I have bipolar disorder and for those that have it….alot of other things come along with it such as personality disorders and other sometimes phobias. On the weekend I find myself trapped inside my bedroom till night fall and unable to leave because I’m scared of people. I don’t like being in public areas and is always concerned with what other people think. I want to find a new job but afraid I will fail because I’m not good at what I do. I know its all in my head but any techniques or personal techniques I can do to lower the anxiety I have.
I also have biplar disorder and have been through exactly what you are talking about—for a long time—and I know lots of biplars who have been through the same. The first thing you need to do is to find a competent psychiatrist who does have experience specific to bipolar and other mood disorders, because this illness is extremely complicated and now there are so many medications to choose from and other kinds of treatment opportunities that you want to make sure you are getting the absolute best care possible. The first thing, regarding the anxiety component, is to discuss and determine with your psychiatrist whether your anxiety is emotionally and perceptually based (we b/p do have a lot of that, because our illness makes our self-esteem go through lots of changes depending on whether we are baseline, going up, or going down, and since we are very often discriminated against and sometimes even harassed at jobs, etc., we often—with good cause—end up feeling like we are freaks, unworthy of love or life, or just plain trash. In their ideal forms, anxiety/fear/terror/flight-flight are life-saving, necessary tools of the mind and body if circumstances in the environment warrant their activity. Obviously, if you were standing in the road and suddenly a car comes down that road at one-hundred miles per hour and you don’t perceive any indication that it is going to stop or swerve out of your way—then the sudden abject terror that you feel will compel you to jump and run as fast as possible to get you out of danger’s way. However, if you are experiencing that same feeling but there is no car to run from and no other cause that can be dealt with—thus creating the conditions for the anxiety to stop—then it can be a living hell. Usually, that kind of sustained anxiety is from a biological cause, which is the next issue you and the psychiatrist must question. In bipolars anxiety can be part of a manic or depressive episode, a carry-over or solitary symptom between episodes, or result plainly from the same brain location and disorder development that causes the separate illness called anxiety disorder (or panic disorder). Unfortunately, bipolar disorder is so complex and yet so poorly understood, that it can affect many different areas of the brain simultaneously or from one to the other. Another possibility, going back to the emotional component, is that many bipolars come from families in which there are other mental illnesses that are evident—from clinical depression to alcohol/drug abuse, battering, emotional abuse, etc. That is often both the genetic and psychological heritage we are dealing with, so we often carry the behaviors and our emotional reactions to them in our minds and hearts and that distorts either our self-image and/or makes us mistrust the world because if our own families could be so cruel to us, then how could the world treat us any better?
A few years ago I developed a symptom of anxiety that was on the verge of terror and which affected me every minute of the day, every day, for about a year. This was, in that case, a pre-dromal symptom indicating that a clinically-diagnosable episode of bipolar depression was beginning to develop. When I eventually became so depressed and terrified of everything around me (leading to a suicide attempt) I was hospitalized and my prophylactic medication for depression was changed to a much more powerful antidepressant (while retaining my lithium and other meds as normally). As soon as the med got into my system and started working, the biting anxiety dissolved into nothing but an ugly memory. I would not wish that previous year on my worst enemy, and I am still surprised that I am alive to tell about it. Anyway, my reaction to the new med showed conclusively that the anxiety was from a biological basis, and happily I was now already on an effective treatment for it and the other symptoms of the depression.
There is a somewhat new talk therapy technique that seem to be the hot thing of the moment among psychiatrists and shrinks, called “Cognitive Therapy”. It is very popular right now as the talk-therapy component for bipolars and borderline personality disorder patients. It basically retrains the patient to investigate their perceptions, thoughts, and feelings (emotional reactions, whether to a real or simply perceived issue) about themselves, their relationships, and the world around them so that they can end up with a truly clear perception of what is going on inside and around them so that they don’t stay caught up in thinking that people are against them because their mother was during childhood or their father was always working and never around to say he loved them, and even to much more painful and devastating experiences and events. At the very least, staying calmer and being more content and “happy” by not driving ourselves crazy with unfounded fantasies and emotional reactions to people around us, fears for the future, etc., will help to avoid our inadvertently triggering ourselves into episodic symptoms and also help us stay away from things like alcohol, pot, narcotics, etc., that can and do have a profoundly devastating effect on our brain chemistry since we are already dealing with over- and under production of the same chemicals that are stimulated by those as well as make us act in ways that are not in our best interests emotionally or materially.
When I was young I could barely buy a doughnut. I would sit in the car for an hour rehearsing what I was going to ask for, recounting the money I planned to use (and it had better be very close to how much it cost so they wouldn’t have to make a lot of change), and when I finally did work-up the nerve to get out of the car and walk into the donought store I was so terrified I could barely walk, and when it was my turn at the counter I could barely say loud enough what I wanted and I was stammering so much that I had to repeat what I wanted about four times anyway. Looking back, I am aware that such fear and anxiety was due to a combination of biological and emotional causes, but I would not let myself become a hermit—and god knows I needed to have my donought. So, I pushed myself over and over and over again, often in tears and wishing I were dead, etc., because it was just so painful.
In your case, along with determing the actual cause(s) with a good psychiatrist, I would recommend a daily activity that shows to your subconscious and waking mind that you won’t settle for anything less than a rich, full, happy life, and that nothing is going to stand in the way of that. For example, for a week every day get dressed and hang out in front of your house or in a nearby, safe location if you are in an apartment building where it would make you look creepy to be just standing in front of. Then the next week every day go down the corner and walk back home. Then the next week every day walk a couple of blocks then walk back home. Extend your distance each week, repeating that every day of that week, until you can go out for a nice stroll every day and be very clear with yourself that you will, unless because of very bizarre circumstances, be just fine, have a good time, get some fresh air, and just plain feel good.
Regarding looking for work, you need to honestly and completely assess your true skills and your true shortcomings and decide where and what kind of job you want to look for. A lot of agencies have job-training, on-the-job development, housing help, life skill training, etc., that can be very helpful and even the “missing link” for a lot of us, since they know at least by education what we are going through and what we really need in order to grow and thrive. Find what you can in that aspect and make sure you take full advantage. Look up NAMI and other mental health websites to determine what is in your area. If you still don’t get enough info from that, call up local hospitals and ask to speak with a social worker or someone who can tell you what is being offered in your area and how to go about getting what you need from it.
Above all, be kind to yourself. Who you are is not determined by any illness, you have as much right to a good, fun life as anyone else, and even if you have to work much harder for it than some, you do have what it takes to do that, and in the long run
GOOD LUCK! HANG IN THERE!!!