For a long time, I’ve struggled with my identity. 

For most of my life, how I felt about myself was reflective of my mood at the time. When I was manic, I saw myself as brilliant. I thought I was doing well enough to be admitted to the best, most elite universities. And, when I was depressed, I was sure I would end up begging for food on the streets.

I had my first major depressive episode as I was graduating from university. So many people with severe mental health conditions struggle first to get a proper diagnosis and second, accept their diagnoses and the implications it means for their life—and I was no exception. It was hard to realize that I was not like everyone else. 

I felt I was giving up my identity for one I didn’t want. 

I didn’t want to be ill. 

My symptoms worsened when I reached my twenties. I went into denial and spiraled into ten years of cyclical episodes. My life consisted of a maze of exhilarating highs, debilitating lows, countless therapist visits, and taking handfuls of antidepressants, benzodiazepines, and recreational drugs. 

While most of my peers were thriving and charting their paths to successful careers and meaningful lives, I struggled to keep myself consistently employed. In addition, maintaining relationships with others was challenging since I had such a shaky self-image. Somehow, my illness kept spinning out of control until I no longer recognized the person who stared back at me in the mirror. 
 
I feared that I would never get better during the worst of my illness. Sitting in my bedroom —each time—waiting for the fog to lift, I felt hopeless. I saw that my friends had lives. They were getting promoted, traveling the world, and getting married. In contrast, I lived a day-to-day existence. I couldn’t plan for the future because I could never predict where my mental illness would take me. 

Then in 2018, I had a massive episode with psychotic features that led me, once again, to a psychiatrist, who finally diagnosed me with bipolar disorder. After receiving this diagnosis, I went through a grieving process. But, I had to accept the reality that I had a mental illness. Being diagnosed with bipolar disorder altered my life course and required me to take time to think about and re-evaluate my sense of self.
 
Integrating this diagnosis into my identity has been a process. First, I had to adjust to the changes that treatment and care of my condition meant for my life. For example, my psychiatrist spent significant time explaining that taking medication was the only way for me to function correctly. As a result, I now understand the importance of staying on track with medications to move forward in my recovery. 

In the first few months after my diagnosis, I believed that the medication would be a magic treatment for me. I didn’t want to work on myself because I thought the pills would bring back my identity as much as I hated taking them. Then I realized, whether I like it or not, that my illness is a big part of my life. It is a part of my identity and something I must approach with proper treatment. I needed to build a healthy lifestyle from the ground up. 
 
My recovery from bipolar disorder started with constructive decisions about my overall health and self-perception. Self-care comes in many forms. To me, it begins with a healthy start to my morning. After waking up, I spend time journaling my intention for the day and adding things to my gratitude list. After that, I meditate, work out and read. 

I take regular breaks during my work day to refill my cup. I am learning to set healthy boundaries and reasonable expectations. I practice yin yoga after work and spend time with my family. I am religious about my sleep schedule and aim to have eight to nine hours of sound sleep every night. Some days are so much more complicated than others. Once in a while, ten minutes of gentle yin yoga will have to be enough. 

More than anything, I’m thrilled just to be alive. I have experienced severe episodes that almost put me in danger. But, thanks to excellent mental health care and my family and friends, I am getting my life back on my terms. I am also developing an identity for myself that accommodates my bipolar disorder. 

But most importantly, my identity is “unapologetically me,” not “bipolar.”   

Since my diagnosis, I have worked to develop a stable, positive identity that keeps me in touch with the full range of my values, abilities, and roles, rather than focusing only on limitations placed on me by bipolar disorder. 

Here are a few steps that helped me develop and maintain a healthy sense of self:

#1 Assess yourself
I have used the CRESTBD Quality of Life Tool to identify my strengths and establish a more well-rounded sense of identity. We all have things that we struggle with, and we all have things that we are good at or areas of life in which we are flourishing – the QoL Tool can be a helpful reminder of all these facets of your identity.

#2 Allow yourself to feel
While I am more vulnerable to persistent mood states like depression or mania, I still have day-to-day or moment-to-moment emotional changes, just like everyone else. For example, I can be excited or happy without being manic or sad and frustrated without being depressed. Teaching myself and others to help tell the difference between regular changes of emotions throughout the day from mood episodes can be very important to feel supported and validated by others. Cognitive behavioral therapy helped me develop an awareness of what fluctuations in emotions are healthy and appropriate given the circumstances and promote more balanced and realistic thoughts about changes in mood state.

#3 Learn to be kind to yourself
When exploring my different characteristics, I learned to be gentle and accepting with the parts of myself that I want to change or are not in line with who I’d like to be. Being critical of myself causes unnecessary hardship. Being kind to myself gave me strength and even helped me make changes for the better. Mindfulness practice helped me identify self-judgments and practice a gentler way of relating to myself. My friends, family members, and the mental health team helped me challenge negative thoughts and develop more realistic and helpful ones.

Have you ever heard of flight, fight, or freeze? 

During times of crisis, chaos, and traumatic experiences, we enter “survival mode.” You might have heard this phrase before, but what does it mean? 

When we experience stressful events, our brains begin to function differently. 

Before we go any further, it is essential to mention that these experiences can be real-life or perceived threats to our safety; our brain does not always differentiate between them. It just reacts.

Survival mode involves adaptive physiological changes in our body that help us respond to the stressors we face. For example, when we experience stress, hormonal changes and physiological responses occur in our bodies, allowing us to respond by preparing them to fight, flight, or freeze. 

When we are "surviving" too long, we can feel its effects on us. Research shows that chronic stress and exposure to stress hormones can be harmful. At times, our body may overreact to stressors that we experience. 

Survival mode is different for everyone. It’s ok if all you did today was breathe and just make it through the day. However, I feel a difference between getting stuck in maladaptive patterns and survival mode serving a purpose. For me, survival mode no longer serves a purpose. But, it still very much lingers, and I do not blame the human in me —I feel survival mode is what aided in evolving me into how I am today. 

When I switch to survival mode, it can feel like this:

• Everything is urgent.
• Things that need doing are regularly canceled or rescheduled.
• I am regularly overwhelmed by stress, disrupting sleep, uneasy breathing, erratic heartbeat, and disorganized thinking.
• My inner sense of joy is diminished, and avoiding some loss has become your primary goal, rather than outright winning.
• Everything is a reaction, i.e., I am never one step ahead.
• Everything matters way too much.
• There’s no longer sufficient time to achieve absolute excellence in my endeavors.

Here’s the good news: there is hope for change. 

First and foremost, if you or anyone you know are experiencing these symptoms and they are interfering with your daily functioning, talk to a mental health professional. The experiences of trauma do not have to impact how we live in the world forever, but you do have to address it. Trauma is hard and scary to discuss, but you are not alone in your healing process.

A few practices I’ve adopted to practice self-kindness and recover from survival mode:

#1 Create space for backlogged emotions.
Often during times of high stress, your brain sorts overwhelming emotions to the side to support daily functioning. When the crisis ends, you may experience large waves of emotional turmoil. Let yourself feel without judgment. Your emotions don’t need to be rational. They simply need pathways to escape your body to complete the release of stress. Let yourself cry, create, be an athlete, journal, go to therapy, vent to a friend, and punch a punching bag. Releasing emotion provides a pathway for your body to return to a normal state. 

#2 Create space for rest. 
Often during a crisis, rest falls off the priority list. When the problem ends, you may find yourself physically and mentally exhausted. You may feel forgetful, confused, tired, or irritable. Take naps, prioritize healthy sleep patterns, read a book for leisure, and take a weekend away.  

#3 Return to healthy practices. 
During a crisis, things like taking walks, doing yoga, deep breathing, and personal growth reading become hard to continue and often disappear entirely. When life calms, remember healthy practices that provided a life-giving foundation before the crisis. Try choosing one or two healthy practices and slowly and consistently return to them. 

#4 Be aware of numbing activities. 
Under intense stress, most people begin unhealthy coping skills to numb and avoid facing difficult emotions. Everyday numbing activities include substance abuse, eating to medicate feelings, overspending, binging shows, social media, and engaging in unhealthy relationships. Try not to judge yourself harshly when you identify numbing. Instead, show grace to yourself. You’ve been through something hard. Try acknowledging your numbing and intentionally begin substituting healthier practices and coping skills. Ask for help if your numbing has become addictive. 

#5 Pursue joy. 
When you’ve been through something hard, it’s not unusual to notice you’ve begun trying to protect yourself from joy. Joy can be as vulnerable as hurt and sadness, especially when faced with imagined or traumatic loss. Your brain might trick you into believing you will experience less pain if you avoid joy. Try telling yourself the truth that experiencing pleasure is not going to create more pain. Avoiding joy simply robs you of joy. When hard times come, the joy you allow yourself to experience is much more likely to bring comfort than to intensify the pain. 

Remember to be kind and patient with yourself. Harsh words and self-criticism are unproductive and feed depression, anxiety, and discontent. Your body and mind will sync up with your life circumstances with care and intentional practice. 

Know you aren’t alone; survival mode recovery is a natural part of the human experience. 

Also, be on the lookout for increased insight from suffering that may surface as you recover. You may also find you have more profound compassion for others going through what you’ve recently experienced. You may eventually want to channel into pouring into others as you recover from survival mode.