Bipolar Disorder and Shame

Whether you have received a mental health diagnosis years ago or just recently, you may be experiencing feelings of shame for having mental health concerns.

The Edmonton’s Healthy Living with Bipolar Disorder Support Group recently had a guest speaker discuss her experiences with her bipolar diagnosis and symptoms.

Some of the questions that group members asked the speaker were:

• If she always felt like she had bipolar disorder symptoms,

• How she was able to accept the idea of being on psychiatric medications for the rest of her life, and

• If she had supportive friends and family.

From these questions and from additional comments made, I felt that the topic of shame was relevant for many of our group members. Even though we are beginning to see less social stigma around mental illness, it is still common for us and others to shame our mental health experiences.

This shame may occur directly and indirectly. This shame may even come from within us as we tell ourselves that we are not normal, or that we are weak for having strong emotions or for having less stability with our day-to-day activities, or because we have irrational thoughts.

When self-shaming continues, we minimize our ability to care for our mental health and to live the life we desire. It is important to work at turning this shame into self-acceptance. By doing so, we will be in a better position to understand our thoughts, feelings, and behaviours, and to engage in the self-care that is needed to improve them.

To help accept your mental health diagnosis, try the following:

1. Remember that Mental Health Symptoms are Physical Health Symptoms

Trauma or difficulty coping with environmental stressors often leads us to develop brain pathways that result in ineffective thoughts, feelings, and behaviours, that are labelled as mental illnesses. Physical ailments are less stigmatized, yet such brain pathways are physical! Just as physical activities of exercising and eating healthy affect our physical health, they also affect our mental health, illustrating the mind-body connection.

Think about how you would support a friend with a physical health condition. You may tell your friend to rest, tell them that it’s ok if they need help with day-to-day activities, and remind them that they are more than their condition. This support is exactly what those with mental illnesses need as well. Try thinking about how you would support someone else with either a physical or mental illness, and practice bringing this same compassion to yourself.

2. Understand Bipolar Disorder

Learning about bipolar disorder may help you begin to accept the disorder. By educating yourself about the disorder’s environmental, biological, and genetic factors, you may come to acknowledge how symptoms of bipolar disorder develop. Mapping mood changes can often help recognize factors that trigger symptoms and subsequently, how to manage symptoms by managing triggers.

Bipolar disorder symptoms may have provided you with a temporary means of coping during times of stress, for example, hiding in bed to hide from life stressors or quickly moving forward with a new plan to release arising creative energy and motivation. These coping mechanisms, however, become symptoms when ineffective and distressing.

I like to take an evolutionary approach to understanding mental illness to recognize how certain symptoms can be effective. Many mental health symptoms are theorized to exist because they had previous evolutionary or survival advantages. Symptoms continue to exist because of some benefits in coping.

Sherman (2001) discusses research about the evolutionary origin of bipolar disorder and suggests that depressive and manic symptoms were adaptive for those living in northern climates that had long, cold winters, and short, hot summers. Depressive behaviours appear to have been adaptive for survival during harsh winters as reduced activity would allow for energy conservation. Manic behaviours would be more adaptive during the warmer seasons that allowed for greater resources and activity to ensure survival (Sherman, 2001). Understanding the evolutionary origin of bipolar disorder can help diminish feelings of shame as we come to realise that symptoms may be related to fitness and survival.

3. Remember that Everyone is Different

Shame around mental illness often arises from comparisons to others. We tell ourselves that we’re not normal and that other people lead better lives than we can. We tend to quickly remember the negatives about ourselves and the positives about others. Others may not have changes in mood that cause distress, but they are most likely coping with different stressors in different ways. We react in ways that we consider adaptive and when they become distressing, we must ask for help and take care of ourselves. Everyone requires help and care in different areas of their lives and these areas differ depending on our experiences and biology. It is important to remember that mental disorder symptoms lie on a spectrum. We all experience ineffective thoughts, feelings, and behaviours, but each, to varying degrees.

4. Increase Connection to Others

Shame often leads to feelings of isolation as we convince ourselves that we are unworthy and abnormal. This isolation can enhance feelings of shame as less connection with others further enhances feelings of unworthiness and abnormality, leading to a vicious cycle. Connection with others can help us remember that we share similarities with others in terms of thoughts, feelings, and behaviours. It is important to connect with supportive people in an environment that feels safe. A bipolar support group can help you realise that you are not alone in experiencing symptoms and connect with others that are both understanding and supportive.

5. Experiment with Self-Care

Taking care of yourself can help increase positive thoughts, feelings, and behaviours that may reduce feelings of shame. Self-care can range from recognizing triggers and taking time off school or work, to taking medication as prescribed, to taking a few deep breaths. It is important to take the time to understand yourself and what has worked or may work to help you feel better. Try practicing self-care by adding small, manageable, and specific self-care activities to your daily routine. Remember that self-care takes practice and compassion.

Shalini Dhunnoo, a graduate psychology student, completed a portion of her internship as a student co-facilitator for the Edmonton Healthy Living with Bipolar Disorder Support Group from Sept-Nov 2016. She valued the time and opportunity to learn from the members of this group and from the guidance and support provided to her by Momentum Walk-In Counselling and from Samantha Pekh, PsychSolutions, Inc.

References: Sherman, J. A. (2001). Evolutionary origin of bipolar disorder. Psycoloquy. Retrieved from http://www.cogsci.ecs.soton.ac.uk/cgi/psyc/newpsy