It is very common for people with bipolar to also have a co-occurring condition such as an anxiety disorder or ADD/ADHD. For me, it’s GAD- Generalized Anxiety Disorder. Basically, it’s like it sounds- you worry all the time, about everything. Whether you have a disorder or not, anxiety is a big part of having bipolar. When bipolar is untreated or unsuccessfully treated, the roller coaster of ups and downs in mood, difficulty functioning in our work, social, and home lives, and difficulty making decisions can cause a whole plethora of worry. When my rapid cycling was at its worst (see “On Mood Cycling” for further reading), I doubted whether I could even trust my thoughts, decisions, or judgement.
When treated, there is still anxiety associated with bipolar. What if I have a breakthrough episode? How long will I stay stable? When can I trust myself again? When do I tell a boyfriend/girlfriend that I’m bipolar? These are all questions we ask ourselves as we begin to glue our lives back together. Since I have GAD, my worries range from major issues like those to miniscule ones like, “should I have strawberries for breakfast today, or save them for tomorrow?” I’m actually serious. For those of us with anxiety disorders, even treated we are looking for strategies to living with daily fear.
So, here are some of my favorites. DBT (check out posts with the tag and category “DBT” for more info) is an excellent treatment program for dealing with anxiety. It helps you focus your mind and strategize how to keep the fear from ruling your daily life. Distraction is an important tool- think about your five senses and how you can engage one of them in something absorbing like eating spicy food, taking a hot bath, foraging outside for a bouquet of branches and flowers, or listen to soothing music. Things that engage your mind in some way are particularly helpful- crossword puzzles, movies or shows, reading, Sudoku, board games, etc. Also, physical exercise helps a lot- gardening, walking or running, mowing the lawn (my favorite-puts me in a great mood every time), or playing sports. When you’ve tried these types of distractions and still feel stuck in your head, try interaction- calling a friend or family member, going out to dinner, or chatting online. Sometimes, just talking about how you feel is enough to quell the force of the fear.
Yeah, yeah, you say- I’ve done all that. Well, don’t worry (ha), there is more. Buy a CBT-Cognitive Behavioral Therapy-workbook for anxiety and do some exercises. They have a similar one for DBT that I love-Dialectical Behavioral Therapy. Some exercises suggest writing down the absolute worst thing that could happen in each situation you are worried about, and then write out a plan for how you will cope.
Example: “I am afraid I will go on the date and be uncomfortable and shy, and they won’t like me.” Plan: “I will wear an outfit I feel particularly attractive in, do some mindfulness exercises before going in, drive myself, and arrive early so I feel in charge of the situation. If I am not having fun, I will politely excuse myself early and go home.”
Another is to write an inner dialogue with your rational self, explaining why the anxiety is blowing things out of proportion. A favorite of mine is to write down the negative worry statement and counteract each one with a positive affirming statement about yourself.
Example: “I am worried that I will go to Easter dinner and no one will want to talk to me, or I won’t be able to have fun.” Counter it with: “I am an interesting, engaging young woman/man who has plenty to talk about with my family. They love me for who I am. I will seek out people or activities that I particularly enjoy and allow myself to relax. I have had fun at many family dinners.”
Workbooks and distraction are all great, but nothing beats professional help. My therapist is an integral part of managing my anxiety, as is my psychiatrist. Ask them to help you think up strategies to deal with the fear itself, but also to help heal the behavior patterns that happen as a result of the fear, such as avoidance, antisocial behavior, irritability, and the inability to take risks, meet new people, or expand your life. Group therapy can be particularly supportive and effective. DBT does groups all over the country-I went through the whole program three times! It was life changing.
Also, make sure you have the emotional support you need, besides a therapist and doctor. Nurture your friendships and family relationships. I know it’s easy to feel like we are a burden when going through a hard time, but we are not. Our loved ones want to support us, so let them. Share with them your worries and really listen to their encouragement. Remember that they can see things from a much more accurate and rational point of view than you can through the lens of your fear. Even when you don’t feel like it, engage yourself with others. It really helps get us out of the repetitive thought cycle of anxiety.
Bottom line? We can live well while battling anxiety. Needless to say, having healthy habits also reduces the effects of anxiety- eating healthy (my rule is eat healthy 90% of the time and whatever I want the other 10%), regular exercise, socializing regularly, sleeping at least 8 hours a night, taking your meds on time, and maintaining a healthy weight. Try to keep your work, family, and life style environments as low stress as possible. Watch out for your triggers and work around them, unless it is a fear you need to face. You CAN do this! But you don’t have to do it alone. Keep reading every week for more posts about managing anxiety. Good luck to you.
Singing in the Rain 