, and the possibility of rejection from peers.

While those things might happen, it's better to remember you must care for yourself first. You are important, and worth everything the world has to offer you. In light of a recent diagnosis, take a break to “relearn” yourself, get to know your moods and triggers better so that one day you too can find your path alongside, and not behind your mental illness. 

Q: How do I get through a quarter-life crisis?
Answered by: Jessica 

A: First of all, it’s important to acknowledge how common a quarter-life crisis is. It’s pretty normal for twenty-somethings to experience feelings of being lost, confused, empty, overwhelmed, worried or scared. Young people experience a variety of sources of stress such as relationships, employment (or lack of), and health. It’s certainly a life stage that is full of change and sometimes it is tough to keep up, or find the motivation to keep up!

In my experience, the most important thing is to take life one day at a time and take care of yourself. The twenties are a great time of self-discovery and realization that you do get to choose your path in life. If this freedom is new, it’s often overwhelming. So talk about it! Reach out to friends, family, instructors, a mental health professional, your colleagues, or a mentor. Consider a more positive outlook, such as your dead-end job helping identify what you don’t want to do for the rest of your life. Slow down! Take a semester off to work or travel. Care for your physical and mental health. Educate yourself, whether it be on your diagnosis, your career interest, a new language, or your dog's breed. Identify sources of major stress and focus your energy on making a change there. Explore! Seek our career counseling and guidance. Volunteer in different fields or taking personality surveys to help find your calling. Practice acceptance! You might not be able to juggle work, school, appointments, meetings, dating, owning a pet, yoga, volunteering, parenting/caregiving, and social media. Set smaller goals. Things will smooth out; it just takes time. The good news is, if it’s a quarter-life crisis, you still have 75% of your life to look forward to.

Q: I recently left an inpatient program after a particularly bad manic episode. While having the episode I alienated a lot of my friends and family and had to take time off my job. How do I get back to my life, now that I left the hospital and am feeling better?
Answered by: Holly 

A: As a person with bipolar disorder who has experienced a hospitalization, I know how scary and stressful the experience can be. You are not only dealing with trying to “get better” but of performing a balancing act with people in your life like friends, family, school, and jobs. After trial and error, I have come to realize your foremost priority after experiencing an episode leading to hospitalization is to take care of yourself. The first few weeks after a hospitalization are a fragile time where it is imperative to have a daily schedule where you eat and sleep regularly and pay extra close attention to following medication schedules and other self-care activities.

In terms of interacting with friends, family, and other people in your life about the hospitalization, honesty and authenticity is important. Depending on how close you are to someone your explanation could range from that you needed a break for health-related reasons to explaining in detail what led to the hospitalization. It is best in job-related situations to explain you have a chronic health condition which required you to take a break. I do not know your personal situation, but if you have lost your job due to your time of illness, you could also explain the same to future employers when they ask why you left your job. Regarding school, most professors and deans are understanding if you explain about having a chronic health condition which caused you missed assignments and tests. From my experience, most professors want you to excel in their class and you will likely be asked to do extra assignments to “make up” for missed tests and assignments. You may need documentation of your condition from your doctor, if this is the case, it is important to provide the documentation. To the friends and family who you alienated it may be helpful to invite them to dinner or coffee to calmly explain your diagnosis, what happens when you do not feel well, and what you plan on doing in the future. From my experience, a heartfelt explanation is helpful. However, if their response is not favorable you may need to give them a little “space” and try your best to take care of yourself. By taking care of yourself you are demonstrating your commitment to your recovery.

Hospitalization can be a very embarrassing and stressful situation. You may feel like a failure or that you took a step back, but that is far from the truth. It may just be a slight detour but you are still able to reach your dreams and goals. Some of the best and brightest minds the world has known have been hospitalized such as Patrick Kennedy, Kay Redfield Jamison, Passion Pit's singer Michael Angelakos, and Fall Out Boy’s Bassist Pete Wentz.

Q: How do I handle the overwhelming feeling that I’m different from those around me who are not living with a mood disorder?
Answered by: Megan 

A: Your initial diagnosis of depression or bipolar disorder can drastically change your life. Coming to terms with your new medical condition takes some time. It’s important to remove the stigmatized label immediately. Change your mindset from “I’m bipolar” to “ I have bipolar disorder”. Make sure those around you who know your diagnosis know that differentiation too. It’s also important to find positive role models who share your same condition. Whether a person in your life or a celebrity, looking to those who are living with a mood disorder and have happy, healthy and fulfilled lives can bring that little piece of hope.

Since being diagnosed with Bipolar when I was 16, I’ve fallen into the trap of “I have bipolar disorder which means I’m limited to what I can do, no one wants an unstable friend or girlfriend and I can’t continue to do the things I love.” All those thoughts separated me from those around me without a mood disorder and whom I considered “normal”. In the years that have passed, I’ve drastically changed that inner dialogue. We are not limited by what we can do per se, but we do have to go the extra mile to stay healthy. You may not be able to go out all night and miss a night of sleep, but you can do what’s important to stay healthy and be able to keep doing fun things, episode free. My closest friends, old and new, have always stuck by my side. Your true friends love and care about you, mood disorder and all. You’re better off without “fair-weather” friends anyways. You can continue to do the things you love. Go to college, pursue your dream career, and build relationships.

Maintaining your well-being can be a full-time job. From figuring out medications and diet and exercise to appointments and meditation, mood disorders take some work to keep under control. In all reality, most of these things are part of being a responsible adult anyways! We’re lucky to realize the importance of making time to sleep and how to take care of ourselves early on in adulthood. Everyone struggles with the transition to becoming a responsible adult, and with a mood disorder, you can actually have a jumpstart. With your friends learning from your example of a healthy lifestyle, being different can be a great thing.

Q: Should I tell my friends about my diagnosis?
Answered by: Emily

A: Divulging your personal life is something friends do with each other all the time. You wouldn’t think it would be so hard to tell your friends about a mental health condition or even just hey I’m really struggling do you think I should get help? We don’t want to change what our friends think of us, lose any social status and have it dismissed as no big deal when to us it is. What we can do is open up an amazing dialog and bring us closer. We often share social experience with our friends and keep our personal lives to ourselves. When we do this there is another side of us that may help others understand who are and why we do the things we do.  The class clown maybe be putting on a front hiding depression, the risk taker or our “crazy” friend may be struggling with mood shifts of bipolar. When I first told my friends I used our social life as examples and then let them in on the personal side I had been keeping to myself. All of a sudden that blow out fight or turned down invitation has more meaning to it. What’s great about telling your friends is they often see behaviors we don’t. When we open up and explain our feeling and thoughts to them we enable them to reach out to us when they see us having a bad day or starting to withdraw. When I first opened up about my battle with depression I found that I was far from the only one “on meds”. A few years later and after a bipolar diagnosis, I’m far from offended when a friend asks me if I am having bad day and feeling manic. Those first few conversations are hard but well worth it.

Q: How do you decide whether or not to have a baby if you have Bipolar Disorder? What are some of the risks involved with pregnancy specific to having a mental health condition that people who do not have Bipolar Disorder may not face?
Answered by Jenna

A: The decision to have a baby is a very personal one that must be discussed as a couple, and it becomes a little more complicated when one of the partners is living with a mental health condition. While everyone's experience is unique and each situation must be considered on an individual basis, and I cannot speak for all people who have Bipolar Disorder, I can share my personal experience of deciding whether or not to have a baby while living with Bipolar Disorder and how my illness has shaped the choices that my husband and I have made for the future of our family.

We always knew that we wanted to have children and we also knew that my Bipolar Disorder would make our experience more complicated. In an effort to maintain the stability that I have achieved over the past six years, we know that when we do decide to get pregnant it will have to be very planned and highly monitored by several doctors. Not only will we have to go to a pre-pregnancy consultation with a high-risk doctor, but we will also be meeting with several psychiatrists who specialize in taking medication while pregnant to determine whether or not I should take medication throughout my pregnancy. My husband and I will then have to weigh the pros and cons of taking medication while pregnant, which is a difficult and personal decision to make and one that requires careful consideration.

The pregnancy itself will also prove to be challenging, but this is something that all women experience (regardless if they have a mental health condition or not) because the female body changes in so many different physical and emotional ways through the surge of hormones and the development of the fetus. One challenge that will be particularly difficult for me with my Bipolar Disorder will be after the birth of our baby when I am faced with all of the postpartum hormones and the lack of sleep and routine. However, I have already discussed this with my doctor and he explained that I will be highly monitored during this postpartum period to make sure that I am doing everything that I can to take care of my health during this time. As my husband and I prepare for having a baby in the [somewhat] near future, one thing is definitely clear to me--it will be a true team effort--I will be closely supported not only be my amazing husband and family, but by my team of doctors who will play a very important role before, during and after my pregnancy in keeping me happy, healthy and stable so that I can be the best mom, wife and overall individual that I can be.

Q: What if I’m feeling better and no longer think I need/or want to take my psychiatric medications that were prescribed?
Answered by Chelsea 

A: Remember, always talk to your doctor or psychiatrist before beginning and/or stopping any medication, as some have side effects that can be permanent.

Personally for me, the reason I feel better is due to the medications I’m prescribed. Although it did take a lot of time and trial and error to finally find the right mixture of medications in my case, I kept close contact with my psychiatrist about what was working and what wasn’t, and how my moods were doing. When I’m feeling well and want to stop meds, I do remind myself that the reason I feel so much better is due to the medications I’m taking.

Many people who are diagnosed with bipolar disorder are put on numerous psychiatric medications to help with symptoms. So when symptoms may “dissolve” or feel like they no longer exist, ask yourself what worked, and again, speak with your doctor/psychiatrist to see if they have any other insight before just stopping prescribed medications on your own.

Q: I’m recently in a relationship, and was previously diagnosed with Bipolar Disorder, should I let this new significant other know my diagnosis? When and why?
Answered by Chelsea

A: Yes, you should discuss your diagnosis with them… eventually. Probably not necessary on date #1 or #2, but sooner than later would be best. I’d say by date #3 or at least #4 you should disclose your mood disorder to them, and then give them some time to think about what it means to them. Don’t pressure them to “stay or go” right off the bat, and also don’t pressure them to speak about it right away if they aren’t sure how they feel quite yet about it. Give them time, and try to be patient with them, just as you did for yourself to think about how it might affect their life with you. You do not need to openly discuss which meds you take, how often, who your doctors are, and other very personal details either—I’d say—unless you’re marrying them and that information then can be extremely helpful in the relationship. I’ve just personally found that disclosing my mood disorder with a sig other can be helpful, not only short-term but long-term especially. Some people are willing to be understandable if you’re having a rough day, so try to stay positive and honest with the person you’re dating.

From my personal experience with this, a lot of significant others will understand be thankful for your honesty; but also some may not be able to grasp the fact that they're with someone who had a mood disorder and could possibly look for an “out”. If they choose to not accept it, then I have learned to deal with that, and frankly I’ve reminded myself that in the long haul, I’m probably better off without them then in my life anyway.

Q: If you could give a young adult newly diagnosed with Bipolar Disorder one piece of advice, what would it be?
Answered by Jenna

A: The best piece of advice that I could offer a young adult who has recently been diagnosed with Bipolar Disorder would be to try to find a psychiatrist that you truly connect with--a doctor who truly listens to you, and one who you feel that you can be entirely open and honest with. While there are many important relationships in my life, as a YA living with Bipolar Disorder, one of the most important relationships that I have is with my psychiatrist. He is a wonderful doctor who I met in the hospital when I was first diagnosed at 17 years old, and I truly believe that one of the reasons that I am as stable and healthy as I am today is because we have established a deep trust and respect for one another over the course of our 14 year relationship. He has a file for me that is super thick (it could probably fill a 2 inch binder!), but in that file are notes recording some of the highest highs and lowest lows of my life. Having a doctor that you can speak honestly and openly about how you are feeling, and what side effects you may be experiencing from medication, is really important. I firmly believe that you should not just settle for any doctor, but rather, that you should find a psychiatrist who you truly connect with because you must feel comfortable with a person to really open up about what is on your mind.

Q: What do you do in social settings—can you still drink on medication?
Answered by Jenna

A: This is definitely a question that you should ask your doctor or pharmacist. Most medications will have warning labels that caution you to be careful about consuming alcohol while taking the medication. However, only once you have discussed drinking while on medication with your psychiatrist should you make an informed decision about whether or not you want to have a drink. If your psychiatrist gives you the go-ahead and you do decide to drink, I would suggest limiting the number of drinks that you have and being cautious because medication can cause our bodies to process alcohol in different ways (you may metabolize it quicker than your peers who are not taking medication so it may affect you faster). Also, sometimes certain medications can interact with alcohol in dangerous ways--leading to higher levels of alcohol in your blood, so always be careful. After discussing drinking while on medication with my doctor, and making the personal decision that when out with friends I would like to occasionally have a drink or two, I soon learned how the combination of alcohol and my medication impacts me. I have figured out what type of drinks I am able to handle (a glass of sparkling wine is my favorite!), and which ones to steer clear of (no more Raspberry Smirnoff thank you college...). OF NOTE: it is important to recognize that you CANNOT drink while taking certain antidepressants and other mood stabilizers--since it could lead to a fatal interaction. If you are taking a medication that you cannot drink on, then you can always enjoy a "mocktail" while out at the bar--there have been plenty of times when I have simply had a soda water with a lemon while out with friends.

Q: What if I'm scared to seek professional help?
Answered by Jessica

A: It's understandable to be scared or nervous to seek professional help. You might not know what to expect or not fully understand what's going to happen from here. You might be afraid of receiving bad news. If your life feels out of control or if others have talked to you about getting help, seeking professional help might end up providing some relief. The "before" is usually scarier than the actual appointment. It can be tough to open up to a complete stranger but keep in mind that mental health professionals help people for a living; there is very little you could share that they would find shocking. There are different types of professionals too, from your primary care physician, to a therapist, to a psychiatrist. Try contacting the one you would feel most comfortable with. You can also have someone you trust go with you to the appointment. Seeking professional help is a way for you to be in control and become involved with your recovery.

Q: What if I don't want to be prescribed psych meds?
Answered by Jessica 

A: The good news is not all mental health concerns and diagnoses require medication. In fact, there are many functioning and successful people who manage mental health conditions without medication. It's important to have self-awareness and be in-tune with your body and emotions, with or without medication. If you are being prescribed medications and don't want to take them, voice this opinion with your doctor! It's important to explain what's going on and why you aren't interested in taking meds. A lot of times people don't want to take medications because of adverse side effects. By discussing this, you and your doctor can explore alternative options. It's also helpful to have a good understanding of what the medication is being prescribed for. That way you can have an idea of what the effect should be if you were to take it. Keep in mind it often takes time to determine the best dosage and combination of medications before you find what works best for you. Communication is key!

Q: What are some good ways to maintain my relationships with the people close to me even when I'm in the middle of an episode?
Answered by Lucia 

A: This is something that I struggle with a lot myself because even though the best strategies are very easy to understand in theory, they're just as difficult to actually implement in practice. The stigma surrounding mental illness can make it feel difficult to feel certain about when, where and to whom you want to disclose your disorder, and depending on where your mood is, sharing may even feel like too much for even those closest to you to handle. Once an episode has subsided, making your through the aftermath may carry with it a not-small amount of shame--especially if pieces of the episode unfold in public. Finally, there still really isn't a lot of common knowledge about what it actually means to live with mental illness; I feel like more people know the colloquial meaning of bipolar disorder as it relates to a temperamental piece of office equipment than they do the difference between bipolar I and II.

For me, the barrier to 100% success in this department has some to do with the character of my episodes and some to do with the fact that it's work to live my life in a way that maximizes my well-being. I've seen my episodes dissipate over the years as I've learned how to manage them, but in the beginning, the line between staying afloat and sinking under the weight of a low mood was a very fine one. Once all the way under, psychosis would pull me even further down, and what had started off as mild anxiety would snowball into something life-threatening.

Because during these episodes I refused to let anyone know what was going on, it became necessary to act pre-emptively in the space between them. With the help of a loved one, I wrote up a list of behaviors that were psychosis indicators and sent it to a small group of people I trusted to get me the appropriate help if they noticed anything concerning. The system worked--the group helped stop my last major episode in its tracks, I was able to start building a support network in earnest, and I haven't had another one in two years.

If you have people in your life who care about you and aren't health-care professionals, it's certain that they want to help you manage your moods however they can, but may not feel like they know how to do so. Making a list of behaviors to watch out for is a good way to get people involved who know you and can advocate for your health. It also may help you, too, identify thought patterns that carry a higher risk of metastasizing if left unchecked. You can also give a loved one formal permission to speak with your psychiatrist if they notice anything off. Taking a preventive approach may seem difficult up front, but ends up making your life easier in the long run.

Whether in a preventive or diagnostic context, maintaining good communication with the people you want in your corner is crucial--"people," not “person,” because as tempting as it is to have one confidant for all of your emotions, it's really not fair to hand off everything to just one person. A friend of mine, recalling her early experience with depression in college, said that relying on only her boyfriend proved to be "way too much...you can't just call someone sobbing for two hours and expect that that's okay." It's completely understandable to rely on people you know you can trust, but handing off all your feelings to one person carries the risk of straining them to the point where they may decide they can no longer handle it and leave, which then affects you.

Being able to be okay with people who can't handle your stuff is also part of the mental-health game. There will always be people who don't understand what's going on during an episode, either because of the silence around mental illness or for some other reason entirely, and some people may just have their own stuff to deal with and can't make room for yours. None of that is a reflection on you or a barometer of your worth as a human being, nor is the other party a villain for not being able to be present. As young adults immersed in the business of being young adults, it can also be hard to remember that we're all in transition in some way, and so people may also just be entering and exiting your life because that's just the nature of things.

It can be hard to talk even to people you love about your feelings, but it's probably the best thing that you can do for your long-term health. Speaking with another friend, she made the very astute point that people who spend a lot of time with you already and care about you can generally notice when something is off; if, after a period of isolation, you come back to them and explain (in whatever detail you feel is appropriate for the relationship) what had been going on, they will generally understand. I still have a lot of trouble with this--this is the work that I referred to earlier--and what keeps me from getting down on myself about not being as open as I'd like with certain people is knowing that it's a process, that I might get down on myself but it's best for my long-term health if I get back up and try again.

If it feels hard for you to talk about the day-to-day of your mental health with those close to you, it may be a good idea to explore the possibility of joining a support group in addition to whatever other mental-health services you include in your care team. It may feel easier to open up to people with whom there is less pressure to explain the basics of your mood disorder; it definitely feels validating and helps combat the loneliness and shame that may accompany your disorder to hear people share stories that sound similar to yours. Access to a group may also free you up to talk with your close friends and family about things unrelated to your brain; valuable as it is to feel like you can share with loved ones, it's also valuable to maintain spaces where you can feel like you don't have to process your feelings all the time.

Often the things that benefit us the most in the long run are the hardest to get started, especially when we're in a space where it feels like the end of the world is imminent. It's a huge immediate relief, allowing people you trust to hold your emotions; once you feel safe with them, you can begin to do the long-term planning that will help you succeed. You deserve it!

Q: My doctor has suggested that I go on medication for my mood disorder, but I'm hesitant. I feel nervous about potential side effects--I've heard about people going on meds and having their personalities entirely changed. I also worry that people will find out and it will affect my relationships. What should I do?
Answered by Lucia

A: There are about a million different reasons why someone would be on the fence about taking medication for a mood disorder, all of them completely valid. Coming to terms with a diagnosis is difficult, especially in a world where it seems as though most of the people talking about mental health are doing it with the volume on the lowest audible setting. Depending on what your ambitions are, it may even seem more beneficial to stay silent about or deny outright a mental-health issue--if you're a an aspiring lawyer with the bar exam waiting down the road, for example (source), or someone with hopes of entering a field where 60-plus-hour workweeks are an expectation.

My first psychotic episode happened right after my first semester of freshman year. Being told as a kid that I could do anything I wanted, and then feeling my body push back on that was difficult and confusing for me, doubly so because I could see my peers starting on their own high-achieving paths. It looked to me like they were sprinting through the long-distance race we were all in with ease, and so I did the best I could to keep up--and did, sort of, though I could feel an injury coming on by my senior year. A couple years after graduation, the pain I felt but tried to mask as I tried to keep up became too much, and another, more serious episode sidelined me entirely.

It took a while before I realized that my primary issue was that I insisted on ignoring what my body needed in favor of trying what seemed to work for others. Naturally, it felt like a sign of failure to be on mood stabilizers because I was the only person I knew at the time who needed them. In reality, meds were the opposite of failure--they were the catalyst for what I can now say is a more balanced life, as I needed to first be okay with the idea that my needs are unique to me in order to build the muscle that would help carry me through to the next goal. The stigma is absolutely real, but I'd rather take the social hit and live than even consider the alternative.

Getting to know yourself will help you make sense of your mood disorder in your day-to-day life and has the added benefit of helping you articulate your needs to your primary care provider. The process by which one gains self-awareness looks different from person to person (of course); for me, it involves mindfulness meditation, journaling and exercise.

The side-effect question is a more tangible and immediate one, and unfortunately also less under your control. Our understanding of the brain and the causes of mental illness is still limited, and the way some psychiatric drugs affect the brain is still a bit uncertain--not a reassuring idea when you're already on the fence about medication for more nebulous (but no less valid!) reasons.

The long-term good news is that projects like the NIH-funded BRAIN initiative (link: http://www.braininitiative.nih.gov/index.htm) are helping us on our way to understanding the brain (and thus maybe also psychiatric meds?) better. The more immediate good news is that you DO have some of this under your control. As one party in the patient-doctor relationship, it's your responsibility to do your own research and ask questions whenever you feel uncertain about a decision your doctor wants to make. I didn't know this when I was first starting out with a psychiatrist and it made those first few months out of the psych ward especially rocky, but learning and putting it into practice made my relationships with all of my doctors much better. Not only are you paying for a service and should feel satisfied with the quality of the care you're receiving, but it makes it easier to get what you want if you show your doctor that you're interested in a collaboration and willing to put in the work on your end (namely, by asking questions). The doctor's wisdom only goes so far, and not every drug works the same for everyone. As the person undergoing treatment, if something isn't working for you, you should feel comfortable speaking up about it. You're neither the first nor the last person to feel weird about starting meds for the reasons you've outlined in your question, and if nothing else, you can trust that your doctor has heard those and countless other questions.

My experience has been that doctors are very careful with the more-serious side effects, and you can generally expect lab work to accompany certain prescriptions. The bottom line is that medication, though not always necessary, is sometimes the only thing that works for a mood disorder; sometimes symptom relief greatly outweighs the slim chance of a negative side effect. I've talked to a few friends whose journey through depression featured similar concerns--they thought they should have been smart enough to figure out how to fix themselves on their own, and they didn't want any of the negative side effects. Eventually, though, the stress of trying to manage their emotions without any kind of help, social or pharmaceutical, overwhelmed them to the point where they were desperate for anything to ease the pain. The issue ended up not being a "I'm not smart enough to fix this myself" thing but one rooted in recognizing one's unique needs. Says one of these friends about starting back on her prescription after a particularly low point, "After 3 or 4 months, I was on my way to work (a peak self-harm fantasy time, when my mind was fairly idle and I was facing a miserable day), when it dawned on me that I actually WASN'T thinking about hurting myself. I was just actually, truly thinking about nothing like a normal person....My mood was still awful and my internal monologue was still very negative. However, the fact that I didn't have to constantly resist thoughts of self harm was a big relief."

As part of your primary care team, your provider should act with your best interests in mind. If you’re asking questions and sharing your concerns and it feels like your doctor isn’t listening to you, you’re not obligated to stay! Finding a provider you trust is like entering into any other relationship with another person; sometimes it takes a long time to find someone who fits, but it’s best for your long-term health that you and your doctor feel comfortable working with each other. You have a great deal more control than you think in this situation, and if you’re working with people who have your best interests in mind, you should feel free to use their expertise to understand what’s going on with you.

Q: How should I deal with failed expectations?
Answered by Emily

A: We all have goals we have set for ourselves. Some of these are extravagant high bar we want to be President of the United States someday kind of goals. Other are basic life time milestones we feel we are expected to meet by society. Graduating high school, getting accepted to college, graduating in four years, getting hired in our career field, getting married having a family. All of these goals seem so simple that is just how life goes. When you have a mental illness achieving those goals isn’t always easy. My teachers in high school told me I could be doing better and I wasn’t applying myself enough.  The stress of life and college made it hard to keep a “full course load” and pass all of my classes. Life doesn’t always go the way its “supposed to” I had my first child and soon after became a single mother. I still kept my life goals of graduating college and getting into my career field in sight but that being increasingly difficult. What I have learned is I can not have static goals we need to learn to be flexible. I can not measure our worth by check marks on a list. Just recently after a bout of depression and two failed classes decided to withdraw from the college I was attending online. This was a huge embarrassment for myself and brought on a lot of emotions including shame. I have other failed expectations about finances and even my home environment. I have to maintain a positive outlook when setbacks happen. I try to get a new “game plan” together and reevaluate my goals and how I can achieve them. Maybe the style of learning wasn’t right for me and I need to find a new type of program. Maybe I didn’t mean to over spend but I can look a new way to track my spending maybe even find an accountability buddy. I have learned to not take me personal setbacks as failures but opportunities to try something new. Maybe right now college classes aren’t what I can attend local workshops and I can share with others what I have learned.

Q: How can I cope with feeling behind my peers?
Answered by Emily

A: It’s hard to not feel left out when you see your peers graduation and advancing in careers while you feel like your trying to just keep your emotions together. It has personally been hard for me to not become jealous and bitter towards my peers because of their achievements. What I lost sight of were my own accomplishments. I am active in my community and workplace, I am a mother and I am active in my childs life. What I had to learn was everyone's life is different and we all have our own struggles. You don’t have to be in the same place in life as everyone else as long as you are moving forward and living life it’s ok to go at your own pace. I used to stress myself out trying to compete and feel equal to my peers and after talking to a few I realized they looked up to me being a single working mother who was so committed to my community and helping other. Never again will i put myself down for being me and not being someone else.


 

Rebecca's Dream  

DBSA would like to thank Rebecca’s Dream for their support of the DBSA Young Adult podcast series and Q&A. Both are an extension of Rebecca’s Dream’s ongoing mission to promote awareness and compassion of depression and bipolar disorder as real diseases. Visit RebeccasDream.org