I have been reading a very good book this spring, called Bipolar, Not So Much written by two practicing psychiatrists, Chris Aiken, MD and James Phelps, MD. Published in 2016, I found it to be very readable, interesting, current and best of all, hopeful for individuals with a depressive mood disorder and the friends and family who love them.
Mood disorders are now seen to form a spectrum of problems, from depression on one hand to full bipolar disorder on the other. Dr Aiken and Phelps write that between the two are multitudes of people who are in the middle of the mood spectrum, and this book is for them.
There is much to value and recommend here. This is not just another book on bipolar illnesses. While the authors write of the basics of depressive mood disorders, they also help readers learn where they fit on the mood spectrum. There are treatment recommendations and they include discussions of medication as well as recommendations on diet, exercise, and a guide to non-medication treatments that anyone can use on their own. Information is included on a number of innovative technologies that can aid in recovery including dawn simulators, mood apps and blue light filters. The authors willingness, indeed, eagerness to present these new technologies and their recommendations, illustrate some of the value and benefit I found in the book; good advice backed by citations referenced for our use. Plus, most references were very current, including 2016 studies.
My favorite portion of the book is the section Reclaiming Your Life: Relationships. Work and school. Friends and family. Their advice on communicating with someone who has a mental disorder is right on, from my perspective as a person with a mood disorder. And as a person who deeply values her friendships and her relationships with friends and a family with mood spectrum illnesses.
Their advice is direct and candid and worth hearing. I am writing this day to share a selection of the good advice with you.
INTERACTIONS TO INCREASE: (The writers note that each of the interactions below has a positive effect on the brain, and sprinkling them throughout the day can speed recovery.)
One: Convey emotional warmth, which you do by having a gentle smile, compassionate eyes and an accepting posture. When you do so you are giving the message that you are genuinely interested and pleased to see them. Dr Aiken and Dr Phelps point out that the voice is soothing, movements are relaxed and gentle, without pressure. This body language telegraphs that you accept things as they are. They write “in its most profound form, warmth is the gleam in a mother’s eye that conveys unconditional love.”
When someone shows me warmth, I feel welcomed, accepted, safe, and yes, more willing to converse.
I’d like to add, pair warmth by saying to people “Nice to see you.” This phrase is much more inviting than: “How are you?” The traditional question we ask – how are you – can put people on their guard wondering just how much you want to know, if anything. Try the greeting “Nice to see you.” I think you’ll get warm response.
Two: Be empathic. Accept people without judgment. When we use empathy, our speech shows that we wish to understand and appreciate them rather than change them. Doctors Aiken and Phelps, MD, say “Empathy doesn’t mean you feel the same way they do, just that you understand them or at least seek understanding”. Furthermore, they advise: “Empathy goes hand in hand with emotional warmth, and both have a healing effect on mood, in part by reducing the isolation that mood episodes bring.” Try responses that communicate your empathy, like “I see your point,””I get it” as well more specific ones like: “It must be hard to go through the motions each day when you’re depressed.” Or, “Though I’ve never been through the kind of depression you’re having, I can tell it is a terrible place to be and you certainly don’t deserve it.”
Three: Positive comments also help family and friends recover from depression. Make the comments accurate and specific, such as “I appreciate how you put the kids to bed last night.”
Doctors Aiken and Phelps reminds us, “WHAT YOU SHINE A LIGHT ON IS WHAT WILL GROW.” They suggest that you retire from being a problem-solver, fixer and psychiatric detective. Instead make it your job to search for anything about your loved one that is not consistent with a mood disorder. The good doctors continue, “ Shift your attention away from the illness. If they oversleep, ignore that. Focus instead on the fact they he/she got out of bed—many depressed people never take that step.”
Four: Optimism about the illness is something friends and family need to communicate. Depression robs people of hope and causes them to blame themselves for the disorder. If you live with someone who has depression, Drs. Aikens and Phelps warn that you not let yourself fall into that same trap.”
They write with urgency, “Always remember that the manic and depressive behaviors are what they have, not who they are ……. Instead of sleuthing for pathology, your efforts will be better spent recalling how your loved one was before the episode, and relaying the optimism that they’ll be that way again.”
I am in complete agreement with their advice here. But I urge that your optimistic responses not be “all this will soon be just a bad memory.” Rather convey your unshakable belief in who they are, and relay the optimism you feel that they will recover that self once again.
We’ve just reviewed some of Drs Aiken and Phelps advice under their banner “What to Increase.” They have much more of this good, down–to-earth advice. A next section highlights: “What to Decrease, five things that harm: Critical comments. Scrutinizing mood. Trying to win or resolve arguments. Overinvolvement. Hostility. I will present their observations and recommendations on “What to Decrease” in my next posting.