From Helicoptering to Collaborating: Working on Recovery with Loved Ones
Having a partner over-involved in your recovery plan can result in frustration, resentment, and confrontation. When you collaborate though, you can work as a team on your recovery.
I couldn’t stand my spouse “helicoptering.” It was part of his over-involvement in my care which disempowered, discouraged, infantilized and enraged me. I admit that at times my refusal to accept my condition, dismissiveness of his concerns, medical non-adherence and ambivalence left him no choice. Still, the helicoptering significantly contributed to my stress levels, which have always been a key trigger for my mania.
It felt like I was under constant surveillance. He’d hover over me, circle round, popup from behind, fly by. He saw impending mania in everything I said or did. I was disempowered as he and my former doctor took control of my treatment. He discouraged me by always expecting the worst, infantilized me by constantly watching over me, and enraged me when he didn’t trust me. At the time, it strained our relationship as management of my condition became highly confrontational between the two of us. We both knew that the situation had grown untenable and that we had to address it to help me recover and to save our marriage from bipolar.
As I started to move towards stability and things got better, we recognized a few practices and changes that could help reach recovery quicker and better. These steps combined into a simple approach to help us work together constructively to address my condition and achieve recovery.
Establish guiding principles
We came up with a set of guiding principles that would define our shared involvement in my care. I recognized that my care was better with his involvement both one-on-one, and together with my clinician, as he has always been better at spotting signs of my hypomania than I have. We agreed that I would take control of my own care. I would set treatment goals, prioritize competing objectives, manage my condition. He and my clinician would play supporting roles, except for cases during which I was incapacitated. This approach allowed me to take more responsibility for outcomes. Perhaps most importantly, he and I both acknowledged each other’s situation. He acknowledged how difficult it must be for me to live with my condition, and I acknowledged how difficult it must have been for him to do all that he could to help me when I didn’t want to be helped.
Establish treatment objectives
It was important that I established my own treatment objectives. I wanted to sleep less since I had been sleeping 14 hours a day. I wanted to lose weight because I was 70 pounds overweight. I wanted to pursue a career. My doctor and spouse recognized my objectives and did everything they possibly could to help me achieve them. My clinician adjusted my medication to cut my sleep time back to 9 hours a day, and put me on a stimulant to address daytime drowsiness. A dosage reduction of one of the medications that was making hard for me to lose weight helped me lose the excess 70 pounds. My spouse did everything he could to help me plan and pursue a career.
Key treatment execution
I promised my spouse that I would be medically compliant and asked him to stop constantly checking in on me. My psychiatrist agreed to let me stay on my stimulant, which could create a risk of hypomania, if I reduced other hypomania threats in my life. I accepted the trade-off because the stimulant allowed me to be more functional in the daytime hours. I also agreed to take better care of myself. I started to work out at the gym with a trainer. My spouse kept me motivated by going to the gym with me. I now go to the gym four times a week. I also agreed to eat better, which my spouse strongly influenced. I now eat a healthy salad for dinner most nights. We also spend a lot of time in the country, which has been critical to my self-care. He encourages me and we do things together, which makes it easier to stay motivated and keep on track.
Triggers and relationship sensitivities
We openly identified and discussed my triggers with to try to avoid them. These included my spouse’s helicoptering and criticizing me for not doing more, and not carrying my fair share. He explained to me that he couldn’t stop watching over me, but that he would not do it so intrusively. I agreed to do more around the house even when I was depressed.
I also explained to him that I found some of the things he said to me to be triggering. When I disagreed with him, he might ask me if I was taking my meds or threaten to reach out to my doctor. He would ask “Are you amping up?” when he thought I was becoming hypomanic. He agreed to modify his behavior and words. Specifically, he agreed to not ask me if I was taking my medication when I disagreed with him, and to only contact my doctor under agreed circumstances (by email with a copy to me and only when I showed clear signs of hypomania). He also agreed to stop using the phrase “You’re amping up.” Now he says something like “I think you might not be well.” It makes a big difference. These changes were important to me because they were connected to my past behavior and I wanted a fresh start, something that didn’t remind me about the past.
We both agreed to do all that we could to avoid the next crisis after I had relapsed four times. The 911 calls and hospitalizations had been traumatizing to me, and my manic episodes had been traumatizing to him. So we both agreed to address signs of hypomania as quickly as possible. My key signs have always been preoccupation with social injustices, unusual stress, a fluster of creative activity, and in particular, reduced sleep. We address sleep disruption immediately. My doctor may make medication adjustments to get my sleep back on track and nip potential mania in the bud.
It’s difficult for me to manage my bipolar, but it can also be very difficult for family members. The best approach to managing my bipolar has been a strong coalition between my psychiatrist, my spouse, and me, with me at the helm. I’ve never felt better. I’ve wrestled back control over my life from my bipolar.