Kevin Varner, MA, NCC, LCMHC

@kevin-varner | contributor
Kevin Varner, LCMHC, is a licensed clinical mental health counselor based in Raleigh, NC. He works with a diverse population, and specializes in counseling for PTSD, grief and loss, LGBTQIA affirmative counseling, HIV counseling, therapy for anxiety and depression, facing fear and uncertainty, bipolar disorders, and relationship issues. He often employs Mindfulness Based Cognitive Therapy and Narrative Therapy approaches in counseling, believing that we all have stories to share, and that the stories that have defined our past don't have to define our present and our future. He would like you to know that he is heavily meditated, and is owned by a cat named Elvis.
Community Voices
Community Voices
Community Voices
Community Voices
Community Voices

My Experience with Bipolar Depression vs. MDD

I used to feel like there was a revolving door in my emotional guesthouse. A joyless, listless version of me wandered in like a vagrant, stayed a while and left. There was enough time to tidy up my mess and have some peace before a charming, risk-taking bad boy version burst through the door. These bipolar guests took control, ran the show, and they all had bad manners. Without psychiatric and therapeutic support to manage my extreme highs and lows, every depressive episode cycled to a hypomanic episode. Sometimes there were periods of a balanced mood post-depression, but hypomania always arrived next. Now that I have become educated about bipolar disorder cycles, I recognize some important distinctions between bipolar depression and unipolar depression, also known as major depressive disorder. Bipolar disorder is easily confused with depression because it often includes depressive episodes. However, there are some key differences: Bipolar disorder tends to recur on a somewhat regular basis. In a typical cycle, a depressive episode will sometimes end abruptly, followed by hypomania, then followed by another depressive episode. They may be weeks to months apart, but the cycle continues. Does it sound exhausting? It is. With depression there is no “up” period. Unipolar depression may feel like a pervasive sense of hopelessness, worthlessness, loss of enjoyment and a decreased ability to manage day-to-day tasks. Depression may slowly creep in, hang around for several days or weeks and have a glacial quality. Bipolar disorder always includes symptoms of mania or hypomania. The shorter-lived cycling between hypomanic or manic episodes and repetitive depressive episodes may be an indication of a bipolar spectrum disorder, not a unipolar depression disorder. While clinical depression cannot evolve or “turn into” bipolar disorder, a person previously diagnosed with depression may actually have a type of bipolar disorder. If you’re unsure whether your experience is one of unipolar depression or bipolar disorder, please consult a therapist and psychiatrist for a full psychological evaluation. Don’t self-diagnose. Before I received an accurate diagnosis, it seemed I had a string of depressive episodes. It’s possible that some hypomanic cycles were milder and went unnoticed. The early experience of hypomania didn’t usually affect me much, if at all. I might feel cheerful, well-rested after just 4 hours of sleep, focused and on top of the world. After a depressive cycle, this wouldn’t seem like a problem. Hypomania felt kind of awesome at times … nothing like how manic episodes are depicted in movies. In the past, hypomanic episodes would sneak by because I didn’t know what the early signs were. I thought, Hmm…I have been feeling absolutely awful for the past four days. Today I feel better…much better just overnight. This quick turnaround isn’t usually associated with unipolar depression. It felt wonderful until it became too much to handle. My bipolar depressive episodes were more noticeable because they were short-lived, intense and sucked my energy quickly — sometimes in a matter of hours. By contrast, once the first episode of major depressive disorder has occurred, recurrent episodes will usually begin within 5 years of the initial episode. On average, those with a history of MDD will have 5 to 9 separate depressive episodes in their lifetime. Another difference is that antidepressants made my depression cycles worsen, which then made hypomania’s impact worse when the pendulum swung in the opposite direction. When I was prescribed a mood stabilizer instead of antidepressant medication, I experienced a steady return to emotional balance within a couple of months. Before finding the right medication, and before mindfulness practices and talk therapy, I would sustain a level mood for several weeks. But the balanced mood would escalate to a level of unstable emotional intensity not found in MDD. This time period of gradual, intensifying hypomanic symptoms is called the “bipolar prodrome.” The prodrome period can be weeks to months long, making it harder to recognize. The most common prodromal symptoms tend to be a sudden elevated mood, overly positive self-talk, decreased need for sleep, increased activity, compulsive spending, hypersexuality, and obsessive, grand ideas. For a while, friends may not notice I’m off balance. I seem confident and purpose-driven. I’m extroverted, charming, quick witted, and I get stuff done. However the prodrome can shift suddenly in a few hours or a few days to unmanageable high-flying moods and poor choices, followed by the depressive shift to a loss of energy, motivation, self-worth, and a flat emotional affect. Unipolar depression is characterized by a slower, pervasive experience of worsened mood without the highs of a manic cycle. While these two have similar qualities, they’re different enough to have distinct diagnostic criteria in the DSM-5 . Unipolar depression and bipolar depression share the same symptoms with three main differences: Bipolar depression is more episodic than unipolar. Bipolar depression is always on the edge of mania. Due to the mania risk, bipolar depression treatment differs from unipolar depression treatment. Here are some steps that will help a mental health provider offer you an informed diagnosis: Make a list of what you’re experiencing, when and for how long. Rate the severity of the symptoms on a scale of 1 to 5, with 1 being the least intense and 5 having the most impact on your functioning. Track this list for at least a month, if possible. Ask your friends, family or someone you trust to tell you what they notice. An external view is important, because both depression and bipolar disorder tend to draw a person inward, away from self-awareness. Note changes to your appetite; quantity and quality of food; sleep; use of substances like cigarettes, alcohol, caffeine and other drugs; and the motivation to do daily tasks before, during and after an episode of depression. There may be important clues that will help your provider offer an accurate diagnosis. When depression subsides, do you return to a balanced mood for a significant amount of time (months or years), or does your mood become gradually euphoric, intense, impulsive and unmanageable for you and those around you? Consider asking a psychiatrist to give you an assessment for both major depressive disorder and bipolar spectrum disorder before a diagnosis and regimen of medication. With medication and interpersonal and social rhythm therapy (ISRT) , my depressive and hypomanic episodes become fewer and less intense. When they subside, life becomes more manageable. I am reconnected with myself, others and the environment. I have more patience. I wake up feeling calm and well-rested from at least 7 hours of sleep. I make healthy meals, find time for rest and play and hit the gym after work. I’ll be in bed by 11 instead of 2 a.m. and drift off in 5 minutes. I don’t feel like a superhero. I simply feel like me again. It’s not always this way; medication isn’t a magic wand. I still have occasional episodes, however, they’re less intense and don’t last as long. The tools I’ve learned have helped me trust my moods as authentic and less worrisome. My emotional life has improved from drastic and exhausting travel between the north and south poles to living in a balanced, temperate emotional climate near the equator. Whether your diagnosis is unipolar depression or bipolar disorder, finding the best tools will make a big difference in living a healthy, emotionally balanced life. That’s something both of these disorders have in common.

Mindfulness Lessons from an HIV Positive, Bipolar Ex-Convict

I used to hang out with ex-convicts, recovering addicts, former prostitutes, homeless men and women, and the occasional drag queen. Several of us, including me, had mental and behavioral health diagnoses. All of us were living with HIV. I led a Thursday support group for HIV positive men at a center in Greensboro, North Carolina called Higher Ground, a community safe space for men and women living with HIV and mental illness. I would walk in the front door to the cheer of “Kevin!” and be served some of the best fried fish I’ve ever tasted, homemade potato salad, collard greens, and as the sign above the percolator read, “Coffee as strong as love and black as Hell.” Jerry sang “His Eye is On the Sparrow” with a bass that shook the furniture, and saying grace sometimes took five minutes before the “amen.” It was a dose of the real-real world: more real than anything on social media or Bravo. It was compassionate and raw, gorgeous and often messy. Six of us gathered in the middle room of the house after lunch. Three on one couch, two on the other. Andy sat in a green plastic lawn chair by the window. Andy shows up when he needs to be there, so I know when he’s there, he definitely needs it. He’s good at taking care of himself. He is self contained, tight and sinewy strong, hidden beneath layers of baggy clothing and dreadlocks that reach his lower back. He looks like a vine—twisted, knotty and tenacious. He thrives best in rocky soil in spite of the elements. Sometimes he comes to the group and stares out the window saying nothing for the full 90 minutes. This Thursday, he spoke. It had been awhile since he’d joined us, so I asked him to ring the singing bowl to get us started. He rang it so softly it barely registered. I opened my eyes, “Did you ring the bowl, Andy?” “I did ring it,” he replied softly, “I hit it real soft. It lasts even longer than if you ring it real hard.” “Would you mind ringing it one more time?” I strained to hear it, waiting for the sound to grow and wash over me like it usually did. Instead, it came to the edge, touched my toes and backed off. The six of us meditated for several minutes, took one slow deep breath together, and opened our eyes. Andy turned away from the window and said, “I got something I wanna say at the start today.” I prayed, “Please God don’t let him go off on a rant.” Instead, he told us a story. “The loudest sound you ever gonna hear is silence. True silence be louder than anything else around it. There be a Sanskrit word…ancient word called mauna and it means silence. It’ll come down from heaven and wash over you, or tap you on the shoulder in the middle of a crowd. Sometimes it’s there when you meditate, other times it be in the chaos, in the middle of a bomb exploding or somebody murdering somebody right next to you. Them times it be harder to find but it’s still there underneath everything.” His black eyes scanned us, asking if we were with him. Our faces said yes, brother, yes. “Why do there be so much noise in the world? Why? Because people be afraid of the silence…of that dark quiet because for them it’s so loud, and they don’t understand it. But in that dark quiet God speaks to you underneath the white noise that just don’t mean nothing. Look at it like this: You got a 60 by 35 foot room. Now, in this room there be 44 men. Twelve of them be playing cards and yelling, and another 12 be watching the TV… You got another three or four listening to the radio, all listening to different channels, two of them just be sitting there, breathing, staring off into space, but still making noise, adding to the chaos.” He looked beyond the window to a memory of the prison common room. “Then the rest of them be fussing, arguing or maybe they be lifting weights… ain’t none of them listening to the silence. They all do their best to block it out because it be so loud. It may make them have to take a good, hard look at themselves, and they might hear something in that silence they ain’t ready to hear just yet. Twenty-one years in prison… it wasn’t ever quiet. Not once in all them years. I had to learn to listen for that silence in the middle of the chaos…to find my peace, because everything there in that small space, in them small rooms…was doing everything it could to block out that silence and keep me from hearing it. They used to… the guards, they did… they used to have this big metal coffee pot. And anytime someone wanted to go in or out the cell block, or anytime anyone was coming or going, they would rap on that coffee pot. Three times for going, and four times for coming with a big metal spoon. All hours of the night. Some cells had televisions. TV would be on all night and all day long. No silence ever.” He paused to tie his shoelace and continued. “So you gotta find your own way. Because maybe you get up at 6 and wash, and help the doctor sew somebody up who got stabbed that night during all that noise. Or you work in the kitchen and no matter how much you didn’t sleep, you still gotta get up at 3 and start making the biscuits. The inmates don’t care if you didn’t sleep last night because it was too loud. They want their breakfast. That’s all they care about. And so you got to find that silence, that darkness behind the eyes, that place that is a peace beyond all understanding… that place you go right before you sleep, when you’re still awake but you ain’t, and you gotta stay there and wait for the voice of God. You lean in closer and it’ll teach you things. Bob, sitting next to me, asked, “What things, Andy? What things will it teach you?” “That be up to you and what you signed up to learn in this life. Whatever you is supposed to hear, if you get quiet enough in your mind, you’ll hear it. You know the best thing I ever learned from the TV?” He waited. “What’s the best thing you learned from the TV?” I asked. “The TV be exactly like the mind. Whatever you think up here,” he tapped between his eyebrows, “you make happen in the world. We create and destroy with our mind. We get stuck in a dark hole and live there. We think other people be monsters when they are just as scared of us as we are of them. The problem with most of us now is we never have a break from our minds. We forget that the TV be on 24/7, playing something all day and night. Used to be that all the channels would go off after 2 in the morning. They’d be a long beep, then silence and then snow. But the TV was still on. Static noise. That’s not the darkness, not the silence I’m talking about. I’m talking about when you turn off the TV.” “You remember how it would slowly fade down to that little white dot in the center? That dot would stay there surrounded by blackness. Then it would go away. That’s the silence. You got to get yourself to that little white dot in the middle of that black screen and stay there, breathe there, be happy there. The first time it happens it’s gonna scare you because it’s gonna be so quiet you ain’t gonna know what to do with yourself, and then it’s too late. You started thinking again. You turned the TV back on.” He chuckled at the irony. “Finding that silence… and listening to it speaking louder than any of the loudest noises is what got me through prison. It gets me through when a problem comes up now. Don’t be afraid of it. Don’t chase it. Just sit with it and it’ll come and find you.” We stayed silent, taking in the wholeness of an unbroken man who had served time, and who served us wisdom. For me, living with bipolar disorder and HIV and finding solace from fear and shame, depression and hypomania has been a long, loud journey. But Andy is right. Occasionally during meditation, underneath the chaos in my head there’s another voice speaking without words. He sounds like me, he is whole, and he loves me very much. If you saw Andy, you’d most likely walk the other way and he’d be glad you did. However, you’d have missed an opportunity. There are the unlikeliest angels among us. Our saints and prophets are faceless, don’t get three square meals a day and often don’t smell too good. When I hugged him that Thursday, he embraced me as a brother. “Thank you, Andy,” I smiled, and he smiled back. That day, I was blessed by one of the wisest men I’ve ever met.

15 Self-Care Tips for People Living with Bipolar Disorder

Over the holidays, I searched for recipes several times, for dishes like pecan-glazed pumpkin spice bundt cake, flawless vegetarian-field roast or the best Dutch baby pancakes. Each recipe began with grandma’s life story, then how the writer’s second cousin shared the recipe with her husband, who swore he’d never eat vegetarian-field roast and was shocked to discover how marvelous it tasted. You get the idea. There are too many paragraphs, advertisements, pop-ups and fast-moving recipe videos to scroll through. All I want is the recipe. When I spiral north or south with bipolar disorder, I don’t need cute anecdotes. I need a recipe . I recommend that others living with bipolar disorder craft their own recipe for self-care, as I have done. You may find some of my practices useful. Feel free to adopt them, or design a way to recognize your symptoms, accept them, investigate which tools to use and nourish yourself with loving kindness and discipline when you need it most. These are my daily practices: I maintain a consistent sleep and wake schedule. Circadian rhythms can be interrupted by the hypomanic symptom of sleep interruptions, caused by racing thoughts and the depressive need for more sleep. Scheduling 7 hours of sleep, shutting down electronics 30 minutes before bedtime and practicing “BFMT” (brush, floss, meditate, and tuck in) make a big difference. If I still have difficulty, I take melatonin and listen to a guided sleep meditation. I make my bed every morning. It’s a task I can accomplish. When I feel hypomanic, it centers me. When I’m depressed, it’s a gentle reminder that I can do hard things. I check in. I document my daily moods in the E-mood app. Every morning, I wake up with a song in my head. Often the song in my head will predict if I am ramping up or sliding down. For example, if it’s “Toxic” by Britney Spears — possible hypomania. If it’s ”Ordinary World” by Duran Duran, depression might be on the way. I text a daily gratitude list. I name six things I’m grateful for and text the list to six friends. Some friends text their gratitude as well. I highly recommend this. I meditate daily. When meditation feels like trying to move a boulder, the I can’t do this message is loud. I pause, breathe and turn toward resistance with the compassion of a caregiver. I say, “ This is hard, I know. Find just one thing to be grateful for today. ” On days when mania tells me I can move boulders with my mind, I meditate with a guided, centering, anxiety-lowering meditation. If I’m too antsy to sit, I choose walking meditation or run on the treadmill. I take care of my body. I take my medicine. I shower, brush and floss. I wear fresh clothes, drink lots of water and limit caffeine to two cups a day. Preparing a healthy breakfast, lunch and dinner are acts of kindness for myself — and healthier than ordering “a depression pizza” or skipping meals. Whatever the mood, I go with the flow. This means facing what’s happening, rather than fighting, fleeing or freezing. One of my acceptance phrases is This is happening now, and this will pass . Facing what’s really happening keeps me present in the now. Going with the flow doesn’t mean feeding mania or wallowing in depression. I use the presence of symptoms to navigate from nowhere to now here, rather than isolating myself in numbing depression or allowing mania to drive the bus. I play with Elvis. Elvis is my 17-pound cat. Playing with him creates immediate connection with a dear animal who offers unconditional love (mostly … he’s a cat after all). Petting Elvis as he purrs on the couch is as calming as meditation. These are tools I use on a regular or as-needed basis: Therapy. I schedule twice-monthly talk therapy and monthly calls with my psychiatrist. I journal. Writing about my sadness and longing helps loosen depression’s icy grip. When I’m feeling hypomanic, scattered and agitated, journaling is the last thing I want to do. Even so, it calms me and helps organize and release my racing thoughts. I’ve developed a support team. I text or call my 12-step sponsor and two other fellowship contacts at least once a week. I’ve shared with my partner and some friends about my struggles and have asked for support before, during and after a cycle. Their empathy lowers my stigma and shame and has deepened these relationships. I watch informative videos and read articles about bipolar disorder. These resources educate me in an easy-to-understand, non-clinical way. They’ve helped to reduce the shame and stigma of living with mental illness and offer tools to recognize symptoms of mania and depression before they start. I’ve found mental-health resources on the NAMI website, The Mighty, YouTube videos by Dr. Tracy Marks, Kati Morton and TED Talks. They are all helpful in educating myself and others. I’ve left social media. I left Facebook, Twitter and Instagram three years ago. They are bipolar triggers for me. I would stay up mindlessly scrolling until the wee hours of the morning and often became obsessed with following and messaging certain users. I worked through social media withdrawal with the help of my therapist, adjusted my usage and eventually let it all go. Now I participate in healthy online forums and publish articles. I text, email, call and mail handwritten cards to friends and family. I’ve set boundaries. I share what I am feeling with one person. It usually dissolves obsessive thoughts and compulsive spending. Admitting when I have these urges takes courage, vulnerability and holds me accountable. Another boundary addresses depression. Regret, shame over past actions and the loss of motivation and self-worth sometimes arrive out of nowhere. When cycles arise, I practice “RAIN.” I r ecognize the symptoms, a ccept and face them with compassion and awareness, i nvestigate what’s happening in my body and ask, What’s the unmet need right now? Then I n ourish myself with healthy options. I’ve made an honest assessment. I’ve composed lists titled “Signs of Mania” and “Signs of Depression” and shared these with my trusted friends, so they can help when they notice I’m ramping up or spiraling down. At first, you may resist some of these practices. For example, when a hypomanic cycle began, I wouldn’t always reach out for support. The option didn’t always occur to me. A regular check-in with someone who understands has become a habit, no matter how I’m feeling, so I’m more likely to call a friend when I need one. When I’m feeling depressed, positive self-talk and affirmations are difficult to believe. Gratitude is a different practice. If I can’t look inside and find one thing I love about myself, I can look outside at Elvis the cat, the cup of hot coffee or the opportunity to connect with others through texting. I breathe in, breathe out and find small moments of thankfulness. For more gratitude practice, I recommend “The Book of Delights” by Ross Gay. I hope you find these useful. When we connect as a community, we end the disconnection and isolation of bipolar disorder. Please share with others what works for you, and strive for balance.          

What My Conversation With My Partner Taught Me About Bipolar Disorder

Buddhism teaches Four Noble Truths: There is suffering, a cause of suffering, an end to suffering, and a path to the end of suffering. If unchecked, bipolar disorder causes those I love, including myself, to suffer. Suffering ends when I surrender, talk about it and ask for help. The path to the end of suffering is a roadmap of self-care and compassion for myself and others. It’s a path from a land of chaos to a more balanced, aware and spacious open field, and I’m grateful that now my partner is on the path with me. When we sat down for an honest, nonjudgmental conversation about our shared experience regarding my bipolar disorder, we agreed to a specific day, time frame and short list of topics. What was it like to be my partner before the diagnosis? What do bipolar disorder episodes feel like? What does a bipolar disorder episode look like on the outside? How are things different for us now? Me:  What is it like to be the partner of someone living with bipolar disorder? Him: I have an anxious attachment style, so I look for stability and consistency. When we met, you were usually elevated and vivacious. I thought that was your normal self, and then your behavior seemed to suddenly go over the top. [You were] saying you loved me and you wanted me to say it back. It was way too soon for me, less than a month into dating. I was being extremely cautious, and you were going a thousand miles an hour. In hindsight you were hypomanic and asking me to participate in your mania. Me: I barely remember that, which tells me I was [often] hypomanic. Him: Before you found support, you presented as one person with your words and actions, and as time passed, I realized the person you showed me was someone you’d created to hide the reasons people had hurt and abandoned you in the past. You presented as a bold, confident, stable, independent person, while in photographs you looked strained, like you were faking a perfect version of yourself to keep people from getting too close to you, and keep you from getting too close to them. It was as if you created a character you could hide behind. Me: I had no idea I looked like that in photos. How about when I was depressed? Him: You’d make plans and abandon them. You avoided phone calls, conversations, and going out. You’d get irritable, make assumptions and take things personally. You were overly critical of yourself, impatient with tasks and with me. An analogy [would be] like when you’re having a good dream that suddenly turns into a nightmare. It seems real, and it’s hard to wake up. You acted as if the “dream” was reality. Is that what it was like for you? Me: You nailed it. Faking it and creating a false, protective self comes from believing the dream and becoming a character in it. I’d tell myself, “Everything is fine, keep smiling,” and you had no idea I was really struggling. Over time I became skilled at masking what was really going on, fearing what being [discovered as] “not fine” would mean. It became an escape from reality, and when I was hypomanic, that “character” took over. It became easy to sell a lie after living it for so long. I sold others a man who didn’t exist, and eventually I believed it. Him: Thanks for sharing that with me. That must have been really hard for you. Me: It was so painful because I just wanted it to stop. Sharing what it was like for you helps me, and I love that you’re willing to tell me when you notice little signals that I might be losing my balance. What is it like now that I have support? Him: Now it’s like you’re aware that you’re dreaming, and you don’t get lost. It’s only happening in your head, and you don’t need to do anything about it. When you’re depressed, you’ll say you’re feeling low, and if you’re irritable, you’ll say, “I love you, and I’m not up for witty banter just now.” You express your feelings, and we talk about it and move past it more quickly. Me: I feel like I “see you” more clearly, because I’m not lost in my “mental movie” as often. Also we’re working to be impeccable and kind with our words, to ask questions and not make assumptions, not take things personally, and to give each other grace. Thank you for doing this with me. I love you very much. Him: You’re welcome. I love you very much too. We still have work to do. We’re seeing a couples therapist that specializes in addiction recovery and healing relationships impacted by mental illness. Once we process the past, we do our best to keep it there: in the past. If the conversation turns toward a painful, touchy subject, we ask, “Is this a more serious talk?” If so, we make time for a longer conversation or save it for therapy. Undiagnosed bipolar disorder, addiction, anxiety and depression were big obstacles until we got support. Now he leaves love notes next to the morning coffee, and I’ve shown genuine interest in his work. We cook together, disagree at times, apologize when we act like jerks, hug and kiss, say thank you and have date nights. Most importantly? We remember to play. The longest, most intimate relationship we’ll ever have is the one we have with ourselves. Author Elie Wiesel wrote, “Never let anyone be humiliated in your presence.”  It makes sense to treat ourselves the way we wish to be treated, accept our humanness and see our imperfections as tiny cracks that let the light in. Addiction and mental illness don’t make us flawed and broken; they make us human, just like every human who has ever existed.

How to Use 'Compassion Practice Meditation' for Bipolar Depression

Before I found support through my friends and family, and before counseling, medication and mindfulness practices helped stabilize my mood, bipolar disorder ‘s message was that I didn’t deserve compassion. I was afraid of my thoughts while also being seduced by euphoric fantasies of escape, or weighed down by depression ‘s longing for something missing. Addiction offered instant gratification against the pain of reality. In high-flying hypomania, I knew exactly what I wanted and how to get it. In depression, there was no point in wanting anything at all. Depression , whether caused by real-world experiences or from a sudden, inexplicable loss of serotonin and dopamine, brings despair and hopelessness. It slides into my bed and wraps its clammy arms around my belly, while restlessness scratches my skin like a heavy wool blanket. I’d kick off the blanket, but there is no blanket. It’s all in my head. Author and speaker Rob Bell gave one of the most compelling definitions of despair I’ve ever read: “Despair is a spiritual condition. It is the false, limiting belief that tomorrow will be the same as today, though logical mind tells us that’s not true. Tomorrow — in fact the next moment — will be different, if we’re aware.” When I’m grieving what my heart most wants and can’t hold, and when I fear the unknown, I can offer myself compassion. If I turn toward grief and fear instead of running away, I can accept them as a part of the human experience, and offer myself grace, emotional balance and connection with present moment reality. When I set aside the story that bipolar depression tells me and connect to what’s really happening, I can find breathing space in the always-present, always-changing external world around me. The pull from reality that accompanies a bipolar cycle begins to dissolve with Compassion Practice. In Compassion Practice Meditation, I repeat three sentences three times, starting with myself. “May I be free from this suffering. May I be kind and gentle with myself. May I experience peace and ease.” Then, I think of someone close to me and offer the sentences three times, then someone neutral in my life. I continue to breathe in and out of my nose at a relaxed pace and offer the sentences three times to someone who angers or frustrates me (I start small here, and save the big-ticket items for later), and then offer these sentences to the world. When I’m depressed, resistance always shows up during this practice. I feel undeserving of compassion, or I cannot access it. In this case, I offer compassion to the resistance, saying “May I be freed from the suffering of resistance, may I be kind and gentle towards resistance, and may I experience peace and ease with this resistance.” Saying “may I” instead of “I am” is the difference between making an offer and making a declaration. The offer of “may I” feels like gentle permission. I can take the offer now, later or some other day. Affirmation meditations don’t work for me when I’m depressed. Repeating, “I am free from suffering, I am kind and gentle with myself, I am living with peace and ease” feels disingenuous, and I ain’t buying it. From “Recovery Dharma: How to Use Buddhist Practices and Principles to Heal the Suffering of Addiction,” pages 26 and 27: “The second heart practice is compassion, which is a willingness to come close to pain: to recognize it, honor it, acknowledge it, and respond to it wisely. This isn’t easy, because just as we want to run from or suppress our own pain, we also want to avoid being with the pain of others. Compassion means sitting with our own pain and that of others. It stops the cruelty of indifference. Compassion for ourselves is crucial. Self Compassion is the key to healing the shame and guilt that we often feel as we begin to recognize the harms we caused to others.” When I allow the pain to come closer, and trust that the world offers me more than sadness, shame and longing for escape, the present moment opens like the bottom of an hourglass. I can sit with depression without sitting in it, soothe hypomania without feeding it, and discover moments of gratitude that appear like rare birds landing on a branch. Sure, they fly away, but they’re beautiful to watch and name while they’re here. The small, meaningful differences that lift me from bipolar despair come from the gratitude I have for a cup of coffee, morning meditation practice, offering compassion to those who have been harmed by my addictions and bipolar cycles, and texting daily gratitude lists to my friends who check-in “just because.” There’s gratitude for occasional hummingbirds, red-headed woodpeckers in the trees beyond my balcony, and the surprise of a handwritten card in my mailbox from a friend on the West Coast. For a few minutes, I am whole, blessed and grateful. I am loved even though I don’t always feel understood. I belong even though I don’t always fit in. I’m not broken, I’m healing. Bipolar disorder doesn’t define me as anything other than human. I am reminded that everything, including a bipolar cycle, including this moment, including me, is temporary. If you find yourself weighed down beneath depression ‘s itchy wool blanket, please try to practice compassion for yourself and others. Find some beauty in the ordinary, and share gratitude for those with whom you already share your life. Don’t believe depression ‘s lie that you’re broken and deserve to be alone. When you’re longing for what’s missing, remind yourself of what’s here. Look at your hand. Feel the aliveness in your fingertips. See beyond what’s dark and look for color. Be astonished, and tell about it.