Gabe Howard’s biggest fear is that his bipolar disorder will get worse. “I’m more worried about the symptoms of bipolar disorder coming back than I am about anything else. Literally anything else. I’ll walk through the streets after midnight in New York City and not be a bit concerned about being attacked — but I’ll be terrified of losing everything to bipolar disorder.”
Elaina J. Martin also fears getting sicker. “I worry I will get in a depression so dark I will become suicidal because it has happened before.” She, too, worries about the mania returning. “Mania is ‘crazy.’ At first it is fun, but then you get out of control.”
Karla Dougherty, a writer who’s penned over 42 books, fears her bipolar II disorder will crush her creativity, because the health of her creativity is related to the health of her mind. “You’re always afraid you’ll lose that flow, that rhythm, that pushed you in a creative direction in the first place.”
When you have bipolar disorder — or any chronic condition — it’s understandable to have anxiety about the illness’s impact. And this anxiety may come with a parade of what-ifs and worst-case scenarios.
Amy Marlow was recently diagnosed with bipolar II disorder (along with PTSD and generalized anxiety disorder). As she writes in her powerful post, “I feel like every thought begins with what if. What if I have to change my medication? What if it doesn’t work? What if I lose everything I’ve worked so hard for? What if I get sick again?”
When you have bipolar disorder — or any chronic condition — it also can feel like you take one step forward and then 10 steps back. It can feel like you’re constantly starting over. Which is incredibly frustrating and demoralizing.
After a manic or depressive episode, Martin, who pens the Psych Central blog Being Beautifully Bipolar, feels disappointed in herself, sparking sinking thoughts like: “It happened again. I thought I was better.”
And it’s downright exhausting. “Both mania and depression zap a lot of your energy and when you are over an episode, you feel washed up,” Martin said.
After experiencing an episode, Howard has felt a mix of relief and terror. “I’m relieved because it’s over and I was able to weather the storm and use the tools at my disposal to get back to ‘normal.’ But, when it is over, I have time to think about how I ‘slipped’ again. I start thinking, ‘What if I hadn’t gotten better? Was this a close call?’ The worse the episode was, the longer those feelings linger.”
When you’ve just had an episode and you feel like you’re starting over, or when you fear getting sicker, the below tips and insights may help:
Practice acceptance. According to Dougherty, the most important thing you can do is to accept that you have bipolar disorder. “Accept that you have a condition that will sometimes affect your life in negative ways. Accept that you cannot get rid of bipolar disorder the way you can get rid of the flu.” But this doesn’t mean that you can’t have a satisfying, successful and fulfilling life.
Don’t get complacent. You do have some control over whether or not you get sicker, said Howard, who hosts The Psych Central Show podcast and co-hosts A Bipolar, A Schizophrenic, and A Podcast . Which is why he stressed the importance of being constantly vigilant, and not becoming complacent.
This seems obvious. But, as Howard said, think about how many people are prescribed 10 days of medication to treat their illness, and stop taking it as soon as the pain or fever or other symptoms subside. They forget or they assume they don’t need it, because they’re feeling better.
Not being complacent means never skipping your medication or missing doctor appointments, Howard said. It means reporting all your symptoms to your doctors and paying close attention to your mood changes, he said. “In order to stay well, we must keep doing the things that made us well in the first place.”
Dougherty also noted that bipolar disorder requires a lifetime of awareness—from knowing when to get help to knowing when to discuss a medication change with your doctor. In her book Less Than Crazy: Living Fully With Bipolar II, Dougherty uses the analogy of a swimming pool. As she explained:
“Water levels and quality must be checked every day before you can safely swim. Like that swimming pool, people with bipolar disorder must check how they are feeling every day to find the right balance. More anxious than usual? Maybe you need to call your doctor. Insomnia? Maybe you need to write in a journal. Not being comfortable in your own skin? Maybe you need to call a friend. In other words, like that swimming pool, you need the tools to stay balanced—where it’s safe to swim and the weather is fine.”
Have a plan B, C and D. This is essential, according to Howard, also a writer and speaker. For instance, he worries about losing his health insurance. (And, sadly, insurance is especially tricky if you have a pre-existing condition.) Which is why he’s saved up money. In addition, Howard has doctors on call and a great support system (more on that below).
Build a support system. When she’s frustrated and anxious about her illness, Dougherty finds comfort in her strong support system: her husband, friends and dogs. Surround yourself with people who have your well-being and best interest at heart. Surround yourself with people you can talk to. This includes your friends and family, support groups and mental health practitioners.
Savor and celebrate your wellness. Martin, author of the forthcoming memoir There Comes a Light: A Memoir of Mental Illness (late spring 2018), believes that the best advice she’s gotten when worrying about another episode or hospitalization is: “It’s OK to be OK.” “I didn’t have to wait for the other shoe to drop. I could revel in being well.”
When her mind starts racing and worrying about starting over, Marlow refocuses. “I have to pick myself up. In this present moment I can focus on who I am and how far I have come — not how far I have to go. I can’t control everything but right now I can do my best to acknowledge the fear and then reconnect with some opposite truths. I am not re-living getting sick again — it feels similar but it is not the same. This is just life with mental illness. This is a bump in the road of recovery.”
When you, too, start worrying and the what-ifs pile up, remind yourself that this is a bump in the road of your recovery.
As Dougherty said, “It might feel like your world is falling apart right now but remember that you haven’t always felt this way.” And remember you always won’t. Because you will get through it — whatever the bumps, challenges and fears.