Bipolar4LifeSupport

1. Can I relieve your stress in any way?

One thing all writing manuals say is SHOW don’t TELL. Words aren’t all that helpful to a person struggling with depression. Because let me speak from experience… almost everything she hears will somehow be twisted to sound like an insult. Every suggestion — St. John’s Wort? Organic apples? Yoga?–are going to come off as: You are doing something terribly wrong and this is all your fault.

SO what I found most comforting when I couldn’t pull myself up by my bootstraps is when a friend came over and fixed me lunch, or when someone offered to tidy up my place. I realize that sounds a tad pampered and self-indulgent, but we wouldn’t think twice about doing it for someone who is going through chemo. Why not go there for a person battling a serious mood disorder?

2. What do you think might help you to feel better?

This one I picked up from parenting manuals. If you tell a little girl to stay away from the Skittles because she becomes demonic after indulging in those tasty sweets, that’s not really going to do much more than shove five in her mouth. However, if you say … “Do you remember when you slapped Cousin Fred in the face at the picnic last week because you got excited after eating a bag of Skittles? Do you think there’s a chance of that happening again?” she MAY very well still desire the Skittles, and hell, she might even shove another five in her mouth; however, there is also a chance she will arrive at her own solutions and, say, … go for the doughnut instead!

3. Is there something I can do for you?

Again, like number one, this is a SHOW not TELL moment, and those are very effective at communicating compassion. Chances are that the depressed person will just shake her head as she cries, but I can assure you that she will register your offer in that place instead her heart that says, “This person cares about me.” Now if she asks you to file her tax return, I apologize sincerely.

4. Can I drive you somewhere?

Here’s something that most people don’t know about folks battling depression: they are really bad drivers. REALLY bad. In fact, when I was admitted into the inpatient psych unit at Johns Hopkins, I was shocked that one of the questions was, “Have you received any speeding tickets, or ran into other cars, or big orange columns in parking garages that got paint all over your Honda and pissed off your husband?” When I inquired with the nurse why that question was on there, she said “bad driving is an easy way to diagnose a mood disorder.”

All I can say there is: True. True. True. So, this suggestion is not only to help out your depressed friends who maybe do need some fish oil or tissue paper from the drug store, but also all the other people on the road.

5. Where are you getting your support?

Notice the difference between saying, “Are you going to any support group meetings?” which implies, “If you aren’t, you are one lazy son of a bitch who deserves to be depressed.” And “Where are you getting your support?” which says, “You need some support. Let’s figure out a way to get it.”

6. You won’t always feel this way.

That was the perfect sentence that I could hear 50 times a day when I wanted out, out, out, of this world. Those words don’t judge, impose, or manipulate. What they do is convey hope, and HOPE is what keeps a person alive, or at least motivated to get to the next day to see if the light at the end of the tunnel is really a place of rebirth or a friggin’ freight train.

7. Can you think of anything contributing to your depression?

This is a very gentle way of saying, “It’s your abusive marriage that’s bringing you down, fool!” or “You think maybe the witch you work with might have a little something to do with the mood dips?” You’re poking around, but not stopping the stick on any one thing. Again, like the preschooler, she has to arrive at her own conclusions, and when she does, she will take accountability for what she can change and not blame you for any negative results.

8. What time of day is hardest for you?

This one was brilliant. It was my mom’s. So she called twice a day, once in the morning–because depression is usually most acute upon waking (“Crap, I’m still alive.”)–and at about 3 or 4 in the afternoon, when blood sugar dips and anxiety can take over. Mind you, she didn’t have to say a whole lot, but knowing that I could count on her during those two times was a little bit like holding someone’s hand through a dangerous intersection.

9. I’m here for you.

It’s simple. It’s sweet. And it communicates everything you need to say: I care, I get it, I don’t really understand it, but I love you, and I support you.

10. Nothing.

That’s the most uncomfortable one, because we always want to fill in the silence with something, even if it’s weather talk. But saying nothing … and merely listening … is sometimes the very best response, and the most appropriate. I love this passage from Rachel Naomi Remen’s bestselling book Kitchen Table Wisdom:

I suspect that the most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention. And especially if it’s given from the heart. When people are talking, there’s no need to do anything but receive them. Just take them in. Listen to what they’re saying. Care about it. Most times caring about it is even more important than understanding it.

We are a psychologically sophisticated society. Emotional difficulties are now shared openly — not only by celebrities but by your average person. It’s not unusual for people to tell friends that they have an anxiety disorder, anger management problem, depression, panic attacks, phobias, eating disorder, substance abuse problem, OCD or ADD.

Yet, there is a widespread psychological disorder that most people know little or nothing about. Why? Because its symptoms are largely interpersonal, causing many to view it as a relationship issue, not a mental health one. Also, people shy away from the term because of its unflattering name: Borderline Personality Disorder.

“Borderline? Am I going over the edge into an abyss? Oh my gosh! Next topic.”

Enough ignorance. Let’s review the major symptoms of people who have borderline personality disorder (BPD):
•They have turbulent and stormy relationships, making it difficult to keep a job or maintain a close relationship.
•They have frequent emotional outbursts, often expressing their outrage with verbal abuse, physical attacks or acts of revenge.
•Though they’re acutely sensitive to being abandoned and rejected, they’re harshly critical of those closest to them.
•They view others as “good” or “bad.” A friend, parent or therapist may be idealized one day, yet viewed the next day as a terrible person for failing to live up to their expectations.
•They may act out with self-destructive activity (i.e. reckless driving, compulsive shopping, shoplifting, cutting, bingeing with food, alcohol, drugs or promiscuous sex) as a way to fend off feelings of unbearable emptiness.

Borderline personalities run the gamut from mild to severe. It’s generally only the people who know borderlines intimately who are aware of the extent of their emotional difficulties.

Some sociologists believe that we are living in a “borderline culture,” heavy on righteous anger, light on acknowledging another’s perspectives. Watch daytime talk shows and you’ll understand what they mean. Or better yet, listen to the rhetoric of Congress and watch them in action (or should I say inaction).

If you recognize your own borderline characteristics, what should you do? If you’re motivated to change, psychotherapy with a psychologist who understands BPD can be quite helpful.

If you’re living with someone with BPD, life probably feels like an emotional roller coaster. So what can you do? Certainly, suggesting psychotherapy is a good idea. Don’t be surprised, however, if he or she uses therapy not to seek understanding but to rage about others. So, if therapy for your loved one is not moving forward, try a few suggestions:

Be consistent and predictable.

Whatever you have told your loved one that you will do (or won’t do), keep your word. If you’re the recipient of a violent outburst of accusations or a tearful meltdown, it won’t be easy. However, if you give in to the outrage, the borderline behavior is reinforced. And if you think your problems are bad now, just wait!

Encourage responsibility.

Don’t become your loved one’s rescuer. Don’t be manipulated into taking responsibility for his irresponsible actions. If he smashes up the car, don’t replace it. If she racks up credit card debt, don’t bail her out. If you keep rescuing her from the consequences of her actions, she will have zero incentive to change.

Offer honest feedback.

Don’t reinforce your loved one’s belief that he’s been treated unfairly unless you actually think that’s true. People with BPD tend to be clueless about how their behavior affects others. Hence, offer honest feedback. Say, “I know it feels rotten when you’re fired” but don’t agree with his assessment that it’s all because of those awful, mean people he worked for.

Don’t escalate the argument.

Your loved one may misinterpret what you mean. Offer constructive criticism and you’re met with a tirade of how despicable you are. Offer a compliment and you’re accused of being patronizing. Explain your intentions and the emotions escalate. Don’t get hooked into a fruitless argument. Do your best to keep your cool and your sanity even though you’re feeling frustrated, powerless and defeated by your loved one’s behavior.