There are many reasons why people don’t accept a diagnosis of mental illness.

I received an email the other month from someone whose spouse had psychotic experiences and was later diagnosed with bipolar disorder. However, the spouse believes they had a powerful spiritual experience.

The spouse has agreed to see a psychiatrist, and continues to see their counsellor, but won’t take medication.

I’ve been in that very position, refusing both the diagnosis and medication. Understandably. The experiences I’ve had (two, quite recently) from a science approach typically are called psychosis. I like to call it non-shared reality. Regardless how you describe them, elements of these experiences are profound for me.

I’ve always had difficulty with the ‘either/or’ perspective. Either my experience is an illness as seen through the medical model OR it’s strictly a spiritual experience as seen through alternative perspectives such as the anti-psychiatry movement or transpersonal psychology.

What I experienced was more nuanced. To cavalierly categorize it as either only alienates me from potential help.

But what to do?

In my case, I encountered a brilliant psychiatrist who helped me understand what I experienced could be both. Or, more accurately, they could exist simultaneously.

I had undergone (and continue to undergo) spiritual experiences meaningful to me. While at the same time I have a mental illness that would benefit from some medical assistance.

I’ve come to understand the diagnosis of bipolar disorder, anxiety and psychosis does not diminish the importance of these personally transformative events. Mental illness and spiritual awakening are not mutually exclusive.

This was life-changing for me. It allowed me to embrace the spiritual path I held so dearly while also accepting much needed treatment for psychiatric disorders which were, in no uncertain terms, ravaging my life and relationships.

I am of the belief, for some people, we need to blend both approaches, spiritual and medical. If either one excludes or denigrates the other, it won’t be helpful. For me, the litmus test is this: does the person have the quality of life they want? Is the approach they are using causing them more suffering or less?

I wanted to be someone who didn’t need to take medications. But I’m not that kind of person. Some people don’t need to or can manage without. For me, I needed to be open to the possibility of needing meds and not needing them. I needed my support circle to be on board with that too. Or to be honest with me about any bias they had. That built trust. Trust in the end is the best bridge to help build a life worth living.

Allowing for ‘Both’ rather than forcing an ‘Either/Or’ stance made getting better, well…better. I am able to comfortably hold both my spiritual and medical model perspectives. It’s a fine line, but that’s fine with me.

The following are resources to help those of you grappling with the ‘either/or’ situation. Whether you are supporting someone who identifies only with the spiritual, even to their detriment, or for those of you given a psychiatric diagnosis and trying to reconcile it with your profound experiences, I hope these shed some light and offer insight.

1. Visions Magazine – This edition focuses on spirituality and how it related to mental illness. Visions is an award-winning magazine that brings together many views on mental health and substance use.

https://cmha.bc.ca/wp-content/uploads/2016/07/visions_sprirituality.pdf

The following I wrote or created in partnership with others. Each describe in different ways my journey integrating both a spiritual perspective and medical model approach to help my life come into balance so I could begin to flourish.

2. Bridging Science and Spirit – a 7-minute documentary https://www.youtube.com/watch?v=sXq9B9a3sOI

3. Does God* Have A Place In Psychiatric Treatment Plans? – blog

https://www.psychologytoday.com/ca/blog/crazy-life/200910/does-god-have-place-in-psychiatric-treatment-plans

Note: I use the word ‘God’ but don’t mean it in the strictly religious sense, per say. I use it interchangeably with Love, the Divine, Universe, Spirit, Goodness, what-have-you. Please replace it with what you are most comfortable with.

4. I Went Off my Meds to be More Spiritual: Spiritual Growth and Psychiatric Medication – an oxymoron?  http://victoriamaxwell.com/i-went-off-my-meds-to-be-more-spiritual/

5. Crazy for Life – My theatrical keynote (aka one-person stage show) focusing on my struggle to reconcile the mental illness diagnosis with profound spiritual experiences. In it, I describe how medication, for me at least, needs to be part of my wellness tool box. Not the only one, but one nonetheless. View a clip from the show here (watch at 1min 25sec): https://www.youtube.com/watch?v=z-CU5DaOl74&t=7s  Also available for download purchase. http://victoriamaxwell.com/product/crazy-for-life-a-story-about-accepting-help-for-mental-illness/

Have you had spiritual experiences within your mental illness? Do you think it is one or the other? I’d love to hear from you to learn about how you made sense of it.  

© Victoria Maxwell

I do it. You do it. Even birds do it. No, not that. I’m talking about sleep.

Anyone with depression or bipolar disorder, including loved ones of those with the conditions, knows how important consistent good night sleeps are to staying well1. They cultivate equilibrium in mood, mind and heart. Sleep is important for everybody. But, doubly so for anyone with a mood disorder.

Lack of sleep (or irregular sleep patterns) can both trigger a mania or be a warning sign of one.2

With Spring, worm moons, new moons, time changes, and solar flares, along with everyday ups and downs, good nights rests have been hard to come by for me lately. Not a good thing.

When I’m hypomanic (I prefer my personal term: the “Spazzy-McGuinty”* phase) I sleep only five or six hours a night. and still I wake up all bright eyed and bushy tailed. But if that goes on for too many days (more than three) it’s a red flag. Luckily, Spazzy McGuinty usually calms down on her own accord within a couple days. *The exact origins of “Spazzy McGuinty” remains unknown. However, I do know it is a ‘special’ term of manic endearment created by my husband Gordon and I.

When dank depression hits me, I sleep too much. I easily log (not necessarily sawing logs) 10, 12 even, 13 hours of sleep each night but still awake leaden and lost. It’s awful. Sleeping too much is part of atypical depression, which ironically, isn’t atypical at all. It’s actually very common. For others, insomnia is the beast of burden when their depression descends.

So how can sleep become a balm, instead of a bomb in your life when you’re living with a mood disorder?

Commonly referred to as “sleep hygiene” (good sleep habits), below are some of my tricks for consistently getting a good nights’ rest. For the record, I never thought my sleep was all that dirty. Who knew? Okay, well maybe the occasional dream, but still…

 Tips to change your sleeping from a bomb to a balm:

 1) Go to bed and wake up approximately at the same time every night and morning. I usually turn out my lights at 9:00 or 9:30 P.M.(sometimes even 8:30 P.M.). Yes, I proudly embrace my inner grandma. I wake up around 5 or 6 A.M. 8 – 9 hours is ideal for me. I can manage on 7 hours but only for a few days. This may seem like a luxury to sleep that long. But, trust me, it’s a necessity. I also don’t have kids – so it’s actually realistic.

 2) Create a pre-sleep ritual. As is the nature of rituals, I do mine in much the same order every night. These cues tell the brain that sleep is coming and accordingly, the brain begins to wind down.

 This is my pre-sleep ritual. Around 8:00 P.M.:

I change into my jammies, take out my contacts, take off my make-up (on a good night), put on my glasses, floss then brush my teeth and take my medication (mood stabilizer and anti-depressant). Then I snuggle into bed with my hubby. I write tomorrow’s to do list, jotting down anything I need to remember or do the next day so I don’t have it in my head to prevent me from falling asleep. I read for about an hour. Then I turn out the lights around 9:30 P.M. If I’m lucky, and I usually am, Gord gently strokes my forehead or arm as I fall asleep. My hubby probably doesn’t know this but he’s the most important and best part of my sleep hygiene.

 3) Keep the room cooler than normal. We keep a window open, just a crack, even in winter.

 4) Block out as much light as possible. Even light from under a door or from a clock radio can make going to sleep more difficult.

5) Use ear plugs and/or an eye mask. Put them on before you turn out the lights or if you wake up in the early morning when you need to get back to sleep. In hotels when I travel, I turn the clock away from me so the glare doesn’t disturb me and unplug the bar fridge so it’s as quiet as possible.

 6) Make it a TV/cell phone/computer free bedroom. This is a hard one from some people. But believe me. It works wonders to not have any electronics in the room. Some say even reading in bed is a no-no. But I’ve found it relaxes me.

 7) Don’t drink caffeinated beverages (if you drink them at all) in the evening. This includes black tea, soda like Coke and energy drinks. I rarely drink soda but do drink decaf coffee, rooibus or peppermint tea. I usually have only one cup per day. If I have more, I don’t have it any later than 5:30 P.M.

8) Exercise, even if only for 10 minutes a day. I do some form of movement every day. I practice yoga, go running or walk to the mailbox. Whatever I can muster depending on the day.

Experiment with these suggestions. See if any work for you. Put them into practice and do them consistently. When you do, your mood and energy levels will become more stable. If however, you’ve been struggling with insomnia or hypersomnia for some time without relief, please see your doctor. Remember: Poor sleep can wreak havoc in the life of someone who is trying to manage a mood disorder. More importantly though, is to remember that establishing regular sleep patterns can also be a heavenly balm.

© Victoria Maxwell

1. Kahn D., Printz, D., Ross, R., Sachs, G., Treatment of Bipolar Disorder: A Guide for Patients and Families; p. 6; Postgraduate Medicine Special Report, April 2000

2. Helmer, J. Slumber Solutions (add hyperlink: https://www.bphope.com/slumber-solutions/ ), bp Mag/ bpHope.com, Winter 2011

 

Feeling powerless over symptoms often goes with the territory when you live with mental illness. At least it can for me, particularly with anxiety and depression. This isn’t just the case for those of us diagnosed but also those who love and support us. They can feel at the mercy of these debilitating conditions when they’re at their peak.

Like a ragdoll in a tug-o-war between two kids or one in the washing machine (the ragdoll, not the kids) I can feel like I’m at the whim of my symptoms: negative self-talk, extreme fatigue, racing heartbeat, racing thoughts, incessant worry, rumination, lack of focus, aches and pains, hopelessness, emptiness – and those are just the pleasant ones. Kidding.

I enjoy feeling in charge of my mental health. Most weeks I am. But not always. Not by a long shot.

So what do I do? What can you do if you feel like this?

This is a strategy I’ve set up with my husband. It’s not a miracle solution, but it can help lessen the blows of bipolar disorder, psychosis and anxiety that I live with. It can help my husband better weather them too.

Let your loved ones help you. Enlist them into your wellness journey:

My husband knows me well. He catches signs of things shifting up or down better than (and before) I can sometimes. We all have our blind spots.

He’ll see me filling the Britta jug over the top line, or I’m getting up earlier (much earlier) than usual. Or like today, he’ll catch me making a grocery list and doing laundry at 5:00 in the morning. We’ve created a code word so to speak to signal I might be hypomanic. With kindness and enthusiasm, he’ll say ‘Oh. Spazzy Maginty is visiting us today!’

Another day, I fidget a lot in my favorite chair when we eat breakfast together. Or I won’t look him in the eyes when we talk. He might gently ask me ‘How are you doing?’ or more specifically ‘How’s your anxiety?’.

A different instance, he mentions my complexion looks grey and I’m sleeping longer than usual. Or he might recognize I haven’t run in a couple weeks. He’ll smile, look at me and ask if everything’s ok, knowing that likely it’s not.

His comments aren’t criticism but instead observation. Facts that I’ve changed from my baseline of wellness. It’s meant lovingly and delivered that way. It’s information I can use to my advantage. If I take steps to care for myself, I may prevent the anxiety, depression or hypomania from blossoming further. It’s not guaranteed, but it can reduce the intensity.

I’m not to blame for my conditions, and he’s not saying I am. I am however responsible for my health and reaching out for help when I need to.

My next steps are to be on the alert. Revisit and perhaps double up on my wellness tools. I check to make sure I’ve taken my meds and taken them properly. I’ll review and adjust my sleep patterns. Ask myself if I’m putting too much on my plate and if I need to, take things off. I’ll look at my exercise and aim to do a bit more, or do any if it’s fallen off the radar. I’ll call a friend and spend some quality time with them – phone or in person, doesn’t matter to me. As the incomparable Julie Andrews sings (sort of) these are some of my favorite (‘wellness’) things.

Ideally this will result in the levelling off of my symptoms. This isn’t rocket science. But it’s amazing how if I don’t see my warning signs early enough, and make the needed adjustment, how off course I can really go. And I’ve gone off course. Really off course in recent months. Think psychosis (twice) and major anxiety. But with the help and delicate diplomacy of my husband and my own willingness to accept assistance, getting back on more stable ground is possible.

3 Step to Help Prevent Relapse of Mental Illness

Note: Do these steps with your loved ones while you’re well, not when you’re struggling with acute symptoms.

To set the stage ask yourself:

What are your cues? Be specific. Ask your friends and loved ones to chime in about the warning signs they see. Compare notes.

Who do you want to be your ‘cue companion’? How do you want your loved ones or friends to approach you? Decide who and what’s most comfortable for you. You don’t need a husband, or even someone who lives with you. Just someone who cares.

What will your next steps be when they mention something? Have a list of your most effective wellness tools that you’re willing to commit to. Then pick one and do it. Be honest and clear about what you’re willing to do when warning signs start to rear their heads. Set yourself up for success Think tiny adjustments.

Then:

  1. When warning signs arise, your ‘cue companion’ has permission to mention what they see.
  2. Review your wellness tool list (with your loved one if you like)
  3. Take action: add, adjust said tools as needed.

Sometimes I worry, even feel ashamed at times, how much focus it takes to ‘manage’ my mental illnesses; that I might be a burden with all my mental health problems. But Gord has told me when he’s asking me about them, he wants to know. It’s ok, more than ok to talk about my mental health. Go figure?!

I’ve come to realize that this little 3-step system is as much of a sanity saver for him as it is for me.

Try this out with your loved ones and let me know how it goes. Or, if you have a similar system already in place, let me know how that works for you!

© Victoria Maxwell

When mental illness hits, it can hit hard. It hits the person who has it hard and it hits the family equally hard – though in very different ways.

One of the most common questions I get after my workshops and keynotes is, ‘How can I help my loved one when they don’t think they need help to begin with?’ So common in fact I’ve written two previous posts, one on my Psychology Today Blog: How to Help Your Adult Child if They Have a Mental Illness and another on my own: Families Falling Apart. There are many reasons for not wanting help. Denial, shame, anosognosia (the inability to be aware of one’s illness – a frequent symptom of psychosis itself ). 

Regardless of the reason, as a family member or friend, it can feel powerless. I’ve been on both sides of the path. I was that ‘someone’ with bipolar disorder, anxiety and psychosis who wouldn’t accept the diagnoses for years. I am also the daughter of a mom with bipolar disorder and severe anxiety, who has accepted the diagnosis, but does little more than take medication, which unfortunately succeeds in alleviating only a few of her symptoms. Good treatment involves more than just medicine.

But there are steps you, as a loved one, can take. Here are a few to help you help your family member or friend move forward on the journey to recovery and wellness. Take what you like and leave the rest.

1. Remember the journey to accept that there IS a problem, is theirs alone. You can help prep the ground, by having discussions and listening with an open heart, by setting clear boundaries, by offering information when appropriate. You can help create an environment that increases the chances of the person reaching out for help, but you can’t do it for them.

Anyone who’s been in this position knows, it takes more than one conversation. It takes many. It’s about opening the door of possibility. It’s about voicing your concerns with compassion and clarity and without judgement. Difficult, I know – especially when the struggle has been going on, in some instances, for years. But the rewards of avoiding power struggles, directives and arguments are great. A list of resources follows at the end of this post.

At the same time, it’s about setting boundaries for your own well-being and recognizing you are not responsible for their health and happiness. If you’re a parent of an adult child, this is one that is most heart breaking to learn and understand. Letting go is tough even when the adult child is well and thriving.

2. Rebuild trust and rapport. When family members ask me how to help their loved one, the issue has frequently been going on for quite some time. During that period, entrenched power struggles usually have developed and mistrust on both sides has been established. Your adult son or daughter, brother or parent, may continue to get angry when you suggest anything. The trick is for you to NOT get angry back. Easier said than done. Tools from Dr. Xavier Amador’s LEAP (Listen Empathize Agree Partner) method (below) may guide you how to listen without creating power struggles and rebuild trust essential for healing. Dr. Lloyd Sederer’s TEDx talk offers excellent tips and encouragement.

It was important that my treatment was a shared decision-making process; that those around me, both parents and professionals, didn’t try to convince me to do something. I needed to have people empathize, understand and reflect back my experience. The more I felt respected and heard, the more open to suggestions I became because I felt like I was being empowered not attacked.

3. Evaluate whether you really are the best person to talk to your loved one right now. Be honest. If conversations almost always end with tempers flying, another person who has his/her best interests at heart and can communicate more easily is a better option – at least for now.

4. Invite your loved one to go to the doctor together to address a legitimate physical issue. The problem could be poor sleep, or frequent headaches. You might feel that they stem from a mental health issue, but tending to a physical complaint is often easier to address first.

If mistrust and tension in your relationship is high, this may not be a good option. But, it’s surprising what sometimes works. The goal is to have them be willing to see someone for a general check-up. In that appointment have a mental health check-up too.

Resources:

  • Crisis Lines:  If you need help immediately, please search this list of crisis lines and centers and contact one of them right away.
  • Download this free Mental Health Resources and Tips e-guide I created from my website. It has many of the resources listed here and others for loved ones, individuals living with mental illness and employers and staff.
  • Dr. Lloyd Sederer’s TEDx talk ‘When Mental Illness Enters the Family offers excellent tips for parents, loved ones and others when supporting someone who is struggling with mental health issues but isn’t able to see they need help. In addition to his talk, he has a widely praised book “The Family Guide to Mental Health Care: Advice on Helping Your Loved Ones
  • Dr. Mark Komrad’s video has some good points. I wouldn’t watch the first part but from 49:30 minutes he describes when, how to talk to someone, some do’s and don’ts. Some of his approach is paternalistic, but some of the tips are useful. His book “You Need Help! A Step-by-Step Plan to Convince a Loved One to Get Counseling may be a helpful read. I can’t vouch for the info as I haven’t read it yet, but it comes recommended.
  • Dr. Xavier Amador’s book “I don’t need Help, I’m Not Sick describes his well-known LEAP (listen, empathize, agree, partner) approach. This post gives a concise summary of his LEAP programThis video illustrates a role play contrasting a traditional communication method and his LEAP method: Dr. Amador focuses heavily on anosognosia (when someone lacks the ability to be aware that they are ill). He makes a point to differentiate this from denial. You can find individuals who have been trained in his method on his referrals page.
  • Practical tips for family and friends on the “Living with Mental Illness: A Guide for Family and Friends” website.

I hope these resources help. Let me know if they do. If you have ones not listed here that are especially effective, please mention them in the comment box.

If you’d like to receive more information like this, sign up for my newsletter. You’ll receive a free e-guide addressing anxiety, depression and perfectionism.

© Victoria Maxwell