It should come as no surprise that the death of someone you love can cause duress. No one is at their best after someone they care about passes away.

Grief is a difficult and misunderstood emotion that often leads to mental health challenges for even the most stable of people. However, if you are managing bipolar disorder, how do you also manage grief?

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,

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

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, everyone. 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: Dr. Nicole a couple of months ago, as you know, my grandfather died. And in preparation for this episode, I was trying to find the right word or phrase to describe this. And as people who know me know, I’m not normally at a loss for words. And I just I couldn’t come up with how to explain it. And I turned to a thesaurus and I found the word gobsmacked. And I really think that’s the right word. Gobsmacked means astounded or astonished, to the point of being speechless. And I shouldn’t be gobsmacked that a 91-year-old passed away. I shouldn’t be gobsmacked that a man who was sick for six months passed away. I shouldn’t be gobsmacked that a man who is in hospice passed away. But that’s the word. That’s how I felt when I was when it happened. I was. I was gobsmacked. The man was supposed to live forever. That’s how we felt. I bring this up because there’s a, there’s a problem here. Do I feel this way because I’m delusional? Because I’m having a symptom of bipolar disorder? Because I believe things that aren’t true, because I have grandiose thoughts, because there’s mania and invincibility involved? Or am I just a typical grandson who thought that his grandpa was going to live forever? Because, well, frankly, I wanted him to. Grief is a challenge, I think, for everybody. But I think that grief is an extra challenge for people with bipolar disorder, because how do we know which of the grief symptoms are? Well, symptoms of grief or symptoms of bipolar disorder. And that’s the crux of our conversation for today.

Dr. Nicole Washington: Yeah, well, the first thing I will say is I need you to quit saying what you should not do. Should is sometimes a very nasty word. Because when you say what you shouldn’t do, then when you do those things, it makes you feel like you’ve done something wrong or like you’re defective in some way. I don’t know that that’s true. Like under what written rule is it that you should not feel gobsmacked at the loss of someone that you love so deeply?

Gabe Howard: I think it’s interesting that you bring that up, though, because many I was like, my grandfather died and they’re like, how old was he? 91. Oh, okay. Like it immediately went to oh, okay. There’s just something about when a 91-year-old passes away that society cares less. So it does make me feel like I did something wrong. And as a person who lives with bipolar disorder, whenever my feelings don’t match the rest of society’s, it triggers that part of my brain that thinks, Oh, is that a symptom?

Dr. Nicole Washington: No, those people are not reliable sources. We don’t listen to those people. They are also the people that tell you weird things like get over it when you say you’re depressed. We don’t, we don’t need that.

Gabe Howard: And the reality is, there is no wrong way to grieve.

Dr. Nicole Washington: Right.

Gabe Howard: Living with bipolar disorder is very, very tough when things like this happen, because there are a number of ways to grieve. But we’ve been trained to sort of follow the everybody’s supposed to be sad and crying method or everybody’s supposed to not care and be tough or everybody. You know, men are supposed to be stoic. And the problem is, people with bipolar disorder, we do have to learn to take our cues outside of ourselves because obviously, if we took them inside ourselves, especially if we hadn’t reached recovery yet, we could get in trouble. For example, my internal cues for the longest time told me that demons were following me and trying to eat my brain. So clearly my internal cues aren’t working. And this, I believe, makes grief and death that much more difficult for somebody with bipolar disorder to manage.

Dr. Nicole Washington: Yeah, well, first I want to say you’ve been in my thoughts and I’ve been praying for you these last little bit. I know it’s been tough for you, but I think what’s important for people to remember and even you to kind of remind yourself, of course, we think our grandparents are going to live forever. They’re our heroes, right? Like growing up. We see them as being immortal. They are our superheroes. Growing up, grandparents do things your parents wouldn’t imagine letting you do. So we see them in a different light. We know that if the timeline goes the way it’s designed to go, eventually we’ll lose them. But I think we’re in a little bit of denial. So even though we know at 91, I mean, I think logically you could have said I’m pretty sure the days ahead of us are much shorter than the days we’ve had behind us. But when it happens and the reality sets in, that’s huge, right? So, you know, I don’t think it’s delusional or psychotic to say, well, I thought he was going to live forever.

Gabe Howard: My grandfather, he had been sick for a little while, but we all believe that he was going to get over it for a variety of reasons, some of which were wishful thinking clearly, and some of them was because he was never really diagnosed with anything. As much as I hate to say it, it was literally death by a thousand paper cuts. Everything just kind of failed a little bit of the time until we reached the point of no return. But I got a call that he was moving into hospice. You know, hospice is six months or less.

Gabe Howard: But I thought to myself, I can fix this. That’s what I thought. I want to be very candid with the audience. I got in the car to make the ten-hour drive from my house to his house with the full idea in my head that I was going to fix it. That’s what was going to happen. I, Gabe Howard, was going to see something that everybody else missed and I was going to fix it. And the reason I’m telling this story is because I want everybody to know it was just denial. It’s one of the stages of grief. But the people in my life were very concerned because it looked a lot like I can jump off a roof. It looked a lot like the get rich quick schemes that I used to come up with. It looked a lot like all of the people who I said were out to get me that weren’t because it was so obvious to them that my grandfather only had a couple of weeks to live.

Dr. Nicole Washington: Hmm.

Gabe Howard: But I was so positive that I was going to fix it and he was going to live forever. And it mirrored that. It mirrored that a lot, and it turned my support group. I don’t want to say into my enemy, but it worried them a lot and it turned them away from supporting me in my grandfather’s death and turned them towards supporting me in managing bipolar disorder.

Dr. Nicole Washington: Was it a reminder of early illness when everybody was always worried about you and your stability and your safety and how sometimes that helicopter loving that you get when you’re in that stage of illness can be really annoying for a lot of people. Did it remind you of kind of earlier times?

Gabe Howard: One of the most difficult things about reaching recovery in bipolar disorder is, you know you’re there, but everybody else is suspicious. They’ve heard this before, right? You’re like, no, no, I’m good. This is a good decision. And they’re like, well, is it? Are you, are you sure, Gabe? They’re once bitten, twice shy, right? They are not as convinced as you are that you are in recovery. And one, I want to thank them all. Like sincerely, thank you. Because I needed that. Being challenged or people being unsure of your next move is not an insult to you.

Dr. Nicole Washington: Mm hmm.

Gabe Howard: But it is annoying. It’s incredibly annoying, right? I said, I’m going to get a job and I’m going to work full time and I’m going to start a business or whatever. And you all said that I couldn’t. I want you all to be on my side. But you’re like, Look, you’ve said that like nine times now. The other nine times you failed, but eventually you’ve got to get it right. So it felt like that, right? I was 100% positive that I could fix it and they were 100% positive that I couldn’t.

Dr. Nicole Washington: Mm hmm.

Gabe Howard: The difference is, of course, the reason. I don’t understand grief well, but what I do understand about grief, based on talking to folks like you, Dr. Nicole, and negotiate death from your loved ones. But I didn’t get that hug. I got the oh, shit, bipolar is back. Let’s get him to a psychiatrist hug. And what do I do with that? Because, listen, if I said, Hey, I think there’s somebody following me, and everybody turned around and there was nobody there, and they were like, okay, well, clearly Gabe’s having a symptom. We’ve got to get him to a psychiatrist. You’d be like, Gabe, that’s great. That’s great that you have that support system. But I told this other story about my grandfather dying and you’re like, Ooh, that’s got to be annoying, right?

Dr. Nicole Washington: Well, they can both be equally true, right? Like it could be annoying, but still be great that you have this kind of support system in place, right? It’s great. Doesn’t mean it didn’t get on your last nerve.

Gabe Howard: They are getting on my last nerve. There’s a concept that in business, it’s called opportunity cost. Right. It’s not where you lost any money, but because you made this mistake, you missed out on making it. While they were sitting me down and talking to me about grandiosity and symptoms of bipolar disorder and asking me if I was okay, I wasn’t getting the support that I needed for my grandfather’s death. So there was an opportunity cost there. That said, let’s not ignore the elephant in the room. You know what a big, big, big trigger for somebody to relapse, for lack of a better word, is with bipolar disorder? Distress, problems, uncertainty, instability.

Dr. Nicole Washington: Yeah. You know, we do always tell people, like, minimize your stress. Minimize your stress. We harp on it. I’m sure your doctors and therapists have. Make sure you’re sleeping. Even I, when we were texting, I was like, Why are you awake? Go to sleep. Like you need sleep. You need to go to sleep.

Gabe Howard: [Laughter]

Dr. Nicole Washington: You’re emailing me at like two in the morning and I’m like, Hey, go to sleep. But, the reality of life is stress happens just as a part of life. Like you could do everything right. You could live in a house where everything’s very zen and peaceful and have the most wonderful job and no stress, but still, something can happen that derails you or has the potential to derail you pretty quickly. And it can even be positive stress. Like this was not a positive stressor. But, I’ve had people who were moving like, oh, we bought a house and it’s a bigger house. And all this stuff is exciting, but it’s still kind of a stress on the system. Even good stresses can lead to relapse. So sometimes it’s not even just always the bad things. But I think this is, that was your fire drill moment, though, right? Like that was the moment. Right? We have this we all have fire drills. We hope we never have a fire. We hope we never do. But we all have a plan on what to do if we do have one. And so I think this was this was your moment to kind of test like, okay, like, how am I doing? You know, your support system. Did they do what you expected them to do? Did they do something that you didn’t like that they did?

Gabe Howard: They’re always doing stuff that I don’t like, Dr. Nicole [Laughter].

Dr. Nicole Washington: Well, but that would be true whether you had bipolar disorder or not, like that would be the case no matter what.

Gabe Howard: Yeah, I want to point out something that you just said, Dr. Nicole, where you said that was the fire drill moment.

Dr. Nicole Washington: Yes, because really, it’s just a stress plan, right? Like extreme stresses.

Gabe Howard: I think when it comes to managing bipolar disorder, if you don’t have that plan.

Dr. Nicole Washington: Mm hmm.

Gabe Howard: I think it could really leave us in harm’s way.

Dr. Nicole Washington: But it can be a plan of, hey, if something really major happens in our lives, because let’s face it, life is unpredictable. There are things that we could never plan for because we wouldn’t even think that they could happen to us. Having just the plan in place for major stressors, like just having a general plan, it’s going to be helpful. You don’t have to focus so much on the death of people you care about, if that’s too morbid for you, but just to plan like stay ready so you don’t have to get ready. We know something’s going to happen at some point. Those people that are your primary support system, tell them what things to look out for. If you know that the first sign of you not doing well or the first sign of mania for you is that you start buying people things randomly that they don’t need, you tell them that and you say, Hey, listen, if I ever start like buying lunch for random people and we’re out or I’m spending random money, I need you to like, call me on that and let’s talk about it. So I think you just need a plan, right? You need a plan for stress, period.

Gabe Howard: I was so worried about having a bipolar issue that I didn’t prepare any of my friends or support system for how to support me in grief or to even ask the question.

Dr. Nicole Washington: Mm hmm.

Gabe Howard: I didn’t make a plan for grief. And that’s because up until my grandfather died, I don’t I don’t think I understood it. So I can make a better plan now because I understand what this feels like, at least more so than I did before. And I think as hard as these conversations are, my mistake is that while I was managing bipolar disorder perfectly, I left the door open to relapse because nobody was helping me manage grief. And that’s really the big message that I want to get out there to people. It’s always the thing that you don’t plan for that gets you.

Dr. Nicole Washington: Yeah, but, I don’t know that you can have a plan for grief, right? Like, I don’t. I don’t know that you can. It’s very different for everybody. And I think that you also don’t know how you’re going to respond to a loss until you’re there. There are times when you think, oh, this is going to be a no brainer, right? Grandpa’s 91. Grandpa lived his best life until he could not live a life anymore. He planned out his death. He had a say so in everything that happened to him. Like what more could you ask for, right? And then it comes and you’re like, Why am I so much more sad than I thought I would be? Like, This is crazy. I don’t know that you can plan it for it because I think you don’t ever know. Your relationship with that person complicates your grief. The way in which they die complicates your grief. And you can plan, you know, this is going to be how I grieve if and when my parents go before me. But then that next fight, you don’t know what’s going to happen. Right. And I do think it’s a slippery slope to spend your time focused on how you’re going to deal when your loved ones die, because that can just lead to a lot of anxiety for a lot of people. I recommend like a plan for grief or loss, but just when it comes to be able to know like, oh, this is it, like this is it, and to be able to recognize it and sit with it. And where I think a lot of times we mess up is that we do everything we can not to sit with it and we try to avoid it and ignore it and distract ourselves from it. When I, I, I just think we have to sit in it for a little bit and feel icky and that’s okay.

Gabe Howard: Dr. Nicole, I’m so glad that you brought that up. It’s. I have a problem in my speaking career now because I had so many examples of my grandfather’s toxic masculinity, and I can’t decide where they fit into Gabe’s future speaking. But my grandfather was in hospice in a bed, and he couldn’t get out. And whenever we’d come over and try to cry and hug him, he’d always say, No, we don’t cry. We’re tough, we’re tough, we don’t do that. And on one hand, my grandfather was tough as nails. I mean, he really, really was tough as nails. And I really look up to him. But on the other hand, I wanted to cry and hold the man for like a half hour. It may be an hour that solidly just wipes snot on him for just just just at least a good 10 minutes. And that wasn’t in his makeup. And he believed that us not crying over him was the best path forward.

Dr. Nicole Washington: Mm-hmm.

Gabe Howard: Look, it was his death and his time. And he gets to decide. And I want to be very clear on that. I respect his decision, but. I also just really wanted to cry and my mom really wanted to cry and if you’re in a situation where the people around you aren’t okay with crying, which many of us are. You

Dr. Nicole Washington: Yeah.

Gabe Howard: Know, the world is changing, but it hasn’t quite changed yet. I really recommend just go be alone and cry. Cry at night when you go to bed. Cry in the in the shower. Cry. For me, it was a gas station. But cry in a gas station. I feel those feelings because I can only imagine what would have happened if I tried to be tough because, well, I just I wasn’t going to be able to. And it’s a burden to have to be.

Dr. Nicole Washington: You are going to know when it’s time to bring that material back to your to your talks, right? It may be for a year or more. You can’t do it without crying on stage. And you’re like, well, I don’t want to do that. So I’m going to leave that that part out. It may be that you find comfort in talking about him during those talks. It may it may give you comfort to laugh about his personality quirks and those things.

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Dr. Nicole Washington: I lost my dad, oh, nine months ago, maybe December of last year. And, you know, it was interesting because I like he was a very interesting man. Like, you know, we could also bring the toxic masculinity in. But my dad was one of those people who would rather live his life on level ten than to ever pump the brakes at all. He’d rather just go, balls to the wall, just like he lives his life on level ten. And we all knew that was probably going to lead to a shorter life expectancy because he preferred to live his life that way. And that was very difficult, I think, for us to all deal with. But at the end of the day, I respect his decision because it was his decision to make. I didn’t like it. Being on the other side of that wasn’t always pleasant, but I respected his wishes. It was his life to live. So, your grandfather kind of planned things out in the way that he wanted them to go. I’m sure you all respected his wishes, but, at the end of the day, you need to do what you need to do. And if sitting in it and crying away from him, it’s what you need to do. It’s just what you need to do.

Gabe Howard: You know, Dr. Nicole, on one hand, it’s a shame that we have to discuss whether or not it’s okay to cry like that. That’s just such a weird discussion to have. It’s a real emotion and you deserve to feel that emotion. But as a 45-year-old man, I got to tell you, in in in many ways the community coming forth and, you know, I’m going to use the phrase gave Gabe permission to cry meant something to me, because

Dr. Nicole Washington: Yeah.

Gabe Howard: All of the messages that I got told me that I needed to be strong and even deaths that happened earlier in my life, you know, other relatives, great grandma, etc., it was always, you know, like stoicism, like you just sit there and you grit it. It’s okay to be sad. Like sadness is okay. The single tear can roll down like, that’s okay. You can kind of wipe it away, maybe blow your nose, but if you’re full-on bawling. Come on, man. Something bad happened.

Dr. Nicole Washington: You can sling snot as often as you need to and still be strong. Like, I think that’s where the disconnect happens because we think like, Oh, something’s wrong with me because I’m so sad or something’s wrong with me because I feel like crying. But the thing about grief is the harder you love that person when they were alive, the worse your grief is when they’re gone. Like, that’s just I mean, that’s just the reality. Like, the harder you love somebody when they’re here, the more important they are to you. The just how much love just oozes out of your body for them is just how hard you will grieve once they are not here. So it will hit you much harder than you expect. But, you know, I kind of tell people when you grieve really, really hard, it just means that that was a fantastic relationship. Like we don’t grieve people we hate. We grieve people we love. So if you are experiencing kind of deep grief and you’re like, oh, I don’t know what to do with this, like why am I not getting over it? It may just be that you love them so much. And so a lot of times, I choose to focus on that part. Not so much the hurt that that you’re feeling in the moment so hard. Grief is not necessarily a bad thing. It’s a sign of a strong relationship.

Gabe Howard: And here’s the tie back to bipolar disorder. If I have learned anything in managing bipolar disorder, it’s that ignoring my body, ignoring my emotions, ignoring my feelings has almost never turned out well. And specifically denying those feelings, especially to others, has never turned out well. It’s the same thing here. Remember, we still have to manage bipolar disorder through everything that goes on in life. Grief being one of them. If you’re denying yourself this ability to cry or to feel your feelings or to share your emotions, etc., you are by definition, not giving your support system the full information that they need. And we’ve talked several times on this podcast about going to see your Dr. Nicole, and they say, How are you feeling? Well, many of us who have been raised with this idea that, Oh, well, I’m fine, I’m fine, I’m handling my grief by myself, I’m handling these emotions by myself. I’m not going to cry. We end up talking to our therapists, our support system, our Dr. Nicole’s, our psychiatrist, and we tell them that we’re fine. And this this this gives an opening. It gives bipolar disorder an opening to seep in. Because when does that fine become not fine? When

Dr. Nicole Washington: Right.

Gabe Howard: Does the what we consider normal management of grief turn into major depression or severe anxiety and because we think it’s part and parcel of the grief and because we’ve never brought it up to any support system, provider or friend, all of a sudden it shows up as a crisis. I don’t think there’s anybody with bipolar disorder that isn’t living in their life to avoid crisis and not confronting grief, feeling our feelings, managing our emotions and just outright ignoring these things really does leave us susceptible to crisis.

Dr. Nicole Washington: Well, and that’s something that I wanted to make sure we hit on this episode. Sometimes you don’t know the difference between grief and depression, whether you have major depressive disorder or bipolar disorder, or if you’ve never had depression, really. And now all of a sudden you’re hit with this profound grief and you’re trying to figure out, like, what am I experiencing? I see people all the time, who’ve lost spouses or parents or children, and they’re like, I don’t know what this is. Like, I don’t know if this is grief, is this depression? If you don’t know what it is, just talk to your therapist or your psychiatrist about like just talk to them about it. And I’m not going to lie to you. Sometimes at the end of those conversations, I don’t know what it is. I can’t always tell. Is it is it grief? Is this a major depressive episode? There are some things we look at, you know, do you have the ability to enjoy things most of the time? But then when you think of your loved one, maybe it makes it a little harder versus, major depressive episode where you’re having a hard time enjoying things across the board? What’s your sleep looking like? Are you having thoughts of death? Well, thoughts are death are perfectly normal when you lose somebody. You focus on your own mortality.

Dr. Nicole Washington: You focus on who’s next. You focus on all these things. But, you know, is it a suicidal thought? It’s the thought that I just don’t want to be alive anymore or is the thought of I’d like to go be with my loved one. A lot of us have those thoughts of, man, I just wish I could be with them and and see them again. And we have those kind of thoughts which aren’t necessarily the same as being suicidal. It’s important to really use your words to kind of describe what it is that you’re thinking. But sometimes it’s hard for us to even know, like, what’s the difference between grief and depression because they can walk a line and it can last a long time, right? We’ve come very far in the mental health world where we’ve even been willing to acknowledge that grief is not something that goes away immediately, that it takes time. I mean, I usually tell people the first year or two is fair game for a lot of grief to creep in.

Dr. Nicole Washington: You know, that first year people tell me they either feel really numb to everything and then the second year is their worst year because then they’re like, oh, they’re really not going to be here for Christmas and the birthday and the Father’s Day and the my birthday and those kinds of things. And then some people say the first year is like really terrible because it’s the year of first, right? It’s every first, every first Christmas, Thanksgiving, you’re going to go be with grandma all of a sudden, like, here it is. I’m going to go be with my children. But my husband’s not here or my kids getting married. And all of a sudden I have to realize my wife’s no longer with us or, those things are going to come and they’re not necessarily depression. So I guess I will say more than anything, give yourself permission to not be in a great mood. That’s okay, because the first question I ask people is, okay, we have to figure out is this depression or is this a normal human response to a loss? So you tell me what you think first and then we’ll dig in.

Gabe Howard: It’s so important to be honest here. And I know that many people with bipolar disorder, we we’ve sort of been traumatized into not talking about death in any way because we’re afraid of getting committed for suicidal thoughts or having something bad happen to us. It’s just the reality of living with bipolar disorder that whenever we start talking about death, the people around us are worried about suicide. It’s a trauma response from their side as well. They don’t want us to die. They want to keep us safe. But we have to find a way past that. Because I agree with you. I immediately thought, well, I want to be with grandpa. So. Well, if I say that I want to be with Grandpa, to somebody, think to themselves, okay, Is Gabe planning on doing on hurting himself? And you think, well, why would they think that? Well, because for a number of years, Gabe planned on hurting himself and even ended up in the hospital because of it. So it’s a reasonable thing for them to think. And it’s a reasonable thing for me to say. And we all have to negotiate that together. Oftentimes, the people with bipolar disorder manage that by not sharing that. And I’m really glad that you’re normalizing that. It’s okay to think these things and not for nothing, especially in extreme pain.

Dr. Nicole Washington: Yeah.

Gabe Howard: I think that it is perfectly normal to think to yourself, man, I just want this pain to stop. And again, people hear that. And when you have a history of suicide, I understand that people are are understandably concerned. So maybe you don’t share that with mom and dad, maybe you don’t share that with your spouse. But if you’re not sharing that with your psychiatrist, your therapist, you’re really doing yourself a disservice. And they should understand that. Your Dr. Nicole understands that it’s normal for you to be thinking about death in the wake of death, and you need to talk about it.

Dr. Nicole Washington: And I always encourage people. You heard me say earlier, use your words, but use your words. You can’t just leave it at I just want to go be with grandpa, right. And then get mad when they drag you off to evaluation at the local hospital because you have a history of attempting to take your life. I just want to go be. I miss him so much. I don’t want to die, but I just miss him. So, you know, I mean, I think that goes a long way, with using your words. And the other thing that I think is important, while we’re talking about grief, you can grieve a lot of things. And you don’t always have to grieve a person. There are things that we grieve in life and people can have a grief response when you change phases of life, when you become an empty nester or you retire or you, God forbid, have some kind of random medical thing happen to you and you’re no longer functioning at the level physically that you’re used to functioning like those are all your grieving. You know where you were in that previous stage of life. You’re grieving that loss of the healthier version of you. You can grieve a lot of things. And so you can have this exact same reaction, exact same response to loss of things other than a whole person.

Gabe Howard: To that point. Being in recovery with bipolar disorder doesn’t mean that you don’t have a normal human range and normal humans grieve things. My mother does not have bipolar disorder. She has excellent mental health. I am so jealous of her. And just if I have to see her clutch her chest one more time and say, Oh, I miss it. When you were children, remember Christmas morning when you would wake us up early and I was so mad.

Dr. Nicole Washington: Hey. Hey, hey, hey, as a mom who is moving into parenting young adults, I’m gonna need you to back up off your mama. Because I am. I am there, like, randomly, I will look at my husband and say, I can’t believe my son lives in Virginia, and he’s an adult. And he’s like, Where did that come from? Don’t worry about it. Just. No, I can’t believe I’m having a moment. So you leave your mom alone.

Gabe Howard: Right. And so if you live with bipolar disorder, you’re going to have those same moments. That’s

Dr. Nicole Washington: Yes.

Gabe Howard: That’s not an example of depression creeping in. But it could be. This is where it’s tough, Right. I cannot be more clear that grief is normal. It is normal and it happens to everybody. I also cannot be more clear that grief provides an opportunity for the symptoms of bipolar disorder to rear their ugly head. So it’s smart for you to be on guard. It’s smart for your support system to be on guard. It’s very, very complicated. But, Dr. Nicole, I like what you said about using your words, communicate with everybody. And remember, you know, I’ve sort of beat up on the support system a little bit in this show. Remember, they experienced a loss, too. You know, as annoying as it was, that these people were like, oh, we’re worried about Gabe’s bipolar disorder and we’re holding the stick a little too tight. And I’m like, Oh, that’s just not the support that I wanted or needed. They are providing support to me while also managing the death of my grandfather. Does it hit them differently? Absolutely. But the man made an impact to my friends, my wife, my mother, my. Well, of course my mother. I just it’s. It’s complicated. We do have to remember that if our support system is there annoying us, it means our support system is there.

Dr. Nicole Washington: Right.

Gabe Howard: I know that we’re running out of time, but I’d like to talk about one more thing that really impacted me, and I’d like your opinion, Dr. Nicole. You know, for our listeners, I went there when my grandfather was in hospice and he ended up being in hospice for ten days. But I went there for the specific reason that my grandfather wanted to pass away at home. That was his wish. And, you know, he’s 91. My grandmother is 86 and walked with a cane. And there was no way that this could happen without me being there. Now, this meant that that they’re there. Their grandson with bipolar disorder, who’s been in recovery for ten years, needed to make a commitment to them to be woke up at any time, day or night. Right. I needed to make a commitment to them to stay up later and to get up earlier, which is not my sleep routine, which we did a whole show on sleep hygiene. I needed to make a commitment to sleep someplace that was not comfortable. Sorry. Sorry, Grandma. It’s just it’s a really shitty bed. And all of these things are excellent decisions to make to help your grandpa and to be there for him like he’s been there for you. And I was able to do it and I’m glad. But if this exact same thing would have happened when I was six months into my recovery,

Dr. Nicole Washington: Yeah.

Gabe Howard: This would not have been a good decision for me.

Dr. Nicole Washington: Mm-hmm.

Gabe Howard: How do you weigh that out? I was able to do it. It was difficult. I was able to do it. But I just can’t help but think in retrospect, if this would have happened when my grandfather was 81 and I had been a year in recovery, this would have been a very bad idea for me to disrupt my life in this manner and disrupt my sleep and my routine and everything else. But do you know the guilt I would have felt? My grandfather literally saved me every day of my life and this is what he needed. Where’s the balance here for folks?

Dr. Nicole Washington: I think, honestly, like, I think that one piece of this is sometimes especially early on when you’re when you’re just still not even I mean, even if you think like, yes, I need treatment, this is what I need, I know this. There’s still a piece of you that just wants to feel and you can’t see my air quotes. Maybe you can normal, right? Like there’s some part of you that just wants to feel normal. And you don’t want to always have to say, Well, you know, I got this bipolar disorder, so maybe I can’t help as much. Like you just don’t want to feel like it’s impacting you that much or you’re in denial about still about how serious this thing is, and how serious you need to be. But I think honesty. I don’t know anybody. And as you’ve described your grandparents, they sound like lovely people who did all the work to understand your illness. I just can’t imagine that your grandmother or grandfather would be happy with you derailing your stability for that. Those are just conversations you have with the rest of the circle, like, hey, I want to be involved. Like, I want to be so involved and I want to help so much as much as I can. But these are some things I think maybe I shouldn’t do because they might really mess up my stability. And I don’t think that’s going to be helpful for any of you all either to have to deal with unstable me on top of everything else. It’s not so much what you’re missing out on like you’re doing everybody else who’s affected a favor, you’re doing them a favor by maintaining stability.

Dr. Nicole Washington: You’re doing yourself a favor, right? Because if you become unstable and you end up in the hospital and you can’t be there for a service or when the time comes, when that person’s gone, that’s going to make you feel even worse than missing a night or two because you needed to make sure you were getting sleep. So I think it’s a matter of like sitting down, talking through it with your family, but thinking through like, okay, what’s the if I, if I do this, what could happen? Oh, you can end up with a real bad episode. Okay. And then what happens? And then I’m in a hospital. And then what does that mean? Well, it means I’m not going to be there for the family at all because I’m going to be stuck in the hospital. And it also means I could miss the funeral and I could not be there, you know, to say my goodbyes. And so I think that if you go down that road, it’s a much nastier, dirty road than saying, I’m going to be with you all day, but come nighttime, I’m going to go to sleep because I need to do that for the family. So it’s not always about you and how you feel, you know, thinking about how that will affect the whole situation and knowing that if you were in your grandfather’s shoes, you would tell your grandchild, you better go get some sleep. You’ve been here with me for 40-something years. I know where we stand. I know our relationship. But get you some sleep. Like don’t let this derail you. So, you know, you got to think beyond that initial feeling of, Oh, I’m going to feel horrible if I’m not there for everything.

Gabe Howard: And that’s. That’s really what I think about because I can only speak for myself, but I know sometimes I just want to do everything. I want to prove that I can do it, especially with the. As we’ve talked about before, Dr. Nicole, you know, bipolar disorder, especially when you have those bad symptoms and those bad outcomes and those crisis points and, you know, maybe you’ve been committed, arrested, homeless, lost your jobs, lost family members, divorces, bipolar disorder takes a lot from you. And I understand our desire to want to reclaim it. There are smart ways to reclaim it. And putting yourself and others in harm’s way is not the smart way to reclaim it. So when these things come for you, just take an honest evaluation of your inventory and do the best that you can. Using your words. I love that. Be honest always, because this is just not a process that you’re probably going to have great guides to go through because I don’t think anybody’s good at it. And truthfully, Dr. Nicole, would you want to meet the person who is good at burying and and grieving their loved ones? Like, wouldn’t that just be a little creepy?

Dr. Nicole Washington: What?

Gabe Howard: He’s a level ten burying and grieving his loved ones there. I mean, yeah, he’s like, really good at it. How do you get good like that? That’d be a little creepy. Just. Just a skosh.

Dr. Nicole Washington: I have no comment. I have no comment.

Gabe Howard: I think no comment is probably the right answer. Dr. Nicole, thank you so much for being here with me. And to all of our listeners, thank you for being here. My name is Gabe Howard and I am the author of “Mental Illness Is an Asshole and Other Observations,” which you can get on Amazon. However, you can get a signed copy with stickers just by going to

Dr. Nicole Washington: And my name is Dr. Nicole Washington. And 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: Dr. Nicole and I love to travel. We love to travel nationally. Hell, we love to travel internationally. And we could be available for your next event. You can get more information on our respective websites or shoot an email over to Listen, wherever you downloaded this episode, please subscribe or follow. It is absolutely free and we need a big favor from all of you. Share the show. Tell a friend, tell a colleague, Tell a member of a support group. Sharing the show is how we grow. We will see everybody next time on Inside Bipolar.

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