Being hospitalized for my mental health has saved my life. But it’s also inspired some serious pledges to self-care. This is what I plan to do to help prevent a future crisis.
Over the years that I have been coping with bipolar disorder, I’ve made many promises to myself that have been hard to keep. Living with a chronic illness, like depression or bipolar disorder, is a constant evolving learning experience. But, honestly, when I’m coming out of a severe depressive or manic episode, there are some promises that must be kept.
I had one such episode last year when I was hospitalized for mania and lithium toxicity. Nobody can say how my levels got toxic. I was stumbling through the streets confused, with slurred speech, and barely able to find my way home.
Luckily, someone called 911, and I was taken to the emergency room, where they knew that I was suffering from too much lithium in my bloodstream. The medication that was supposed to be saving my life — by evening out my mood swings — was nearly killing me.
The doctors convinced me to check into the hospital to get my psych meds sorted out. I was unhappy about another hospital admission but so grateful that I was still alive. I had a wonderful psychiatrist who was easy to talk to and brilliant, too.
But I knew it was time to make some promises to myself.
The medications for bipolar disorder are excellent. The catch is: you have to take the pills the doctor prescribes as he prescribes them. Sometimes, I fall into a pattern where I think I can function without my pills. This gets especially intense when I’m in an episode.
If I am manic, I think I don’t need to take medications anymore. And if I’m in a depressive episode, I don’t have the energy to reach into my medication bag and count out the right dosages of each prescription — it hurts too much to even think.
Every time I stop taking my medicine, things get bad. Fast. I have come to the conclusion that I really do need these chemicals just to function like a normal person. I just feel better when I take the right doses of each medication. I have to trust my psychiatrist, that he knew what he was doing when he prescribed the medications. I know that he wouldn’t make me take something that I don’t absolutely need.
And even when I’m stable — no mood disorder symptoms present — I am tempted to go to sleep without taking my pills. I mean, I do take a lot of those tablets and capsules, and it would be so much easier just to fall asleep, right?
But after enough of these patterns of severe bipolar mood swings, I have concluded that I really do need my medications. Mental health is the best gift I can give myself, and it can only come through adherence to my psychiatrist’s recommendations.
I talk more about the importance of taking your medication here.
Another mental trap I get into is comparing myself to other people. Usually, they are friends and/or relatives who are not dealing with a mood disorder. But it’s so easy to do.
I get frustrated about all the things I missed out on because I was busy being “sick.” For example, it took me a lot longer to graduate from college. If I were kind to myself, I would accept the fact that I have some limitations — some genuine obstacles that make ordinary tasks seem extraordinary.
Comparing myself to others is the worst thing I can do to myself. People don’t usually talk about their problems at work or school, so the person you think “has it all” might be going through some stuff of their own.
In the end, I just try to do my best, given my limitations. If I need extra rest, then that’s what I need. Instead of comparing myself to others, I need to be my own best friend and treat myself with respect.
Luckily for me, I have a psychiatrist who is very accessible. If I think I am starting to hear the warning bells of bipolar mania or depression, I can reach out to him, and we will talk about making adjustments to my medications.
I used to hate reaching out to my psychiatrist. I thought I was bothering him with my “insignificant” problems. I quickly learned, however, that the little bouts of sadness can quite easily accelerate into a depressive episode. I have clear warning signs that a mood episode is on the horizon. And why hire a psychiatrist if you only go to see them when you’re completely sane?
It helps to attack the depression (or mania) before it becomes a runaway train, and I end up in the hospital. When I was making promises to myself during that first night of my hospitalization, I dedicated myself to reaching out sooner to avoid these major disruptions in my life.
When I’m not doing well, it also helps to see my therapist, even if just for emotional support. My therapist got me through one of my last bouts of depression: I saw her twice a week, and even though I cried practically the whole time, it was extremely helpful to have a place to go to where I could unload about how badly I was feeling.
Coping skills: those great techniques you learn in therapy. For so long, my coping skills were downright terrible. I could not sit with my own depression, anxiety, distress — whatever you want to call it.
Over the years, I have learned skills in intensive outpatient and partial hospital programs. Dialectical behavioral therapy (DBT) is currently a trendy way to cope with the pain of emotional distress, but you can also use cognitive behavioral therapy to do battle with your irrational thoughts.
One of my favorite aspects of DBT is the distress tolerance skills. It’s all about soothing yourself in the moment, even when you feel like everything is breaking down all around you.
For example, when I’m feeling crappy, I will treat myself to something nice: a meal at a favorite restaurant or a manicure, for example. I will also watch favorite movies and TV shows even if I have seen them so many times that I can recite the lines. Others in the community have also found DBT helpful for managing depression.
Basically, it’s about finding what works for you and using it whenever you feel yourself slipping. Coping skills can be taught, but they must be practiced in order for them to work. Doctors used to say that I had terrible coping skills, but I have really made an effort to practice these techniques more often.
And these skills could keep me out of another hospital bed.
This can be one of the hardest promises to keep when you’re in the hospital recovering from a manic or depressive episode. When everything is so fresh and raw, and you might feel deeply ashamed for ending up in the hospital.
I let myself grieve life in the real world for a few days, and then I promise myself that I’m going to develop myself as a person. And I am a person. I have interests, goals, and things that excite me. Depression can sneak in at times and really mess things up, but I can’t let it define me. And, believe me, that’s exactly what depression wants to do.
I try to read books and watch movies that have absolutely nothing to do with depression or mental illness. Sometimes, it may be helpful to see how other people relate. But when I’m in the hospital, supposedly recovering, I will do whatever I can to get life back to normal.
Being hospitalized for your mental health is sometimes necessary, and I am definitely grateful for the care I’ve received when I’ve needed to be there. But at the end of the day, the goal is to learn what I can do to help keep myself safe — and at home! It’s a journey, but holding myself accountable is the first step.
So, lastly, I promise to keep my promises.
Medically reviewed on February 27, 2023
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