6 Tips for When Your Mental Health Is Going Downhill

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Living with bipolar disorder isn’t easy. Recently, I had an epic relapse, a rather serious near miss with a suicide attempt and scared the numerous people who care about me. I realized what I normally do to take care of myself is great, but things are different when I find myself in a crisis situation. So, I’ve discovered I have a totally different set of rules for crisis management, and I think they can also be a great tool for preventing crises as well.

1. Don’t change your treatment without consulting your doctor.  

Honestly, this could probably be the only rule and the end of this article. If I hadn’t quit my meds, the rest of these rules probably wouldn’t be necessary. Sometimes when you’re experiencing side effects or feel “better,” you think you don’t need to take your medication anymore. I stopped taking my best line of defense because I was feeling insecure about my weight, even though I was doing phenomenally mood-wise. I know not to quit my meds usually, but I was just so tired of feeling hopeless about my size. If you’re unhappy with your medication, talk to your doctor. That way if you do decide to go off medication, you can have a game plan in place if you become unstable.

2. Utilize your support system!

I did not utilize my support system at all during the last six weeks leading up to my attempt. I talked to my therapist about quitting my meds, so she knew, but my husband didn’t know I’d quit them until the week I started to really go downhill. I think if he’d known earlier, he could have pointed out the warning signs of my instability to me sooner. My husband is the one who encouraged me to go back on them ASAP, thankfully, but by then it was just too late for much to be done. I didn’t call my doctor when I started spiraling downhill to see what he could suggest as emergency options. I didn’t reach out to my friends for support. I just isolated myself more and more and got worse and worse.

3. Don’t shut your therapist out. 

I shut down and stopped working with my therapist for a couple weeks before my attempt. I knew something was getting to me, and I was feeling more and more down, but I couldn’t express what it was exactly. Instead of telling her that, I just put on a show and pretended everything was fine. I did try reaching out a couple of times in the days leading up to my attempt, but I denied feeling suicidal right up until I sent her my final text saying goodbye. Not such a smart idea.

4. Accept you might have to go to the hospital, and embrace it for what it is — an opportunity to get help. 

There’s no shame in getting treatment. Repeat that mantra over and over to yourself, especially if you’re having a hard time coming to terms with possibly being “labeled.” Labels aren’t always a bad thing. I’m lots of labels. Mom, Wife. Teacher. Advocate. Writer. Storyteller. Bipolar. When I first got admitted, I was angry at the world. It took a lot of patience from the nurses’ and therapists’  for me to come out of that bitter shell and start working on feeling better.

5. Recognize that treatment doesn’t end after the crisis has passed and you’re relatively stable again. 

You’re going to need aftercare. A good doctor and a therapist is going to be crucial to keeping you stable. You might even need more than just a good therapist and doctor (preferably a psychiatrist if you’ve got a serious mental illness, in my humble opinion). Using me as an example, this has been my fourth hospital stay in the last two years. I’ve made lots of progress, but I’ve finally realized that I’m not progressing enough with what I’m doing when I get out of the hospital. Now, I’ve decided to do intensive outpatient treatment, meaning I’ll be doing group therapy as well as a education group three times a week for three hours a day for six weeks, in addition to meeting with my individual counselor once a week.

6. Practice self-compassion, yet again. 

This is so important. I made a lot of mistakes. I burned some bridges with this last crisis. Thankfully those bridges were built with something stronger than wood, and I was able to extinguish the fires rather quickly, but I hate letting people down. That all being said, I’m still trying really hard to tell myself I’m good enough. Eleanor Roosevelt once said “No one can make you feel inferior without your consent,” and that includes yourself. I’m not giving myself permission to beat myself up.

I wish I had a silver bullet for dealing with bipolar disorder. I wish I could say that doing all of this is cake, and “since I can do it, you can too!” But even if one of these rules I have for myself can help one person, then I’ll have not suffered all this for naught. I’ll consider my time spent learning these rules the hard way time well spent.

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