I’m generally a happy, positive person when I’m not experiencing bipolar depression. I take my meds every day and I go to therapy once a week, which is the minimum I need to stay healthy. Managing my bipolar also means I stay in touch with friends and family, make plans, and follow through on my commitments. Not managing my disease means I isolate and ignore people who reach out to me; doing well means I socialize and connect.
So when my dad died last December, I was prepared. I don’t mean I was ready for him to go, but I knew how to plan the funeral, who to call, and how to proceed. He’d been fighting stage IV cancer for three years, and I’d spent those years making mental arrangements.
In the years before he died, my dad often encouraged me to make plans for what was coming. He reasoned that his death would make me very depressed. Taking care of arrangements right then was really the best thing for me, he’d say, in case I wasn’t emotionally able to do so when the time came.
My dad was right. Planning his funeral, grieving his death, and controlling my bipolar disorder at the same time has been extremely challenging. The grief hasn’t come all at once, but it has come in waves that sometimes tear me down.
The arrival of grief
I call grief the most difficult emotion. It comes with anger and regret, not just sadness, and it requires acceptance and time.
My grief arrived while my father still lived but was getting sicker by the day. I’d been balancing visits to the hospital with taking care of his business affairs, and I was exhausted from talking to doctors and making decisions. My depression came on during this time, and I couldn’t tell whether it was chemical or emotional. It feels the same either way, but the solutions are different. Did I need a medication change, or was this just grief masquerading as depression?
I was filled with anxiety. I had a panic attack, and I cried every day—not just tears and gentle sobbing, but soul-wracking wailing. I screamed and beat the walls. I cried out, “I can’t!” when the pain seemed like it would never end. I cried myself awake, and I cried myself to sleep. I lived in dread of losing my last living parent, of being an orphan and feeling like there was nobody left to take care of me.
Once I’d cried, I felt paralyzed by exhaustion. Not only was I emotionally drained, but my body was slow and tight. I had to cut myself off from outside stimuli both to preserve my mood and because I just couldn’t think. There were so many decisions to make about my father and his medical care that they seemed to knit themselves together. With my intellectual capacity and executive function nearly decimated by grief and depression, I couldn’t untangle them.
Riding the waves
My breaking point came during a visit to my dad’s hospital room. He was due for physical therapy, and he was in so much pain that his medical team asked me to leave the room. I was scared and frantic. Was I doing everything I could to help? Was I actually being lazy instead of stressed and depressed? If I couldn’t manage to look after my ailing dad, how would I be able to look after myself?
I began to cry in earnest, my anguish coming from a seemingly bottomless well. I didn’t know if I was sadder for my dad or for myself, as both of us faced a medical emergency. My tears eventually became sobs, and I had to bend over to get air into my lungs. A nurse saw me and brought over a chair and a cup of water. Then she took my vitals and determined I’d had a panic attack.
As we were talking, a social worker and a nurse practitioner came to check on me as well. I told them I have bipolar, and that the depression made it hard to handle the grief of my dad’s illness. I gasped for breath through my tears as I said I was an only child and solely responsible for making decisions about my dad. They offered words of encouragement and understanding that helped calm me down.
Then the nurse practitioner asked if I’d taken my meds. I couldn’t remember, though I knew I’d let one prescription expire because I wanted to be present and available for my dad and for his doctors. As I blew my nose, the nurse practitioner reiterated what I already knew: I had to take care of myself first, because I would be of no use to anyone if something bad happened to me.
Letting your own needs go is particularly harmful for someone with bipolar disorder. My grief could—and did—sink into depression, then anxiety, then panic. If I didn’t take my meds consistently, I would be at risk for a deep emotional spiral and possibly a psychiatric hospital. I called my doctor for a new prescription.
After the storm
Now that my father has passed, my grief doesn’t feel as deep as it did while he was dying. I don’t have to worry about his business affairs or his health, or about my depression preventing me from functioning. That swirl of obligations no longer looms overhead constantly, making me feel anxious.
I also have the medications I need, and I keep my therapy appointments so someone can witness my moods and help me notice when depression slips in. My dedicated psychiatric team has made the biggest difference in keeping my mood as stable as possible throughout the grieving process.
So my father was right, as fathers often are. Not only did he understand that grief would be a heavy burden for me, but he also knew it would affect how I manage my bipolar disorder.
Two months later, I’m still not finished tying up all the loose ends of my dad’s life. But at least I’m out of the darkest and most debilitating parts of grief—and I’m in a better place to handle both my illness and my responsibilities.
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