There are times in life when we must be our own best advocate. This can be difficult when depressed or manic; however, it is doable.
Countless times, I have thought to myself, “All persons with bipolar disorder should have some type of advocate.” Not only the sort of advocate you’d find in a lobbyist group or at support organizations like NAMI, but on a one-on-one basis. Therapists and psychiatrists are great and very helpful. But on a practical level, they may not have the time to step into the case management or advocacy role. A good case manager is worth their weight in gold. However, with high caseloads and such, they are often spread thin as well. And for whatever reason, they are often reserved for the most extreme cases. Persons labeled high or moderately functioning are often left out of the case management loop.
This is problematic, as, with bipolar disorder, there can be periods of normal euthymia and increased functioning, followed by a crash into depression or mania. Having advocates at all phases of the mood spectrum could go a long way as far as harm-reduction and damage control, as well as helping people find the resources they need when things are not going so well. Not to mention, they can help us navigate the mental health system and resources more seamlessly. They could be a great resource for family members and support persons as well.
Life, of course, is not perfect, and unfortunately, we have a mental health system that often fails to see the big picture or implement the sweeping changes that are necessary for optimal functioning of persons with mental illnesses.
So what are we to do? We can throw our hands up in the air and wish for change, but that won’t get us very far. I propose that mental health clinics and such should be required to increase the availability of case managers and/or hire more peer support specialists. And I think that many of us who have been stable for a long period of time should consider the possibility of mentoring others, both those newly diagnosed and those having difficulty functioning at the moment.
Why is this issue on my mind?
As a 48-year-old woman who has been on the bipolar disorder journey since her early teens, I have had to be my own best advocate on many occasions. Especially in my single years, prior to marriage. Having always been a person who had difficulty with assertiveness, this was not always an easy task. When one’s thoughts are racing due to mania, or when one’s thoughts are slowed due to depression or medication side effects, effectively asking for help becomes difficult. Not to mention, when one’s cognitive functioning is less than ideal, it can be extremely difficult to locate resources, offices, providers, etc. It can feel impossible to even follow simple directions. Family can help, but this assumes that the family is nearby and/or available.
There are a few things that I have found that are helpful when you are in these types of situations:
Write everything down
Ask other people to write things down for you if you can’t handle it yourself. Carry a notebook/journal with you everywhere or write in the memo section of your phone. This is extremely helpful.
Find a trusted confidante
Let them know what you are going through. They may know some resources and/or may help you. Even little bits of practical help can go a long way. Your spiritual community/church/house of worship can be a good resource for this as well.
Contact human resources
Your workplace human resources department should be able to walk you through the process of requesting what are known as reasonable accommodations. Under the Americans with Disabilities Act, people with documented medical conditions—including mental health conditions—must be granted “reasonable” accommodations to help them maintain employment. This could mean anything from being able to work at home to changing workplace policies.
Call all your healthcare providers
Reach out to your healthcare team, including your therapist, psychiatrist and primary care physician. Let them know what is going on and that you need help. If at first, you don’t succeed, try and try again.
If you have a gut feeling that something is wrong and you
need help, don’t ignore it. Keep plugging until you find someone to help you.
Finally, know that this is temporary and that it will get better! In the meantime, for those of us who are currently doing well, may we always take the time to look out for our comrades who are struggling. It is the least that we can do.
Carol Borrelli is an RN, makeup artist, writer, musician, and published poet, who has bipolar disorder. She was diagnosed with the condition at the age of fifteen, and has 32 years of wisdom to share regarding coping and thriving with the condition. She has twenty-five years experience working in the psychiatric field. Carol is the author of the Sweet Minerals cosmetic company Beauty Blog, as well as Girlfriend’s Guide to Good Mental Health, a blog dedicated to mental health, beauty, and poetry. Her work has been featured in the Gift of Second, a website dedicated to suicide loss survivors, and The Mighty. Carol is herself a survivor of suicide loss, having lost her brother. She is a Field Advocate for the American Foundation for Suicide Prevention. Everything she does for mental health promotion and suicide prevention is dedicated to and inspired by the memory of her brother, Jefferson Joseph Blanton-Harris.
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