“Why do I have to have a regular schedule” was the lurking question that hung over my conversation with Ann.
She didn’t actually ask me that question but I could see that there was a rebellious child hiding in the corner of the room who was making the conversation we were having about getting regular sleep much less productive than it could have been.
The evidence about the ability of strong and regular circadian patterns of activity and sleep to help manage mood is increasingly strong. A recent post on Mood and the Brain’s Clock highlights just one of the studies on the subject.
I’m not going to focus on that evidence or even on the question of what the ideal schedule should be. I’ve talked about that a lot in other blog posts and I’ll reference some of them at the end of this one.
What I do want to talk about his the process of rebellion and how it affects us once we are no longer children.
All of us, to a greater or lesser extent, remember feeling frustrated with our parent’s seemingly irrational demands and requests.
And a certain amount of rebelliousness is inherent in the creativity which is one of the hallmarks of bipolar mood.
Variations on this theme are pretty common in my experience working with people with bipolar. My struggle as a clinician is to try to avoid accepting the parental role. Not to take responsibility for trying to change another adult’s behavior.
This may be particularly important if the person I am coaching grew up in an unstable environment, perhaps with a bipolar parent, for example.
Children growing up in a world of changing rules may have learned to avoid change of any kind. Just to wait and see.
If I am not very careful my conversation with Ann will become a power struggle between an authoritarian doctor and a free-spirited patient. Or between an irrational and authoritarian doctor and a patient who is not sure which recommendations should be followed and which resisted.
I need to avoid tapping into this pattern because in reality what is happening is no longer an external struggle. The struggle is between the person and his or her body and brain, or between the person and his or her bipolar moods.
An expression from the 1970’s comes to mind: “Don’t try to fight the river.”
Or in terms that are very relevant to this website, don’t try to fight the tides or even the waves of mood… instead surf them, use adult knowledge to create a better life with bipolar.