Inside Bipolar Podcast: Pinpointing Recovery: Defining ‘Regular’ Moods and Self-Directed Goals

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: Welcome to the show everyone. My name is Gabe Howard and I live with bipolar disorder.

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

Gabe: And today we’re going to talk about defining recovery. And when this topic first came up, I actually thought, well, this is going to be the shortest show ever. Recovery has a definition. SAMHSA, which is the Substance Abuse and Mental Health Services Administration, has defined recovery for us. So we just use that definition and we move right along with our lives. And in fact, I wrote the definition down. SAMHSA defines recovery as a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential, which of course is broader than just absence of symptoms. But yet there’s still a debate. Now, whenever I talked to a room full of psychiatrists and I ask them what recovery is, it’s always some version of, well, the symptoms are gone, the symptoms are gone. The person is no longer suffering from the illness, and they define that as recovery. When I’m in a room full of peers and I ask them how they define recovery, I always get a I have a job, I have a wife, I’m going to Hawaii. I’ve got lots of money. They talk about their dreams and goals. Now, I don’t think that these two things are mutually exclusive. I want to be very clear, but there definitely seems to be a difference in not only the way psychiatrists look at it, but the way peers look at it. The way people living with bipolar disorder look at it. And then there’s subgroups off of that. Were you surprised it wasn’t that simple, Dr. Nicole.

Dr. Nicole: No, I wasn’t actually, because I think recovery is very complicated and I don’t think it’s a one size fits all thing.

Gabe: You know, it’s it’s very atypical to hear that from a psychiatrist.

Dr. Nicole: I don’t even know that I that I think most psychiatrists feel that way, that it’s just an absence of symptoms. Yes. At the basic level, that’s our goal when we are using medications, when we’re asking you to engage in therapy, we’re looking for your symptoms to be at zero or as close to zero as we can get them. But I think we also appreciate that there’s more to it than just you not having symptoms anymore.

Gabe: I love to discuss recovery, and one of the reasons that I love to discuss recovery is because it’s such a positive discussion. Are you reaching recovery? Are you making it to recovery? What do you want to do in your in recovery? It’s almost always positive, but I want to take everybody back a step. I sometimes think that these discussions about recovery take a really good thing reaching recovery and turn it into an argument point. And I want to address that because so often I hear different versions of recovery and they’re like, well, mine is right and yours is wrong. And I want to say that I have a different definition of recovery than SAMHSA. I define recovery as spending more of my time doing whatever I want than I do managing bipolar disorder, because I’m always going to spend some amount of my time managing bipolar disorder, whether it’s standing in line to fill a prescription, whether it’s the time I spend talking to my Dr. Nicole, whether it’s the time I spend keeping a mood journal or just using my coping mechanisms, going to therapy, or being aware some small part of my life is going to be spent managing bipolar disorder. So this works for me. But sometimes when I say that, people are like, well, that’s a stupid definition and I don’t like it, so you can’t use it. I’m like, well, now wait a minute, I it may not be right for you, but can it be right for me? And I do think that sometimes in the recovery movement we have a hard time accepting that self-directed recovery means just that self-directed. So I think we’d be doing a real disservice if we didn’t bring up the controversy.

Dr. Nicole: Yeah, you have every right to name your recovery however you want to name or define it. It’s yours. You can do what you want with it. I’m not gonna lie. I see people whose goal of recovery is to just not go into the hospital. They are happy if they can just stay out of the hospital. Because for them, that’s been such a huge part of their illness in the beginning. That’s their goal. And if they can reach it, they are happy campers. And that is really all they care about is staying out of the hospital. And then I have people who say, well, I mean, yeah, staying out of the hospital is great, but I want more than that. I want to have a job. I’d like to have friends. I’d like to have a social life. One of my goals is to take a weekend trip away with friends. That is a huge goal for some people. So everybody’s definition is different. Everybody’s goals of recovery are different.

Gabe: This really reminds me of my uncle Jack. I once when I, when I was a when I was young, I said to my uncle Jack, I said, what’s the what’s the right amount of money to make? You know, I was in high school and I think we were like learning about salaries and budgeting etc. and I was like, well, what’s a good salary? What’s the right amount of money to make? And he said, $20,000 more than you’re currently making. And I said, what? And he goes, no matter how much you’re making, you’re always $20,000 away from something bigger, better. And I was like, so you’re telling me that if you drive a $100,000 car that you need more? And he’s like, yeah, there are $200,000 cars. And I was like, well, what if I’m driving the $200,000 car? And he’s like, I don’t know, you might want to consider getting a helicopter. I’m like, well, what if I have a helicopter? And he’s like, private jets? Gabe. I think recovery works the same way, and I, I use that as an example because I’ve known so many people throughout my life, myself included, that when I get the job offer, I’m like, I did it, I made it, I made it, look at this money. This is awesome. And then within six months I’m like, how can I get promoted? How can I get a raise? And I think recovery works in much the same way because I agree with you. One of my recovery goals was just to get out of bed. Like when I started moving around and participating in my own care, I really thought that I had achieved a lot because I had.

Dr. Nicole: Of course you did, because you were at a place where your symptoms were more severe. They were really dragging you down. You couldn’t even think about relationships and jobs and careers and things like that because you weren’t there yet. So your definition of recovery at that moment was very different than it was. Once you had achieved a level of stability that gave you the freedom to start thinking about more, to have that uncle Jack mentality to your bipolar disorder.

Gabe: And I think it’s a good mentality to have in recovery. I think resting on our laurels gets us in trouble with bipolar disorder, I myself included, I’ve known more than one person who’s like, well, I’ve reached recovery. I don’t have to pay attention to this anymore. And I’m like oh oh. You know, having recovery goals moving forward gives you goals to move forward. This is all just been a very esoteric and long way of saying that. I think recovery needs to change. I don’t think that your recovery goals and your recovery definition should be static. Again, as we’ve talked about before, there’s not a blood test for bipolar disorder. So by definition, there’s not a blood test for bipolar recovery. So there really is a lot of introspection, a lot of considering and a lot of personal opinion and feelings and thoughts that go into a recovery definition. Now, I understand why the federal government, you know, SAMHSA, had to define it. I think that’s a good thing. It gives us some guidelines, but I really do like people defining their own recovery in positive and meaningful ways.

Dr. Nicole: And I do like what you said. Recovery is active. You have to be active in your recovery. You can’t just say, oh, I made it to this place, and I’m just going to lay here and this is where I’m going to exist. You have to be active for someone who has an addiction. They have to be active in their recovery. They’re constantly doing the things they know they need to do to avoid those substances. When you have a mental illness and you reach that place of what your recovery looks like, you have to figure out, what do I need to do to maintain this? It’s not going to just happen without work. So recovery isn’t just this passive place. You just go lay down and just bask in your recovery. The other thing that you said that really made me think, when we talk about the whole absence of symptoms in recovery, sometimes recovery does not involve the absence of symptoms. Sometimes the symptoms are still there. And I think a person can still feel like they’ve reached a point of recovery. And I know that sounds strange. Somebody is like, well, how can you be in recovery if you’re still having symptoms? I think that’s where the uniqueness of each individual comes in.

Gabe: I am so glad you said that. For those who can’t see me, I’m like. I’m like Cheering. I’m doing the raised fist in the air. Because so often we hear that recovery with bipolar from bipolar disorder has to be symptom free. Like it’s no longer bothering you like it’s not, you know, they’re poking at you or that you never have a bad day or that you never have a symptom. And I think that thinking of recovery like that from bipolar disorder is very dangerous, because as soon as you decide that you no longer have to watch for bipolar disorder symptoms, that that’s, that’s when bipolar disorder is like nobody is staffing the door. I’m gonna walk right through it. Again, I use spending more of my life living my life than I do managing bipolar disorder, because I know that some amount of time is going to be spent managing bipolar disorder, and that’s looking out for symptoms. I think people think that that in order to be in recovery, they have to be symptom free. I think that’s impossible. Now. Now you’re a doctor, so please feel free to correct me. But I think living with bipolar disorder and being 100% symptom free for a lifetime is a goal that is going to set you up to fail. And if that’s the only acceptance of recovery that you’re willing to accept, I really do think that’s going to put you back on your heels.

Dr. Nicole: By definition, bipolar is an episodic illness. We know episodes can come. We know that full episodes can come. But what I see in my patients a lot, people will tell me things like, you know, Dr. Nicole, I ultimately I’ve been doing really well. My mood’s been stable, but maybe once or twice a month I wake up and I’m having a bad day. And I asked them, well, define the bad day and they’ll tell me, well, you know, it’s a day where I wake up and I just feel blah and my mood feels low and I don’t want to do things, and my motivation isn’t as great. And I feel kind of like I felt when I’m depressed, but I’m still able to function. I just kind of have this day. And then after, you know, sometimes it’s hours in a day, sometimes it’s a full day, sometimes it’s a couple days, and then it just kind of goes away. I hear that a lot. And those are mood symptoms. It’s not a full depression episode, but they get these they get these moods. So if you based your definition of recovery off of I never have symptoms, then you would think, well, crap, I’m never reaching recovery and you would be in a position where you would completely overlook all the other great things that are going on in your life, and all the ways that you’re able to manage those low mood days. You would just overlook all of that good stuff.

Gabe: And I’m also thinking about there’s that constant struggle of is it a bipolar symptom or is it just my regular mood? You wake up and you’re having a down day. People without bipolar disorder wake up and have down days. We

Dr. Nicole: Mm-hmm.

Gabe: Hear constantly in 2024 about taking a mental health day because you’re overwhelmed or anxious or, you know, experiencing some depression or just need a break. So it might not have anything to do with bipolar disorder at all. But we’re sort of taught to think in that singular way, because that’s where our coping skills come in. That’s where managing our symptoms come in. So we do have to be careful. I’m not saying that if you wake up and you’re feeling depressed, you should automatically assume that it’s a normal mood state. But I’m also not saying that you should automatically assume it’s bipolar disorder. It’s one of the things that makes it so hard to manage.

Dr. Nicole: I think that brings us to where we should talk about what is a normal mood and what does that look like? When I define a normal mood, which I think is a very important part of the recovery conversation, because a lot of people, not just people with bipolar disorder, don’t really understand, like what is a normal mood? People say things to me like Dr. Nicole, I think I’ve been depressed. And then they tell me about this really big bad thing that happened, and they were down for a few days, and then they were able to move through it and they moved on. And I say to them, well, that sounds like a pretty normal response to something really crummy happening. That sounds like a natural human response. And people tend to think of normal mood is, oh, I’m just happy all the time. Nobody’s happy all the time. And the people who are I’m concerned about them. There is nobody that should be happy all the time. You know, having a normal mood means I’m appropriately happy. I can’t be happy when the occasion calls for it. It means I can pull out my happiness when something is going on that would normally bring me joy. It also means that when something happens that would make me sad or make a person sad, I feel that I can feel it and I can deal with it, and I can put it back on the shelf and I can move forward. I can be appropriately angry. I can be appropriately frustrated; I can be appropriately scared. And none of those things linger on. I can manage them, set them back on the little shelf and move forward.

Dr. Nicole: So we have to think about what normal looks like because it could be normal mood. It could be just in response to just life’s ups and downs. I think I’m talking more about the people who say, I don’t know, like nothing happened. And all of a sudden I just woke up and I was in a really bad mood and I was just, oh, it was bad. And then in my in my women, I have to ask questions about hormones. And is it related to your menstrual cycles? And because that could be related to that. So there’s lots of pieces to it. I just don’t want anybody to walk away thinking, well, if I have a bad day, if I have a low mood day, if I have a day, I have people who sometimes say, you know, I had a day or two where I was really concerned that I was approaching hypomania or mania. I had a day or two where I felt myself kind of getting a little too amped up. The people who live at home with me were saying, hey, are you okay? Did you sleep well last night? Because I was just really getting kind of amped up. I didn’t get to where I normally am when I’m hypomanic or manic, but I was getting close, and then it kind of just went back down. And it’s not I’m at Disney World and I’m on vacation and I’m just having a great time. It’s just random days. So I see those things. But the absence of symptoms doesn’t necessarily mean recovery. Sometimes you have symptoms and you can be in recovery.

Gabe: I think there’s a lot of people who really sell themselves short when it comes to recovery. I want to really pound home that self-directed recovery is really, really important because the way that you define recovery is going to largely determine whether or not you are in recovery or not. Dr. Nicole’s cannot just look at you and declare that you’re in recovery. And if you don’t believe it, your life is going to get suddenly better. You’ve got to have some buy in. You’ve got to believe it. And that’s where I believe that these recovery definitions, these self-directed recovery definitions, are important. Now I want to say they also need to be reasonable. If somebody would come to me and say, the only way that I will consider myself in recovery is if I’m the richest person in the world, I would say, well, that’s unreasonable. And I would probably also point out that a lot of the richest people in the world are going through divorces, struggling with their families, their children, the aging process, etc.

Gabe: So, I would I would caution them to rein it back in. And I just use as an example, because I do think sometimes we can be our own worst enemies where we look around our support groups or our peer support groups, or our friends or our families or our colleagues, our coworkers, people who go to school with and think they have it all together. So I will be in recovery when I’m like them. You don’t know their life. You just know their public life, what they’ve said to you. So I, I just want to tell everybody that when it comes to self-directed recovery, self is the key word. Don’t base your recovery on what other people are doing or what you believe that other people have.

Sponsor Break

Dr. Nicole: And we’re back discussing your recovery journey in bipolar disorder.

Gabe: Towards the beginning of the episode, Dr. Nicole, you mentioned using your support group, and I want to get back to that because I do think there is some value in listening to the people around you. I can only speak for my personal experience, but one of the things that made me really know that I was in recovery was how well those relationships were repairing, how people were starting to rely on me and count on me and say things to me like, you know, Gabe, we’re really proud of you. You’re not the same person that you were two years ago. So I just wanted to make sure that we got back to that and that I said that again. When I say that it’s self-directed, that doesn’t mean completely without input from your doctor. Nicole from your friends and family. It’s just about taking that information and gauging it for yourself and deciding where you want to be.

Dr. Nicole: Mm-hmm.

Gabe: And also to tie back to something specifically that you said, Dr. Nicole your recovery goal might be to stay out of the hospital, and that’s a really, really good goal and then we move forward. So again, I just I really want to pound home the self-directed part of recovery. And I also want to say that your recovery goals can change. And in fact, I would encourage them to do so.

Dr. Nicole: In thinking about that and the support system, that’s a fantastic piece of that puzzle. If we think about and we go back to our puzzle picture, you close your eyes, picture a puzzle, the bipolar puzzle. There’s many pieces to the bipolar puzzle. I’m kidding, I’m kidding. So you have your piece right there. There’s the things that you have the direct control over the decisions you decide to make. Am I going to take meds? Am I going to jump in and be a part of this and do what I need to do? And then there is my part the Dr. Nicole my goal is to get your symptoms as low or minimal as possible. That’s my goal. I want to get you to a normal mood state with the medication. But let’s be real. We’ve talked time and time again on this podcast about how you don’t get to see your psychiatrist for that much time. So yeah, that’s all we’re focused on is the symptoms, because we have like 15, 20 minutes to get the most of it. I can’t spend half of that asking you about what are your career goals? What are you what are your relationship goals. That would be a waste of time. To be honest with you, I would love to know those things about my patients, and I would love to spend that kind of time with them, but I don’t have that kind of time to spend.

Dr. Nicole: So I have to focus on the things that I know I absolutely need to cover in that short period of time. Now, if there’s time left over, we can talk about some of those other things. But the reality is I’m focused on symptoms. So yes, your Dr. Nicole of the world are focused on your symptoms and people get frustrated. All my doctor cares about are my symptoms. That’s all they talk about is medication and symptoms. And I’ve had patients tell me all you ever talk to me about are my symptoms and the medicine. And I ask them, what? What do you want me to talk about? I am your psychiatrist. That is my job. If I don’t do that, I’m not doing my job. I can talk to you about the weather and the Olympics and everything else that’s going on, but that is not my job. And that that that would be a waste of your time for me to focus on other things.

Gabe: I think it’s also worth mentioning that sometimes these things are just set up this way. Again, this is my Uncle Jack’s episode. He also he was an engineer, and he says that buildings need a certain amount of stress in order to stand, and if they don’t have that stress, they topple over. I think there’s some amount of stress that needs to exist in the therapeutic relationship. If your Dr. Nicole is your buddy who’s giving you everything that you want and you’re just thrilled to hang out, you’re not describing hard work. You’re not describing a medical appointment. You’re describing a friendship. And I would argue that that could be dangerous. I do think that sometimes that patients and doctors are like cats and dogs. We’re just we’re destined to disagree. But I got to tell you, the internet is a wonderful thing. And there are so many pictures of kittens falling asleep on puppies and dogs and cats playing together. We can find ways to get along, and I think that podcasts like this are doing a better job of showing you where your Dr. Nicole is coming from and helping you understand where you’re coming from and ultimately helping you define those goals. But I do think it’s disingenuous to pretend that when it comes to the recovery conversation, I think that the doctors and patients, doctors and peers, doctors and people living with mental illness are often not on the same page.

Dr. Nicole: Now that’s true. We are often not on the same page, but I think it’s really unnecessary because we all have the same goal at the end of it. All of our goal is for you to reach the maximum level of improvement that you can reach. That’s our goal. That’s what you want. That’s what we want.

Gabe: I love that. Focus on that.

Dr. Nicole: Why can’t we?

Gabe: I know, I know why, why can’t we?

Dr. Nicole: That that is the goal. But you can’t be upset. Well, I mean you can you can be upset with whoever you want to. It is it is your right to be angry. You can be the angriest little nugget in the world to whoever it is that you want to be angry to. We all can. But it isn’t always helpful. At the end of the day, your psychiatrist has the medication piece. That’s what we do. It is. It is literally why you come to us. You don’t come to us. For us to just talk you through things. You’re. You’re coming to see us because you have a disorder that requires medication. We don’t always agree about what the medication is, how we’re going to use it, how many medications you’re going to take, the side effect. We don’t we don’t always agree on that part of it. But you’re coming to us because at least on some foundational level, we both agree that medication is needed to treat your disorder. And I and I think if we spent a little more time focused on the things we agree on and then figuring out what we need to do to be on the same page as we go along, I mean, I think that’s going to be most helpful. But, you know, I mean, people have lots of negative thoughts about medication. And I think it affects your recovery, how you think about medication and treatment, and it’s going to affect your recovery.

Gabe: You’ve touched on something extraordinarily important in the recovery movement. There are some people who believe that recovery from bipolar disorder means that you’re no longer on medication. They take an abstinence approach because they believe that they’re able to manage it entirely on their own. Now, listen, I don’t want to start a controversy. I do believe in self-directed recovery. And if you are listening to this show and you are not on medication and you are doing just fine, I am not going to be able to conclusively tell you, using some sort of game magic, that you are wrong. But I can tell you that the research shows over and over again that bipolar disorder is a lifelong illness, and it usually takes lifelong medication. Now, there’s a million caveats to that that we don’t have time to get into. But what I want to touch on specifically that you said, Dr. Nicole, was that the way that you feel about medication is going to determine your recovery? If you are living your best life and you are well medicated and you’re not having symptoms that you cannot live with, right? You don’t have sexual side effects, you don’t have weight gain.

Gabe: You’re excelling at your job and you’re thinking, well, I’m not in recovery because I take a pill every morning or I take a pill every night. I would encourage, and that’s all I can do, I would encourage you to think about this, because you’re meeting all of these goals that you weren’t able to meet, but you’ve put a little asterisk on it for no reason. And I, I don’t know, I don’t know. I’m an avid sports fan, and I always hate it when I hear such and such. Won the national championship. And then somebody will say, well, yes, but they didn’t play X team if they would have played X team, they never would have won. And some people buy into this, they’re like, well, that’s a good point. They had a light schedule and then all of a sudden they’re starting to put like asterisks it know what we have is the national championship the end hard stop. We don’t need to diminish our success. And I do feel that a lot of these conversations surrounding recovery and medication often try to diminish people’s success. And

Dr. Nicole: Mm-hmm.

Gabe: As somebody who does take their medication and who’s somebody who does consider himself in recovery, I don’t want anybody looking at me and diminishing my success. I like that, I don’t like that at all.

Dr. Nicole: Yeah, I mean I don’t blame you, I would feel the same way and, and I, I would just say this, I can’t tell you that there are not people out there who are in recovery who are completely unmedicated. I can’t tell you that. You know why. Because I would not see those people. Because they don’t need to see me. Because they’re not medicated. And if there are people out there who say I have bipolar disorder, I’m able to manage it with whatever, whatever they manage it with, however they choose to do it. Great, fantastic for them. But I will say that is not the majority of folks’ story. And I have seen all the people who’ve said, well man, I really tried to do it without meds. I was able to do really well for like a year, like it was really great. And then here we are again. I’m back. I’m back on the medication. That’s what I see. Those are the people that I see, the people who have tried to go off meds time and time again, and they haven’t been able to achieve stability for more than six months, maybe a year if they’re lucky.

Dr. Nicole: Those are the folks I see. So I think your recovery should really be based off of your history, not some other random person who you saw on YouTube or TikTok or wherever who said, oh, I haven’t taken meds in ten years and I’m doing great. What is your history tell you? Because we talk time and time again about how you’re an expert on your bipolar disorder. You know your history and your symptoms. If you’ve tried this before and it hasn’t worked, chances are it’s not going to work in the future. And if you really want to be in recovery, then you have to take a step back and objectively look at your history. The best predictor of future behavior is past behavior. You’re gonna know what exactly your future’s going to hold. And then we have to make decisions accordingly so that you can reach that recovery state that you so desperately want to want to meet. And who cares if it requires medication for you to get there?

Gabe: Recovery is complicated. It shouldn’t be. You wouldn’t think that it would be, but it is. And I think once we get comfortable with the idea that recovery is complicated, we can then get comfortable with the idea that recovery is personal. And once we get comfortable with the idea that recovery is personal, we can get comfortable with the idea that recovery is self-directed. Now we’re nearing the end of the show and I, I there is research out there, you know, SAMHSA, who we talked about at the beginning of the show, the Substance Abuse and Mental Health Services Administration. They came up with the eight dimensions of wellness. And we’ve been talking about the vast majority of these dimensions through this entire podcast. And I just wanted to end with the very specific research from SAMHSA to where they sort of give you these dimensions that you need to pay attention to if for no other reason. Dr. Nicole that I see it as a way to compartmentalize, to look at different areas of your life and see them now. But before we get into them, Dr. Nicole what do you think about the eight dimensions of wellness? Are you a believer? You’re the doctor in the room.

Dr. Nicole: And I mean, I believe, I believe it. I believe that for some people this is spot on. And I just like with most things, I believe somebody is going to read it and say, well, that’s dumb. I don’t think that makes a lick of sense to me at all. And that’s okay too. But I am a believer, yes.

Gabe: I’m a believer too. Not in all eight. There’s some of them that speak to me more than others. And here’s just the real quick no commentary list. There’s your emotional, your environmental, your financial, your intellectual, your occupational, your physical, your social and your spiritual life. If you pay attention and have success in those regions, you will be in recovery or do better in recovery or come closer to recovery. And you can even see in those examples, I’m going to pull out the financial one and go right back to uncle Jack, saying the perfect amount of money to make is 20,000 more than you’re always making. You can see where these are very personal. What I consider to be intellectual, and what Dr. Nicole considers to be intellectual is going to be very different. But I do think it’s a nice guideline. It’s just a way to segment our lives and decide, hey, am I doing emotionally well? I think that’s the one we’re all going to agree on. If we are in control of our own emotions, we are closer to recovery than if we’re not. And then on and on and on and on. I think SAMHSA gives a decent framework, guidelines, but that’s what it is. They’re guidelines.

Dr. Nicole: No, I agree with you. When I talk to groups or people about self-care, those are all the areas of life that I that I hit. When I talk about self-care. I think self-care has to be beyond spa days and pedicures and massages, which I mean, who doesn’t love a great massage and pedicure? But, if you’re not paying attention to all of those areas that you just named, you think about those eight areas. They all play a part in your mental wellbeing and your ability to feel good and feel stable. And when we talk about bipolar disorder, we talk about self-care. Once you get into that maintenance phase, we talk about how stressors in our lives will derail your success that you’ve had in managing your bipolar disorder. So yeah, financial stress absolutely will have a way of playing a part in derailing your symptom control and all of those other areas that you named have a way of derailing if they’re not in check, especially if there’s something that’s important to you. So, yeah, I mean, I think it makes sense.

Gabe: Well, we will absolutely make sure that we link the SAMHSA Recovery Definition and Dimensions of Wellness in the podcast show notes. If you want to learn more. And again, your mileage may vary. The last thing I am going to say is that I believe in self-directed recovery. I believe in comparing your present self to your past self to get to your future self, and I really think that that is the best way to move forward. I also believe that our recovery goals can and should change, just like all of our other goals in life. I do not believe in static recovery and Dr. Nicole I want to say the more I learn from you about where you are in my recovery, and by you I mean the Dr. Nicole’s of the world. It can be very frustrating getting through the medical system, and that’s not because of a person. It’s because of systemic flaws and issues and stress. And of course, we’re doing all of this while sick. And the more I think about the differences that we have, and the more I learn about how we see recovery, the more I understand how these things are bound to happen. But with a little communication and a little understanding, we can get through it. Because the thing that you said that really resonated with me is that we both have the same goals. We both want the person living with bipolar disorder to be in recovery and to lead their best life. That’s what will make me a successful patient and that’s what will make you a successful doctor. So we are absolutely aligned.

Dr. Nicole: Oh, that was so sweet. It’s like holding hands across America. Psychiatrist

Gabe: Awwwww.

Dr. Nicole: And bipolar people all around the world. Holding hands. Holding hands.

Gabe: All right, everybody, thank you so much for tuning in. We need a few favors from you. Wherever you downloaded this episode, please follow or subscribe to the show. It is absolutely free and also share this episode. Share your favorite episode. Share the podcast. Tell people in support groups. Send people text messages. Share it on social media. Do whatever you can to get the word out about the Inside Bipolar podcast. My name is Gabe Howard and I’m an award-winning public speaker and I could be available for your next event. I also wrote the book “Mental Illness Is an Asshole and Other Observations,” which you can get on Amazon because everything’s on Amazon, but you want to get a signed copy with some free swag. And you can also learn more about me if you just go to my website, gabehoward.com. You can also follow me on TikTok or Instagram @AskABipolar.

Dr. Nicole: And I’m Dr. Nicole Washington. You can find me on all social media platforms @DrNicolePsych or on my website, DrNicolePsych.com.

Gabe: And what we’ll see everybody next Monday on Inside Bipolar.

Announcer: You’ve been listening to Inside Bipolar from Healthline Media and psychcentral.com. Have feedback for the show? E-mail us at show@psychcentral.com. Previous episodes can be found at psychcentral.com/ibp or on your favorite podcast player. Thank you for listening.