Notes for Friends and Family

Dear People Around Me,

Here are some things you could take note of that will be helpful to both you and me.  If you are involved in my life, you might as well be informed.  Ignorance can be more destructive than apathy.


The disorder can be unpredictable and difficult, not just for myself but also for the people around me.You may find certain things here annoying or demanding, but please consider that am not  a "regular" person, and that we will both benefit from your understanding.

  remember

I am bipolar, not an idiot.
Remember that I was born bipolar.  This did not "happen to me", so don't grieve.  I’ve already had it before we met.
You don’t have to feel all sorry as if it’s a tragedy or something, but I will really appreciate your understanding and sensitivity .

how this involves you

Bipolars will sometimes have to depend on their loved ones in able to function normally. 




Support

Given the difficulty related with the condition, it is very important for bipolars to be surrounded by caring, supportive relationships.  The benefits of good relationships are actually more important and more effective than medical treatments,


Assistance


While it is certainly my responsibility to take care of myself, I will sometimes need the help of others because during episodes, there is the possibility that I will feel too devastated to do anything, or even too darn happy  or energetic that I can be careless.


Acceptance and understanding

During episodes, my behavior will not be very likeable [words like slob, bitch, overreacting, jerk or bad Christian may come to your mind] - just trust me that it isn't on purpose. When you don't feel like murdering me, you may feel like avoiding me because I will be too much to handle - but don't avoid me because that is the time that I need you the most.
 
When I say that, I mean I need understanding, not a list of expectations. The bottom line is that I NEED TO FEEL SAFE and not rejected.  The more you try to shape me up or attack me, the more it worsens the ongoing elevation / depression.  It would be more fruitful for you to be patient and sensitive instead of controlling or demanding.

coping with the episodes

My family, friends, doctor and I can create an action plan, which can be used if mood symptoms appear. The goal is for me to be able to function and interact normally.

These are not just for my personal benefit, but they will also help to preserve our relationship with each other, so please take note.


 

Coping with Elevation / Mania

When I am showing symptoms of elevation / mania, I should…

1. Make necessary adjustments in my medication
2. Record my mood and meds daily
3. Identify any triggering events [physical and emotional] and avoid them
4. Maintain regular daily activities
5. Reduce the amount of lost sleep
6. When severe, contact Dr. C or Dr. Z.

Other coping skills


What I should do:

• Stick to a schedule; prioritize, write things down so as not to spread myself too thinly
• Take regular breaks
• Move away when feeling overwhelmed, overstimulated or agitated
• Exercise
• Wind down after dinner time - to make sure I don't overwork or undersleep
• Sleep well. To aid sleep: Melatonin supplement in the evening; sleeping pills when going to sleep is extremely difficult.

What I should not do:

• Overload myself with activities
• Drive
• Shop or handle money
• Consume caffeine or high-sugar food or drink after 3 pm
• Listen to, watch or read media with aggressive or violent content

How others can help me when I am showing symptoms of elevation

How you can tell if I am elevated:

• I become restless and hyper
• I become busier than usual; I take up more responsibilities / projects.
• I am easily excited or angered.
• I talk excessively, loudly and rapidly, to the point that you may feel stupid in my presence or annoyed by my rambling. In my excitement, my ideas may run into each other.
• I become very aggressive and intrusive, even offensive.
• I can be angry and happy at the same time.

Know the following triggers that heighten the elevation; and keep me away from them whenever possible  [because I tend to enjoy elevations, I will not do a good job of keeping away from these things and will likely chase after them] :

• Extreme excitement; exciting new things [activities, media, projects, friendships, etc.]
• Busy-ness; excessive stress, pressure
• Someone else's aggressive or excited behavior
• Spirited confrontation, debates and argument [including "healthy" intellectual discussions]
• Noise and crowds
• Exciting or interesting data 
• Stupid, nosy or annoying people
• Words like "You can't," "You shouldn't,"  "Calm down," "Back off," "Shush" or anything of the sort

*NOTE: I am usually more elevated in the summer months or "project season", especially in the evening and late nights


More specific ways:

• As much as possible, please lessen aggressive or intrusive behavior around me when I am already aggressive and intrusive myself. At the least, it will over-excite me; at the most, I will verbally massacre you and you will regret it.
  
  That includes:
  
  - Arguing, confronting, debating  [I enjoy this, so when you give me a chance, I'll pounce. But if you are in the mood for it too, I say game on]
  - Raising your voice
  - Disturbing me when reading, working, etc. [Please wait until i am rested and calm]
  - Anything that communicates hostility [I am not afraid to call you out on it]

• I may not notice that I am elevating, because I enjoy the energy . You may point this out to me, but don't be condescending; just say it as a matter of fact. 
  Basically, don't do it the way a teacher or parent would do to a misbehaving child.  I would much prefer to be treated like a friend, not an inferior.
  
  
• DO NOT use words like "calm down," "back off," "keep quiet" or anything similar - when I am already elevated I will tend to be insulted by those. A lot of times, it just offends me and I will likely say something hurtful back at you
  
  What you can do instead:
  - Distract me or calm me down SUBTLY. Hand me a drink, give me a hug, tell a joke, walk outside with me, etc.
  - Relax yourself or lower your own voice.
  - Give me something to keep me busy - like a puzzle, a stuffed animal or a massage
  - If you want me to quiet down, give me something to keep my mouth busy - like a snack or a drink.
  
  
• Don't try to control me. It doesn't help if you try to tell me how to behave.  It will frustrate you, so don't bother.
  
• Don't call my attention or correct me in front of others. You may do that when we are alone; make sure I am calm and rested. Expect that I will be defensive and argumentative, but don't avoid the confrontation. Tell me what I need to hear but do it with wisdom and care.
  
  
• When I am already agitated, don't argue with me if you don't want things to get messy.  In case you and I get into an argument, don't stoke it [in other words, huwag ka nang pumatol]. Just be the first one to concede or apologize, because I will rarely back down.
  But DO NOT walk out on me or turn your back. Finish the discussion.
  
•  If you must disagree with me, don't attack me.
  
• In case someone else does end up arguing with me and it begins to get ugly, please get involved. But DO NOT oppose me, or tell me to calm down or back off or anything like that.
  Pacify the situation, but DON'T BREAK IT UP - insist on resolving things as much as possible right then and there. it is very important for me to resolve things with that person a.s.a.p. because I tend to feel worse as time passes. Don't pull me away to "let my head cool", because that doesn't happen. Just be there as arbiter to make sure nobody ets killed.
  
  
• There will be times when I will have to withdraw because I feel overstimulated, overexcited , agitated or stressed. When this happens, just leave me alone.
  
  
• Concerning work / ministry:
  
  - I am not supposed to overload myself with involvements or projects, but I likely will. I will feed on the stress, even if I already feel stressed-out . It would really be helpful if you could check on me to make sure that I am not overloading myself.
  - If i overload myself and say I have no choice, don't believe me.
  - FYI: I may not be able to finish certain things, for 3 reasons (1) I may be easily distracted to do something else more exciting; (2) When the mania hits high, the work I do will be messed-up and thus counterproductive (3) I may shift into depression without warning; the stress that is already there can trigger it to worsen.
  - You may encourage me to stay on track and finish what I've started. But DON'T talk down to me or insinuate that I am incompetent.
  - Don't pressure me because I will work until I crash.
  - Allow me to take breaks. Remind me if necessary, because I normally won't bother to. Breaks are important to slow my momentum and thus slow the elevation.
  - Find me a good assistant. This will ensure better focus and help prevent me from overloading myself. A good assistant can also take over in case my symptoms suddenly cause me significant impairment.
  
  
• I will likely be extremely insightful and talkative at this time, intrusively so, and maybe even intimidating. I will tend to talk quickly, loudly and passionately in long, run-on sentences. PLEASE INTERACT WITH ME; do not brush this off as "just another manic episode". If you can't catch what I am saying, please ask me to slow down or repeat myself. If you don't respond or simply stare when I talk, I might just  be louder and more aggressive until I am absolutely sure you are a thinking lifeform.
  
  
• I have at times said extremely tactless and / or hurtful things to people [or about other people], sometimes because I think it's clever or funny [and I swear, in my head, it really is]. I usually don't realize I've hurt anyone, because I'm having fun. If I do this, trust that it is not my intention to offend anyone. Please correct me about it when I am calm and rested.
  
  If you catch me doing it to somebody, please help do some damage control without attacking me or making me look like the bad guy.
  
  
• Please ask my husband before you ask favors, play pranks, plan surprises or carry out something potentially stressful, exciting or annoying.
  
  
• If I make you feel bad [and I probably will], remind yourself that it's not your fault. But don't hate me for it either.
  
  
• When mania is severe, contact Dr. C or Dr. Z.
  
  
• Because I generally feel good during these times, I tend to skip meetings with my doctors / counselors.  Ask me about the last time I've gone to visit.

Coping with Depression

When I am showing signs of depression, I should…

1. Make the necessary adjustments in my meds
2. Record my mood and meds daily
3. Identify triggers and avoid them [physical, emotional]
4. Maintain regular activities
5. Reduce the amount of lost sleep
6. When severe, call Dr. Z or Dr C.

Other coping skills

What I should do:

• Talk to someone.
• Express myself in creative ways.
• Exercise for more energy; take a walk in the sun for serotonin
• Keep busy
• Eat serotonin-rich food: chicken, turkey, seafood,walnuts, whole wheat bread / pasta, dark green leafy vegetables
• Find someone else I can cheer up or help, so I won't be so self-centered

What I should NOT do:

• Stay idle or in bed
• Listen to, watch or read media with themes of depression, doubt, death, loss, etc. or those with sad endings
• Take long mid-day naps, so sleeping at night won’t be difficult
• Keep thoughts and emotions to myself
• Be alone
  

How others can help me when I am showing symptoms of depression

How you can tell if I am depressed:

• I am not as chatty or witty as usual. My words tend to trip over each other.
• I will be  lethargic, lazy, sleepy or tired, and I will say so. I will have a glazed look in my eyes.
• I withdraw and would rather not be bothered.
• I bail out on gatherings and events, or arrive very, very late.
• I can't make decisions, not even simple ones (that's why I arrive late for things)
• I have a lot of negative meditations and observations.
  

Know the following triggers and keep me away from them:

• Rejection or disappointment from other people
• Failure or disappointment at self
• Excessive stress
• Aloneness, loneliness
• Somebody else’s anger or aggressive behavior [esp. when the depression is high to severe]

* NOTE: I am usually more depression prone in the typhoon months; I am also depression-prone in the holiday season. I am especially prone the two weeks before my time of the month, and the first few hours after waking in the morning


More specific ways:

• As much as possible, don't leave me alone. Being alone is a trigger in itself, and often leaves me spiraling down into harmful though patterns.
  
• It would be very helpful if you talked to me more when I am depressed. I will usually have a lot on my mind and I will need to unload, though I will not usually initiate conversations. I WILL NEED SOMEONE WHO WILL LISTEN intently, and for a long time, without judgment or criticism. Acknowledge my feelings as valid.
  It's alright to ask me questions, but don't pry too much.
  
• Give me a call or text a few times within the day. This is good for me even if it annoys me.
  
• Don't give advice or unsolicited opinions [unless you are my doctor or counselor], because it doesn't help. It only confuses me and worsens the depression.
  
  
• Keep your sentences simple. Don't over-explain. What you can say in a few words, don't elaborate in several paragraphs.
  
• Lower your expectations. Don't give me a list of things to do, don't tell me how to act.
  
• Please avoid aggressive or intrusive behavior, because this may cause me to worry or I may misinterpret this as anger toward me.
  
  That includes:
  - Loud, passionate speaking
  - Too many questions
  - Arguing, debating, confrontation [although I usually enjoy this, it is tiring during depression]
  - Interrupting
  
• DON'T TRY TO JOLLY ME UP. At least, not directly. Don't say things like "Why so serious?" or "Why the long face?" or "Smile ka naman".  I find that insensitive and offensive.  Don't you dare make fun of me either. If you really want to cheer me up, see below.
  
• Distract me. Invite me to do something or suggest activities. Lend me some positive videos or children's books. Bring me little gifts or snacks, or things for my rabbits. Visit me - but NO SURPRISE VISITS. Keep me occupied.
  
• I will sometimes feel the need to cry, for no reason. Just let me cry; you don't need to do anything.
  
• Since my energy is very low at this time, I will often need to withdraw, especially when there are a lot of people and noise. I will even need to take a nap, even at awkward times or places. But don't leave me alone if the depression is deep to severe.
  
• This is not the best time to point out my weaknesses or let me know about your disappointment at me. This is not the best time to follow me up, pressure me or annoy me. Don't talk to me about should'ves and could'ves. No sermons please.
  
• This is the time I NEED AFFIRMATION the most. Help me see the good things about myself and my life. I am unable to "think positive" at this time, so be the one to do it for me and claim it over my life.
  
• Please consult my husband before you ask favors, play pranks, plan surprises or make decisions that concern me . When there's bad news, give it to him; he'll decide what to do with it.
  
• Don't ignore me or take it lightly when I start talking about death. Don't stop me from talking about it, because I will just obsess about it secretly. Ask me occasionally if I thought of a new suicide plan, then make sure that the tools I need are not within my reach.
  
• In group / social settings:
  
  - I love crowds when I am elevated, but I feel overcrowded when depressed, even with just a handful of people. I'd get tired easily and need to rest. When you notice that I am getting disinterested or drowsy, help me to make an exit.
  - I feel extra insecure when depressed. I will withdraw, fidget and exhibit signs of discomfort. Try your best not to forget, ignore or overlook me. But don't draw too much attention to me either. I will also request that you don't draw attention to yourself if we are together.
  - I tend to be extra anxious when depressed. Don't put me on the spot, don't draw attention, don't volunteer me, don;t force me to do anything, don't wheedle. Don't leave me with unfamiliar people or with noisy or nosy ones.
  - Due to the low energy, it's not uncommon for me to get sleepy, or even fall asleep.  Don't take it personally.
  
• I will likely have difficulty making decisions [where to go, what to eat, what to wear], so don't bother to ask me. Feel free to give suggestions or go ahead and decide for me.
  
• Unless the depression is high to severe, don't count me out of ministry. Being involved in ministry is helpful for me at depression times because it keeps me from being centered on my own problems.
  
• The hours after waking and before bedtime are critical. Whenever possible, help me get out of bed in the morning and appreciate life. Whenever possible, make sure that I have some human [or rabbit] company when I wake so I don't retreat into myself. Give me something to look forward to in the morning, such as a TV program or a nice breakfast. If I am really unable to get up, just hand me a stuffed animal, or bring one of my rabbits to the bed.
  
  
• In moderate to severe depression, I will likely not bother to get out of bed but just wallow in sadness as long as possible. I will not even bother to take meds, exercise, eat, pray, see the doctor or anything that I need to do. I will not be inclined to help myself. I will need to depend on others to make sure I do the things I need to do.
  It's fine if you have to push me a bit, but please do it with intelligence and concern, i.e., don't be a stupid jerk. I may hate you for it, but someone has to do it.
  
• If I make you feel bad [and I probably will], remind yourself that it's not your fault.  But please don't make it mine.  Just forgive me.
  
• When the depression is severe, contact Dr. C or Dr. Z.
  

BMD and Christianity

My personal insights

I must say that being a Christian and belonging to a church has been very helpful. Without my knowing it, church and faith have provided ways for coping.

Christianity however - particularly being in ministry and leadership - place on one a certain amount of expectations. These expectations often have been for me the cause of much anxiety, discouragement and even self-loathing and shame.

For example, even years before I knew about the BMD, I have admitted that I have never known the true peace nor true joy that Christ is supposed to bring into one's life. Total "peace" and "joy" are abstracts known to me by principle, but not by experience, due to the constant anxiety and irritability that comes with Bipolar. For a long, time, this has been a source of self-condemnation, thinking of it as some deficiency of my faith or maturity.

For another, there have been times that my behavior has been tagged as inappropriate and unacceptable for a Christian and a minister. I understand the need for ethical guidelines. But what people around me need to understand is that a lot of times, my behavior has NOTHING to do with my attitude, character, intentions, faith, pride, level of maturity, spiritual fruit or whatever else. Disciplining my thoughts and emotions into proper behavior is not as easy for me as it is for everyone else.

Finding out about the BMD was, in a way, a relief for me because it made me realize that I am not a bad Christian - just a Christian with faulty wiring.
I have to say this because it's important to me: I rarely  find church as a safe haven, a place of healing or anything of that sort. It's a place where I am constantly evaluated and I feel I am often found wanting. It is for me a place where I find condemnation and control instead of assurance and rest. I do not feel safe with anyone outside of my immediate family, and I most especially feel unsafe with Christians because they often expect a certain standard of impeccable behavior that is supposedly befitting a Christan minister. Every trip to church is a cause for more anxiety for me, at times even anger and depression.

I still don't know what God expects from bipolars. But based on what I know about God, I don't think he would demand a man born mute to sing and shout, nor a man with no limbs to skip and dance; He would extend his compassion and healing first.


How you can pray for me

If you want to pray for my healing, go ahead, but I'd rather that you don't tell me about it. I know God answers prayer and He heals, but let's face it: there are some people that He doesn't heal for one reason or another. You may disagree with me in this, but I feel like this is one thing He chooses not to heal - at least, not right now. I believe [and it was confirmed by someone else] that He is not interested in healing me just yet. He likes this "abnormality" in me and plans to use it somewhere.

Don't try to cast it out - 'cause you can't. It isn't an evil spirit and it won't obey you.
Don't prematurely claim "victories". My normal moods are not "victory" or "healing"; they are just part of the cycle.
Don't tell me that I am healed, not even as a "positive confession", especially when I'm depressed. It's stupid and insensitive.
Don't try to prophesy anything that you aren't a hundred percent sure about. I already heard from God about this condition myself. It won't encourage me for you to embellish your words with "the Lord says", because I know and am sure about what the Lord said to me.

If you're going to pray for me, I believe it would be more beneficial for you to pray for my coping more than my healing. And pray for provision - because the meds and the doctor appointments cost much.
cost much.

Actually, pray for yourselves - for grace, patience and whatever - because you're the one ones who have to deal with me. Think of it this way: I am in your life because God wants YOU to learn something (hee hee). Don't think of me as the one you need to shape up; the fact that you are still mortal means you need some shaping up yourself. And maybe instead of praying out of frustration that God will change me, it will be more beneficial for you if you allowed God to change you.