ANNA: Welcome to Courage to Heal a podcast where we explore the battles we wage within ourselves. I am your host, Anna Khandrueva, a psychotherapist, and a mental health advocate. This is Season One, Episode Seven: Bipolar Disorder Type II.

Welcome to our discussion about bipolar disorder type II. If you listened to last week’s episode, we dove deep into type I and now it’s time to do the same for type II.

Unlike type I, where you only need a manic episode for the diagnosis, in type II you need both hypomania and depression. Hypomania can be seen as a less severe form of mania since their symptoms are exactly the same, but hypomania doesn’t have to cause severe impairment in functioning.

As a reminder, these symptoms include an elevated or irritable mood combined with a higher level of energy, a decreased need for sleep, a sense of self-importance or grandiosity, fast speech, flight of ideas, distractibility, impulsivity, and an increase in various activities and projects. The combination of impulsivity and an increase in activities can often result in overspending and hypersexuality or a higher sex drive, which can lead to unsafe sexual behavior.

A combination of these symptoms must be present for at least four days to be counted as hypomania. Something worth noting is that hypomania can feel good and enjoyable, especially when there is low irritability. As a result, people with bipolar type II rarely end up at the doctor’s office while hypomanic and they do not get hospitalized for hypomania. They tend to seek help during depressive episodes and can be hospitalized for depression, which often leads them to be misdiagnosed with Major Depressive Disorder.

As a matter of fact, as many as 40% of people with bipolar initially get misdiagnosed. Not every mental health professional screens for hypomania when a person shows up depressed, although they most definitely should. Bipolar type II is especially hard to diagnose because hypomania can seem simply like a good stretch when depression was in remission.

Before diagnosis, I often thought that the hypomanic me was the real me and that real me went away during depression. Little did I know that the real me was the stable, slightly boring me that I rarely got to experience before treatment.

Let’s take a look at what a person experiences during depressive episodes. These symptoms must last for at least two weeks to officially count as depression. First, you must either have depressed mood or a loss of interest or pleasure in almost all activities. One of these is required to be considered clinically depressed. In addition, you need to have four of the following signs:

Significant weight loss or gain without dieting or significant decreases or increases in appetite.
Sleeping too much or too little nearly every day.
Moving too much or too little nearly every day in a way that’s noticeable to other people, not just yourself.
Feeling fatigued and devoid of energy nearly every day.
Feeling worthless or inappropriately guilty nearly every day.
Having brain fog and indecisiveness.
And, finally, having thoughts of suicide.

These symptoms must cause noticeable distress in important areas of life, such as work or social life. I think it’s important to note that you do not necessarily have to feel sad or depressed to have a depressive episode. You could simply be numb or have what’s called “empty mood,” where you simply do not care and are unable to find pleasure in anything. This is also called anhedonia.

So, there you go. To be diagnosed with bipolar type II, you need to have at least one hypomanic episode and one depressive episode, but never mania.

Although by definition, hypomania is less severe than mania, the overall impairment and disability are similar for bipolar type I and type II. In type II, depression is much more chronic and tends to last longer. Depression typically brings a higher likelihood of chronic unemployment or underemployment, thoughts of suicide, and instances of self-harm. The number of lifetime episodes also tends to be higher for type II, and hypomania with mixed features is more common.

This latter part – mixed hypomanic episodes – deserve their own mention. A mixed episode is when a person experiences symptoms of hypomania and depression at the same time, as oxymoronic as that sounds. They can have anxious energy that causes that ‘I want to crawl out of my skin” feeling, they can swing between irritable and sad mood, they can feel fatigued instead of energized while still being unable to sleep, their racing thoughts can be depressing in nature, and their energy doesn’t necessarily end up in starting lots of projects but in that nervous, “I need to do something, but I don’t know what to do” state.

These mixed episodes tend to be slightly more common in bipolar type II and often have the highest rate of suicidality.

Another thing that’s more common in bipolar type II is rapid cycling. By definition, rapid cycling is having 4 or more episodes of any kind in one year. Some research indicates that people can cycle much more rapidly than that, with mood cycles that switch every few days. This is called ultra rapid and ultradian cycling. Rapid cycling can feel hellish because you get so few breaks in between feeling depressed and feeling hypomanic. It’s really hard to maintain stable employment and a consistent routine when you cycle rapidly.

So, what can help bipolar disorder type II? Just like with type I, medication is usually the first line of treatment, with antidepressants being frequently prescribed along with mood stabilizers because of those prolonged episodes of depression. It’s worth noting that antidepressants prescribed alone can trigger hypomanic and mixed episodes in people with bipolar, yet that’s what we often see because of that misdiagnosis issue. As always, never stop taking your medication without talking to your doctor.

Today’s guest mentions having side effects from taking medication that was not right for her, especially the side effect of akathisia. Akathisia is a state of extreme agitation and restlessness that causes a lot of distress to the person experiencing it. You can feel jittery and develop a strong need to move your legs and feet during akathisia. This side effect is quite common with bipolar medication but often goes unrecognized. This shows that it’s really important to report any changes in how you feel and act to your doctor when taking psychotropic medication. Another common side effect is weight gain, which can only add to the feelings of worthlessness already common during depression. It’s no wonder that people with bipolar can often decide to go off their meds without talking to their doctor, especially during periods of hypomania when they may feel “cured.”

Another type of treatment – also mentioned by today’s guest – is electroconvulsive therapy or ECT. While it can also be used for mania in type I, it’s more commonly used for depression, especially depression that does not seem to be helped by medication alone. ECT involves a brief electrical stimulation of the brain while the patient is under anesthesia, which causes a brief controlled seizure. It is typically administered by a team of trained medical professionals that includes a psychiatrist, an anesthesiologist, and a nurse. ECT can be extremely effective in improving depression, especially in cases with high suicidal ideation.

ECT treatment has been associated with temporary memory loss and temporary difficulty learning. Some people have trouble remembering events that occurred in the weeks before the treatment or earlier. In most cases, memory problems improve within a couple of months, but some people may experience longer lasting problems, including permanent gaps in memory.

Both medication and ECT can be extremely effective in addressing bipolar type II, but there are other, less drastic things you can do to improve your symptoms. Keeping a daily routine, exercising, engaging in mindfulness meditation and self-compassion have all been shown to be effective.

Self-compassion can be especially hard during depression. Those feelings of worthlessness and guilt get in the way of being kind to yourself. And the meaner you are to yourself, the more likely you are to feel depressed and numb. According to researcher Kristen Neff, self-compassion has three components: mindfulness, kindness, and common humanity. First, you have to notice you are being mean to yourself. Then, you have to try your best to turn harsh words into kinder ones. And lastly, it helps to think that you are not alone because suffering is a part of human condition, and many others are out there feeling exactly the way you are feeling right now.

Let’s see what self-compassion looks like in practice. Take a piece of paper and a pen right now and write down your one negative thought you have about yourself most often. It could be something like “I’m a failure” or “I’m forever broken” or “I’m all alone.” Then, write a more self-compassionate statement. “I’m a failure” could become “I’m not perfect and I’m learning to be better.” “I’m forever broken” could become “I can heal with patience” and “I’m all alone” could turn into “I may feel alone now but that won’t always be the case. I can find support with time.” All of these statements could be complimented by saying “there are others who feel this way, and they are hurting just like I am.” Sit with these self-compassionate thoughts for a moment. Let them sink in. Cry if you need to.

At first, self-compassion feels alien, clunky, and even fake. But with practice, it can become second nature. Self-compassion is not about toxic positivity, it’s about recognizing you are only human, and you are doing your best.

Another very important action to take during depression is reaching out to others. Today’s guest mentions how helpful it was for her to find support. Asking for help is hard and intimidating, yet that’s exactly what you must do if you want to feel better. And once again, this becomes easier the more you do it. Take out another piece of paper. Write down 1-3 people who can provide distraction when you are at your lowest, even if you don’t feel like you could bare your soul to them. Then, write down 1-3 people with whom you can be emotionally vulnerable and honest about going through rough times. Finally, write down 1 person to whom you can reach out if you feel suicidal and need immediate help. It’s ok if you cannot come up with people but consider that your wake-up call to start seeking support. Even if the people around you are not supportive, you can look for a virtual and in-person support groups and make connections there. There are communities on social media that provide incredible camaraderie to complete strangers. I will link a list of Instagram accounts you can follow and some virtual support groups in my show notes.

Another thing I will link is a safety plan. Suicidality in depression is a fact of life, and we cannot dance around the topic. As a matter of fact, research tells us that talking about suicide reduces the risk of someone taking their life, not increases it. A safety plan is a one-page document that lists warning signs, actions you can take, people you can contact, and numbers you can call in case you feel like you want to kill yourself. It also lists the one thing to live for. For some of us it’s our pet or family member, for others it might an opportunity to see another sunset. It’s important to give a copy of this plan to a trusted friend or family member – the one you can call when things get dark. They can help you go through the plan and help you feel like life is worth living again.

I will leave you with this one thought – when it comes to bipolar type II, you must strike while the iron is hot. What I mean by that is you need to start forming healthy habits and your support network when you are either stable or hypomanic because you know that depression could be right around the corner. It may seem pessimistic to think this way at first, but I would argue it’s realistic. It’s easier to start an exercise routine or a self-compassion practice when you already feel good about yourself. Of course, hypomania comes with its own set of problems, but it does allow you to be more productive and goal-oriented – so put that energy to good use. Choose one – and just one – area for you to work on during your next period of stability and hypomania. Commit to putting energy into it. No one is going to come and rescue you from distress – you have to be the one to help yourself first. Don’t let bipolar win.

My guest speaks eloquently on all of this in her interview. Without further ado, let’s hear her story.

ANNA: Today I am interviewing Sydney, a passionate mental health advocate who lives with bipolar type II. Welcome Sydney, and it's so very nice to have you here today.

SYDNEY: Hi Anna. Thank you for having me. And maybe you could start by telling my listeners about yeah, so my name is Sydney. I live in Washington State.

I was diagnosed with bipolar type two back in 2020. Prior to that, I was diagnosed with some other diagnoses like pre premenstrual, dysphoric disorder, depression, anxiety. But I was diagnosed bipolar type two in 2020, and I run bipolar and bougie on Instagram and TikTok where I post mental health content.

ANNA: And it's great mental health content; I will definitely make sure to link that in my show notes. I'm a huge fan of what you post and how much awareness you spread. And you said you were diagnosed in 2020, which is relatively recent. How did you find out, and did you have any suspicions before that?

SYDNEY: Prior to that, I didn't really have a suspicion that it could be bipolar disorder at all. I just knew that I wasn't stable. I was very moody, very, you know, my moods were up and down. I would go from happy to sad and dealing with a lot of depression, deep depression. I found out I had a suicide attempt July 2nd, 2020, and I went to an inpatient psych facility where I. Met with a psychiatrist and did a lot of deep diving into my medical history and family history, and they came across the diagnosis of bipolar type two as something that I might have.

So, when I was in the inpatient facility, that's what I was treated for. And when I got out of the inpatient facility, I finally met with a psychiatrist outside of the facility for the first time and that's where we started treating bipolar type two. And it started to make a lot of sense kind of putting things.

ANNA: What was it like for you to receive that diagnosis?

SYDNEY: It was definitely shocking at first when I was in the inpatient facility, it seemed like a lot of the other people were being diagnosed with bipolar type two, so I didn't really believe it at first because prior to being diagnosed with bipolar disorder, I'll admit, I was one of those people that kind of listened to the stigma about mental illness and I was like, no, there's no way I have bipolar disorder. Like that's super severe. That's not what I have. But as I started to kind of be treated for it and learn more, I started to realize that it really does make sense and it definitely… kind of depicts what I'm going through.

ANNA: Right, because with bipolar type two, you don't necessarily, of course it depends on the person, but you don't necessarily have very severe symptoms. So it could look like, you know, depression with some periods of not depression, and it can be really hard to tell looking back at what is this actually?

SYDNEY: Absolutely. Yeah. And like I said earlier, they diagnosed me with premenstrual dysphoric disorder prior because of the mood swings going from highs and lows. So, I always just kind of concluded it to being that and depression and anxiety.

ANNA: From the knowledge and wisdom that you have now, what would you tell your old self after just getting diagnosed?

SYDNEY: I think honestly, all I could really say to myself would be that it's gonna be okay and that it's not as gonna be as bad as you think it is. Yes, there's gonna be rough days and good days and bad days, but it's gonna be okay and things will get better as you start to progress into recovery.

ANNA: So, what are some of the adversities you faced, whether it was before the diagnosis or after that you can tie to bipolar?

SYDNEY: I would say probably what I kind of noticed most looking back would be the deep depression. I would go through really deep, deep episodes of depression that would last days and weeks. Or the suicidal ideation. I had that quite a bit. But I kind of just chalked it up to things that were going on in my life that were kind of influencing.

Or, you know, the constant, not constant, but the changes in my moods. I, I was very easily irritable, very easily angered very easily frustrated or overstimulated by just, you know, everything. And, you know, and bipolar type too. Depression is more chronic. We definitely have more with of it than type in, in type one.

ANNA: So, you mentioned suicidality. What else is depression like for you? What are some of the symptoms you experience?

SYDNEY: Before I was on medication or currently?

ANNA: I would say both. I would love to find out both.

SYDNEY: So, prior to being on medication, it was very, I would say it was just very dark days. Just very, a lot of crying, a lot of irritability and a lot of self-harming.

And now that I'm on medication and kind of more stable than what I have been in the past. I would say there still is some instances of self-harming. And it's a lot of just feeling kind of confused or lost about my emotions that I'm feeling or just kind of not feeling very, wanna feel very involved in things.

I kind of just kind of isolate myself from people and kind of just stick to my own little routine. I don't really go outta my way to hang out with friends or anything. I kind of just stick to myself nowadays, or it's a lot of the thing that I noticed the most is it tends to be a lot of missing work or missing activities that I have planned.

I notice that I start to get, start to miss work when I start to get into a depressive episode, and I kind of notice it after the fact. I don't really put it together when I'm in the middle of it.

ANNA: So that's interesting because you say that it's hard for you to put it together that this is depression happening to me. Could you tell me a bit more about that? Are you starting to grow more awareness of it as time goes by?

SYDNEY: I'm definitely getting more awareness as I start to learn more about myself and kind of not my habits, but kind of things that normally occur when I'm going through a depressive episode. But before, you know, leading up until this point, I really wouldn't even notice.

I would just be like, oh, I'm just depressed. And now I can kind of visualize it and see, oh, okay, I'm going through a depressive episode. This is what I need to do to take care of myself. I need to talk to these people to get help and support, and I need to do this to feel better for. It was just, I would kind of just sit in my feelings.

Go through it alone and not really reach out to people. But now as I start to pick up on the symptoms a little bit more, I start to realize that I need to do things to keep myself safe and stable. I remember personally going through two pretty lengthy medical leaves from work because I think I'm just like you in that when I'm depressed, I don't wanna work, I don't wanna do anything.

Now looking back, if I could just tell myself this is what's happening, there are things you can do about it, just try your best to get up. Try your best to talk to somebody. I really wish I could do that.

ANNA: Absolutely. I completely agree. So, the other side of bipolar type two, hypomania, what is that like for you?

SYDNEY: Oh boy, it is a lot of impulsive spending. I spend a lot of money when I'm in a hypomanic episode. I, it's almost like a search for dopamine at that point. I just need that constant flow of happiness and spending money brings me happiness, so, spending money sometimes drinking. I try not to do that only because obviously you shouldn't be really drinking with psych psychiatric meds.

But sometimes I do drink or it's just a lot of getting three hours of sleep and being energetic for a day and a half and going to the gym twice a day and doing all these things and really, Kind of poor decision making. I would say at the time it sounds like a really great idea. But after I'm kind of like, why did I do that?

Like, why did I decide that opening a spray tan business at like three in the morning and buying everything off Amazon was a really good idea, but which I still have today, which is weird. But, it was just kind of like a random thought at 3:00 AM that I wanted to do and I did it. So it's a lot of impulsive decision making and usually they're not decisions that hurt me unless it's like drinking that kind of thing.

Usually, it's kind of things that are just, they might hurt me financially, but they don't physically or mentally hurt me. I guess I could say.

ANNA: You know, I'm thinking a lot of people with bipolar, regardless of the type, even when they're stable, when they don't have depression or hypomania, they can still have cognitive impairment or some other kind of impairment. I wonder if you can relate to that at all.

SYDNEY: I relate to it. I, I don't know if it's because, cause I'm doing ECT and this could be a side effect of it, but I noticed that I'm starting to have some, like memory issues just remembering things and. Not really like important stuff. It's just random stuff, like who did I stay with when I visited Pennsylvania six years ago?

Like just random things like that. So it's not really important stuff, but I do notice that, or sometimes the decision making process is a little hindered by just the impairment and just not really making the best decisions.

ANNA: Sometimes ECT can have that effect for sure. So can bipolar. So yes. Who's to tell what it is. And you are on medication as you mentioned and sounds like it's been helpful to you. Have there been things about it that aren't as helpful? Any side effects?

SYDNEY: Yes. So, when I first was diagnosed with bipolar disorder, they put me on a medication that caused some really bad side effects. Like akathisia?

ANNA: Akathisia, yeah.

SYDNEY: Yeah, it caused that, which was pretty rough. And then we switched medications and now I think the only side effects that I get are just some fatigue and exhaustion and it makes me sleepy or I'm very sensitive to one of my medications. Fluoxetine. I'm very sensitive to any changes in it. So sometimes we try to go from like 20 milligrams to 40 milligrams and I hit hypomania, but right now I'm kind of at a happy medium at 30 milligrams. But I tend to be a little bit more sensitive to medication changes. So, I kind of have to adjust over a few days. But being on medications has definitely been very helpful in maintaining stability and kind of balancing out between hypomania stability and depression for me as well.

ANNA: I cannot imagine my life without medication currently, even though lifestyle changes have been tremendously helpful, but medication was the one thing that got me on the right path, so to speak.

SYDNEY: Yes, I completely agree. I can definitely tell if I miss medication for a few days. I can definitely tell that things start to get a little rough. So definitely sticking to it and taking it consistently is very important.

ANNA: Couldn't agree more. And you mentioned ECT as well. What led you to decide to do that?

SYDNEY: It was, I started back, I started the process of getting started on ECT back in October of 2021. I had just had another suicide attempt, and I was very, very depressed and very, very suicidal to the point where medication wasn't helping, helping therapy, wasn't helping psychiatry appointments weren't helping. And my psychiatrist was kind of like, you know, there's this thing called electroconvulsive therapy that they use for patients who have treatment-resistant depression or severe bipolar, severe suicidality.

She's like, you know, I could refer you to it if you want to give it a try. At first, I was like, that sounds super scary, you know, knowing what I, of course I Googled it. It's very scary if you Google it. And I was just kind of like, no, no, I'm, I definitely don't wanna do that. And I met with her again and we talked about it, and we decided that it would be something to at least try.

So, I met with the psychiatrist who runs the program and talked more about it, learned more about it, and realized it's really not as scary as it seems. And it's been super helpful. They do unilateral treatments, so it's just on the right side that they stimulate the seizures, and it's been really helpful.

I was going last year. I started January of 2022, and I graduated from the program in June. And I stopped completely, kind of stopped cold turkey going cause I thought I was cured. I thought it was fixed. And I ended up having another suicide attempt in August of last year. And it was after that suicide attempt that I realized I need to keep going cause it's something that's been very beneficial to me. So, I started going again and it has definitely helped minimize or almost eliminate the suicidal, suicidal ideation and depression. So it's been very, very helpful.

ANNA: I'm glad that you found that.

SYDNEY: Me too.

ANNA: Do you ever experience mixed episodes where depression and hypomania combine?

SYDNEY: Yes. And it wasn't until recently that I realized what a mixed episode was. I had no idea that that was what I was going through. Cause I would experience depression and hypomania in the same day. It, it just, to me, I thought it was my energy just wearing off or too much caffeine or. just kind of crashing at the end of the day.

But it wasn't until my psychiatrist pointed out like, Hey, there's this such thing as a mixed episode, and that's kind of what you're going through is I would have hypomania in the morning and then by the end of the day I was depressed and just very sad. And it was interesting once I realized that what a mixed episode was, because at first, I thought it was going through hypomania, just crashing at the end of the day. Just tired or fatigued, but it was more than fatigue and being tired. It was depression, so it kind of helped me put two and two together and realize what I was going through. And I find that mixed episodes can also be hard to tell from rapid cycling, which is defined as having four or more episodes in one year.

ANNA: So, for people who cycle very rapidly, it can be hard to tell is this a mixed episode or is this a very quick interchange of hypomania depression? I wonder if you can relate to that rapid cycling too.

SYDNEY: I think I can. Only because I notice. kinda looking back in the year last year, I definitely had more than, I would say, probably about five to six hypomanic episodes that lasted probably about two to three weeks each.

And then it would drop to depression probably a week after that. So, I definitely can relate to the rapid cycling, but I also feel like it's kind of hard for me to state like, this is what I'm going through. This is a hypomanic episode. Cause I feel… I kind of know the symptoms and a lot of people that are in my support system are like, no, are you sure?

Like, is that really what you're going through? Or how do you know that's what you're going through? It could just be like a normal period of time. So, it's sometimes it's hard for me to pinpoint exactly if I'm in an episode. Cause I don't wanna just jump to conclusion and be like, yeah, this is what I'm going through.

I'm going through a depressive episode and it's… I don't know. Sometimes I feel like it's hard to clear cut. Say it's hypomania depression. I can relate to that because with type one, if I'm manic, I know it. People around me know it. And when I'm hypomanic, I'm not quite too mania. It's very hard to tell.

What if I just have a lot of energy because you, it's a good day. Or something like that. And of course, noticing that there's lack of sleep and maybe the mood is too good to be true is what helps. Yeah, definitely that it's, I feel like it's a little bit more… the symptoms can kind of be hidden and you don't really notice them until after the fact.

At least I don’t for hypomania as I usually just conclude it, like, oh yeah, I'm having a great day. I have a lot of energy. Or, yeah, I did drink a lot of caffeine today. So sometimes there's some other factors that kind of hinder me being able to see exactly that it's a hypomanic episode or depression.

ANNA: You mentioned your support system and I'm curious what was it like when you first started telling people you have bipolar? What kind of reactions did you get?

SYDNEY: I definitely got a lot of shocked reactions and a lot of people that were kind of downplaying it like, oh no, you don't have bipolar disorder.

There's no way you have it. Or that's something so severe you don't have it that severe. But as I start to go through the recovery process and just maintaining stability, I start to realize that more in my support system is like, yeah, you know, it makes sense. It kind of explains why you're going through the depression and the higher days and the lower days and that kind of thing.

But it was definitely kind of hard to, it's, I mean, for any really mental illness, it's kind of hard to come out and say like, Hey, I have bipolar disorder, and not expect some sort of negative reaction or some reaction that's just kind of downplaying it. But when I first started talking about it, it was a lot of disbelief and not a lot of reassurance that, you know, things are gonna be okay.

It was a lot of, no, you don't have it. Like stop saying that you have it. You don't have it. Your psychiatrist is wrong. But you know, it also, a lot of the disbelief came from people that I believe have downplayed their own mental health. So I feel like it's kind of natural for them to kind of downplay it.

And not really acknowledge that it can be as severe as what you're talking about. It's not just me being a moody, 18 year old, being sad and depressed and going through my down days. It's me actually suffering from a chronic mental illness that affects my entire life. So, it was kind of hard to start coming out and say it, and especially to friends.

You know, friends are supportive. They love you. They, they aren't like family where your family's… you know, they're just, they're family. It, you know, friends pick each other, you pick your friends. So, my friends were definitely supportive. But some of them still were kind of like, no, I don't think you have that. Like, I, I really don't think you do.

ANNA: You mentioned not drinking as much. What are some other lifestyle changes you've had to make because of bipolar?

SYDNEY: I definitely have noticed I personally started working out a lot almost every day, so taking care of myself physically as well. Cause before that, before I was working out, I noticed that I just.

Didn't really feel good about myself. Kind of had more depressed days, and I realized that I couldn't really just rely on my medication solely to help me, that I needed to make changes in my life. So like cutting back on the drinking and working out doing like more self-care, you know, going for a walk or eating healthier or, you know, spending time with friends or just doing things that really benefit me. Cause I noticed when I start to get into those episodes, I kind of just isolate myself and I don't really want to do those things. So kind of having a routine of, essentially it's just sticking to a routine for me is I get up, I do this, this, this, and this, and then I go about my day and then I do this, that kind of thing.

ANNA: So having a routine has been really helpful with maintaining some level of stability, right? People don't often think of routines as self-care, but that's exactly what it is. Especially when you have bipolar.

SYDNEY: Exactly.

ANNA: So out of all of these lifestyle changes, medication, ECT, what would you say has been the biggest help?

SYDNEY: I think the biggest help is definitely ECT. I definitely have to accredit a lot of my recovery process to ECT. But I also think just realizing that. I don't, I don't know how to say this, but kind of to not be so hard on myself about it, cause I was very, I'm very critical of myself like most people are.

And I feel like that does nothing but only hinder the healing process and the recovery process. And I think realizing that I am really hard on myself, and I can kinda loosen up a little bit and not be so hard on myself and treat myself with kindness and self-care and take care of myself has definitely been helpful.

Cause I know you, as some people do experience, when you start to get into these episodes, you know, you stop taking care of yourself, you stop showering, you stop brushing your teeth, brushing your hair, whatever it may be. And I, I notice that I did, I do go through that when I get depressed, but, Keeping a routine has been the most helpful for me with, you know, going to ECT, seeing my psychiatrist, going to the gym and taking better care of myself, and definitely making an effort to take better care of myself even on the days that I'm going through a depressive episode is still trying to maintain that routine.

ANNA: Have you found therapy to be a helpful.

SYDNEY: Therapy is definitely helpful. I notice sometimes I don't really have a whole lot to say, so sometimes I don't feel like it's so helpful. But it's definitely helpful to have someone there that's not biased, that's not essentially your friend, you know, they're just there to listen via soundboard and offer you advice.

Sometimes it's helpful in that aspect when I really need someone to just straight up tell me like, Hey, look, you're doing this. You're hurting yourself. You need to stop doing that. You need to. You know, they don't coddle you, or at least my therapist doesn't coddle me or, you know, kind of baby me like some people might do, they might be like, oh, I'm so sorry you're going through that.

You know, they'll be very straightforward and direct with you. Like, “Hey, you know, like you're doing this, which is causing this.” Like, they're very straightforward. So, I find it helpful in that aspect.

ANNA: That makes sense. Because I do, you know, as a therapist I find that different people need different approaches and some people love, like you said, that more of a gentle, just let's figure it out together. You talk, I will listen. Whereas other people want you to be directive and want you to tell them, no, this is what you're doing. That needs to stop because you're hurting yourself and let's figure out together how to stop.

SYDNEY: Exactly. And that's definitely the approach that I need is a very direct approach and very blunt in a way, because I, yeah, I'd love to have someone tell me, oh yeah, let's figure this out. It'll be okay. Don't worry about it. You know, things will get better. But I feel like, and I know I've posted about this before, but I, I feel like some of that sometimes is toxic positivity. Just, you know, the constant like, oh, it'll be okay. Don't worry about it, but in all reality, I should worry about it because it's affecting me and it's affecting my life.

So having my therapist who's direct and blunt with me about it and it's like, Hey, you know, this is what we need to do to fix this. This is what we need to do to dig deeper. It's definitely very beneficial.

ANNA: Do you think that there are any strengths or positives to having bipolar?

SYDNEY: I feel like with having bipolar disorder, you kind of see things in a different way than what most people see things. I feel like I kind of analyze situations a little bit more. I feel like, I don't know, I'm not really sure. I feel like weakness could be, at least for me, is it tends to be a lot of missing work and not a lot of not being very reliable. So that's definitely a weakness for me.

But strength, I feel like I… I feel like I've seen some of the darkest days of my life and I was able to come back from that, and I feel like that's seeing how strong I am mentally in a way is definitely a strength that makes sense to me.

ANNA: And you're not the only one who gave that answer or a similar answer is that we do see the depths of depression and we also see the highs and not a lot of people get to experience such a range.

So, our view of others of the world can be really different. Our perceptions can be really different from people who don't have bipolar.

SYDNEY: I agree. Yeah, exactly. That's a really good way to put it. I wonder what do you wish people who don't have bipolar understood better about those of us who do?

Personally for me, I work in healthcare and I find that it's still kind of hard to talk about it with, you know, my coworkers, that kind of thing, and I just wish that people, I guess, personally, yeah. With working in healthcare, I'm definitely an overachiever as an employee, like I'm the type of person that will be like, yes, I'll do this.

I'll take on this task, I'll do this. I'll volunteer for that. I'll train that person. I'll teach this person, I'll learn with this person, that kind of thing. But I wish that the days when I hit depression and I start to kind of recoil back and just kind of. Miss work and start to not really be very reliable and just kind of be a little bit distant.

I wish that they would be a little bit more understanding and realize that it's not laziness or just not wanting to be there. It's going through a chronic mental illness situation, and I feel like it's really hard to talk about with people, especially in healthcare, because I feel like even healthcare, a lot of people have very, very weird interpretations of bipolar disorder, and they view it negatively. with, you know, with the stigma that's just kind of there. So, it's not like I can really go out and just say like, Hey, yeah, I'm going through a bipolar episode, a depression episode, and you know, I'm sorry that I'm missing work.

And it's hard cause I know at my last job I had a coworker that would always get mad at me every single time that I missed work. And I just really wish that I could have just like sat her down and been like, Hey, this is what I'm going through. This is why I'm missing work. There's always the worry that they don't understand or that I'll make them look at you in a different way that's not beneficial to the situation, or that they'll just see it as being an excuse.

And I feel like a lot of people do find that. people. I mean, yeah, there's, I'm sure there's people out there that use it as an excuse. I'm sure that happens, whatever. But I feel like a lot of people kind of see it as just being an excuse to miss work or just being an excuse to not wanna do things or to not be as proactive or like active as what you were when you're in a good episode.

So, I wish people would understand that more. It's just... It's hard for me to go through it, but it's harder with people judging me and making me feel like I'm just doing it to be lazy or that I'm just making up these excuses to miss stuff and not do things correctly.

ANNA: Right. It's so interesting to me because what you're mentioning now sounds like you'd like a bit more compassion and understanding from people. And then earlier you said it also helps to be gentle with yourself. So, there it's self-compassion. So I'm noticing this theme of compassion in general, whether it's coming from yourself or from other people, can be really helpful with this disorder.

SYDNEY: I definitely agree. Yeah, because definitely having self-compassion, you know, that's a huge one. But just, yeah, I just wish there was more compassion from people and I wish that I didn't really have to go into the deep story of my life for them to understand it. Cause sometimes you have to, sometimes people don't understand it right away, but just having more compassion for people that are going through mental illness and kind of, I, I saw this quote the other day that it was like, seek to understand what people are going through that may not always be obvious and you may not always see it. It doesn't always appear to the eye. So just having more compassion for people in in general, not just in mental illness realm, but in general. You never know what someone's going through, so just having more compassion for them.

ANNA: That's wonderful. I would love for that to be the case too. Always can improve the world a little bit with compassion.

SYDNEY: Yes, absolutely.

ANNA: And, you know, to start finishing up here, what are anything, any words, any messages you want to share with people who do live with bipolar, especially maybe those who may be newly diagnosed?

SYDNEY: Like I said earlier, if I could say one thing to myself when I was first diagnosed is that it'll be okay.

It's not the end of the world. It may feel like it, it may feel like you've reached the deep, dark depths of hell with some of the depressive episodes, but that things do get better. You just have to put in the effort and the willpower to want to get better, is kind of how I feel about it, at least for me personally.

You know, I've gone through times where I want to get better, but I don't feel like putting in the effort to get better and I kind of just remain stagnant in my situation. Realizing like, Hey, yeah, I really do wanna get better, so this is what I need to do. That's beneficial, but also just realizing that your best is your best and it's good enough and to not be so hard on yourself.

ANNA: That's great. Thank you for that message. Once again, goes back to self-compassion, but also that positivity that's not toxic. Saying that, you know, not everything's going to be okay, but this is not something that you cannot figure out that there is a way to make this work.

SYDNEY: Also, I think I've talked about this with you before, maybe it was another person. But one thing that I could recommend to people that are newly diagnosed or even like been diagnosed for a long time is when you're in a stable state or even hypomanic state. Find your support system that you can rely on when you're in the depressive episodes or the not so good times because it's 10 times easier to have it already known and know exactly who to reach out to before you reach that episode.

Cause I can't tell you how many times I wait until I'm in a depressive episode and I'm like, who the heck do I reach out to? Like I have no. And not only that, but you also lack a lot of motivation to wanna do that too. So, knowing ahead of time and kind of preparing yourself for that situation is definitely something that's helpful for me, and I feel like it could be helpful for a lot of people.

ANNA: That's excellent advice. And I would even add to that, you know, some people are not as fortunate as you and I to have a great support group or just a great support team. Whatever you wanna call all the people who are there to care for you, to make sure you're okay. And for those people, I always say, look, if you're already on social media, come join these little communities that formed for bipolar disorder and your account is a great example of that, @bipolarandbougie.

On TikTok and on Instagram, you post so much good stuff and there's so many of us that then comment, and it feels like there's definitely a sense of community and that you're not alone. Other people get it, and sometimes you can just DM people when you're having a really rough time and relate a bit.

SYDNEY: I definitely agree. The mental health community, when I started TikTok, I, you know, I felt very vulnerable posting online. I was like, gosh, I really hope people that I work with don't see this, or people that I know see this and finding the mental health community, it's so supportive and they're complete strangers and sometimes they're more supportive than people that you know and love, which I've seen a couple times and it like you said, random people that you can just DM and be like, Hey, you know, can I talk to you for a few minutes? I'm having a really rough day. And they'll absolutely, and it's just, it's amazing how compassionate the mental health community is online for being a random group of strangers that you've never met in your life before.

And it's just seeing them come together and form this community of support and working to end the stigma on mental illness together... It's really reassuring and comforting.

ANNA: It definitely is. And I think this is the perfect note for us to end on, is knowing that there is hope, there is a community out there. And Sydney, thank you so much for being honest, for being vulnerable, for giving such excellent advice. I really hope people find you on Instagram and TikTok and follow you. And once again, just thank you so much for being here.

SYDNEY: Yeah, thank you so much for having me. I really appreciate this.

ANNA: For me, hearing Sydney’s story gives hope, which is something we all need, especially in our darkest moments. I have faith that it will do the same for you.

Thank you for listening to this episode – please consider leaving a review so that other people may find Courage to Heal. Next time, you will hear an interview with Jess Kanotz, a speaker and a mental health advocate who will share her story of healing bipolar through lifestyle changes.

Until then, take care and stay courageous.

Anna Khandrueva

S1:E7 - Bipolar Type Two

Episode Notes

Transcript

S1:E8 - Healing Bipolar Through Lifestyle Changes

S1:E6 - Bipolar Type One