Wednesday 27 November 2019

Managing My Dual Diagnosis on a Day to Day Basis

By Kailey Fitzgerald

Being in recovery from drug addiction and having a mental illness concurrently can be extremely mentally taxing. On my off days, when I am not keeping up with my daily routines and neglect my self-care mechanisms, my life can seem chaotic and unmanageable. I often say it feels like I am just constantly putting out one fire after another. On the other hand, when I do manage my dual diagnosis well, I am truly happy.

Finding coping mechanisms and a healthy daily routine that worked for me took a lot of time and effort through trial and error. What may work for one person, may not work for another. It wasn’t until I went to an addiction treatment center and began true, honest, and rigorous therapy that I finally found what worked for me.

Go to Therapy Regularly

Going to therapy and giving it a real, honest shot is what saved my life. For years I was repulsed by laying down on some brown over-sized couch and telling some stranger with a medical degree all of the reasons my life sucked. To my surprise, I learned that real therapy is not like what you see on TV. My therapist treated me like a human and really allowed me the time and pace I needed to begin to open up to him.

In therapy, I learned many valuable coping mechanisms that I incorporate into my day to day life. For example, I suffer from a couple of anxiety disorders. When I begin to have a PTSD flashback or an anxiety attack, my therapist recommended I ground myself through breathing techniques. I try to apply this and when I do, it typically helps in centering my body and mind enough to get through the flashbacks and anxiety attacks.

That being said, after a few therapy sessions I began to feel better. In my own naivety, I thought that meant I was recovered and could stop attending therapy. The first few weeks were great, I had more financial freedom and more free time on my hands. Quickly I realized I had made a mistake when I ran into one of my PTSD triggers and had a complete meltdown. Luckily, I was able to make the conscious decision to admit my wrongs and call my therapist to resume our biweekly appointments.

Maintain the Sobriety Aspect of My Recovery

It is extremely important for me to maintain my sobriety in concurrence with the treatment of my secondary mental illnesses. This means continuing to participate in the fellowship I chose, utilizing my meditation practices, keeping in contact with my sober support, and remaining diligent in monitoring whether I begin to romanticize drug use or old habits. The combination of all of these practices is what allows me to remain sober without becoming a “dry drunk”. Dry drunks are defined as people who are chemically sober but behave in the same manner that they did while they were using. For example, if I stopped maintaining my sobriety I would begin to become easily agitated and unable to control my emotions — causing me to resort to fantasizing about using a substance to numb my feelings.

For all intents and purposes, let’s just say I let the maintenance of my sobriety slip. I become discontented with my life, the people around me, and the fact that I have to abstain from using drugs. This would begin to affect my secondary mental illness because I am already slipping into a dark place. With the combination of my unmanaged sobriety and the symptoms of my anxiety disorders beginning to intensify, it would be extremely hard and maybe even impossible for me to remain sober. So, keeping that in mind, I do the best that I can in order to maintain my sobriety every day.

Remember That Recovery Is Not Linear

Recovery from any ailment takes time. Some days you will progress, while some days you may backslide. It is important to remember not to beat yourself up when you have an off day. When recovering from dual-diagnosis mental illnesses, these off days may happen more often than you’d like. I remember at the beginning of my recovery, everything was seemingly perfect. I had the desperation and time to do everything in my power to maintain my substance abuse recovery and my anxiety disorder recovery. As time went on, I regained responsibilities that left me with less time to pursue my recovery. This meant that life began to become increasingly difficult.

In order to balance my recovery, work, family and my social life I had to readjust my expectations. In addition, I needed to gain confidence in my recovery. I had built a strong foundation of life skills, coping mechanisms, and a support network that could carry me on my “off days”. When I had less time to make meetings or therapy sessions, I would call a sober friend to give me advice or just lend a listening ear. Initially, I felt guilty that I wasn’t doing as much as I had been in early recovery. But, despite my guilt, the truth was that I was still doing everything in my power to maintain my recovery. We get sober and recover from our mental illnesses in order to build a life worth living. Once I realized that my guilt dissipated. All of these responsibilities that I thought were taking away from my recovery were, in fact, the gifts of recovery.

About the Author

Kailey Fitzgerald is a young writer in the recovery community. She has found passion in writing for websites like Discovery Transitions, who work to spread awareness and break stigmas in relation to recovery from addiction and mental illness. She has found this passion through recovering from her own dual-diagnosis and attempting to help others do the same.


Saturday 23 November 2019

How to Be Honest without Losing Your Friends

I’ve learned that the best relationships aren’t just about the good times; they’re also about the obstacles you go through together, the undying support, love, and the ways you help each other grow. — Sibyl Chavis

Fran and I believe openness and honesty are essential if you want your friendships and relationships to be successful. As we write in our book High Tide, Low Tide:

We believe it is healthier to be open about our thoughts and feelings than to dismiss, hide, or avoid them. .... We sometimes get upset or angry with each other, but we deal with discord promptly if it occurs, recognising there is no need to fear even powerful emotions when they can be explored safely.

It’s not always easy. Being honest requires mutual respect and trust, a commitment to work through whatever comes up, and the belief that your relationship is worth the effort. Here are three examples where I’ve worked through disagreements and issues honestly with friends. If I can do it, you can do it too!

“Over there — that’s where we had our first tiff!”

My friend Vikki and I were standing at the bar in Hadrian’s Tipi in Newcastle for the first time in about a year. I smiled. “Yeah. I was pretty grumpy that day!” She didn’t contradict me.

I remembered it well. Vikki sharing what was going on for her that day. People. Conversations. Frustrations. Whatever she needed to get off her chest in the safe space we’d learned to hold for each other as friends. I had things to talk about too; specifically the great response I was getting to my article about bipolar anger which had been published by Bipolar UK. I was feeling positive and proud and wanted to share that with my friend, not least because she had contributed to the article. But Vikki was in full flow. It was hard to get a word in and I began to get frustrated. Even when she paused long enough for me to speak I didn’t feel she was paying attention. I took myself off to the toilet but we both knew I was angry.

When I got back Vikki apologised for interrupting me. I explained that the news about the article was important to me, the way her stuff was to her. She acknowledged my point of view and pointed out I had told her my news — twice — but said we didn’t need to seek validation from each other all the time. That aggravated me all over again — because of course, she was right! The atmosphere was brittle for a while but we put it behind us and enjoyed the rest of our time out.

It wasn’t our last disagreement or the worst. For a while we weren’t friends at all but now we are, and our friendship is stronger for all we’ve gone through. We’ve certainly learned a lot about how to handle things that come up for us.

Maybe you only really start to get to know someone when you’ve had an argument or disagreement and come through it together. That’s certainly true of me and Fran. I’m not sure which was our very first but we’ve had many such moments in the eight years or more we’ve been friends. I’ve written elsewhere about some of them, including this example which I’m not proud of.

A couple of months ago we were talking together on webcam. Suddenly, I was more furious than I can ever recall being in my life. I was yelling at her, swearing at her, raging at her. I can still recall the fury. I can taste it. I have no recollection now of what triggered my outburst, but I know we stayed on our call. Fran waited for me to calm down. We talked it through. I could ask Fran to remind me what it was about. Perhaps I will. But the point is we can experience moments of even extreme anger, process them, and move on.

How do we do that? First and foremost we are honest and open with each other. We are not proud of our anger but neither are we ashamed. We do not take it as a personal affront or as a threat to our relationship. We talk as soon as possible, looking “under the bonnet” at what might actually have been going on. It can be a very cleansing experience, and allows us to move forward without feeling guilty or nursing bruised egos.

That article includes a situation similar to the one I’ve described with Vikki. I clearly have some issues around feeling not listened to when I’m sharing things with people, even people I feel safe with and trust.

I could tell Fran wasn’t paying attention, and as soon as I stopped speaking she took the conversation back to what she’d been talking about earlier. I let it go but I felt aggrieved. I’d have liked some acknowledgement of what I’d shared. I was also irritated by some of what Fran was saying about other people and events, as though everything and everyone was against her.

After talking for a few minutes Fran paused. She’d noticed my shift in mood. She acknowledged she was being unreasonable. She knew I was excited about my news, but couldn’t focus on that because she was so worried about what was going on for her. She was also concerned her bipolar might be kicking in again. I realised I’d not picked up on just how concerned she was about everything. Although “tired and grumpy” she had seemed to have things in hand.

It didn’t take long to talk it through. No more than a couple of minutes. Before we ended our call I told her: “I’m proud of how we do this stuff, Fran. You get to say how it is for you. I get to say how it is for me. And we get over ourselves and move on.”

My third example concerns my friend and fellow mental health blogger Aimee Wilson. It happened earlier this year when she was in hospital following an overdose. (You can read Aimee’s account of what she was going through at the time on her blog I’m NOT Disordered.) Aimee asked if I could go in to visit her and I was happy to do so. She was still in A&E at the time and said she’d tell me when she was moved onto one of the wards. I confirmed the ward visiting times and told her I’d be there.

I had to catch a train and a bus to get to the hospital and decided to travel in early. I arrived with a couple of hours to spare and asked at reception if she’d been moved onto a ward yet. She was still in A&E and I was allowed through to visit. I thought she’d be glad to see me, but she was cross because I’d not waited until she was on the ward. She asked me to wait outside and at first I said it was OK, I’d sit with her. She told me again and this time I did as she asked. I went back to reception and settled down to wait. I was sorry I’d upset her but it didn’t seem too big a deal. I passed the time working on a blog post. Ironically, it was an open letter about a previous occasion I’d visited Aimee in hospital.

Finally it was visiting time. I’d heard nothing so I went back to ask how she was. I was told Aimee had been moved onto a ward but didn’t want to see me. As I left the hospital it’s fair to say I felt hurt and angry — mostly at myself but also at Aimee for not letting me know what was happening. (In fact, she’d asked one of the nurses to find me in reception but I’d not got the message.) I messaged Aimee as I waited for my bus:

They’ve told me you don’t want any visitors after all so I guess I’ll go. I’m not cross, just sad.

Aimee replied later that day. I will always be grateful that she was completely honest about how deeply my actions had impacted her.

I did tell you that I’d let you know when I was on a ward and what the visiting times were and you just turned up and then I had to repeat myself for you to leave. Like I already don’t feel like I’m in control of anything and you did that... it was upsetting and hard.

In that moment I saw why it had hurt her so much. I replied more defensively than I wish I had, but I took responsibility and apologised. It was our first serious disagreement and I wasn’t sure how it would affect our friendship but Aimee accepted my apology and we moved on from there. When I told Aimee I’d like to include what happened in an article about arguments between friends, she said “Sure. It wasn’t an argument, though. It was a misunderstanding. And I think it made us stronger.”

I agree. We’ve not had any other big disagreements (so far!) but something came up recently which left me feeling hurt and less than valued. I considered keeping it to myself but figured Aimee would rather I brought it into the open. It was the right decision. Aimee acknowledged my feelings, apologised, and shared her perspective on what had happened. It’s good to know we can do the honesty thing.

I saw a meme on social media the other day which read:


I laughed. I get it. But the friends I value most are the ones who say yes.


Wednesday 20 November 2019

How Honest Friends Helped Me Find Stability

By Julie A. Fast

Do you have bipolar, schizoaffective disorder or a different mental health disorder that affects your friendships? I have bipolar and a psychotic disorder, now called schizoaffective disorder. As you can imagine, relationships were difficult when I was undiagnosed and didn’t know how to manage my own behavior! I’d like to share how I progressively righted my often out of control relationships and found more stability and happiness in my daily life.

Paranoia and Friendships

I lived with undiagnosed psychotic paranoia for many years and it greatly affected my ability to have stable interactions with friends and coworkers. My diagnosis helped me name what was going on in my brain and I finally knew that I wasn’t thinking and acting oddly out of obstinance. I was ill! Even though I now manage my psychosis with a plan that keeps most symptoms calm, I still had to teach myself to live with the symptoms that I can’t always control. I lost friends along the way, but after almost twenty years of regular practice, I can now live with my psychosis without acting on it. Yup. I still have psychotic paranoia in certain situations involving work and time with friends.

Here are some very typical thoughts I have when interacting with friends. These thoughts are accompanied by a strong feeling that something is wrong and that I’m being ignored or used:

Why is she calling her other friends and not calling me!

Why does he only want to see me on a Monday and not a Friday? Am I not good enough for a Friday night out?

Is she upset with me? Is that why she didn’t answer my text?

To counteract these thoughts so that I won’t act out on them quickly, I first have to determine if my thoughts are attached to a real behavior by the other person — is someone trying to put me off? Or, am I simply paranoid and unreasonable? It’s not easy to live with this constant need to check my own thoughts. It affects my life in every way, but like any illness I have to get my thoughts and subsequent behaviors under control if I want strong friendships. I find that in 99% of situations where I have these thoughts, I am WRONG. It is paranoia and not real. Thank heavens I can see this now!

What a life! But it’s a much better life now that the paranoia isn’t controlling ME.

Euphoric Mania and Friendships

I think I’m so fun and lively and sexy and wonderful when I’m manic. That might be true to strangers who meet me in a bar, but for my friends? No way! I’m an annoying, loud, prideful, grandiose, narcissistic doofus!

Friends can get very upset and embarrassed by my mania. I talk so much! I have way too many boyfriends! I drink. I don’t slow down and then I crash. It’s ridiculous.

I stopped this behavior over ten years ago. I simply said no more mania in my life. I now manage it as diligently as I do my depression and psychosis. I had to choose between the wild times with strangers and healthy stability with friends.

Learning to manage paranoid thoughts and truly committing to ending mania in my life deeply affected my friendships with people who have bipolar disorder and psychotic disorders. I have lost a few friendships due to friends who like their mania more than they like stability. I ended friendships when their paranoia showed up in a text at 2 AM accusing me of something I truly had not done. It’s not my job to change anyone, but it is my job to keep myself stable, so these friendships are no longer in my life. It’s probably the same thing when a person stops drinking and friends continue to drink heavily! You have to make a choice.

Just like Marty and Fran, I work super hard on my friendships. I look inside myself before acting out of a mood swing or paranoia. I wasn’t born with this ability. I created the plan in my book Take Charge of Bipolar Disorder and I USED it.

Is it hard? Yes! Hard, so hard! But I did it anyway. You can do this as well. I believe in our ability to change.

We can be GREAT friends!


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. She struggles a lot due to bipolar disorder. Friendships keep her going. You can find more about her work at and


Wednesday 13 November 2019

Caregivers Need Care Too

By Janet Coburn

Originally published in May 2017 at Bipolar Me.

While there are professional caregivers, family members often provide care and support for those with bipolar disorder and other mental illnesses.

My husband of 35 years is my caregiver. He does a spectacular job – making sure I have my meds, taking me to my appointments, running the errands that I have no spoons to do, keeping the house quiet when I need to sleep, making sure I eat at least one nutritious meal a day.

It’s a lot. And there are things I can give him in return. Things he needs.

Appreciation. When my father was dying of cancer, my mother was his primary caregiver. One day she came to me, wanting me to tell her that she was doing a good job. She knew that she was. She just needed to hear it from someone else, someone who could tell her that her excellent care had been noticed and appreciated.

Appreciation – validation – is the thing that caregivers need most, to replenish themselves, to allow them to keep doing the things that are so vital for their charges. And it’s the easiest to give. When you’re in the depths of depression, it may be difficult to remember to say “thank you,” but it means a lot to your caregiver.

Now I’m mostly out of my depression (usually), and I say “thank you” a dozen times a day. And he always responds, “You’re welcome, friend.”

Alone time. Primary caregiving can be a full-time job. I know that one thing I need in the process of healing is alone time. Dan needs it too. He needs time off, even if that’s just time to retreat to his study and watch a movie or go outside and dig in the garden. I can always reach him if I really need him – for example, if I have a panic attack – via cell phone if nothing else. But, as the saying goes, you can’t pour from an empty vessel. That’s part of the reason that he’s able to give me so much of what I need.

Couples time. This doesn’t necessarily mean sex. It means time spent together, doing something other than dealing with mood swings and trauma. It’s a little gift we give each other. Sometimes I sit through a movie I don’t really care for, just to give him the gift of snuggling on the couch. He got me color-and-bake ceramic mugs that are great for creativity and distraction. One rainy afternoon we sat together and each colored one side of the mugs.

Life stuff. Dan does most of the chores and tasks of daily living, but I do what I’m able to. I earn money. I pay bills online and do most of the other computing, except what he does for leisure. I help with cooking to the extent I can – sous-chefing, finding recipes, breading or mixing or inventing dressings and sauces, making grocery lists. He can ask me for help too.

Sharing my spoons. When I do find myself with a few spare spoons – a little extra energy occasionally – I try not to be selfish with it. When I have spoons to spend, I like to shower and dress and go out for lunch. But the other day, I showered and dressed and went for a walk in the woods with Dan, something he’s been longing for. My spoons ran out pretty rapidly, but he appreciated that I made the effort and shared one of his delights. It was another gift that cost no money.

In other words, when you have a caregiver, don’t think it’s all one way. Your caregiver needs care too. Small or large, what you are able to give will be appreciated.

About the Author

Janet Coburn is a freelance writer/editor with bipolar disorder, type 2. She is the author of Bipolar Me, available on Amazon, Barnes & Noble, iTunes, a through other outlets. Her second book, Bipolar Us, will be published later this year by Eliezer Tristan Publishing.

Janet writes about mental health issues including talk therapy, medication, books, bullying, social aspects, and public policy, but mostly her own experiences with bipolar 2. As she says, “I am not an expert and YMMV – Your Mileage May Vary.”


Friday 8 November 2019

A Few Thoughts on Friendship Whilst Waiting for a Friend

I’m sitting at a table in Newcastle’s City Library. At my side is the library copy of High Tide, Low Tide, the book I wrote with my best friend Fran. I never tire of seeing it on the shelf. It’s a proud moment for any author; second only to not seeing it because someone has taken it out on loan.

I’m waiting for a friend. We’ll meet for coffee and then go for a drink or two; maybe something to eat. We’ll catch up with what’s going on for us. We’ll laugh, share old memories and make new ones. It is at moments like this that I feel most blessed. There were times in the past when I had no one to meet up with. I shared a quote on Facebook yesterday:

I don’t chase after people anymore. If they like spending time with me they will do so. (Barry M. Sherbal)

I posted it as a reminder to myself. Over the past year or so I’ve realised that chasing after people is unhealthy — for them and for me. I’ve done a lot of it in the past and the results have rarely been pretty. Some friendships have survived. Some haven’t. With some the jury’s still out. Letting go of the neediness and insecurity hasn’t been easy for me. In fact it’s been really hard and I’ve put in a lot of work. I am not altogether “there” yet but it has brought peace, and the realisation that in fact yes, I am worthy of having people like me and want to be with me. I don’t have to chase or coerce them into doing so.

I appreciate those who want to be in my life and want me in theirs. These are the relationships I value above all and within which I feel the most valued.

My friend has just messaged to say she’s on her way. Time to return the book to its place on the shelf and head out to meet her.


Wednesday 6 November 2019

Chapter and Verse: A Few Thoughts on Poetry, Creativity, and Mental Health

I met up recently with fellow blogger Aimee Wilson and we got talking about poetry and mental health. She showed me the blackout poem she’d created at a writing class run by Northumberland Council.

Watch it
I would
tolerance was not to be tested
increasingly restricted
reality reliving   particularly happy distracting
not dared to return
approved of
given up hope

Poetry is a new avenue for Aimee but she writes prolifically for her blog I’m NOT Disordered. As she says, “I find writing so beneficial for my mental health.”

We agreed there can be a close relationship between mental health and creativity. I shared with her how Fran had never written or been interested in poetry until she met me in May 2011. At the time, she was highly manic. Our early emails and online chat conversations were full of wordplay and had a free-flowing stream of consciousness quality that I found intoxicating. Sparked by that, and my own poetry which I shared with her, Fran began to write.

She wrote prolifically. Her poems were long; sometimes rambling, often brilliant. She wrote blisteringly of her experiences as a woman living with serious mental and physical illness in a small island community that did not understand her or what she was going through. She posted most of her work on social media. She held a live book reading and went on the radio. We talked of finding her a publisher.

Fran’s mania was eventually reined in by a change of medication, precipitating a winter of crippling depression and suicidality. Her creativity ceased as suddenly as if a switch had been thrown. It took months but eventually she began to re-emerge. The following description is from our book High Tide, Low Tide.

The wild, personal, and passionate poetry which flowed during Fran’s major episode of mania ceased when she fell into depression. Her creative voice was silenced for months. When it returned it was completely transformed. The haiku forms that emerged as she began to climb out from depression were more than descriptions of the island scenery around her. They were Fran’s attempt to find a reason to go on living.

boat on the water
slicing the calm
foaming leftovers..

quiet day
loud heart

high tide
low tide

what else is there to do but live life..

These poems were written on Centennial Beach, a short walk from where Fran lived at the time. She would return home, show me her latest poems, and then share them on her social media page. It was her way of reaching outward again. As she said later, “I was trying to save my life, to get out of the house onto Centennial and wait for the haikus to come. That was all I had.”

As her mood stabilised Fran found less of an impulse to write poetry and it’s been a long time since she did so. This saddens me because I loved the insight and wisdom her poems expressed, but they are red flags for mania and her health is more important to me than poetry.

Aimee’s principal diagnosis is borderline personality disorder (BPD) but she could relate Fran’s story to her own mood instability. We agreed it will be interesting to see if she adds poetry to her options for self-expression and self-care.

I don’t have a mental health diagnosis but my writing interests and outputs have changed a lot over the years. A collection of my poetry was published in 2008, but I stopped writing poetry much earlier at the age of twenty-three. Since then I have written only two poems. Ironically, the first arose in response to a period of writer’s block. The second was inspired — triggered, really — by attending my mother’s funeral in 2018.


How do I feel
What do I feel


Re birth


Un known
Un homed

Un tethered


Centred (thank you

— Liverpool, March 26, 2018

Between 2001 and 2005 I wrote articles and short stories in the fantasy genre for Reunion: The Alternative Tolkien Society. Most are still available on the society’s website. In recent years my work has been in the mental health arena; our two books High Tide, Low Tide and No One Is Too Far Away, and our blog.

Do you write poetry or prose, or do you have a different creative outlet? Has your creativity changed over time? Does it follows your moods or aspects of your mental health? We’d love to hear your experiences.