I’m pretty open about the fact that I have bipolar disorder, and can talk very comfortably about the fact that I’ve had manic episodes, what they’re like, and the after effects of them. I’ve agreed to give a talk at my work (a large, government organisation FTR) about what it’s like to experience bipolar disorder as one kind of mental illness, talk about how it has affected my job, and also give some general advice for managers about what to think about when dealing with people they have concerns about, or who do actually have a mental health disorder, as well as general advice about it for everyone.
I know broadly what I want to say, but if anyone here has anything that they’d like to add as insight or from their own experiences it’d be really helpful. I’m not looking for case studies particularly, more like dos and don’ts, advice on what to do generally, and any insights you might have had from your own experiences with mental health (yours or dealing with someone else’s). Thanks in advance everyone.
To clarify, do you want tips on dealing with people with bipolar disorder, stories on what it’s like to live with it in a professional context, both, or something else entirely?
Anything really - doesn’t just have to be about bipolar. If you have stuff you think is relevant from your own personal experiences of dealing with something, or dealing with someone else who suffers from something, that’d be good. What I’m most interested in though is any insights or advice you would give to others who have to deal with it, so for example one I will be giving in the talk is saying when considering whether you should try and help someone who is mentally ill (or if you think they are mentally ill) don’t treat it differently to what you would with a physical illness: if you find someone lying in a pool of blood do you think “I’d love to help but I’m not a trained doctor!” or do you call an ambulance? A lot of people seem unwilling to engage with people who are exhibiting strange behaviour, even when they know them, because they seem to feel then it’s their responsibility to care for that person, when it absolutely isn’t, or they don’t necessarily know what is the best course of action so don’t do anything for fear of making things worse. Engage mental health services, let the family or next of kin know something is happening, sure, but don’t refrain from acting because you don’t want to be made responsible for the person’s well being or that you could make things worse, like that’s possible!
When I was in college I finally got good treatment for my depression. It was fantastic - life was actually enjoyable! Then I realized that the depression had been masking an anxiety disorder. I was randomly breaking down crying in class for no reason at all. I was hideously embarrassed by it. I could identify some contributing factors, but I did not have control over when or where the crying spells struck. I would have stopped it and pulled myself together in a second if I could have. Fortunately it was brought under control fairly quickly, and it never got bad enough to need official accommodation.
My point is that emotions can run off and do their own thing, for no logical reason, and the person feeling them doesn’t necessarily have a choice in the matter. Most people don’t experience that severe a disconnect between reality and their emotions, in fact if it gets bad enough to interfere with life it’s usually considered a mental illness and treated as such. I’m not making excuses for drama queens, but if you’re working with someone who has mood swings that they are embarrassed about and say they can’t control, they’re probably telling the truth. It can be hard to imagine for people who have never been there (though I suspect any woman who’s dealt with bad PMS has some idea!), but it is a real medical problem and not a personality flaw or lack of self control.
Hope that’s useful for you, and good luck with the presentation!
Well, from my own (strictly personal/interpersonal, non-clinical experience):
Dealing with it in others:
Because there is a cultural stigma around mental illness, discretion and a gradual building of trust seem to work better than direct confrontation. In my experience it’s a lot easier to get to know someone as just another individual, rather than pre-assuming there’s an illness and calling them out on it. “You seem bipolar. Do you need a therapist?” probably isn’t the best way to make friends or try to help anyone because people get defensive.
Unless you’re their therapist, you’re not their therapist. You are a friend, family member, or colleague, not a mental health professional. Even the mentally ill have lives outside their illnesses, and they need normal friends just like anyone else. Relationships have value outside of crisis care and treatment of illnesses. Just like you wouldn’t necessarily want to spend all day hanging out with your doctor, it’s nice for people suffering from mental illnesses to get out of their patient roles and just be normal around other normal people.
If you choose to develop a lasting relationship (friendship or otherwise) with somebody who you know or suspect to have a mental illness, be supportive, transparent, and firm. Help them as much as you are able and willing to (but no more), tell them what you are and are not able to do, and explain why when you say no, but don’t let people step on you and/or manipulate you. This applies to dealing with anyone in general, but it’s especially important when dealing with people with significant mental or emotional issues who may react explosively or become increasingly more dependent on you. Boundaries are important and you have to enforce them, especially if the other party isn’t able to.
Don’t be scared to interact with them, but do remain aware of your involvement. Most mental illness sufferers are non-violent and non-dangerous, and very often they just want the company of somebody who will listen, give a damn, and treat them as another human being. The stigma and subtlety of mental conditions make them scary to outsiders, and that unfortunately means sufferers often become isolated. Humans are social creatures and need companionship, and that’s no less true for the mentally ill. On the other hand, as above, it is also possible to get tangled in unhealthy, dependent, or abusive relationships (with anyone, really), and if you see that coming… back off or get out. But at least judge people on an individual basis after getting to know them; don’t pre-assume anything.
Don’t give people a free pass on hurting you just because they’re mentally ill. If you find yourself in a bad situation with someone, disengage. Your own health and well-being are important too, and if somebody else is dragging you down with them and it’s more than just an isolated incident here or there, cut them off. You’re under no obligation to be their caretaker or friend if they’re not treating you the way you deserve to be treated. If they’re in danger of hurting themselves or others, call the proper authorities. And then disengage and take care of yourself.
What I wish others would understand about what it’s like:
(I’ve been alternately diagnosed as depressed, bipolar, borderline, or perfectly normal and faking it all, depending on which professional you ask)
There’s more to me than psychiatric labels. The vast majority of the time, I’m a relatively functional, productive, occasionally even normal, member of society. All I ask is that you give me a fair chance and not treat me like a freak (unless I’m acting like one at the moment). You don’t have to become my best friend, but you don’t have to act like I have the bubonic plague, either.
If, in the normal course of our friendship, you discover something about my condition that makes you uncomfortable… I understand. Believe me, you’re not the first and you won’t be the last. However, I hope you can find the compassion and courage to talk to me about it in the open, as one human being to another, instead of silently worrying about it and then disappearing from my life without saying anything further. I care and form attachments to other people, just like you or anyone else, and it hurts me unnecessarily when a friend suddenly shuns me due to a misinterpretation of my situation. It’s one thing if I have a history of behaving inappropriately around you, in which case you have every right to disengage, but otherwise, dammit, I’m not going to suddenly go all Hannibal Lecter on you. So don’t freak out. (Unless you’re exceptionally delicious.)
If you haven’t gone through similar things, please don’t try to downplay what I’m experiencing. Having gone through really bad periods and subsequent “normal” periods, I know firsthand just how bad things can get and how far out of the normal range of human experience it is. Unless you’ve been there, you have no idea what it’s like and trying to tell me that what I experienced wasn’t real just makes you an arrogant, idiotic prick. Likewise, telling me to “just get over it” is like telling me to just get over cancer. People can and do recover from both, but it takes heroic strength and support and it doesn’t happen overnight.
The only thing I would add is that people can distinguish sincere concern from nosiness. Private people have their reasons for not being an open book; the last thing they need is a pseudo-intervention from faux-worried co-workers who just want the latest gossip. If someone has abruptly adjusted their work schedules so that they can bop out of the office for the same two-hour block of time every week, don’t casually bring it up in hopes that they will spill the beans. It takes enough guts for someone to go into therapy. They shouldn’t have to come up with extra guts just to satisfy someone’s curiosity.
Having to explain my weekly afternoon absences was the toughest part of starting therapy. People would see me gathering my things to leave and want to know where I was about to go. Week after week, it was always the same “Doctor’s appointment.” I would have loved to have been able to lie, but my boss insisted that medical appointments be broadcast on the Outlook calendar for everyone to see. So I couldn’t be discrete, and nosy parkers were all over me. Eventually I got my schedule changed and people grew accustomed to me leaving early on Mondays. But for those first few weeks, I was besieged with questions about my health and wellness. But I ultimately blame my boss more than anyone else because no matter how much any of us complained, he never budged from his “open book” policy regarding that damn calendar.
People need to be aware that in many instances, mental illness is a lifelong condition that has to be managed, like diabetes. Those of us who have mental illnesses get used to this (though we don’t like it) but others may not know it or may conveniently forget it. It used to drive me nuts that my family kept wondering when I would be cured… They reasoned that it should all be getting better because I’d been in therapy. They had to see me at my worst to understand that my bipolar was real and not going to go away.
That it really is that bad, and that mental illness has its own internal logic with no reference to the real world.
I’m finally out of my last bout of depression. It was severe. There were a couple of times when I thought I might be better off going to an ER, handing over my purse and asking them to put me someplace where I couldn’t hurt myself. I had constant thoughts of death, of suicide, of self-loathing, and of despair. I honestly wanted to be dead. It would have hurt less.
Why?
Because my brain chemistry was off. That’s all. I made a series of changes both on my own and with my psychiatrist’s guidance. I stopped taking oral contraception. I switched from Prozac to Welbutrin. I got a new bite plate (stops nocturnal toothgrinding). Over the course of about six weeks, I got better.
I lucked out. This time. Some people never get relief. I may cycle through another bout at some point (I’m statistically very likely too). There is no equation that adds up the value of a person and determines if they get depression or not. It has nothing to do with how good a person is, how smart they are, how pretty they are, how competent they are, or how likeable they are. Depression, like death, is completely indiscriminate. It will take anyone.
I have a very close relative who did this. Checked herself into a hospital. I wasn’t sure if I should try to leave a message for her there to show support…or wait for her to work through everything, get the help she needed, and let her reach out to me when she was ready.
I eventually called, and was told they wouldn’t even confirm if she was there. They told me their policy is they can take messages and if anyone shows up asking, they can deliver them. So I did that.
I don’t know if she did get the message…but after a few weeks, she left the hospital. She’s has a few issues over the years, but now hold a good job with a career path, and has been fairly stable for a while. I’m happy for her, and thankful for the help she was able to get when she needed it.
-D/a
If you grind your teeth at night, the tension in your jaw overnight triggers feelings of stress and anxiety - Your physicality impacts mental/chemical balances. Or, conversely, the anxiety and stress can cause the teeth-grinding, which is just generally bad for your mouth.
Basically, preventing it is just another way of making sure your body is as relaxed as it can be, to keep from piling on top of the existing anxiety. If it’s a cause, then yay for reducing anxiety, if it’s a symptom, then yay for preventing damage.
Even if all of your coworkers seem perfectly “normal” and well-adjusted, that doesn’t make stereotypes and bad jokes ok. Don’t make hurtful statements in a professional setting, thinking you know your audience well enough to judge. You don’t.
If you think that someone is suffering from mental or emotional imbalances, don’t treat them with obvious kid gloves or over-help. Trust the person to let someone know if they want or need assistance before you do things for them or make decisions for them regarding their needs.
Patience is awesome. I have social anxiety and basically had a breakdown when I moved cities for a new job. I thought for sure I was going to be fired because I had to take a few days for treatment, but my boss treated it just like I had pneumonia for a week or something, and not like I was batshit. It’s a good way to look at it - it’s like any other illness and it sucks to have someone out sick, but please don’t think of employees with mental illness as flakes.
Giving me the chance to get my shit together and my meds adjusted has made me extremely loyal to both my boss and the company.
Thanks for the responses so far everyone, these are really good. If anyone has any more keep them coming, my talk is on the 13th so anytime up to the day before is good.
