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Having gotten past the initial “welcome to your bipolar dx” and getting-stabilized-on-meds stages, the question of what I’m actually doing in therapy has come up repeatedly. Hippie Dude kept pressing me for goals for therapy recently, with his usual statement that the goal of therapy is not to be in therapy. I love that.

But even though I’ve been slow to admit that therapy is useful for me, we hadn’t really worked on anything goal-oriented in the last 8 months. So last month I said that I’d like to work on figuring out triggers and how to respond. What I’m hoping we can do with these lists of triggers is figure out which ones really matter most, and which ones I can control or address proactively. And at my last appointment, Hippie Dude gave me homework for the first time: think about triggers.

So I did. When I couldn’t work because I was feeling too low, I thought about triggers for awhile instead. While that pondering itself was a bit painful, at least it made me feel that I had accomplished something and not entirely wasted the day.

Spending time trying to figure out what sets me off was not the most fun I’ve ever had, but hopefully a useful exercise. The first challenge was figuring out how to even proceed with the assignment. I ended up using worksheets from a couple books to provide structure and prompts for the task. The main one was Take Charge of Bipolar Disorder by Preston and Fast.

Figuring out triggers started with thinking about symptoms and the things I usually say or do at the start of mood swings. In the book, these chunks are presented in different chapters but I found them complementary for my purposes. After listing out symptoms and behaviors, mood by mood, I could think more clearly about what makes me feel and act that way. And my oh my, what a long list I generated! I’ll save that for another day.

Just the lists themselves were depressing to see – so many things that can mess with my head. So many things I can’t control. So many things related to work, and taken to extreme due to the nature of my work. If you have problems with rejection and lack of positive reinforcement, for example, academia is nothing short of brutal.

So I was actually prepared to discuss triggers last time I went for therapy. I was pretty pleased with myself for that, since it was really rather difficult and all the harder due to the incessant bursts of tears. Given how poorly I was doing, however, it got no attention. Maybe next time.

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