Onika L. Dainty

You don’t have any understanding that Bipolar relapse is a natural part of the recovery cycle because you don’t quite have a grasp of your own cycle until months or even years after your Bipolar disorder diagnosis. Women facing Bipolar disorder often encounter unique challenges from societal stigma to personal guilt and shame. It’s important to remember relapse isn’t the opposite of recovery–its a step within it. This article shares powerful stories of how to rebuild your life after relapse, along with expert advice on recovery, resilience and self-compassion.  

Bipolar Relapse: Why It Happens and How to Respond

Bipolar disorder is a mental health condition that involves shifts in mood, energy and activity levels. The three main types of bipolar disorder are Bipolar I, Bipolar II, and Cyclothymic disorder. Bipolar I disorder involves longer periods of Mania that last at least a week to eight weeks with depressive episodes that last two weeks. Bipolar II disorder is characterized by cycles of hypomanic episodes that can last for up to four days and depressive episodes that may be shorter and less severe. Cyclothymic disorder involves frequent mood swings of hypomania and depression that are not severe enough to be considered episodes of hypomania or depression.

Understanding and avoiding triggers can help people with Bipolar disorder minimize symptoms and limit the number of cycles they experience. Below are some common relapse triggers to consider when managing your Bipolar disorder cycle.  

Relapse Triggers That Effect Bipolar Cycle

• Stress: Stressful life events such as loss of a loved one or loss of job. Stressful events often trigger a mood episode.

• Sleep: Changes in sleep patterns, such as insufficiencies or severe insomnia can trigger a mood episode.

• Medications: Certain antidepressants and other medications can trigger a mood episode.

• Substance Use: Drugs and alcohol use can trigger a mood episode.

• Hormones: Menstruation, pregnancy and other hormonal shifts can trigger a mood episode.  

• Other Factors: Grief, change in season or events like travel can trigger a mood episode.

The above list seems to incorporate everything one may go through on a daily basis. That’s the challenging part of managing Bipolar disorder, there are every few life events that can’t lead to cycle changes and ultimately relapse. Stress, for example, is a natural occurrence in our life cycle but for women with Bipolar disorder how we manage stressful events can mean the difference between experiencing severe mood changes that lead to a hypomanic, manic or depressive episode. Another common life event in people with Bipolar disorder is medication changes. It is important to stay mindful when going through changes such as this one by staying in touch with your medical team and taking time to rest though this process of transition to ensure your body and mind stay balanced. 

Remember, Bipolar relapse should never be considered a failure, rather it is an opportunity for healing and a deeper understanding of an illness that is by its nature full of ups and downs. The emotional toll that relapse can have on an individual can range from guilt and shame to fear of further setbacks, all realistic emotions however can be misplaced. Consider the following: if you are always in a state of wellness on your journey, how can you identify when you are unwell unless you experience low and high periods that characterize Bipolar disorder? A part of maintaining good health is recognizing the experiences that challenge your mental health. Feelings of guilt, shame and fear are normal but are also indications of feeling failure and Bipolar relapse should never be considered a failure rather a learning lesson on your journey to overall wellness.    

Embracing Strength: Stories of Finding Hope After Relapse

Embracing My Bipolar I Disorder

Early on in my mental health journey I didn’t have the knowledge and understanding of my Bipolar I disorder cycle. Mania and depression were my state existence and constant self-blame and self-loathing were my mental baseline. I blamed myself for my mental illness, I blamed myself for the recurring symptoms of Bipolar I disorder and the co-occurring substance use disorder I was experiencing not knowing how to manage either. It took many years to first accept that my Bipolar disorder was not going anywhere, that it was a permanent part of my psychological make-up but that didn’t mean that it had to live in the passenger seat of my life or dictate my future. Secondly, I had to show myself compassion regarding my substance use, finally coming to the realization that the substance use was a symptom of the larger issue of unmanaged mental illness. 

Once I accepted these two truths about how I was handling my illness, once I recognized that my struggle was not unique and could be overcome, I started doing the work. I made a declaration about my life. If I was going to live my life as a woman with Bipolar I disorder, I was going to make it the best life it could be despite my mental illness. I decided to embrace my Bipolar disorder through psychoeducation, counselling services, medication management, self-care, creating structured routine and good habits, sharing my lived experience and advocacy work. I stopped blaming myself for a condition I was born with, I stopped running from a disorder I had to stand and face and I started fighting for my future knowing that Bipolar relapse is always around the corner but arming myself with the tools to face any challenge.    

Embracing Grama Judie, My Mental Health Mentor

It starts with one person. One person in your life to reach out to you and say, “I’m here for you, I want to help you and you are not alone.” It may not be a member of your family, your mom or your dad who are struggling with the reality of their daughter having a severe and lifelong mental illness. It may not be your little sister who is too young to understand the consequences that mental illness brings. It may not be your circle of extended family and friends who are focused on having you be who you were to them before the chaos came. Instead it could be a stranger you meet along your journey who sees you hurting and reaches out to help. For me that was an 80-year-old woman I met while in the hospital 17 years ago. Her name is Judie, fondly known as Grama Judie, my best friend and who I’ve often referenced in my articles as my Mental Health Mentor. 

Seventeen years ago she saw a lost young woman sitting at a table reading a book and she approached me. “Whatcha reading?” she said. “A Historical Romance,” I replied. She sat down and thus began a relationship that has almost spanned two decades. She has been my friend, my  mental health advocate, my substitute decision maker, my community connector, she has taken care of my home when I’m hospitalized, visited me in and out of psychosis, been there for wellness checks, though the good, bad and challenging times are always ready to support me. Her confidence in my ability to rebuild and reinvent myself after every episode has been unwavering. I cannot negate the others who have joined my support network over the years of dealing with my mental illness but I am most grateful to my Grama Judie because her belief in my strength and resilience is what has given me the fortitude to continue rebuilding after every major episode.    

Embracing My Setbacks

On the road to wellness there have been more setbacks than I care to admit or recount. However, what I can say is that every setback has been a learning experience. In few years ago I experienced a year-long Bipolar relapse which included several suicide attempts,  homelessness and nine hospitalizations. The constant chaos and instability led me to a place of dejection and hopelessness. I was sick and tired of being sick and tired. I had to take stock of my life and the decisions I had been making or rather not making concerning my mental illness. I call this year in my life “The Great Rebellion,” as I had rebelled against the mental health care system, against my psychiatrist, against my medication, against those who loved me and to what ends? I was the one who was suffering for not doing the work I knew I needed to do to live a full and healthy life. 

The structure, routine and habits that I was able to maintain during my four month stay in Ontario Shores Centre for Mental Health Sciences gave me the clarity I needed to forge ahead in a positive direction where relapse was still possible but manageable when making good decisions around my mental health. I was also able to maintain my sobriety with the help of counsellors and therapists that gave me a better understanding of how substances interacted with the chemical imbalance that defined my illness. For the first time I was listening and learning about myself in a way I had never done before. I was once again in a space where self-awareness and self-compassion took the lead on my journey of resilience and recovery. Although there are many reasons for setbacks in my life, the biggest challenge has always been getting out of my own way and allowing myself to heal and be whole, seeing relapse as an opportunity to learn lessons about myself that I have yet to learn.    

Final Thoughts

Bipolar relapse exists within mental health recovery, it is not the end of the road but a part of the journey. It acts as a barometer which allows you to reflect on both the changes made and the changes you may need to make on the journey to your final destination of mental wellness. Every woman’s recovery journey is unique and full of challenging experiences but the common theme is always resilience, your ability to keep moving forward towards your goals regardless of the challenges. When managing a severe mental illness like Bipolar disorder it’s important to remember relapse is almost always inevitable but knowing this can mitigate the severity and make the road to recovery more accessible. 

Seeking support from your mental health network during challenging times can go a long way in your journey to recovery. Sharing your lived experience story can inspire and help others in their own recovery journey. Finally, continue moving forward because your journey is not defined by your setbacks but by your resilience. Remember, there is light at the end of every dark tunnel and there is always sunshine after the rain.