Communication, Disclosure and Getting Support – Nancy

Sharing information about a diagnosis, disclosure, can be a constant tension for people with bipolar.  On the one hand, you need a support network that includes family, friends, co-workers and even employers.  On the other hand, any or all of these people may create more difficulties, or even be a part of the problem from the beginning.

Dr. Cannon Thomas of the University of California, San Francisco, was interviewed in Moodsurfing a couple of years ago, and his comments are still useful and worth looking at again.  He speaks mainly about disclosure at work, and secondarily about disclosure early in a developing romantic relationship. In both cases, he emphasizes the importance of communicating your own competence in dealing with your diagnosis and treatment, and handling your life.

He warns that we all have a tendency to seek understanding and emotional validation, which will only be a distraction to straightforward communication that asks the other person to take some action or support you in concrete ways (such as time off from work for therapist appointments, or a partner’s accompaniment to such an appointment).

Dr. Thomas suggests using “I” statements: “I was feeling really overwhelmed at that time, but now, I’m feeling uncomfortable with how closely you’re monitoring me.”  Instead of feeling blamed, this opens up room for you and your supporter to have a conversation about what kinds of help are helpful and how to signal when you need more or less support from a friend or colleague.

Common Themes

Moodsurfing has explored the issue of disclosure in a number of posts, and we have found some common themes.  First of all, it’s important to remember that most people probably don’t know much, if anything, about mental illness as it is understood in the present day.  Assess your contact’s level of knowledge carefully, and be ready to go back and fill in gaps if it becomes necessary.

Don’t be ashamed.  A health condition like bipolar is not something that should be covered up.  If people don’t understand you, just try again using different words.  You are in control of what and how you disclose information to people, and you are also in a learning process about your condition, so you can explain that sometimes it’s hard to convey all the right information, but you feel confident that once understanding is established you can both move ahead with your relationship.

Parents

If you are receiving a diagnosis of mental illness as an adult, the question of whether, when and how to discuss this with your parents (if they are living) can be a significant source of struggle.  Especially if you believe that they have had a role in the development of your condition, or if you are looking back and realizing that your situation could have been easier if your pain was recognized earlier.  Resentments and what-ifs on your part can engender defensiveness and anxiety on theirs.

So make a plan about how you are going to approach your parents.  If necessary, role play the conversation beforehand with a therapist or friend.  Practice getting permission to have the conversation first: “Dad, there are some things I want to talk about with you, and this could be a really hard conversation, are you willing to try?”

Emphasize that the reason for the conversation is for better communication, to know eachother better, to understand the past more clearly, to seek and offer forgiveness, to be closer together going forward.  Try not to be distracted by their capacity for understanding or for emotional intelligence.  Just say what you need to say and listen to what they have to say in return.

Disclosure is a complicated topic, with ramifications for many different types of relationships.  Let us know what your own experience has been in the Comments section below.