What’s it like to have PTSD and bipolar disorder? Many people know that mental health conditions, like anxiety and depression, frequently co-occur. Having bipolar disorder doesn’t preclude you from other mental health conditions like PTSD. Seeking treatment for bipolar disorder alone can feel daunting enough. Compound it with PTSD and it may feel ever more complicated and maybe even scary. In this episode, we explore different treatment options, how bipolar and PTSD can overlap in terms of symptoms, and more.

Gabe Howard

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

He is also the host of Healthline Media’s Inside Mental Health podcast available on your favorite podcast player. To learn more about Gabe, or book him for your next event, please visit his website, gabehoward.com.

Dr. Nicole Washington
Dr. Nicole Washington

Dr. Nicole Washington is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions.

Find out more at DrNicolePsych.com.

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Bipolar, a Healthline Media Podcast, where we tackle bipolar disorder using real-world examples and the latest research.

Gabe Howard: Welcome, everybody. My name is Gabe Howard and I live with bipolar disorder.

Dr. Nicole Washington: And I’m Dr. Nicole Washington, a board-certified psychiatrist.

Gabe Howard: And today we’re going to be talking about post-traumatic stress disorder or PTSD and bipolar disorder. But believe it or not, you can have both which shouldn’t have surprised me as much as it did. But I think maybe surprise isn’t the right word, Dr. Nicole. I think it scared me a little bit that you can have more than one mental illness because we tend to talk about them all separately.

Dr. Nicole Washington: Yeah, that’s true. We do that. It’s kind of my first time thinking about it that way. You’re right. We do tend to talk about them separately as if people can’t have multiple diagnoses. But we know that about 50% of people in this country experience at least one adverse childhood event. Right. So it would not be a far stretch to think that there would be people who have bipolar disorder and also have PTSD.

Gabe Howard: Obviously, on a single episode of one podcast, we’re not going to be able to get into all the nuances and all the nooks and crannies of managing PTSD and bipolar disorder. But we want to touch on some of the things, the causes, for example, the managing, the moving forward, the talking to your doctor, and of course, talk about ways to advocate for yourself so that you can get the help that you need. But let’s make sure that we’re all playing with the same definitions. Dr. Nicole, what is the definition of PTSD or post-traumatic stress disorder?

Dr. Nicole Washington: Yeah. So, you know, when we think about PTSD, initially you have to have been exposed to some traumatic experience. And then the question becomes what? What’s the trauma? What constitutes the trauma? There are some things that some people would definitely say I was traumatized by A, B or C, but if you happen to see somebody who’s very, very strict to the DSM criteria, they may say, well, that doesn’t meet criteria for a trauma, which is here nor there and can be very frustrating. But the bottom line is you have to be exposed to some kind of traumatic experience where you felt that you were threatened or in danger or someone you love was threatened or in danger. Or maybe you work in a field where you see a lot of other people’s traumas and have to deal with that. So those are your basic criteria to have PTSD. And then there are symptoms like nightmares and flashbacks and intrusive thoughts and, you know, being reminded of the trauma and getting angry or sad or scared, being extra jumpy, like nobody can sneak up on you or always looking for the next bad thing to happen, or just having a really negative outlook about yourself or the world or people and just really struggling with how that trauma has affected you.

Gabe Howard: Managing bipolar disorder is certainly difficult. I don’t think that you’re going to get much pushback on that. While I do not myself live with post-traumatic stress disorder. Based on your description, it sounds equally difficult to manage. It really sounds like something that would disrupt your life and cause you a lot of problems. So the intersection there is if you’ve got two things that by themselves are extraordinarily difficult to manage, and then you have the convergence of those two things and some of those symptoms even overlap.

Dr. Nicole Washington: Yeah. I was going to say what makes it even trickier is I have seen people misdiagnosed as bipolar disorder who actually had PTSD. So that brings in another like, oh, great, here we’re making it even more complicated. So I think if we take them a piece at a time like right, there are going to be a category of people who have had a trauma, who have PTSD, who may also have bipolar disorder. They are going to be a group of people who have bipolar disorder. And because of some of the things they experienced as a result of their bipolar disorder, they may develop PTSD. And then you’re going to have people who have PTSD who may get misdiagnosed as bipolar disorder.

Gabe Howard: We know that diagnosing people with any mental illness is difficult because there’s no blood test. Right. There’s no definitive you can’t swab the back of my throat. You can’t do a culture. You can’t send in lab work and wait for the lab to come back and confirm your suspicions. Right. A doctor has to evaluate your symptoms. I don’t want to make it sound like doctors are literally just guessing or throwing darts at a list of symptoms. There’s a there’s monitoring. And we’ve discussed this before on the show, why diagnoses change and things like that. But is it and I’m asking you as a psychiatrist, Dr. Nicole, if somebody does have bipolar disorder and PTSD, how can you decide that they have both? Because there is so much overlapping. Is the reason they’re jumpy because of, you know, paranoia with bipolar disorder certainly possible or is the reason that they’re jumpy because they have PTSD? So making the leap to. No, no, no, no, no. You have two things. It sounds really, really difficult when there is a reasonable explanation for all of those symptoms and just a single diagnosis.

Dr. Nicole Washington: A lot of times I will step back and really think through like, what am I looking at here? What is this? And so usually for me, the first thing I want to do is get the mood stable. So I want to hit the bipolar disorder first. I want to know if those overlapping symptoms are because your mood is not stable or because of your PTSD. And then if I can get you to a somewhat normal, or at least not manic mood state, because it’s really the manic symptoms that are overlapping with the PTSD symptoms that can get confusing. Like if a person says, oh, I’m paranoid? Well, if you are manic and paranoid, you may be paranoid that someone’s following you or out to get you or, you know, reading your mail with scanners or has your apartment bugged or things like that. When you have PTSD, it’s not really paranoia, it’s hypervigilance, right? You’re always watching your back because something bad happened to you and now you feel like you always got to be on guard. Those are different things, but can be described by people in the exact same way. So that’s why we have to really kind of dig through the weeds and try to figure out what it is.

Gabe Howard: It is my understanding that the treatment for bipolar disorder and the treatment for PTSD are wildly different. For bipolar disorder, there is, as we’ve talked about before, there’s medication, there’s support groups, there’s coping skills, there’s therapy. There’s a there’s just there’s a lot of treatments available. But the primary treatment for bipolar disorder is medication that that always seems to rise to the top. It’s a very important treatment of bipolar disorder. Let’s go over to the post-traumatic stress disorder side. Is medicine equally important? Are there medications for PTSD or is it a completely separate treatment mechanism?

Dr. Nicole Washington: There are SSRI antidepressants that are approved for the treatment of PTSD, and we use those. But that’s where the trickiness comes in because we do try to avoid those same medications for people who have bipolar disorder because we don’t want to make their moods more unstable. So that’s where it gets very tricky. And we are having to see if we can get benefit of those symptoms with the same medications that we’re using to treat the bipolar disorder. So there are treatments. Therapy is a very, very significant part of treatment for PTSD. But of course, you have to be in the right mood state to actively participate in therapy in a meaningful way. And usually when a person is manic, they are not in the space to be able to participate in a therapy session the way they need to be able to in order to see benefit.

Gabe Howard: As a person who lives with bipolar disorder, I know how incredibly difficult it is to manage a bipolar disorder. If at one point in my life, it consumed my life, it was every single moment was Gabe versus bipolar. And as I as I got better, it took less time. But even today, as we sit here, some part of my life is still spent managing a severe and persistent mental illness. Over on the PTSD side alone, without the co-occurring bipolar disorder. What’s that like? What is it like to manage post-traumatic stress disorder treatments from a medical standpoint?

Dr. Nicole Washington: And so from a psychiatrist standpoint, the most difficult part for me of helping someone through their PTSD is I’m always left with this feeling of and I tell patients this frequently, I can give someone enough medicine to have them in the corner drooling and wetting their pants, but it will not change the fact that they went through this traumatic experience. And the medicine won’t help them forget and the medicine won’t make them pretend like it didn’t happen. And so the medicine really is just one very small piece of the puzzle in treating PTSD. And it really is important that the person is in therapy also, because that’s where the big work comes in, in trauma. I mean, you can’t un remember something that happened to you that was really bad. I can give you medicine to take the edge off, to decrease the anxiety, to help you put the work in in therapy. But really, it’s work. It’s work and therapy. And sometimes people who have PTSD are just very fragile and not able, or at least they don’t feel like they’re able, to put that work in.

Gabe Howard: Now let’s talk about putting that work in while managing bipolar disorder. And that’s even a very difficult question to both ask and answer because not everybody managing bipolar disorder is the same. And when trying to structure this episode, that really got in my way, like just to, to let you know, Dr. Nicole and let the audience know, because I think about Gabe with bipolar disorder. So let’s say that right now,

Dr. Nicole Washington: Okay.

Gabe Howard: Literally 2022, I get done recording this, I go out and something happens that causes me post-traumatic stress disorder.

Dr. Nicole Washington: Okay.

Gabe Howard: I am in a much better position to manage that because I’m already stable

Dr. Nicole Washington: Yes.

Gabe Howard: With bipolar disorder.

Dr. Nicole Washington: Absolutely.

Gabe Howard: So it’s not that bipolar disorder wouldn’t interfere. It just wouldn’t interfere as much. But then I think about Gabe back in 2003, you know, walking out of a psych ward and let’s say that something happened then that caused that trauma, or let’s give a small nod to let’s say that the diagnosis and or early-stage interventions of bipolar disorder cause trauma. I would be in a very different place to manage it.

Dr. Nicole Washington: Yeah.

Gabe Howard: And this is really handcuffing me because I’m like, Well, if you live with bipolar disorder, how should you manage it? And it’s like, well, it depends. Are

Dr. Nicole Washington: Yeah.

Gabe Howard: Are you still actively manic? Are you stable on medications? Do you have a good support system? Do you have a job? How long have you been diagnosed? How are you managing? Are you doing well managing bipolar? Because then you could probably do a better job maybe of managing PTSD. And of course, I haven’t even gotten to does post-traumatic stress disorder unravel all of the progress that you’ve made managing bipolar disorder? I’m going to just shove that over to you, because I honestly, it was like an octopus every single time. I every single time I wrote a question, the other seven hands like shot up and they’re like,

Dr. Nicole Washington: What about this?

Gabe Howard: Nobody.

Dr. Nicole Washington: What about that?

Gabe Howard: And notice how I just gave octopuses hands. Like, like everybody listening is like, dude, they have arms. They have eight arms. They don’t have

Dr. Nicole Washington: They

Gabe Howard: Hands.

Dr. Nicole Washington: Have tentacles. Aren’t they called tentacles?

Gabe Howard: Listen. I don’t know, I.

Dr. Nicole Washington: Aren’t they called tentacles?

Gabe Howard: It’s not a nature show. It’s not. It’s not a nature podcast. Don’t write me emails about this. We get anything

Dr. Nicole Washington: Oh.

Gabe Howard: Wrong. Mental health, bipolar disorder, mental illness. Then you can write us emails. Don’t go correcting my grammar, my making up words or animals, and stop telling me my analogies are too long.

Dr. Nicole Washington: I want somebody to draw an octopus with, like, eight hands. Like jazz hands.

Gabe Howard: I’m doing it. I’m doing it. Fact.

Dr. Nicole Washington: Like jazz hands.

Gabe Howard: Listen, it might be the episode cover for this title. It’ll just it’ll just say Inside bipolar disorder. And it will be a hand drawing of an octopus with eight hands. People will be like, what? What is happening over on Inside Bipolar?

Dr. Nicole Washington: It’s ridiculous. Ridiculous.

Gabe Howard: Did somebody not? Gabe clearly did this. Dr. Nicole had no part of this. That’s what everybody will say.

Dr. Nicole Washington: I had nothing to do with this. But you’re right.

Gabe Howard: That’s what everybody will say.

Dr. Nicole Washington: But you are right.

Gabe Howard: It’s a big, big quagmire.

Dr. Nicole Washington: You are right. It is. It’s very, very complicated. So teasing those out a piece of time. Absolutely. It matters what phase you are in your life or in your bipolar illness when you when you experience your trauma. Of course, that matters. Right? You’re absolutely right. If your mood is up and down, if we can’t get you to a place of stability, if you’re still in that fragile state and you experience a trauma, it’s probably going to be much more impairing and just much more of a problem for you than if you are more stable. You are 100% correct. But regardless of where you are in your bipolar illness, it’s still important to make sure you are in treatment and make sure you’re talking about that with the person who prescribes your medicine and a therapist.

Sponsor Message: Hey everyone, my name is Rachel Star Withers and I live with schizophrenia. I’m also the host of Inside Schizophrenia, a podcast that dives deep into all things schizophrenia. Featuring personal experiences and experts to help you better understand and navigate schizophrenia, Inside Schizophrenia is a Psych Central and Healthline Media podcast and we are available right now on your favorite podcast player. Check us out!

Dr. Nicole Washington: And we’re back talking about the intersection of PTSD and bipolar disorder. Now, you talked about also the people who experience PTSD as a as a result of their bipolar illness.

Gabe Howard: I’m glad that you brought that up, because we absolutely need to give a nod to trauma that is caused from the process of being diagnosed. Unfortunately, because of just a whole host of reasons, from a lack of understanding to lack of early intervention, to police being called when we’re in crisis and not having the proper training to just a whole host of societal and systemic problems, a lot of people with bipolar disorder do not get diagnosed in the most caring or supportive of ways. And unfortunately, our society, for whatever reason, doesn’t really acknowledge that trauma too much. When somebody with bipolar disorder says, hey, you know, I was out of my mind, I didn’t know what was going on. The police showed up. My mother was crying. Everybody was screaming at me. I got drug out of the house. All the neighbors saw me. And then I ended up in the hospital for a week and I was told that I had bipolar disorder and it was awful. Everybody around them closes ranks and says, What? It was for your own good? Well, what were we supposed to do, leave you?

Gabe Howard: Well, yeah, you were, you were throwing cans at your brother. You could have hurt him seriously. And all of those things are true. But it’s also true that this person was sick and they were hauled out by the police and taken to a hospital, and they lost certain freedoms. And of course, it’s scary to be told that you have a lifelong illness. Right? Let’s just remove all of that other stuff and just say, hey, you walk into a hospital, you’re like, Hey, I think something’s wrong. The doctor looks at you and says, Yeah, I’m diagnosing you with an illness that there is no cure for, that you will have to treat for the rest of your life. And by the way, it has a 15% death rate. And that is terrifying, very terrifying. Now, all of that is I want to be completely fair and honest. Like all of that is it’s not quite right. Obviously, if you’re receiving treatment, if you have access to care, if you have support, those things lower. But it’s scary.

Dr. Nicole Washington: It is scary.

Gabe Howard: And things that are scary cause trauma, rather, that rises to the level of post-traumatic stress disorder is unknown because it’s so individualized. But how do you allow for that as a as a psychiatrist, Dr. Nicole?

Dr. Nicole Washington: So I will say, you know, the one thing and I’m glad you said it in that way, because this is kind of what I was alluding to earlier when we talked about the criteria for PTSD. So it is scary. It’s very scary. Nightmarishly scary. But there are a lot of mental health professionals who will say, but that doesn’t rise to the definition of what we would consider a trauma as it relates to PTSD. And that is sometimes where the fight comes in. Right. That is where the battle, the death match, the cage comes up. That is where it all goes down. When you explain to somebody that even though something was very scary to them, it doesn’t necessarily meet criteria for PTSD. Now, me personally, I don’t think it matters because I think that if it was scary enough that you see it as a trauma, that’s important enough for me and then we can work from there. Right? I don’t have to call it PTSD to validate the fact that you felt traumatized by what you experienced. I don’t have to call it that. And sometimes I will admit mental health professionals get really hung up on like what people want to call things. Right. So, you know, I do have lots of patients who will say, oh, I have PTSD from when the police put me in the back of the car and put me in the hospital.

Dr. Nicole Washington: Technically, maybe somebody could interpret that that is not going to meet that criteria for PTSD. But it doesn’t matter. My patient is traumatized, my patient is upset and they’re scared and we got to work through that. So I think sometimes we get hung up on DSM and oh, that’s not right. It doesn’t meet criteria. So you can’t have this and that. And then sometimes I think patients get hung up on wanting to have a diagnosis of something like they want that PTSD diagnosis, right? They want that bipolar diagnosis. They want it because they just want to be able to put a name to something and be able to say, this is why I behave the way I do. So I don’t think that part is that important. But I will tell you, for both sides that may be listening, we probably all need to get it together, get our get our poop in a scoop. We probably all need to do that because both sides kind of struggle.

Gabe Howard: I appreciate the honesty in this. I mean, sincerely, as we’ve talked about on this show before, we always believe that psychiatrists are lording over us and telling us what to do and not willing to admit that there’s growth potential, that there’s that there’s shared human experience. It’s and I know part of it is managed care. Part of it is you only get 15 minutes. But I, I appreciate when you throw those little parts out there because I think as a patient, it makes me feel better about my care. It’s like, okay, she gets it. She gets it.

Dr. Nicole Washington: And it’s really how do I say it, right? If you say I have PTSD from this and I say you don’t have PTSD, that’s not really a trauma. That is so dismissive. You are going to be ready to fight me for real. But if I say to you, well, it sounds like that was really terrible and really scary for you. While that does not fall into the category of what like by definition we would call a trauma for PTSD, I still think we need to explore that because obviously it’s very upsetting to you and we need to work through that. And not to risk upsetting anybody. But I do also know that there are times when a person with bipolar disorder is maybe in a manic episode. Their memory of things that happened are not 100% based in reality. Right? You have a manic episode. You, you know, are kind of removed from that episode. Or you start to clear your memory of how you think things went down may not be 100% accurate. And so the way you remember something may be that someone committed some kind of trauma towards you or something like that.

Dr. Nicole Washington: It may or may not be that that’s actually what happened. Your memory of how things went down during your mania may not 100%, but even that really doesn’t matter. Because if at the end of the day you felt like this thing happened and it’s causing you these symptoms like nightmares, and you’re thinking about it and you feel violated and you feel sad and it’s affecting you in that way. Then we still got to do something about it.

Gabe Howard: If you believe that it happened, then therefore it did. I’m going to use the example of the 80’s satanic daycare scandals. The in the eighties, when daycare started to open up, people got mad at this because they felt that women should stay at home. So in order to discredit daycares, they started saying that these were hotbeds of satanic rituals, assault, sexual abuse, child pornography, just everything that they could lob at the daycares to get them shut down they did. And in some cases, this this mass hysteria and that’s really what it was went so far that they convinced children that they were molested, that they took part in pornography, that they were part of satanic cults and worship. And these children actually testified in court. And unfortunately, quite a few daycare owners and workers went to prison. Now, fast forward 30 years. We know that it was made up. We know that it never happened. We know that it was mass hysteria. We know that these children were never touched. They were never part of a satanic cult. They were never part of abuse. Nothing happened. The daycare workers were let out of prison. They were exonerated.

Gabe Howard: They many of them had already served their time, unfortunately, which is time that they will never get back. But as a country, we had to reckon with the fact that we just made it all up. But here’s why I’m telling this story. The children who were involved are now adults. They still believe it. Many of them, they think it is a travesty that it went the other way. They believe that the satanic cults, that the Cabal or whatever it was, has convinced society that it didn’t happen and that they are the only ones who know that it did. So not only were they traumatized the first time from what they believed happened, but now they’re traumatized again because people are ignoring their pain and while this is interesting from a psychological perspective, these kids, many of them, they never had a chance. They were ruined for life because of this mass hysteria. So, Dr. Nicole, whether it happened or not, if they believe it happened,

Dr. Nicole Washington: Yeah.

Gabe Howard: We have to do better. And I want to point that out there, because many people, they’re like, I know that it happened.

Dr. Nicole Washington: Right.

Gabe Howard: And I’m on your side. I’m you know, there’s video, there’s information. They’ve gone to lawyers, they’ve looked at it and it’s like, look, that’s not what happened.

Dr. Nicole Washington: Right.

Gabe Howard: And everybody just wants to tell them it didn’t happen instead of addressing that trauma. So I appreciate that you bring up that that just because it didn’t happen doesn’t mean that it’s not causing you trauma. And I also appreciate you telling people that you really need to evaluate strongly what you remember from the time that you had psychosis, that you were manic, that you were not in your right mind. Because I, I work with people with bipolar disorder a lot and they tell me I was really, really sick. Demons were chasing me. Elvis was singing at me. But in this, in this, in this one moment of time, I have a perfect memory, and I know that it happened. And it’s so tough because you’re like, why did your brain do that to you?

Dr. Nicole Washington: Right.

Gabe Howard: Well, because that’s what disordered thinking is. That’s what an illness is. That’s why you need treatment.

Dr. Nicole Washington: Yeah.

Gabe Howard: I also want to say this is very important, Dr. Nicole, that just because that is the case sometimes, it is important to understand that unfortunately people with serious and persistent mental illness are easy victims.

Dr. Nicole Washington: They are easy targets because who will believe them? Right. I can get

Gabe Howard: Exactly.

Dr. Nicole Washington: Away with it. I can just say they were unstable and nothing happened. So I can’t tell you those things have not happened. And we have to we have to figure it out.

Gabe Howard: I only point all this out because I think the providers might want to look into when somebody reports a complaint like this rather than being defensive and saying no, etc., you know, all the things that you tell patients not to be, right. Keep an open mind, work with me, consider everything, right. Generally what happens is we’re told we’re wrong. That’s not true. That didn’t happen. That that that’s. No, no, no. You’re misremembering. Perhaps if the first words were, tell me why you feel this way. Let’s investigate this. Let’s talk about this. Then when we did see a tape or something, we’d be more inclined to see it for how it is, rather than have this emotional baggage and frankly, fear and anger lumped upon it. It’s really hard to report something bad that happened to you and have somebody look you right in the eyes and tell you that you’re lying. And even if it’s not their intent, and I think your side, Dr. Nicole, might be able to do a better job handling the complaints.

Dr. Nicole Washington: No, I mean, but I agree. I think, like I was saying before, I don’t I don’t know that we have to get into a fight about what we call it. I think we take every complaint. Most places I’ve worked anyway. I will say when I have personally been involved in a patient complaining about something like this traumatizing experience that they are reporting, we investigate it. I mean, we investigate it like we would anything else. And we, you know, they get a letter, a written letter back with the findings. We talk about it. But I do think it’s important on my end, you’re right that we are less hung up on what they’re calling it and more concerned about how we can help them through it. I agree with that.

Gabe Howard: As we’re nearing the end of the show, let’s talk about positive steps forward, because I know there’s many people who listen to shows like these because they feel like they have trauma, they feel like they have post-traumatic stress disorder. They feel like something is going wrong along the trauma spectrum in addition to their bipolar disorder. And they don’t have the words to bring it up. They don’t know how to get to recovery. They don’t know how to move forward. What advice do you have for those folks who are listening, who are traumatized by something or who feel that they’re traumatized by something in order to get the attention of their providers, of their team, whether it’s their psychiatrist, their therapist, their support group, they want to move forward and they’re taking active steps to move forward. That’s what I love about our listeners. You know, people tend to forget that people who are reading articles and listening to podcasts like this, they’re taking control, right? They’re looking for solid advice. I want to give kudos to everybody listening. You’re taking control. Good job. This is for many people, step one, which is learning how to better advocate for yourself. So we’re really, really glad we’re here. And if nobody else has told you, good, good, good job, you should be proud of yourself for taking the reins. But Dr. Nicole, expand on that. How can they move forward in a positive way?

Dr. Nicole Washington: Yeah. I mean, I would encourage you to be less focused on what everybody’s calling your diagnosis or calling your symptoms or whatever it is. Even though I know that comes with a certain level of comfort for a lot of people. I am going to encourage you to focus on your symptoms and focus on what can be done. And so if that means medication, so be it. If that means that you don’t agree with the medication that your psychiatrist is recommending, do you trust that person? You’re going to them for their expert opinion. Sometimes what we recommend may not sound like what you were hoping you would get. And your psychiatrist may say that’s not going to be a good idea with your bipolar disorder. And then here we go again. Cage comes up and we’re all ready to fight. But we don’t need to because we just need you to trust us that we are trying to avoid doing anything that would set you back.

Dr. Nicole Washington: I don’t want to try to improve your PTSD symptoms if it means making your mood symptoms worse. I don’t want to do that. So I would say you have to have a level of trust in the person who is prescribing your medication. If they violate that trust, then maybe if you have the ability, looking for someone else may be a good answer. But you need to give us the opportunity to fail you, like give us a chance. Sometimes people don’t even give me a chance. Like, give me a chance to mess up. Okay? Don’t just assume I’m messing up out the gate. And then being in therapy, it’s also going to be extremely valuable. You can’t un-remember, un-feel, forget stuff that happened to you. It happened. It’s there. The best way we can deal with it is to work through it in therapy. So like, those are the things that I would say that that need to happen kind of on your end. And then to any of my psychiatrists out there listening, you know, we just need to focus more on people’s symptoms and less on what we’re going to call it, because sometimes that is just an unnecessary battle.

Gabe Howard: I agree with you. Don’t get hung up on semantics. We really need to be focusing on wellness and moving forward.All right, everybody, thank you for spending your time with us. My name is Gabe Howard and I am the author of “Mental Illness Is an Asshole and Other Observations.” I’m also a public speaker who may be available for your next event. If you want my book, you can head over to Amazon. But if you want to sign a copy of my book with free swag, head over to gabehoward.com.

Dr. Nicole Washington: And I’m Dr. Nicole Washington. You can find me on all social media platforms @DrNicolePsych to see all the things I have my hand in at any given moment.

Gabe Howard: Hey, can you do, Dr. Nicole and I a favor? Wherever you downloaded this episode, please subscribe. It is absolutely free. Tell your friends, family, colleagues, whether it’s social media, email, text message, or good old fashioned word of mouth sharing. The show is how we grow. We will see everybody next Monday on Inside Bipolar.

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