I did it!

I have achieved my 1 year goal...I finished the second phase of nursing school.

I am officially an RN, BSN!!

I worked very hard. Most of my coursework was completed while working a job. I also did both (work and school) with a toddler at home! Even on vacation, I chugged away at my homework.

Not only did I graduate from the program, but I was able to achieve a CGPA of 3.59 which prepares me for entrance in a competitive masters degree program to become a psychiatric-mental health nurse practitioner (PMHNP).

I could not be more pleased with myself at this point in my life. Do you know how hard it is to maintain a job, a family life, and full-time coursework in nursing school having bipolar disorder?!?!? Extremely challenging!!

But I did it.

Only by the grace of God, I must add. All praise and honor be to Him for giving me the patience, the strength, the courage, and the ability to advance my career! I will not soon forget his grace upon me!!

Excitement brewing

First of all - good news! I found the perfect job... safer, less stressful, and fewer hours. Just what I wanted and still in the mental health field!! Yay for me!!! All those prayers were answered and the hard work paid off. It was nice to have some time with my children this summer and fall but I'm ready to get back to the grind.

I also attended my very first ever girls' trip! It was amazing! I laughed, I cried, I danced, I sang, sat in the hot tub all night... it truly was refreshing. We all made crafts before checkout time on Sunday and it truly was a very soothing environment.

Now, I have 1 week of training for the new job before I leave for vacation in Tennessee! Every year, my sister and her friends take a week long trip around this time of year to celebrate her late son's birthday (he committed suicide in 2010) and to memorialize his girlfriend (who committed suicide on his birthday - October 21 - in 2010 as well). Both families have become friends and they go on many trips together and partake in activities for suicide prevention efforts. They have a scholarship as well at the high school where they attended. And every year, we walk for suicide prevention in September. I've never been able to go on these trips because I couldn't afford to go to Cancun or Hawaii, as they usually do go out of the country or on a cruise. This year, they are travelling to Tennessee and renting a house. It will be very interesting to see how everyone gets along for an entire 9 day trip!

THEN, in mid-November, our family of 4 is taking a quick trip to the Wisconsin Dells. This will be Lydia's first time going to a water park resort and her first time in the Dells. Dugann is super excited to go - even though he won't go into the water slides or wave pool.

There is so much for me to look forward to right now. It somehow feels like an adrenaline rush. I am just hoping I don't bottom out in November and fall into a deep depression. I need to stay positive and on track with my new job!

I am SO BLESSED!

Should you tell your employer about your diagnosis?

Bipolar disorder (BPD) is just one of various mental illnesses that can affect you in the workplace. A study conducted by the Depression and Bipolar Support Alliance concluded that 88% of participants (who were diagnosed with either BPD or depression) admitted that their condition affected their ability to work." However, the law protects you if you are diagnosed with a mental illness that impairs your ability to work.

Borchard of Psychcentral states that "the World Health Organization predicts that by 2020, mental illness will be the second leading cause of disability worldwide, after heart disease [and] major mental disorders cost the nation at least $193 billion annually in lost earnings alone, according to a new study funded by the National Institute of Mental Health." According to Forbes, "[u]nder the Americans with Disabilities Act, a person with a disability is not required to disclose it unless seeking an accommodation at work." While some people may require some accommodations, most people find that they do not need them. Forbes further reports that "[a] survey conducted by the Center for Psychiatric Rehabilitation at Boston University found that 73% of 500 professionals previously diagnosed with a psychiatric illness were able to maintain full-time employment in their chosen fields, including nurses, executives, lawyers, professors and newspaper reporters." This brings up the dilemma, to tell or not to tell.

Regardless whether you disclose the BPD diagnosis to your employer or not, you are protected under the Americans with Disabilities Act. This piece of legislature is in place to guarantee that you are not discriminated against. An employer cannot fire you or lay you off because they learn of your diagnosis of a mental illness. Just as they would not penalize a person for being a diabetic, they cannot penalize you for your illness. And if they try, you can - and should - seek legal counsel.

Many blogs and websites attempt to give advice on this topic but they pretty much fail at doing so. And here's the reason: you can't advise someone (in this economic climate) to be as open as we would like to be. Being open and honest with your employer, disclosing a diagnosis of BPD, could help fight against the stigma surrounding mental illness. In fact, if you are a good worker, then this is exactly what it should do - reduce stigma. But not all employers are sympathetic or educated on the matter. Some choose to be ignorant of issues surrounding mental health, ignoring the magnitude of its effects. In these cases, opening up about your illness could create a climate of scrutiny and/or hostility in the workplace.

And it's not just your employers you have to worry about - it can be your coworkers. How much is too much to reveal to a colleague? Well, that depends. How well can they be trusted?

This is a timely topic for myself, as I am seeking employment. Rest assured, though, that my digital footprint all but alleviates this situation. The truth of the matter is, if someone wants to know about my diagnosis, they're going to find out. I've invited that risk already, by hosting this blog without using an alias. And my reason? Because I believe it's time to end the stigma against people suffering with mental illness. We need to create a culture that supports and sympathizes with those who suffer daily. We need to raise people's awareness of what we go through - to help them help us - to help them understand. Instead of sitting idly by and allowing the stigma to perpetuate, we can do something about it.

I've been diagnosed with bipolar disorder since the age of 19. I've lived and suffered through many ordeals related to my diagnosis. The path of recovery is not always straight. It is not always moving forward. Sometimes, it takes you back. But you have to keep striving for your goals. And this is what I have done. Every day that I wake up, I say to myself "how am I going to achieve my goals?" And the answer?? Hard work. Nothing in my life comes easy. And if you ask the millions of employed Americans with a diagnosis of BPD, they would tell you the same. But we do it. We push through it. We not only manage our illness, we make strides. We not only survive, we can thrive!

But how does a flower blossom if not in the light? This is why I share.

Do I tell my employers about my diagnosis? Yes and no. Each situation is different. It has come back to bite me in the ass a time or two. What you do is all up to you...

Please share in the comments what you think? Would you disclose? Should you disclose? Why or why not?

"bipolar" is not an adjective!

I hear it everywhere I go. People using the word "bipolar" to describe things like the weather, animal behaviors, cars - you name it. And I wonder, how do these people not know IT'S NOT OKAY to use this word in such a way?

Bipolar disorder affects 2.6% of the country, roughly 5.7 million Americans (National Institute of Mental Health). Bipolar disorder is a brain disorder that affects a person's ability to regulate their own emotions. It is characterized by 2 phases - the manic phase and the depressive phase.

During mania, people diagnosed with bipolar disorder tend to behave in manners that draw negative attention, which unfortunately leads to these being highly publicized. Troublesome behaviors can lead to psychosocial trauma and issues with health, relationships, and even the law.

During depression, people diagnosed with bipolar disorder are at a high risk for suicide. In fact, approximately 50% of persons with bipolar disorder were found to have a history of a suicide attempt (Dilsaver, Psychiatric Times). People with bipolar disorder are known to attempt suicide and succeed at a rate of 1 in 5 attempts (National Institute of Mental Health). The Center for Disease Control and Prevention reports that 113 people complete suicide each day, which is 1 every 13 minutes!

Bipolar disorder IS NOT an adjective. It is not a laughing matter. It is not a joke. It is not make-believe. It is a real disorder that threatens the lives of millions every day. It is a crippling disorder that prevents people from leading meaningful lives. According to the World Health Organization, bipolar disorder is the 6th leading cause of disability worldwide!

I am not bipolar. I have been diagnosed with bipolar disorder. I live with bipolar disorder. But I am not my disorder. And yes, I DO take offense when you call me "bipolar." I don't care who you are and what you mean to me, if you refer to me as "bipolar," I will think less of you and be less likely to trust your judgment.

It IS NOT OKAY to call someone "bipolar."

It is a reference people make when they are attempting to be hurtful. I cannot ignore it and I will not tolerate it because "that which you tolerate, you teach."

The use of the word "bipolar" as a mere adjective perpetuates the stigma of mental health and dilutes the seriousness of the disorder.

If you have good intentions, make it a priority to get rid of this word from your vocabulary. It's simple! Use another word, such as "unpredictable," "ever-changing," or "unsteady."

Actualizing your future: A 10-year goal

I want to challenge all of my readers to sit down with a piece of paper and a pen or pencil. We're going to write out some goals.

Let's start small

What would you like to accomplish by next week? Do you really want to tackle that pile of laundry you've been putting off folding? I know I've been there before. Weeks go by sometimes. By the time I fold it, I need to wash laundry again!

Do you want to apply for some jobs? Do you need to mow the grass? If you're in school, do you need to catch up on some reading assignments? Or maybe you want to read a novel just for leisure. Perhaps you look forward to going down to the creek to do a little fishing. Whatever your goal is for next week, write it down.

Now, let's expand on that

What would you like to accomplish by next month? Do you need to cut back on how much you spend on groceries in a month? Do you want to re-stain your deck? Do you need to finish that quilt you've been procrastinating on finishing? What is it that you desire for yourself? It could be anything. Write it down.

A bit further out

What would you like to accomplish by next year? Do you want to graduate college? Get your GED? Learn how to cook a few new meals? Learn how to play the violin? Find a new church family? Get a raise at your job? Pay off your car loan? Learn a computer programming language? Learn a foreign language? Think BIG! Write it down.

Now, were talking long-term

What would you like to accomplish in the next 5 years? Do you want to buy a house? Go on a cruise? Get married? Have a baby? Start a business? Write a book? Write it down.

TEN YEAR GOAL

Now, I want you to think really hard about what your passion is and where you want to be in 10 years. It can be as reasonable or as lofty as you want. Whatever it is, just be sure you truly want it. It can be something you've dreamed about doing since you were little. Even if you don't think you'll ever achieve it or be able to make it there, just write it down.

Okay...

First of all, congratulations! You've just done a lot of thinking and reflecting and all of that is wonderful and good!! Secondly, you're not done.

This is going to take some time, but it's very important that you do this... and I recommend that you do it yearly to re-evaluate and/or reaffirm your goals. Because seeing how much progress you've made can motivate you and seeing how challenged you've been can also motivate you or it can help you redetermine what your priorities are.

I want you to go backwards... starting with your 10 year goal... and ask yourself, what needs to happen in those 10 years to get there. Logically and reasonably, think about the steps it would take to get there. Write them down.

Once you've got those ideas jotted down, write out the things you can do TODAY to take the first step toward that goal. Is it sign up for a class at your local community college? Is it go to a networking event and meet some business professionals? Is it getting an appointment with your gynecologist and talking about your desire to add to your family? Write it down.

Lastly, no plan is complete without accounting for some of the pitfalls and setbacks. Think about all of the reasons that you haven't done these things yet. Think about all of the barriers that have kept you from making a move in the right direction. Think about your fears, what you think might happen to keep you from attaining your goals. Write them down.

And there you have it... a 10-year goal. You did it! Now all you have to do is take that first step. Baby steps. And you can get there, gradually, slowly, and maybe in 15 years instead of 10. Maybe you won't own a house in 10 years like you wanted, but that 30-year mortgage is still a possibility. Maybe you won't graduate this year, but next year is a possibility. You can do it!


What's my current 10-year goal?

10-year goal: to become a Psychiatric Mental Health Nurse Practitioner (PMHNP). I started the journey a year ago, so my expected graduation is 2026.
Barriers: finances, paying for childcare, the long commute to downtown Chicago every day, the long hours, less sleep, less time for self-care, less family time.

5-year goal: to get into a competitive program at Rush University that will be paid for, in full, by RUMC.
Barriers: a less than impressive GPA, not enough letters of recommendation.

1-year goal: to graduate with my bachelor's of science in nursing and get a job in the psychiatric department at RUMC.
Barriers: not enough experience in the field for the job requirements, commute, childcare costs, difficult coursework, academic coaches that grade harshly.

1-month goal: to get a nursing job, most preferably in the mental health/behavioral health field. To complete this difficult nursing course I'm in currently.
Barriers: not enough time to complete assignments, not getting interviews.

1-week goal: to apply to 20 jobs. And, although I can't really control it, to get at least 1 interview. To get full points on all of my assignments.
Barriers: no interviews, no job leads, lack of motivation to complete assignments thoroughly, overlooking instructions in the rubric and syllabus by mistake (like I did in my last class).

Today's goal: to complete some schoolwork and post a blog.
Barriers: I've already done them. Boom!

Failure to achieve

Regardless if you are working towards learning new coping skills, gaining an education, obtaining employment, or parenting... failing to achieve your self-professed goals can be detrimental to your emotional health.

Although it is not intentional, we all set expectations for ourselves. Many of us compare ourselves to others and want to believe we can achieve the same goals, as if we possess the same capabilities as those we compare ourselves to. This is an unhealthy behavior and a form of self-sabotage. We must learn to stop comparing ourselves to others and focus on improving upon who we were and what we did in the past.

But my past was great and I'm struggling now... why?!?!?!

This question may come to mind. Your emotions are likely situational. Even for those diagnosed with clinical depression or manic depression, your feelings of despair can be merely situational. This is not to say you were misdiagnosed, but some struggles are part of everyone's human experience. Situational emotions can be remedied quite easily. Once the distressing situation no longer exists, these emotions become positive. If they do not, you should probably seek help because it is likely you're suffering a depressive episode.

But I never seem to get anywhere, I can't achieve my goals!

I know you feel that way now. And it's a valid thought, although not reasonable. I'm prone to catastrophizing situations, too. It's easy to lose self-confidence when things don't work out the way you plan. You must remember that everyone experiences setbacks. You can overcome them, in time, but it takes patience and perseverance.

Patience does not come easy for me. In fact, I'm quite impatient. I have a love/hate relationship with life. I love that it's always new and changing, but then I hate change. I don't like having to adjust to new things - housing, job changes, new developmental milestones of Lydia's, etc. I'm only human and I want things to turn out a certain way. It's not that I must get my way all the time, but I take time to plan out my days, weeks, months, years and only to find out that there's a kink somewhere along the way and now I have to rearrange my plans.

I'd like to tell you that everything will work out the way you planned, but the truth of the matter is, they don't always work out the way you plan. In my experience, things do eventually work out, but in ways I never imagined possible. Just weeks before I found myself jobless, I made a facebook post about being a stay at home mom. Joke was on me... I didn't know that that's exactly what I'd be doing for 3 months now...

But you have to find the silver lining, the irony, the humor in life's twists and turns. You can't see every setback as a catastrophe. You need to trust the process, learn how to let go of what you can't control, and also learn to go with the flow. For me, this applies mostly to life... except my manic episodes. Those are SO HARD to let go of... mostly because of the after effects and consequences that come after the behaviors. And even though you can't always control the behaviors and outbursts, you convince yourself that you could have somehow prevented the episode. Which is probably what most of your family and friends are also telling you. But I want you to know that you are not alone in that predicament. You cannot keep badgering yourself about mistakes you have made and the outcomes that follow. You need to learn how to use those experiences as a learning tool. Learn what not to do, what to do, who to avoid, who to reach out to, what to avoid, what coping skills to utilize in certain situations and which just will not work for you in certain situations, too.

We all have our ups and downs, some more rapidly and more severe than others. We all make mistakes. We all have setbacks. And yes, I realize that sometimes they ARE catastrophes. Oh yeah, been there done that! But you are more than what you have done. You have a purpose and you will achieve your goals if you just keep fighting for what you believe in. Believe in yourself and you can never go wrong.

If you're a Christian, I'd like to remind you about:
Romans 8:28 "And we know that in all things God works for the good of those who love him, who have been called according to his purpose."
And Jeremiah 29:11 "'For I know the plans I have for you,' declares the Lord, 'plans to prosper you and not to harm you, plans to give you hope and a future.'"

I know it doesn't seem like it right now, but you CAN achieve your goals, despite any setbacks you may have.

My most common setbacks are a result of self-sabotage and a lack of self-confidence. But how does one build self-confidence? I recommend dialectical behavior therapy. Let's try it out, right now!

I choose to use the Harbinger self-help workbook titled "The Dialectical Behavior Therapy Skills Workbook" by Matthew McKay, Jeffrey Wood, and Jeffrey Brantley


Recognizing Your Self-Destructive Behaviors

I challenge you to keep track of your self-destructive behaviors and thoughts over the next week or two. If you have the workbook, I'm using the materials on page 144. Use a blank sheet of paper or a journal, whichever you prefer. On the left side of your paper, you're going to write out some questions. On the right side of your paper, will be your responses to those questions. This tool will help you identify some of the behaviors that are sabotaging your success and recovery, behaviors that are contributing to your lack of self-confidence and negative emotions.

The questions are as follows... you may want to write them down, or you may choose to just follow along with the questions in my blog and write down your answers on your paper. Whichever suits you best, do that.

Questions

When did the situation happen?
What happened?
Why do you think that situation happened? (Identify the causes)
How did that situation make you feel, both emotionally and physically? (Try to identify both the primary emotions and the secondary emotions, for example, if at first you were angry and later felt guilty)
What did you want to do as a result of how you felt? (What were your urges)
What did you do and say? (What self-destructive behaviors did you engage in as a result of how you felt)
What was the emotional reward for your self-destructive behavior? (Identify how the emotional reward was temporary)


For reference, here is a list of some possible self-destructive behaviors you might be engaging in.

Self-Destructive Behaviors

Cutting or self-mutilation
Overeating or undereating
Poor sleeping habits
Manipulation
Can you think of any others???

Keep track of these occurrences for the next week and see if you can identify a pattern that needs to be changed. You can learn to change your responses to distressing situations by reflecting on them and dissecting how to respond better next time.


Another way to challenge those distressing, self-destructive thoughts is to reduce your cognitive vulnerability. The following is a list of some trigger thoughts, write them down if you've had them. After you make the list, we're going to challenge those thoughts.

I'm an idiot/jerk/moron/________
I can't do anything right.
I'm a failure.
I'm incompetent.
No one's ever going to love me.
I'm unlovable.
There's something wrong with me.
I'm broken.
No one cares about me.
Everyone always leaves me.
People always hurt me.
I can't trust anyone.
I'm going to be alone forever.
I can't make it in life without the help of ____________
I don't deserve to be happy/successful/loved/_______________
Can you think of any others???

From the Harbinger workbook, page 147, "a trigger thought can be a powerful negative force in your life if it constantly comes to your attention and leads to distressing emotions. But remember, in addition to trigger thoughts, you can use a coping thought. Coping thoughts can be an equally powerful force if you know how to use them."

And page 149, "coping thoughts are designed to soothe your emotions when you're in a distressing situation. They are statements that remind you of your strength, your past successes, and some commonly held truths... Find a few coping thoughts [from the list below] that you consider powerful and motivating, or create your own. Then write them on a note card and keep them with you in your wallet to remind yourself of them when you're in a distressing situation. Or put them on sticky notes and post them in spots where you can see them on a regular basis, like on your refrigerator or mirror. The more often you see these soothing and self-affirming thoughts, the quicker they'll become an automatic part of your thought process."


Coping Thoughts

Mistakes happen; nobody's perfect.
This situation won't last forever.
I've already been through many other painful experiences, and I've survived.
This too shall pass.
My feelings are like a wave that comes and goes.
My feelings make me uncomfortable right now, but I can accept them.
I can be anxious and still deal with the situation.
I'm strong enough to handle what's happening to me right now.
This is an opportunity for me to learn how to cope with my fears.
I can ride this out and not let it get to me.
I can take all the time I need right now to let go and relax.
I've survived other situations like this before, and I'll survive this one, too.
My anxiety/fear/sadness won't kill me; it just doesn't feel good right now.
These are just my feelings, and eventually they'll go away.
It's okay to feel sad/anxious/afraid sometimes.
My thoughts don't control my life; I do.
I can think different thoughts if I want to.
I'm not in danger right now.
So what?
This situation sucks, but it's only temporary.
I'm strong and I can deal with this.
Can you think of any others???


It will take some practice and some time but be patient with yourself and know that you are relearning a new pattern of thinking that requires effort to overcome the negative thought patterns you may have been nurturing for years. When in doubt, if you feel like your emotions are stronger than you can handle or if you feel suicidal, seek professional help. You can always call the suicide prevention hotline.

Why shouldn't I be angry?

I read this paragraph in the book The Bipolar Relationship: How to understand, help, and love your partner (by Bloch, Golden, & Rosenfeld).

"As the healthier partner in your relationship you need to guard against coming across as judgmental, anxiety ridden, or even angry. Since emotions can be contagious, the calmer you remain, the less you will be contributing to the feelings of shame, guilt, or anxiety that may encompass an episode or hospitalization for your partner...Especially if it is not the first time your partner has required hospitalization, you need to convey this attitude even though you may experience moments of doubt."

What I want to draw attention to is this: when you express anger as a result of our episodes, it only intensifies our current emotions and causes more trouble. Although I do not like to think of myself as the less healthier partner, it is true. And because of that fact, I have expectations of my partner, too. Just as a child who has little self-control and makes poor judgment calls, relying on the help and guidance of an adult figure to make the best choices in life, so, too, do I expect my partner to come alongside me when I'm struggling and help me in a nurturing way, not a condemning tone.

I realize that my partner also may have some expectations of me. As the less healthier partner, my needs demand that these expectations not be as high as you'd have for someone who is generally well. In fact, even relatively high expectations place such a great burden on me that it causes me to GO INTO an episode. So, there's a fine line between what you can and cannot expect from me. As the healthier partner, set expectations but be careful what you do expect from someone who suffers with mental illness. What seems reasonable to you may not be reasonable, relatively speaking. The better option is to just discuss with your partner what kind of expectations they CAN live up to and be forgiving and empathetic when they cannot meet them.

In my experience, when I'm in a manic or mixed episode, I lack self-control. The rules and ideals by which I typically live are not at the forefront anymore. And it's NOT BY CHOICE.

Oh! What I would give to explain this to people!!! Stop acting like my episodes are my choice, as if it is me choosing to behave badly or make poor choices. No, that's not what's happening. What takes place during an episode is happening TO me. Most times, I find myself as a third party, as a passenger, who sees the car moving through traffic carelessly and at rapid speeds. And although, as a passenger, you want the driver to slow down or be more careful, you cannot control their actions. THIS IS WHAT IT FEELS LIKE in a manic episode.

I know people who claim that this is just an excuse for bad behavior and poor choices. Hey, listen, I have to live with the consequences regardless of the reason for my actions. But that doesn't mean that I should be crucified for unwillingly, and sometimes unknowingly, taking a back seat to my illness. And the last I checked, we're all human and everyone makes mistakes. I doubt people would like it if I randomly called out their own mistakes and humiliated them publicly and then also blamed them for the fact that there will be other consequences of their actions.

So, why shouldn't you be angry at your partner during an episode? For all these reasons and more. Your partner cannot always control their actions, despite the fact that they have to live with them. And that's the harder part - living with the actions. Feelings of guilt and shame accompany episodes, as the author above pointed out. The last thing your partner NEEDS is to be isolated even further by the one person that's supposed to have unconditional POSITIVE regard towards them.

I recommend that you save your anger and frustration for a therapy session OF YOUR OWN with your therapist. Keeping your anger from your partner is not the same as denying yourself or bottling it up. What I'm asking you to do is recognize that YOU are the healthier partner. Take the responsibility that comes with it. You knew what you were getting into when you married (hopefully), and even if you didn't, you love your partner. Every good relationship requires sacrifice and many relationships are one-sided in that respect. I'm not saying it's completely right... I'm not saying you deserve to be treated badly... and I'm NOT saying that you should expect to be treated badly.

My advice is to simply remember that you are not the one suffering from bipolar disorder. You have little insight into what it feels like and how devastating it is. With the little insight you DO have, you NEED to HELP, not intensify. Please remember that the next time you feel yourself getting angry at your partner.