On Healing 4/18/2005: Bipolar patient feels angry and alone

Dear Dr. Dan: I am a young woman who was diagnosed with bipolar disorder nearly 10 years ago. But I manage to work and am in a relationship.

Yet I struggle daily with feelings of isolation and anger. Somewhere along the way, I lost my ability to make friends. It’s embarrassing and shameful. I feel as if I’ve been deprived of the one thing in life that is supposed to be really important.

I do see a therapist and am on medication, but even on my good days, I feel empty. I can’t fill this hole that I have inside. And it’s killing me.
– Alone and lonely

[I wanted to know more about this hole she feels inside and why she is trying so hard to fill it. She added this:]

“The hole has to do with feeling that nothing I do matters. And it’s got to do with being lonely and feeling different from others. I don’t feel as if my life means too much, the way I live it now. This is not really living; it’s surviving and I know that life is more than that.”

Dear Alone: Some of your suffering could stem from the bipolar disorder. I know it’s easy to blame everything on one thing, but feeling unimportant, anxious and angry could be symptoms of depression.

You are also describing classic symptoms of social anxiety, which is quite treatable.

But let’s look beyond the brain at your very human struggles. Your letter begins with themes of anger and isolation. That tells me that you are fighting either with your environment or with yourself. Often anger is a reaction to a more tender emotion. In your case, I would guess that under the anger is longing for relief from the lonely, empty feelings.

But feeling alone and empty inside are just facts that don’t automatically cause suffering. And like most people, you look for a way to end that suffering.

Perhaps much of your pain is because you are fighting against yourself and your life. Internally, you might be fighting with your illness or your personality. That makes sense. But the question becomes what is causing your suffering? Is it your life or is it your fighting against your life? My initial advice is to stop fighting.

Once you do that, you might find yourself sitting with some pretty difficult feelings. Perhaps you will feel grief about your diagnosis, or that painful aloneness that goes with feeling alienated. Once you can tolerate these emotions, you will discover that you are just a young woman who is suffering in this moment. This is the beginning of compassion for yourself. You don’t have to change anything; all you have to do is experience today’s life with genuine caring.

To do this, start by just noticing that you are fighting and feeling pain. Then notice the critical voice inside. Then observe your entire being through caring eyes. This is not self-pity or self-absorption. This is just being aware of your experience – and caring.

This is a new kind of thinking, and might take years to perfect. But it takes only a moment to begin. If you can interrupt the cycle of suffering with a moment of compassion, you have begun a critical process.

None of this may change your sense of being small or unimportant, but it will diminish the suffering. And once that happens, you may feel more a part of the human family.

So you and your therapist may want to check your medication and explore cognitive behavior therapy for anxiety. And stop fighting. Have faith in the health and sanctity of your own being. As you embark on this journey, I think you will meet many kindred spirits.

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