Control your moods or live with them?
A guy we’ve been working with for some time commented today that he didn’t want to focus on control of his moods. His focus is on living with them.
This is an attitude that we often recommend to patients who have trouble accepting a diagnosis or a treatment option. Acceptance of the reality of bipolar is the first step towards stability and recovery. Some therapists speak of “acceptance” and the first step, and some even call it “radical acceptance”. Marsha Linehan, a psychologist and writer says that radical acceptance means completely and totally accepting something, stopping the fight against reality, and ultimately, suffering less.
Acceptance is not the same as fatalism, where “nothing ever changes”. Acceptance means stepping into an ever-changing reality and figuring out how to grow and move forward within that reality. Acceptance also means not judging or criticizing yourself for how the situation makes you feel, or for how you have faced it in the past. Feelings just are, you can’t make yourself feel the way you “should” feel. And you are always doing the best you can, there’s no need to beat yourself up for not being perfect.
Crisis Plan
Once you have started thinking about accepting reality, the next step is to have a crisis plan. Even if you are ready to live with moods as they come and go, it is also important to recognize that sometimes they reach a level that is beyond self-management. For those times, you need a plan so you can act when you realize something is wrong. You don’t have to think about what to do in a crisis, because you already have a plan. Remember, a crisis is by definition short-term. You will get through it. Learning how to live with moods means having a plan and knowing how to implement it.
Distraction and Defusion
Here are a couple more skills that come in helpful for living with moods. Distraction (not avoidance) means giving yourself a break until the “heat” comes down and you can breathe again. Just do something fun or have a treat, get back to a stable feeling before trying to deal with the stuff life throws at you. Avoidance would be pretending it isn’t really happening and trying to escape for good, but distraction is just telling the hard stuff to wait for a little while. You will come back and deal with it when you decide the time is right, not when crises are pushing you from every direction.
Defusion, on the other hand, is about what is going on in your head. The idea is that your thoughts become “fused” with your self, until you believe that what you are thinking is who you are. In reality, thoughts come and go in our heads, and they are not necessarily the same as facts and reality. Learn to step back from whatever you’re thinking and watch what’s going on inside your head. Sometimes you can determine where a thought came from, like a teacher once told you you’re not good at math. Sometimes it’s not so clear: doesn’t everyone think they’re “too fat”? But no matter where it came from, a thought is different from reality. Once you get them defused, you can start to consider what the real reality might be.
There’s a lot you can do to make unstable moods more manageable. And sometimes you need to ask for help, but that’s also a skill you can learn. And in the long run, surprisingly, it may just be that “learning to live with it” is the best way to bring those moods under better control