6 Monday May 2 2022 | the times
life
as this only leads to our getting more
tangled up in them. It’s like trying to
fight a battle with a significantly
stronger opponent — you cannot win.
Also, trying to avoid them reinforces
them by giving them a louder
presence. The best skill to master
them is to accept their presence and
focus on remaining calm while trying
to give them as little attention as
possible. This can be done by labelling
them for what they are: intrusive
thoughts that you have no control
over but which cannot harm you.
Accept what you cannot change (the
past) and instead focus on your
breathing and try a meditation
exercise (you can find audio guides
online. See calm.com/meditate).
The aim of this is to rise above the
noise in your head and take yourself to
a more peaceful place. In time, the
lack of attention will lead these
thoughts to fade into the background,
but expect them to return for a while
and do not be afraid when they do. I
recommend the book Overcoming
Unwanted Intrusive Thoughts by Sally
Winston and Martin Seif. It tackles the
management of these thoughts and
also enables readers to overcome
intense shame and anxiety.
In your letter you state, when
referring to the challenging times
managing your condition, “I hate —
and am deeply ashamed of — the kind
of person I became at that time.” I
want to challenge this by offering a
different perspective. Who you
“became” was a result of a condition
that would not have been treated as
efficaciously back when you were
struggling in adulthood as it would be
now. Who you are is a resilient woman
who continued to live her life as best
she could, in the face of a debilitating
condition that was relatively
unsupported and only garnered her
rejection and judgment. Who you are,
and have always been, is a woman we
should all aspire to be. I send you all
my best wishes — please let me know
how you get on.Stigma comes from ignorance,
prejudice and fear. It is bullying and
can be classed as a hate crime if
directed at another. The result is
lowered self-esteem, despair, guilt,
shame and worsened depression; it
can lead some people to take their
own lives. It can also cause people to
avoid asking for help even when very
unwell, thus worsening their
experience of their condition.
To address your intrusive thoughts I
suggest that you find support from
those who bring knowledge,
understanding and compassion. You
need to have space to process these
thoughts by hearing them out loud
and having time to reflect. It’s your
right to grieve for past losses and
missed opportunities and also express
your anger and pain at the lack of
understanding and support you
received. There are many excellent
therapists, some who work with older
adults with lived experience of mental
health challenges; talk to your GP and
also have a look at HCPC-registered
therapist directories such as bps.org.uk
and welldoing.org. Also look at
bipolaruk.org where you will find a
wealth of empowering information
and local support groups. The
pandemic has enabled professionals
to provide online therapy, which is
also an option if travel is an issue.
I can imagine that you would
be a real asset to a support
group, given your years of
experience and your incredible
resilience in the face of the
greatest stigma — not only
would you receive support but
you could also provide great
comfort to others. I urge you to
share this advice with someone
close to you, so that you have
support to build these networks.
To manage intrusive thoughts
when you are alone, I suggest the
following. First, it is important to
understand that unwanted intrusive
thoughts are strengthened by attempts
to control them and reason with them,I’m ashamed of the way bipolar disorder has disrupted my life
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I am 90 and live
alone. Increasingly I
find myself looking
back over a long life,
but the memories I
recall are deeply
painful and a source of shame.
Having started my career as a
teacher, I became profoundly
depressed in my early thirties and
was diagnosed as bipolar. There
followed years of hospitalisation
interspersed with attempts to hold
down a job. First I was asked to
resign from my teaching post, then
dismissed from two secretarial jobs,
eventually ending up as a healthcare
assistant. This position also proved to
be more than I could cope with.
Some words of my father’s echo
down the years. When, a few months
after my mother died, I was
dismissed from a good job at a
university, he said: “I’m glad your
mother didn’t live to see this day.”
I hate — and am deeply ashamed
— of the kind of person I became at
that time and, while for the past ten
years or so the depression has been
mostly controlled, I cannot seem to
break free from these feelings.
Reason tells me that bipolar disorder
is an illness, but I am emotionally
overwhelmed by frightening negative
thoughts. I do not want more
medication. Is there any other way I
can be helped or help myself?
Bettina
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N
Your letter has really
moved me and I don’t
like to think of you
alone and battling
negative and intrusive
shame-based thoughts
that you have carried all of your adult
life. You are a resilient woman who
has lived a full life and despite being so
often knocked down, seemingly kept
getting up and continuing on. You
really do have my respect.
You were born at a time when
mental health challenges carried
Ask Professor Tanya Byron
immense stigma and associated
shame. So much of what we now
understand about mental health was
previously met with fear, derision,
judgment, bullying, institutionalisation
and even criminal conviction. This is
all despite the fact that bipolar
difficulties were first documented by
“the father of medicine” Hippocrates
(460-375BC), who described people
who experienced shifts between two
extreme mood states: very high,
excited and energised, or very low,
despairing and depressed.
This neurocognitive condition can
bring emotional, practical and social
challenges and can have a serious
impact on everyday life when not
treated properly or not treated at all.
Medication is not enough to enable
people to live with their bipolar
condition and best outcomes are
shown when the approach is holistic
and includes psychological and social,
as well as pharmacological,
interventions. Living with bipolar
difficulties can be exhausting and have
significant impacts on work and
relationships. However, with
nonjudgmental support, consistent
routines and evidence-based
treatments, many people live full and
happy lives despite the challenges of
the condition. This would also
include others, such as employers,
having a full understanding of the
condition and offering all support
necessary — thankfully more
common (but not across the board)
in today’s more inclusive world.
The stigma you have felt, the
lack of support and being told you
are a disappointment live inside
you and now present themselves
as unwanted intrusive thoughts.
It’s as if you have internalised
your father’s voice and are
tormented by it. I expect that you
will have suffered discrimination
at work, in school, in social
situations. When your condition
was challenging, I suspect you
withdrew to avoid judgment.You are a
resilient
woman
who
continued
to live as
best she
could
If you would like
Professor Tanya Byron’s
help, email proftanya
[email protected]