Monday, 16 July 2018

Bipolar and Saying No: Why I Can’t Always Do Fun Things with You

An open letter to a friend by Julie A. Fast

Dear Friend,

It really upsets me that I have to say no all of the time. I see that you are going to the coast and staying in a cabin while having a barbecue. That really sounds fun. A few of you went to New York last week for a vacation. That sounds amazing. Another friend often has a TV night with her friends and sleeps on the couch if she has too much wine. That sounds like fun!

Some of my friends work a seventy hour week and it sounds exciting.

Others go to sporting events and sit way up in the stands and tell me it was amazing!

I want you to know how much I appreciate it that you ask me to do these things and then explain why I can’t join you.

It’s the bipolar. I don’t ever use bipolar as an excuse for bad behavior. That is why we are such good friends. You trust me and I trust you. But I know that my inability to be as social as you might like can cause us some problems.

If there is a party, I might say no or I might have to leave early. I will never hang out all night for New Year’s Eve and that block party that everyone says is so much fun is just a lot of noise in my bipolar brain.

You are not the reason I say no. In fact, I want you to continue to ask me to do things. You might have noticed that I sometimes do say yes to the evening or day long plans!

But for now, I want you to know how much I appreciate it when we meet for breakfast. Tea or an early happy hour is really great. I love going to karaoke by the hour because we can get there early and leave early. We still get to sing!

I LOVE it that you have so many friends and that you invite me to your parties. I know it is frustrating when you hear me say I am lonely, as I am the one who often says no to your events.

I’m writing this so that we can keep our friendship strong. Here is how you can help me and here is why I appreciate your friendship SO much.

  1. Bipolar is a sleep disorder. If you think of it that way, it will help you see why I have to say no to anything that disrupts sleep. You know how you can do a hood to coast run, stay up all night manning a booth for your other runner friends, meet for pancakes the next morning and then sleep it off the next day? That is not possible for me. That situation could put me in the hospital. I know. It’s crazy, but sleep is that important.
  2. Bipolar is predictably unpredictable. I never know for sure when I will be triggered but I know my basic triggers. Crowds — so sporting events and concerts will always be hard on me. Meeting new people. I CRAVE new experiences, but my bipolar brain interprets them as stress. So anything new is a challenge.
  3. I’m easily tired out by life. Work and seeing you for coffee might be all that I can do in one day. I hate this. I really do! But I have not been in the hospital for years and my friendships are stable because I am so careful.

These are just a few of the reasons I have to say no to things you find enjoyable and easy. And here is how you can help me.

  1. Encourage me to try new things and let me know that I can leave if it gets too rough. I am NOT saying I should say no to everything. That is unreasonable. I want to say yes, but let me have an outlet. For example, if I make it 90 minutes at a party, that is a success! If I have to leave a concert early, I probably enjoyed the first part a lot!
  2. Remind me that I am in control of my life and taking care of my bipolar is what makes our friendship strong.
  3. Remind me to think of YOUR needs. I can’t say no to everything you like and expect you to only do what I like. I truly want to find middle ground. You are my guide with this. Be honest with me. I can learn!

Thank you for being such a great friend. It has been fifteen years and counting. You are the best!



About the Author

Julie A. Fast is the author of Loving Someone with Bipolar Disorder, Take Charge of Bipolar Disorder, Get it Done When You’re Depressed and The Health Cards Treatment System for Bipolar Disorder. Julie is a board member of The International Bipolar Foundation, a columnist and blogger for BP Magazine, and won the Mental Health America journalism award for the best mental health column in the US. Julie was the recipient of the Eli Lily Reintegration award for her work in bipolar disorder advocacy. She is a bipolar disorder expert for the Dr.Oz and Oprah created site ShareCare.

Julie is CEU certified and regularly trains health care professionals including psychiatric residents, social workers, therapists and general practitioners on bipolar disorder management skills. She was the original consultant for Claire Danes for the show Homeland and is on the mental health expert registry for People Magazine.

She works as a coach for parents and partners of people with bipolar disorder. Julie is currently writing a book for children called Hortensia and the Magical Brain: Poems for Kids with Bipolar, Anxiety, Psychosis and Depression. She struggles a lot due to bipolar disorder. Friendships keep her going.

You can find more about her work at and


Thursday, 12 July 2018

No Promises Asked For, Offered, or Needed. A Vacation Postcard to My Best Friend.

Monday July 9, 2018

Dear Fran

It is 7:10 p.m. here in the UK. 2:10 p.m. with you in Maine. This hour is our hour. Usually we would be on Skype, catching up on our news and our plans. Just hanging out together, as friends do the world over no matter where they live or how far apart in miles those places might be.

This isn’t a normal week, though, is it? I am on vacation here at Ambleside in the English Lake District. Travel – on either my part or yours – inevitably means some disruption to our routine. One Skype call per day instead of two, for example. Or shorter calls. Occasionally none. That used to hurt. These days not. Or not so much. We have learned to trust.

We are doing okay so far this week! We had video calls on Saturday and Sunday evenings, down by the jetty opposite the fish and chip shop. It is always fun to be on with you when I am “out and about,” able to not merely tell you what’s going on for me but show you.

The lake here at Ambleside (technically, where we are staying is called Waterhead, but it is part of the town of Ambleside). The roar of motorbikes leaving the car park next to where we were sitting yesterday. (Sadly, Skype doesn’t yet permit the sharing of smells: I would so have liked to share with you the tangy aroma of exhaust fumes as one biker revved her Harley in my face!) I showed you inside the Wateredge Inn, your first English pub. Maybe next time we will stay for a drink.

We touched a couple of times on chat earlier today to share our respective good mornings, and our weights. (At 185.2 lbs mine was close to the lowest it has been in many months which is especially rewarding given I’m on vacation when good practice is harder to maintain.)

No call today, though. Whilst I am enjoying the peace and tranquility of Borrans Park at the very northernmost point of Windermere (note I say tranquility, not silence: I can hear the lapping of waves at the shoreline, the call of birds in the air and on the water, voices from the pub, traffic, and a troupe of teenagers making their way in a very orderly fashion through the park) – whilst I am enjoying all this and taking photos and writing these words to share it with you later – you are out with friends having adventures of your own!

All being well – no promises asked for, offered, or needed – we will have our call tomorrow evening. And then you are off on a mini vacation of your own to Monhegan island! Four days. Three nights. No promises asked for, offered, or needed – but we will do our best to connect. To share words, the sounds of our voices, video, photos – the essence of who and where we are in the moment.

Because the moment is what we have to share. It is all any of us have. Seven plus years of moments have brought us to here as best friends. A heap more will carry us wherever we are set to go. Calls or not, Fran, I will be with you when you are away. As you are with me here today.

Hah! You just messaged me:

Milkshake AND ice cream. On boat.

– I figure you’re having fun! It’s not just that we are best friends, of course, is it? There is more to it than that. There is trust. And honesty. And vigilance. You messaged me earlier today:

Should I bring risperdal? I wonder if I am bordering on mania.

You mean today? Or for your trip? Definitely on the trip (it is on your packing list already). Worth bringing with you today if you are asking the question.

And so, at the mention of “milkshake AND ice cream,” I remind you to keep an eye out for that edge of mania. And that is how we are. We can switch seamlessly from whatever it might be that we are doing or talking about, into a deep and yet simple caring awareness that works both ways. (Not everyone gets that – that you are here as much for me as I am for you. In different ways, perhaps, but no less.) Thank you.

See you soon.



Wednesday, 11 July 2018

How Writing a Memoir Has Helped Me Talk More about My Mental Illness

By Peter McDonnell

I’m going to dive right in and begin. I hope people with similar problems with psychosis and anxiety can relate. Since writing a memoir of my experiences with psychosis, anxiety and recovery I have found that I can talk much more easily about my mental health issues.

Before I began my memoir in 2015 I had no interest in sharing how I was feeling about my illness with my supportive team (my parents who are both qualified psychiatric nurses, my various psychiatrists, my care coordinators etc.), friends, family and work colleagues. Now, just try and shut me up!

I often have to remind myself in general conversations that though my mental health and recovery fascinates me, other people are usually not as interested in my experiences as I am (but sometimes they are!). I had my annual appointment with my psychiatrist two weeks ago. She asked how I was, and so I began.

I am doing really well. I’ve been a bit blocked up with constipation – I understand that my medication (Clozapine) can sometimes affect this. I’ve been eating lots of fruit and veg and I bought some prune juice earlier today, so I expect the prune juice to work and I should be fine by tomorrow.

My anxiety is still improving, it’s at such normal levels now that I’m not really thinking about it and I’m not sure it’s any higher than what normal people get from time to time.

But I am wary that I’ve been challenging myself less recently. My nieces and their parents lived in London until a few months ago before moving to Denver, and taking the train or driving up to see them fortnightly was a challenge that helped me keep my abilities to stay on top of anxiety I think, and I do wonder sometimes if not having this regular challenge might make me rest on my laurels a bit and get too comfortable. For the last few years I have found that remembering to keep well is sometimes very important and if I forget to, I feel a certain dip in my general mental health.

I keep well by doing a mix of little and big things. Sometimes it’s just a case of asking my brain in the morning what kind of positivity I want to feel that day, and for reasons unknown to me, it works and eight times out of ten at the end of the day, I find that I have felt exactly how I told my brain I wanted to feel!

Other times I have found it helpful to push myself a bit and do more challenging things, like spending the day looking after my nieces in London. They lived in Chiswick and I’m very close to them, they are two and four years old. I think looking after them taught me responsibility and some of how to be a mature adult, and after doing the parenting thing for a bit, whether for an afternoon, overnight or for a few days and nights I felt very in step with the world.

It’s at this point that the doctor senses that I am doing well. I sense her sensing it. I then decide that I have more to say.

My psychosis and ideas of reference are still there, but I am controlling them well. I used to feel like people in queues and waiting rooms could read my thoughts, but it’s happening less recently. When it was bad I’d be standing behind someone in a queue and my ‘Telepathic Tourette’s’ would start and if the person in front of me was very ugly, then I’d hear in my mind “fuck me aren’t you ugly” and because of my stupid and annoying telepathic abilities (that I don’t think I have anymore) I’d think they heard me.

Then in my mind I’d feel like I had to explain to them, telepathically, that I don’t really think they are ugly, even if they looked like a Hyena. I am a nice person who doesn’t insult the afflicted; I’m not a ten out of ten myself!

But then like Tourette’s syndrome all the other insulting thoughts come out and the people around me can hear them, like ‘you’re a prick with a stupid haircut’ or ‘you smell like a landfill site’. It’s annoying, but recently it hasn’t been a problem and thoughts are appearing in a softer way in my head in these situations, so that’s a good bit of progress.

My job is going well, I used to get anxiety at work a few years ago, but I don’t anymore. My mental health memoir and website is coming along, I recently had a friend with lots of Facebook friends share a link to it and I got 2000 visits in four days. I have been working with a website guru to improve my website which is going well too.

By this stage my Doctor begins indicating that she isn’t interested in a haphazardly scattered lecture and that she has other people to see. So I wind it down and she does the usual thing, checking that I am still taking my Clozapine without any problems and she says that we could do a full check on everything via blood test, a sort of annual check-up of glucose levels, lipids, Amylase, B12 and calcium etc. She says that I seem to be doing very well. She gives me a blood form to take to the phlebotomist and we say goodbye.

I throw her an accidental curve ball as I remember that I wanted to ask if she could recommend a popular online psychosis journal that I might write a paper for. She says “No, sorry – but good luck with your writing, Peter”.

So that’s how I tend to speak to my psychiatrist. I hope it shows that a person can be comfortable talking about whatever they like to them. When you are ready, open up.

I rarely opened up to people about my mental health before I started writing about it in my spare time. For me it wasn’t really stigma or the taboo factor that made it difficult to talk. It was that the words were hard to find. It’s not easy to talk about why a panic attack may have started, or the processes involved with bringing about a period of good mental health, and often it’s complicated to answer a simple question like ‘how are you’ when you are at the doctor’s office. One is supposed to elaborate when they are asked how they are by their psychiatrist. In regular daily exchanges ‘fine thanks’ is sufficient.

If you are like me and have or have had limited social conversations due to staying at home a lot, because of anxiety issues perhaps, then the power of descriptive speech can begin to fade. Lots of people get embarrassed when discussing their mental health too.

Before I wrote my memoir, talking about the finer points of my mental health often felt like a fruitless endeavour – an impossible task. I felt like I could talk if I wanted to, but that there was no way I’d find the words to be understood properly. For many years I had very little insight or understanding of my illness. It felt like there was no way my team could understand it any better by me talking about it, because I didn’t even understand it myself.

But these days I talk about it all the time and talking is helpful for mental health for hundreds of reasons. So helpful in fact that there is a phrase assigned to the action of talking about mental health – ‘talking therapies’. Talking can help you take charge of your well-being.

The thing that allows me to verbalise it all is my writing. I have been writing about my mental health and recovery for at least four years now, including a book, articles like this one, papers for online mental health journals, travel articles and my blog. Writing has instilled a sense of enthusiasm, so now I find that my mental health and mental health in general (especially how my own experiences with mental health compare with other peoples) is my favourite subject. I can also find the right words when I need them and I am keen to pick up knowledge and tips through conversation.

If you want to use talking to feel better about your mental health I would recommend writing a journal of your thoughts about your mental health at the end of each day. Then when someone asks you how you are, either a friend at work or your psychiatrist, you will remember your journal and feel like you have some thoughts to share. You will often feel more enthusiastic and the words will be ready to go on the tip of your tongue.

About the Author

To read more of Peter’s writing about his journey with mental illness and recovery visit his website which has extracts from his memoir, articles written for other websites, his blog, a guest post page and more.


Wednesday, 27 June 2018

Being Jimmy Perez: Shetland and the Art of Listening

Spoiler alert: this post touches on aspects of the British television crime drama “Shetland.”

Photo credit: Doris Pecka.

Fran and I watch a lot of tv and movies together. Our talking done for the evening, Fran turns her laptop (and thus me) to face her television and we settle down to Netflix, a DVD, or occasionally a tv show.

We can see each other reflected in the screen: Fran on her couch and me in my desk chair. We might comment on what’s going on or ask a question but it’s hard to hear each other unless Fran pauses the show. So for the most part we sit and watch – and listen – in companionable silence.

It sometimes feels like we do this a bit much. We used to talk more, sharing what had gone on for us that day or making plans for whatever was coming up. We still do that, of course, just less than we did. There are reasons for the change, not least the fact that Fran’s fatigue has been especially hard on her this year. By the time we get together of an evening she is often too tired to talk much. But the other night as we watched the British detective drama “Shetland” something fell into place for me about the value and importance of listening.

We both love the show: the stunning scenery, the gritty city environment of Glasgow, the accents, the superb writing and storylines. We’ve taken the characters very much into our hearts. Played by Douglas Henshall, Detective Inspector Jimmy Perez is one of very few male roles I’ve ever identified with or wanted to emulate. This series has seen him navigate a range of personal challenges, most notably with his detective sergeant Alison “Tosh” Macintosh (played by Alison O'Donnell), his stepdaughter Cassie (Erin Armstrong), and Cassie’s biological father Duncan (Mark Bonnar). Jimmy and Duncan have a close, awkward, almost brotherly, relationship that is beautiful to watch.

What struck me is how good Perez is with people going through crisis and change. (He is less good with his own crises and changes, but isn’t that the way of things? The series closes with a hint he may finally be finding a way forward.) Whether interviewing a suspect, talking with witnesses, confronting a violent crime boss, or engaging with colleagues, his stepdaughter, or a new lover, Jimmy Perez is usually calm and measured, although he can be assertive when necessary. He doesn’t always get it right but he owns his mistakes. He comes across as honest, genuine, and caring. He is someone you’d feel safe with.

It is this aspect of his character that most interests me. More and more I find myself in a listening role. I don’t always know what to say but I have learned that what matters most is showing up, being present, and being prepared to listen. It is good to see this demonstrated so clearly, even if it is in a fictional setting.

A friend said to me the other day, “The distinction between hearing and listening is important.” She’s right. So often we imagine we have been listening to someone when really all we did was register the sounds they made. Listening is as much about the spaces between the words (and at the end of them) as it is about the words themselves. It is not as easy as it might seem.

At a meeting last week with our company’s mental health team I suggested setting up a small lending library. I have lots of relevant books at home and am more than happy to bring them in. One is Gail Evans’ Counselling Skills for Dummies: A Practical Guide to Becoming a Better Communicator and Listener. It has lots of useful information, tips, and techniques. It is well worth checking out if you get chance. I might read it again before I take it in.

Genuine listening involves far more than letting someone talk. (Or write. Much of my listening takes place online using social media, instant messaging, and emails.) There are certain things not to do. Don’t interrupt. Don’t leap in with potential fixes or your own experiences. These get in the way and are rarely as relevant to the other person as you imagine. There are specific things you can do. Check in now and again to confirm you are picking up what the other person wants to convey. Ask for clarification if necessary. Encourage gently. If you want to know more, check out the Dummies book – or ours.

Best of all, practice. That means engaging – with your friends, colleagues, partner, children, strangers. We are all different and our needs are complex and wonderful. This was brought home to me on a neurodiversity workshop I attended recently at work. The course material was good but what I found most valuable was listening as the trainers and others in the group shared their experiences, and I shared mine. (I have just noticed I am wearing a Stigma Fighters t-shirt today with the slogan “Sharing Our Stories.”)

This is where the magic happens. We can aspire to no higher calling than to be someone others feel safe enough with to be vulnerable. Be like that. Be like Jimmy.


Wednesday, 20 June 2018

Looking Back on a Productive and Positive Week

Saturday, June 16, 2018

I am at Tynemouth Metro station this morning. The weekend market is relatively quiet so far. Bustle without the hustle. I have a large Americano from the excellent Regular Jo’s coffee stall, and the table to myself. [Later, I was happy to share with two very dapper gentlemen I’ve spoken to before.]

I’ve caught up with my diary and written to one of my oldest (ahem, longest-standing!) friends. It is time to open my Midori notebook and think about this week’s blog post.

It has been a busy but very positive and fulfilling week for me on the mental health front. I spent an hour last evening editing the latest in a new series of articles by a great friend, renowned author and family coach Julie A. Fast. Julie’s posts are always amongst the most popular on our site. This latest one focuses on managing paranoia.

Fran and I received several messages this week from people who have read or are reading our book, or have connected with us in other ways. We’re not in the advice business but it means so much when our words resonate with others or if we have been able to shed a little light on someone else’s situation. It sounds trite but that really is what it’s all about for us.

And we gain so much in return. At the moment I am working on what will be my sixth article for Bp Magazine. (You can find the first four on my author page. The fifth will be posted up in a week or so.) My latest topic is the glamour (in the sense of enchantment) of euphoric mania. I am working from our own experience (as many of you know, Fran was in mania when we met back in 2011) but am also drawing on the experience of others who have shared with me and are happy to contribute. This kind of collaboration expands my knowledge and hopefully makes for a more rounded article. Fingers crossed on that score!

Speaking of collaboration, as I’ve mentioned elsewhere I am working with some fabulous people at the company where I work to get some new mental health initiatives off the ground. It is early days but we are beginning to pull some ideas together.

It is hard to overstate how much it means to me and I am determined to make the most of the opportunity. It has already led to new connections and conversations, new training including a half-day session next week on neurodiversity and an excellent dial-in last week on resilience, as part of Carers’ Week.

That I can do this at all is down to the support and encouragement of my boss Judith. When people care for those around them as much as she does — at work or in any other environment — anything is possible. That is the culture our newly formed mental health team is looking to foster. I drafted Vision and Mission Statements this week for us. They may be amended or someone may come up with something better altogether! But for me they capture the essence of what we are about.

OUR VISION is a working environment in which we all feel safe, supported, valued and heard.

OUR PURPOSE is to foster a workplace culture and practices free from mental health stigma and discrimination, by raising awareness of mental health conditions, support services, events and organisations, encouraging relevant education and training including Mental Health First Aid (MHFA), and providing appropriate support to colleagues, including signposting to internal and external services.

Okay. I’ve just about finished my coffee. It’s time to take a look round the market. Who knows what I might find. I am curious to find out. That’s kind of what life’s about, I think.

[I was delighted to find a superb vintage tweed jacket by Haggart’s of Aberfeldy on one of the stalls. Exactly what I have been keeping an eye out for.]


Saturday, 16 June 2018

Effective Strategies to Manage Paranoia in Bipolar Disorder and Schizoaffective Disorder

By Julie A. Fast

In part one of this blog, Exploring Bipolar Disorder and the Sister Diagnosis of Schizoaffective Disorder, I talked about psychosis in bipolar disorder and how some of us with bipolar also have a separate diagnosis of a psychotic disorder. Bipolar with a separate psychotic disorder is called schizoaffective disorder.

In part two I explore the topic of paranoia, a psychotic delusion. All people with bipolar disorder live with the possibility of paranoia. It’s more common than most realize. Paranoia is quite a friendship wrecker. I lived with paranoid thoughts and behaviors for many years before I learned how to control them. I still get paranoid but I’ve learned not to take it out on my friends the way I used to.

As a side note, please know that people can have paranoid behavior without having a mood disorder. Paranoid personality disorder is an example. This article is relevant to anyone who experiences paranoia.

How I Manage My Paranoia

I’ve taught myself to know what I think, say and do when I’m paranoid. I explain how I use this process in my Health Cards Treatment Plan for Bipolar Disorder. It is the only way I have found to manage my bipolar disorder as I can’t take many medications. Before I learned this system I was a tiny boat on a raging ocean of moods. I still have mood swings but I know now what they are and am able to control them. You can learn to do the same. If you’re a friend or loved one of someone with bipolar disorder or schizoaffective disorder, you can also learn to use this system to help. Here is how it works.

What I Think, Say and Do When Paranoid

What I think when I’m paranoid. Please note that I use the word ‘think’ but with delusions it really is more of a feeling than a thought.

Something isn’t right with my friend. She is upset with me and doesn’t want to tell me the truth.

People are meeting and having dinner parties and doing things without me. They don’t want me there, so they don’t invite me.

Friends think I don’t know what is going on, but I do.

Someone is upset with me. I can feel it.

No one is calling me. They are upset with me.

This is not a safe place. I have to get out of here.

Someone is following me in the car.

What I say. This is where I used to get into so much trouble! I would either say these things out loud or send an email.

I write an email or text and accuse someone of not wanting to contact me.

I ask friends, “Are you made at me?” or, “Is there something you want to talk to me about?” Or ”Is something wrong?”

I tell people, “I’m not stupid and I know that there is something wrong and you should just tell me the truth!”


What I do.

I can’t look people in the eye.

I obsessively pour over emails and texts and search for hidden meanings.

I can’t sleep.

I look in my rear view mirror and see that cars are way too close. Someone is following me.

I look for recording devices. Maybe someone has hidden cameras in their kitchen.

I cut myself off from people I feel are harming me by not talking to me.

These are just a few examples. I’m interested to know if you have experienced anything listed above, either as a person with bipolar or as a friend. This paranoia symptom is often missed as it can be subtle. The internet has made paranoid communication much easier and people are very quick to accuse when it takes just a few seconds to send a message.

What if the Paranoid Feelings are Real?

I live in the creative world now and I often see my work used by other people. This is deeply distressing as you can imagine. The difference between this and what I describe above is that in most cases people actually have plagiarized my ideas. I tend to keep quiet about this as it can lead to actual paranoia, but sometimes I do have to take action. The main difference between paranoia and noticing that someone is using one of my ideas without credit is that paranoia is NEVER real. Can the two get confused? Yes, if I am paranoid I can think that someone is using my work who isn’t. This is why I use my Health Cards and never say anything unless I have facts to back me up. Even then, I might not be right!

How I Changed

One day, after a really terrible situation where I sent an awful email to a friend and effectively ended our relationship, I realized I had to change. I write about this experience in my Bp Magazine article Relationships and the Bipolar Trap. Was it easy to change? No. In fact, I still have to watch myself very carefully even though it has been almost twenty years since I sent the letter to my former friend. Here is what I do now.

  1. I memorized what I think, say and do when I’m paranoid. I can’t trust my ill self, but I can trust my well self. The well me creates the Health Card (you can simply create a list of what you think, say and do) and I then use it when I start to get paranoid. Yes, you can teach yourself the signs you are paranoid and you can learn to stop the episode from going too far. It is NOT easy. I first had to see my paranoia was a problem and then had to stick to documenting my behavior so that I could use it later.
  2. I made a promise to myself (and for the most part I have kept it) that I will NEVER, and I do mean NEVER, send a text or email or any form of communication that is accusatory. I stick to my own feelings and my own experiences. This has helped greatly. I no longer say You did this! or You are thinking this! Stopping this one action — the writing and accusing — has saved me a great deal of trouble and saved many of my relationships.
  3. I accept that I still get paranoid. My symptoms are still here but I have learned how to minimize the symptoms.
  4. I do not use any hallucinogenics. This means no cannabis (THC is a strong hallucinogenic and even when I tried low THC, or what was labeled as no THC, I got psychotic.) I keep away from any spiritual journey drugs such as magic mushrooms or Ayahuasca. My brain is too fragile to handle anything that is hallucinogenic.
  5. I tell my friends what to look for. In the beginning I needed a lot of help from others. I needed people to say, “Julie, you asked me to remind you if I thought you sounded paranoid. I am reminding you now.” This helped me a lot. Eventually, I was able to control it on my own.
  6. I keep away from people who are paranoid. I don’t have friends who believe in conspiracy theories, government cover-ups or chem trails. This doesn’t mean they are wrong and I am right. It means that this kind of person is not safe for me. It makes me ill to be around another person with paranoid thinking and talking.
  7. I put my thoughts in a journal and they STAY there. I am always shocked to go back and read what I wrote when I was sick. I think, “Good heavens. I was really paranoid. I am SO glad I didn’t say anything!”
  8. I take meds if needed. They help a lot.

It’s incredibly important to listen to others if you have the symptoms of paranoia. Your brain is not your friend when symptoms are raging. I had to ask for help with all of this.

Tips for Friends, Siblings, Family Members and Health Care Professionals

Make your own thinks, says and does list so that you will not get caught in a Bipolar Conversation. You can then decide how you want to approach the issue. I believe in preparing scripts to use when a friend is not doing well. For example,

Julie, you have been very honest with me about your bipolar disorder and I appreciate this. Right now, I feel that we are in a situation where the bipolar is doing some of the talking. I am concerned about what you are saying and feel you are in a mood swing. I’m here to discuss this with you.


I know that these thoughts come up when life is stressful. I can tell you that I have not changed and you have not changed. The thoughts you have and the feelings you are experiencing sound intense, but please know they are not related to us. We can work on this together.

It helps to have a plan in place that you discuss when your friend is stable. You can ask, “What would you like me to say when I can tell you are paranoid?” And then use the words another person created for you.

Do you have signs of paranoia? Is paranoia causing problems in a friendship with someone who has bipolar? Please know that paranoia rarely goes away. It is a symptom that needs to be managed. Doing this as a team makes a lot of sense!


PS: My next post will be on trigger management. I’ll cover how I recognize and remove triggers to manage the paranoia as well as other aspects of psychosis.


About the Author

Julie A. Fast is the author of Loving Someone with Bipolar Disorder, Take Charge of Bipolar Disorder, Get it Done When You’re Depressed and The Health Cards Treatment System for Bipolar Disorder. Julie is a board member of The International Bipolar Foundation, a columnist and blogger for BP Magazine, and won the Mental Health America journalism award for the best mental health column in the US. Julie was the recipient of the Eli Lily Reintegration award for her work in bipolar disorder advocacy. She is a bipolar disorder expert for the Dr.Oz and Oprah created site ShareCare.

Julie is CEU certified and regularly trains health care professionals including psychiatric residents, social workers, therapists and general practitioners on bipolar disorder management skills. She was the original consultant for Claire Danes for the show Homeland and is on the mental health expert registry for People Magazine.

She works as a coach for parents and partners of people with bipolar disorder. Julie is currently writing a book for children called Hortensia and the Magical Brain: Poems for Kids with Bipolar, Anxiety, Psychosis and Depression. She struggles a lot due to bipolar disorder. Friendships keep her going.

You can find more about her work at and