No one told me grief would mimic my Bipolar Disorder
Updated: Jul 1, 2020
"Maybe the most complicated thing about grief is the time spent trying to fit it neatly into a box"
By Paula Dennan
In the aftermath of my father’s death last year people told me that grief would mess with my
sleep, my appetite and probably my ability to carry out day-to-day tasks, such as making sure
dirty dishes don’t pile up in the sink.
I nodded, smiled and thanked each one of them for the information they shared. Telling people I would be extra kind to myself and that I have my husband to support me.
What I didn’t realise because I hadn’t put all these friendly warnings together or spoken to
anyone who was experiencing grief alongside a mental illness, is just how much grief reminds me of going through a bipolar episode.
No one sat me down with a checklist of warning signs for bipolar disorder and a checklist for the grieving process and pointed out that they are basically the same. For me, at least.
My previous encounter with insomnia was coupled with hypomania. The last time my appetite disappeared it was the beginning of a major depressive episode, which saw me eat nothing but my husband’s risotto for the duration of it. When dirty dishes piled up in the past it was because the only task I could manage was moving from my bed to the couch. I cry a lot when I’m depressed. I am crying a lot due to grief.
Whether grief itself is a mental disorder has been the subject of much debate. For everything I read from one side that makes me nod my head in agreement, I read something saying the complete opposite and find myself agreeing with that as well. Maybe the most complicated thing about grief is the time spent trying to fit it neatly into a box.
The World Health Organisation’s International Classification of Diseases (ICD-11) includes
prolonged grief as its own mental disorder. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) removed the bereavement exclusion for diagnosing major depressive disorder, meaning that in psychiatric terms grief can trigger depression. The DSM-5 introduced the category of persistent complex bereavement disorder.
Both of these disorders acknowledge that for some people their experience with the main symptoms of grief lasts longer than six or twelve months.
This is not to say that you should recover from your grief within a year. It is common for some
healing to have at least begun by the six month mark and these persistent, complex and
complicated grief disorders recognise the negative impact on people when they, for a variety of reasons, have not yet begun the healing process.
I worry that my grief will become complex grief. I worry that worrying about it means it is already complex grief. I worry that I’m heading toward a mixed bipolar episode. I worry that worrying about it will make it happen. I worry that all this worrying means I’m not processing my grief properly, which will only prolong the amount of time I spend worrying about these things.
I have taken proactive steps by contacting my psychiatrist seeking reassurance that I’ll be able to differentiate a bipolar episode from grief. I have checked in with my GP so they know to keep an eye on my sleeping habits. I am attending grief counselling. Yet, the worry remains.
I worry that I have deliberately, albeit unconsciously, shifted the focus to my bipolar disorder so that I do not have to deal with the complexities of grieving. As if I can postpone it forever. As if that won’t negatively affect my mental health.
There is no blueprint for managing your grief while managing bipolar disorder. It may be out
there, but I haven’t found it among the many articles, books and podcasts about grief that I have read and listened to since my dad’s death. I try to stick to my finely tuned evening routine; a long bath, no time on my phone at least one hour before bed, and getting into bed at the same time every night to read for at least 30 minutes.
My morning routine is equally important; trying and failing to get up at the same time everyday, taking the mood stabilisers and antidepressants that enable me to be myself, writing in my journal, meditating for ten minutes, eating breakfast, and doing yoga.
Grief rearranged my life the same way that active bipolar disorder does. I have to force myself to do things that I know are crucial to my self-care. They feel impossible, despite the fact I have completed them many times before.
I will continue to take it one day at a time, knowing that my life will adjust to accommodate my grief. I also know that if my grief does trigger a bipolar episode I have the tools to cope with and recover from that as well.