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Jerry

Compassion Fatigue

When our life involves caring for someone with a mood disorder we can become so caught up in helping that person that it’s easy to overlook our own well-being. We may feel that it just doesn’t seem appropriate to be thinking of ourselves when someone we care about very much is having a difficult time. We’ll get to us when we have time, we may decide, but right now our own needs will just have to wait.

Somewhere in the future those bottled up feelings and concerns are eventually going to surface. We may become so mentally fatigued and physically exhausted that we start isolating from others. When we are around other people they may remark that we appear preoccupied or even sad. We may deny this is the case, but we have to admit to ourselves that we are having trouble concentrating and we simply don’t feel very well. Our appearance may also seem less important. Then, unlike our usual calm and patient temperament, we begin blaming our loved one for our problems. We’ve even considered taking a drink or using a drug to help cope with the pressure, pressure that seems to be getting even worse.

A family member, companion or caregiver displaying these symptoms may themselves be suffering from a disorder: compassion fatigue. This is a normal condition that can result from the ongoing challenges of supporting a loved one in the throes of a brain illness. These are normal yet highly disruptive symptoms that will not go away on their own accord. Untreated, they are likely to only get worse.

If you or someone you know is experiencing symptoms such as these, it’s a good idea to see a therapist. Getting this negative condition under control will take hard work, but it can be treated. Talk to a therapist right away.

Just like you tell your loved one, he or she cannot get well by themselves. Maybe you can’t either.

Bipolar and the Treatment Team

 
Bipolar is an illness with many fronts:
 

• The illness itself, its symptoms and treatment.
• Possible blood pressure problems.
• Possible blood sugar problems.
• Diabetes concerns.
• Heart disease awareness.
• Weight issues.

Working closely with a doctor means all of the present and potential problems are on the table and are being addressed. A positive, close working relationship with a psychiatrist is basic, of course, but let’s not forget the important roles that families and caregivers play. And therapists, spiritual coaches and support groups can also prove quite helpful in remission and the probability of continuing recovery, both mental and physical.

Relationships are vital in the recovery process and they need to be built on solid trust. Spotty, irregular or infrequent visits to the doctor and other members of the treatment team are not very effective and of minimal help in recovery.

Having a brain illness is serious, so giving it our wholehearted attention and care is required to achieve maximum benefits such as long-term remission.

Taking a half-hearted approach may be more foolish than one realizes. It can forestall recovery and make someone more vulnerable to a number of additional problems--problems that may not only exacerbate the bipolar disorder but also raise the chances of exposure to risks on several additional fronts.

The smart thing to do is be an active and involved member of the treatment team, and look to a trusted psychiatrist as the captain of that team.

Be Careful of Misdiagnosis

Depression is a serious illness which can be quite disabling if it is not properly treated. The good news is that when accurately diagnosed and an appropriate treatment plan is implemented and followed, the severity of the symptoms of depression can be significantly reduced and the likelihood of future relapse minimized if not even prevented. The bad news is that depression can be difficult to accurately diagnose. All too often the illness is misdiagnosed and improperly treated, making an already challenging situation even worse.

Misdiagnosis sometimes occurs because symptoms of the depressive phase of bipolar disorder share a number of similarities to those of severe depression. Fortunately, most psychiatrists are fully aware of these similarities and understand how critical it is to conduct a thorough medical history before making a diagnosis and developing a treatment program. The treatment plans for persons who have severe depression are very different than those that are developed for persons in the depressive phase of a bipolar disorder.

Psychiatrists know this. It is the specialty in which they are board certified.

Non-psychiatrists do not know this. It is not their specialty. They may be general or family practitioners, internists, cardiologists or psychologists, but they are rarely board certified psychiatrists, as well. They do not know how to accurately diagnose patients with brain illnesses.

Avoid the serious problems of misdiagnosis. Make sure the physician doing the diagnosis is a psychiatrist. Accept no substitute.

Knowing Our Limits

Something all of us experience at one time or another are the challenges that can occur when we take on more than we’re able to handle. While these are often viewed as disappointments if not defeats, they may also be great teachers. Discovering and recognizing our limits can mean the difference between going out too far (and needing help to get back) or remaining on solid ground and keeping our sure footing (to be able to do whatever may be required).

Knowing our limitations helps us to focus on what we know we can do and gather the energy we need at the place and time it‘s needed. With our capabilities very much in mind, we may then:

• Examine the situation or challenge and thoroughly think the matter through
• Plan for the possibilities of unknown occurrences
• Expect the unexpected and prepare for them
• Do our very best…always
• Exceed our expectations

For those of us caring for someone with bipolar or depression, it is important that we stay in good health. Our loved ones need us and may look to us to provide needed guidance and support when the challenges of their recovery become overwhelming. It’s vital that we’re able to provide the needed guidance and leadership whenever and wherever it is needed. Taking proper care of ourselves and respecting our own limits should be the goal of every companion. We never know when we’re going to be called upon, so always be ready to help.

Knowing our limits and staying grounded in our role of an effective and successful family member, caregiver or companion will help us to be ready for whatever’s next, regardless of what that may be.

Choosing the Positive

People who have mood disorders are on the receiving end of a lot of negative energy in their lives. Things like criticism, disagreement, discord, faultfinding, judgment and nitpicking are seldom strangers to someone who has depression or bipolar. Sometimes the negative feedback comes directly from the person themself. All too often they are their own worst critic, and this steady stream of negative feedback can make problems even worse:

• It deepens discouragement that may trigger additional stress.
• It usually adds to a loved one’s shame, guilt and already low self-esteem.
• It makes difficult situations even more difficult.
• It can cause a loved one to lose hope, give up and adopt a “what’s the use?” mentality.
• It may eventually lead to suicide ideation, or even worse.

Something they don’t often get enough of is understanding and compassion, and this is so unfortunate. When we as companions, family members or caregivers are able to provide compassionate understanding of our loved one’s behavior, however irrational or inappropriate that behavior may be, we have the potential of gaining the following:

• Greater insight of what our loved one is dealing with and how their illness is interfering with their ability to make healthy choices.
• Identifying and prioritizing our loved one’s needs (medical care, therapy, support groups, nutrition, stress reduction, shelter, etc.)
• Discovering and implementing recovery tools that help motivate our loved one toward achieving managed stability.
• Establishing mutually agreed upon realistic goals (“small steps”) and avoiding pressurized unrealistic goals (“huge steps”), and then achieving those goals.

When our loved one uses poor judgment or makes an unhelpful or unhealthy choice, our choice should be to stay positive and remember that they may be doing the very best they can at the moment. Through compassionate understanding we and our loved one can continue to move in the direction of stability, regardless of how small the steps we are able to manage at the time.

Choosing positive directions is vital to recovery. Let’s try to always choose wisely.

　

The Habit of Healthy Choices

Many of us have heard the phrase, I have bipolar but bipolar doesn’t have me! (Or, sometimes, I have depression but depression doesn’t have me!)

This can be especially true for those of us with loved ones who are doing everything they possibly can to assure their own ongoing stability and the enjoyment that comes with managed recovery. As companions, family members and caregivers, we can all feel blessed when someone we care very much about is consistently highly functional and maintains a daily habit of making healthy choices. Choices like:

• Getting adequate sleep each night.
• Eating regular, nutritious and balanced meals while maintaining weight control.
• Following all aspects of their treatment plan and not deviating from the plan without first discussing any possible changes with their doctor.
• Staying sober--no alcohol or un-prescribed drugs…ever.
• Seeing their therapist…regularly.
• Attending a support group…regularly.
• Successfully avoiding all “triggers” (stressful situations, people, choices that can bring about anxiety and other emotional upsets).

Someone with a brain illness who is experiencing ongoing stability can see how recovering from a disabling mood disorder is always more successful when done with others in supportive roles. They also usually realize recovery is rarely successful when going it alone.

When our loved one has a mood disorder but their disorder doesn’t have them, we know it. And we know, too, it will never have us, either.