Managing the most difficult symptoms of Bipolar Disorder I

Paranoia is, in my opinion, the most vicious symptom of Bipolar Disorder. Even with therapy and medication, it can rear its ugly head at the first instance of disturbance among one’s peers.

The workplace is especially difficult. Aside from the home, work is the only area of life where we must spend extended periods of time, day upon day, with the same group of people. Small aspects of your colleague’s behavior can seem dramatic and hurtful, and wear down your defenses.

What others might be able to shrug off or “live with,” indications of disapproval among peers can spiral into your delusion of a full blown conspiracy with a purpose like humiliating you, and indicating you as necessary for termination with acknowledged shame.

I was fired following such delusions; as a result, my symptoms got worse. In a vicious cycle, my performance had become especially bad leading up to that point as my fears were slowly realized in the true disapproval of my colleagues.

I emphasize the importance of recognizing our despair as being a symptom of the disease — one who fiendishly disguises its origins as being our personal character and our surroundings, obfuscating its firm roots in our illness.

Paranoia is a symptom we can manage with therapeutic techniques, those most easily gained through Cognitive Behavioral Therapy.

You are at work, and the fears begin. It grows like a cancer, so that every overheard whisper gives you the impression that a plot against you is in development. My first effort to overcome this was to ‘check’ — to seek out approval from the ‘conspirators,’ dispelling my beliefs that there was any ill will. But through Cognitive Behavioral Therapy I learned to recognize those fears as symptoms — look at them rationally; and ask myself as if asking another, saner person, “Do these fears make sense?”

Choose someone who, in your mind, you can use to ask you this question; someone who might ask you this question if you were to explain your fears to them, and who will expect the rational answer you otherwise cannot seem to acknowledge. (And in the real world, find this person whom you can share your ‘fear stories’ with — a therapist, a spouse — psychologically carry them with you so they are there as your internal sounding board when you need them.)

99% of the time we feel the need to ask this question, the answer is a resounding “No.”

‘Checking,’ by the way, is on some levels normal, and is not in bad form — but manage your approach. Ensure you frame your effort as being one of ‘healthy concern,’ not ‘paranoid delusional.’

Interacting with others can be distressing for everyone — and there is no reason you should have to suffer more than anyone else. These methods will help you cope with paranoia as your mental health gradually — very steadily — improves.

We will grow, as anybody would — but we will always be mentally ill, so that no matter our efforts we will always have to care for ourselves differently; especially in those two essential areas: therapy and medication.

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