The Process of Recovery
It is possible for people with either bipolar disorder or depression to live a happy, satisfying, and rewarding life. It is possible for families to survive, and for relationships to grow and strengthen. The process of recovery is not just a description of how "to learn to live with it." It is a process of developing the strengths and abilities to make your life what you hope it can be.
It is a developmental process. This means that things must be done in order and each accomplishment is based on the ones that proceeded it. From the foundation of first accomplishments comes later ones, and from those still later ones, in a process which continues throughout life. Recovery is not a product. It is not a something you "have" or "get." Instead it is a process. It is a way you live.
The first task of recovery lays the foundation. One of the most frequent mistakes that people make it to try to accomplish other tasks before they are successful here. The result is to get overwhelmed and more often than not get discouraged and quit. If you have more stress in your life than you can deal with it acts as a trigger to make mood disorders worse. If you try to do too much or do the wrong thing the resulting stress will make you very susceptible to a decrease in functioning level as your mood disorder begins to take over more and more of your life.
GET FROM THE BEGININNING OF THE DAY TO THE END WITHOUT DISASTER;
This is the first task of recovery and probably for most people the hardest one. It means getting to the point where you can deal successfully with the stress of everyday living. It means basically two things.
You start by learning to control what you can control. Focus on and do everything you can to lower your vulnerability to stress. People with mood disorders are extremely vulnerable to the stressful forces in their life. Decreasing that vulnerability is a substantial step towards leading a more successful life. Here are some things you can do to decrease vulnerability.
Knowledge is your greatest tool. Do not let your disorder be a scary, unpredictable thing. What you can "see it coming" you have a hope of dealing with it. When your disorder is constantly blindsiding you your life will be in ruins, with seemingly no hope for anything better. Become an expert on your disorder and how it affects you. Read, talk to experts, talk to others who have lived with what you live with-- Do whatever you have to do, but learn to "see it coming."
Medication. Mood disorders are brain disorders. They are not personal failings. They have nothing to do with you not trying hard enough. Your brain chemistry puts you at risk for disasters in living. Give yourself as close to a level playing field as you possibly can. Find a medicine that works for you. Find a doctor that you feel you can learn to trust and partner with him in an effort to find the right medication. Ask questions. Learn about side effects. Make sure your doctor knows what is going on with you. Let your doctor know what you want and work with him. If he will not work with you find another doctor-- but find another doctor! It is very rare for someone with a mood disorder to be successful in life without finding the appropriate medication for them.
Sleep. You must take care of your body and an essential part of that is to get the sleep it requires. Sleep should be a routine part of your life, not something you do when you're too tired to go on or something you do when you get a chance. Sleep should be part of the automatic routine of the day. A good rule of thumb is make sure that anything that is good for you automatically happens. Make good things habits that require as little effort or focus as you can.
Routine. You should have a predictable routine to your day that maximizes your chances to do what is good for you. Often with mood disorders your day is marked by a lot of conflict. Too often we get absorbed with doing what seems urgent to take care of and forget to do what is important. For your routine to be routine you must plan it and practice it. Practice may not make perfect, but it does make better.
Exercise. In the pressures of everyday living this is one of the things most easily forgotten. It is one of those things we know we should do, but never seem to be able to "find the time." Exercise is good for your brain. It is a natural anti-depressant. Know what your limits are. But do what you can do. Find a way to make it an automatic part of your routine. People do what they are used to doing. Get used to exercising.
Food and nutrition. Eating in a healthy way is an integral part of taking care of yourself. Some foods may actually trigger depression. Unhealthy nutrition decreases your ability to live life successfully. It makes you more vulnerable to ordinary stresses. Learn how to eat well and practice doing it.
Build connections with others. Life is what you do with others. It is not lived well in isolation. Build friendships. Learn that others will be there to give to you. Equally important learn that you have much to give. It is a two way street. In living successfully not only do others help to get us what we need, but we are also there to make sure they get what they need. If you don't know where to start go to places where people are. Go to support groups. Go to church. Go to where people go.
The points listed above give you a place to start. By making them part of your life you help to decrease your vulnerability to the stress of everyday living and help to make sure that your life can be something more than just waiting for the next wrong thing to happen.
Much of the stress of everyday living is a product of the way we think and perceive people and situations. Cognitive behavioral therapy is an efficient way of dealing with the problem we so often pose for ourselves. Find a therapist or counselor who can help you to make sense of the ways that you make sense of things. It is a critical skill to be able to know when your perceptions are a reflection of the world or a reflection of your disorder. So much of life is messed up by assuming things are true that are not or taking things personal that are not personal.
Much of the wisdom in getting from the beginning of the day to the end is summed up in the phrase "see it coming." Part of being an expert on you is being an expert on your day. Plan for stress. Plan for challenge. Plan for success, because if you don't you probably won't be.
Once you can "see it coming" you basically have 3 options:
Avoid it. If there are people or situations that are not good for you then seriously consider how necessary they are to deal with. You may need to kick some things or some people out of your life.
Escape it. No matter how well you plan you will be confronted with people or circumstances that are not good for you. Make plans on how to minimize that contact or cut it short.
Cope with it. Make a plan about how to cope successfully. Plan what your are going to say, what your are going to do, and how you are going to think about the situations in daily life that make up the fabric of your day. Make your plans practical. Adjust them when you need to. Get used to doing things that work. If you don't know what might work or just feel too stuck to move lean on other people.
Life is composed of two things: those things we have to do and those things we want to do. The things we have to do are not necessarily bad. The things we want to do are not necessarily good. Still it is important that there be some balance in your life. Stress must be balanced with satisfaction. If you see your life as being dreadful the odds are that it will not dissappoint you.
REPAIR AND REBUILD RELATIONSHIPS;
It is probably inevitable that any person trying to cope with a mood disorder will have serious problems with relationships in life. Crucial to having a good life is doing whatever needs to be done to repair and rebalance relationships with those key people in life that help us to have a life worth living.
Obviously this stage and the first stage overlap. Much of what you do in the first stage helps to build relationships with people in your life. At this stage though what we are looking at more is developing a shared perspective about what has happened and a shared commitment as to where you are going.
Everyone must be educated about why things have gone as they have. Family members or people in relationships must understand what it means to have a mood disorder and how that has played out in their loved ones life and how that disorder has affected their relationship. A large part of the poison in any relationship begins to be changed when you begin to change your ideas about what you should take personal and what you shouldn't.
It is important to understand what you can hold people accountable for. Family members should be partners in recovery and it is important that people hold each other accountable for doing what they need to do to make the process of recovery real. Having a mood disorder does not mean you have a free ticket.
Forgiveness and letting go of the past are obviously major parts of this stage. Equally important though is a commitment to the future that is made evident through what you do in the present moment. To get excited about the promise of the future you must first be convinced by the reality of the present. Relationships take time and rebuilding relationships in particular take time. Just remember it is time well worth taking.
WHO AM I AND WHAT IS LIFE ABOUT:
By the time your focus shifts to this stage you will have found out two things: daily life can be successfully lived and your relationships are an intergral part of the happiness you have in life. In this stage your focus shifts to who you are and what is the purpose or mission of your life.
Central to this stage is the question of identity. It means coming to a sense of peace with having a mood disorder. It means understanding clearly that a mood disorder is what you have and not who you are. It means dealing with issues of guilt and shame and beginning to believe that hope is more than wishful thinking.
It also means coming to believe that there is a purpose in life worth living for. It means knowing that life is not just about coping with a mood disorder. It means that you have come to believe that life is not just about you. Think about what a substantial accomplishment that is for anyone whether or not they have a mood disorder.
This is only a sketch of what it means to work through the process of recovery. In real life people deal with each of these stages on a daily basis. Nothing is ever done. Focus and emphasis change. Somethings must happen in order for others to be possible. The biggest mistake is to ever believe it is done. It is a way of life. You have never recovered. At best all any of us can hope for is to be recovering.