Us vs them, choices and consequences

I know I said my next blog would be how to approach your doctor, however, I came across a comment on another blog and I felt compelled to address it here – on my blog.  When I was in the full throws of bipolar depression I viewed the world and me (my mental illness) vs the world (the normal people) but I realized after reading this I never had the thought of “them” being able to choose and “myself” not being able to choose. This reinforces the need for a good therapist that is willing to help make the connection between the choices that are made and the consequences of those choices!  It can be done, however it will be some work.  Just like training a child with autism to mirror behavior or a person who suffers an injury, either at childbirth or as an adult, to learn to walk again, a person with bipolar disorder has to learn the connection between choices and consequences and learn how to make the choices that will lead to the consequences they desire.  Including the mood they desire.  I choose to be stable and have learned how to make choices that will lead to a stable life.

This is a comment on another blog I read. It is incredible insight into the disconnect between choices and consequences that people with bipolar disorder have.  (I have permission from the author ( of this comment, thanks so much for letting me use it!)

“I think the key difference between “us” and “them” is choice. A norm can choose to drink, shoot up, smoke a joint, run a marathon or whatever to change their mood, but we don’t get that choice – our mood changes of its own accord, often in response to triggers which a norm can choose to ignore. When we’re triggered by a shift in cycle or by a mood altering event, we don’t get a choice as to whether our emotions are affected – they inevitably are. We don’t get to choose not to let it get to us, or snap out of it, or put on a happy face. Sure we can try to deal with the sudden change in emotions, we can remove ourselves to prevent snowballing reactions, or we can pop a pill to calm us down, or we can use some techniques like CBT or ACT to deal with the emotions that are suddenly coursing through us. But we don’t get to choose whether we experience the reaction or not. My psychiatrist explains this using an analogy of a nerve which responds to certain triggers (which can encompass all sorts of things from multiple stimuli like musak as well as someone talking, trying to do more than two things at once, several different objects moving simultaneously in one’s visual field) and that the “normal” nerve responds a little, but in our case the response is blown out of proportion as a result of our biological predisposition. In other words we “can’t stop feeling that way when something happens” – all we can do is try to avoid a situation in which we’re triggered, deal with the feelings once they’ve occurred as best we can, and/or take something to steady us when our mood destabilises.”

Making choices and understanding the consequences can lead to a stable life.  Perhaps we “can’t stop feeling that way when something happens” , but if we can predict the outcome with some certainty by identifying the choices we made that triggers the high or low or anxiety we can modify and/or change that behavior.

Choices and consequences – learn them, understand them, identify them… the author of the comment is right – this is the difference between “us and them”!  But where he is incorrect is we can choose – we just have to learn how!

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