When Care and Mental Health Collide: Finding Purpose Amid Pain with Stephen Nawotniak - Episode 174
Caregiving is a journey of immense love, but it is also one where mental health challenges—both for the caregiver and the care receiver—often go unspoken. In this powerful episode, host Diane Carbo, RN, sits down with Stephen Nawotniak, an occupational therapist, author, and advocate who lives with bipolar disorder.
Stephen pulls back the curtain on the "intangible" experience of mental illness, offering listeners a profound shift in perspective. Instead of viewing mental health through the lens of "brokenness," he shares how to treat it as a journey of wisdom and personal growth.
💡 Episode Highlights: What You’ll Learn
- The "Flu" vs. The "Hangover": A brilliant analogy for understanding what clinical depression and mania actually feel like from the inside.
- The Acceptance Ladder: Stephen’s signature 5-level tool to help you move from feeling "cursed" by your situation to finding the "gift" within the journey.
- WRAP (Wellness Recovery Action Plan): Practical steps to identify your "Triggers" and "Daily Maintenance" items to stay balanced.
- Reframing the Narrative: How to stop arguing with "reality" (especially in cases of dementia or delusions) and start connecting with the underlying emotion instead.
- Negative Self-Talk: A simple technique to treat your inner critic as an "opinion" rather than a "fact".
🪜 The Acceptance Ladder: Where are you today?
Stephen outlines five rungs to help caregivers and those with mental illness navigate their hardest days:
- Cursed: Feeling like a hopeless victim of the situation.
- Difficult: Resisting the situation with "shoulds" and negative judgment.
- What It Is: Accepting reality without judgment (not giving up, just acknowledging).
- Teacher: Asking, "What am I learning from this experience?"
- Gift: Recognizing the unique strengths (empathy, gratitude) you’ve gained because of the journey.
📝 Key Quotes from the Episode
"Living with bipolar has been much more similar to learning how to drink responsibly than it is treating an illness... It becomes a wisdom thing, not an illness management thing." — Stephen Nawotniak
"Perspective is so powerful. All we can ever do is recognize what rung am I on today, and am I willing to go one rung up?" — Stephen Nawotniak
🔗 Resources Mentioned
- Stephen’s Website: StephenNawotniak.com
- Books: Handbook for Healthy Living with a Mood Disorder and Mubu the Morph
- Tool: Wellness Recovery Action Plan (WRAP)
Podcast Episode Transcript
Diane: Welcome to the Caregiver Relief Podcast, where we hold space for the unsung heroes, the family caregivers. I'm your host Diane Carbo, a registered nurse and lifelong advocate for caregivers everywhere. Today's episode is called When Care and Mental Health Collide. Finding purpose Amid Pain. Today we'll be joined by
Stephen Nawotniak, an occupational therapist, certified psychiatric rehabilitation practitioner and author who has turned his personal journey with bipolar disorder into a mission to help others find meaning and strength.
Stephen's story takes us from a major depressive episode to a life of advocacy and purpose. Together we'll explore what happens when caregiving and mental illness intersect, both in those who give care and those who receive it, and how tools like the Acceptance Ladder can guide us towards empowerment and peace.
Diane: Stephen, thank you so much for, joining us today. When I learned about your book and I read your, bio, I thought I really had to contact you because this is a topic that is not talked about enough. So I thank you
Stephen: very
Diane: much. Yeah,I appreciate your honesty about this 'cause I've worked in senior behavioral health and I know the challenges, but they are not addressed at all.
And that's brave of you to share your personal journey.
Stephen: Thank you. And I find that, there's a couple parts to that stew. I always look at things as ingredients to the stew because there's a lot of components. Yes. And one component is a. Misunderstanding a lot of times because with mental illness, the symptoms are an atypical.[00:03:00]
Intangible experience that comes from within the person.
Diane: Yes.
Stephen: And so that's different than the shared experience without ourselves. So we can understand and grapple with. So because of that you can see different behaviors or different things that don't always make sense 'cause they're not consistent with the external environment.
Diane: Yes.
Stephen: And then if you've never had those, you're trying to figure out what. That means and makes sense of it.
And so one of the things that I like to do is try to share a little bit about what symptoms, what my symptoms feel like. Not to say that everybody has the same thing, but rather to try to help give an anchor point
Diane: Yes.
Stephen: So that there can be some sort of connection made to help put things in a little bit of a perspective.
Diane: So you're gonna explain to us how the two worlds interact, especially with somebody living with mental illness. Is that what you're going to do?
Stephen: Yeah, what I would love to do. Okay. What I would love to do is share just a little bit about what the bipolar symptoms feel like and then how those perfect that understanding can support with things.
Is that okay?
Diane: that's perfect. That's perfect.
Stephen: Excellent. So when I give presentations about what bipolar feels I like to start off with depression and. If you, what I have found is that my experience with clinical depression has been much closer to having the flu than it is being emotionally sad.
So what do I mean by that? Like when you're having the flu, whenever I ask you what stands out the most of the time people say the lack of energy, the lack of drive, the exhaustion, the mental fog. The difficulty figuring things out, like those are the things that stand out the most. Very rarely do people talk about headaches, stomach aches, sore throat, fever, chills, correct.
All that kind of stuff.
Diane: Yeah.
Stephen: So what I mean by my experience with clinical depression is there's that exhaustion and the simplest things seem big. Just like when you have the flu, you don't want to get up and get dressed, you don't wanna go take a shower because those simple activities seem exhaustive.
There's a withdraw that can happen with depression. Just like when you have the flu, you don't wanna go out with a whole lot of people because all that input, that, that noise, that loudness, that brightness, all those kinds of things can be overwhelming. So you tend to withdraw. can anybody, and I also offer this, can anybody relate to this?
Oh my god, I am so sick. Would someone just put me out of my misery?
Diane: Yes.
Stephen: Yes. we've gone there, right? Yes. So I'm not saying it's the same thing because, but like suicidal ideation, why someone can go there? Yes. Because the experience is so uncomfortable. You just want it to stop. Yes. So what I'm saying is it's the, I have found, for me, the debilitating elements have been much closer to that.
Than it has just being sad. Can there be crying? Yes. Can there? Can it come from loss? Yes. Can there be all those kinds of things? Absolutely. But the hearts of it is much more like having the flu. And so when you're talking to somebody with depression, it's not okay. You got so much going for you.
Let's go. It's more I know you're feeling uncomfortable. What can we do to help you feel a little bit better right now? Yeah, and working from there. So it's just, it's that approach. Just if you have the flu, do you want someone coming in saying, come on, you got a full day ahead of you? Or do you want someone saying, Hey, I know you're not feeling good.
What can we do? So that, that's with depression, with hype. Now with mania, the part of bipolar, the other extreme, there's two parts to it. There's Hype O mania, which is little. So you have a lot of energy, restlessness, all that kind of stuff. And then there's full blown mania where you can have delusions and all that kind of stuff.
Diane: Yes.
Stephen: So with hypomania, that little one, I like to say it's a combination of having being over caffeinated and pleasantly buzzed on an alcoholic beverage. Putting those two together, that's parallel. That's the closest thing that I can come up with what does it feel like to be hypomanic? Because you have a lot of energy, but it doesn't really dissipate.
you can have a lot of creativity.
you can have that liquid courage, the inhibitions are gone, so you feel and you feel like everything's gonna work out.
But what you lose is objectivity and groundedness.
Diane: Yes.
Stephen: So that's with hypo omi. And then with mania, following that parallel, it's like it goes from being pleasantly buzzed to being drunk.
And for example, hyperverbal, have you ever met the drunk philosopher with the secret to life figured out in the answers?
Diane: Yes.
Stephen: And that's a long, drawn out conversation. And it's not necessarily logical, right? So that can be hyperverbal with that. there could be intensity of emotional expression.
some people can be very, liable, cry. Some people can be very giddy and laugh. Some people have been aggressive. But here's the thing to understand. Are there people that have been, are there people who have been drunk? Have they been aggressive? Yes. But just because someone's drunk does not mean they're aggressive.
Diane: Correct. Yes.
Stephen: Same kind of thing can go on. Are there people? Absolutely. But just because you're having a symptom does not mean you're aggressive. And so there's this whole kind of piece to understand there. And we can go into a fear mode when the people are doing something that, that we don't understand.
And then the final part, so that's like with. Mania. It's much more like being drunk.
And then the final part is what follows intoxication can be the hangover. And so as drunk as you get, that's how bad the hangover can be.
So just like with mania as high as the mania goes, that's how much the post manic depressive episode can go.
That's how low it can go. And so what I have found is living with bipolar has been much similar. To learning how to drink responsibly Than it is treating an illness. for example, if I'm drinking alcohol, you start to learn. Don't chug it. If you wanna extend, eat when you're doing it, take breaks, drink water, hand over the car.
Keys don't drive if you're finding yourself, getting, at a certain level. And that's always safe to do before you go out. So same kind of thing with dealing with the hypomania, mania and depression of. Bipolar is starting to say, Hey, I'm starting to recognize what's going on, so what can I do about that?
I start to recognize triggers. What are those external events that can set me off, such as having lots of creativity can send me up a little bit? And so what kinds of things can I do if I feel myself revving up? What can I do to help bring myself down, listen to calm music, go into a darker place, deep breathe, push my feet into the ground so I start to learn what are techniques that I can use to help soften its intensity?
Then use those as I start to experience things. So it's much more, as I said, learning. Just learning how to deal with alcohol in your system. While you're living and doing things. It's like starting to understand what these symptoms feel like and how do I work with them so it becomes a wisdom thing.
Not an illness management thing. And so that's just what I like to do is try to, hopefully that helps demystify what some of the experiences feel like a little bit when you're, if you're talking with someone with depression or bipolar or some of those things.
Diane: Yeah. I find that very fascinating how you explain that.
I've never heard it, but you for the first time, and I've been a nurse for 54 years. I've never heard it explained that way, but you made it so perfectly clear to me, and now it makes a lot of stuff Makes sense Because, nothing makes me crazier When I hear people say, when somebody's depressed.
Get over it. Get up and get moving. You'll feel better. But it doesn't work that way for some people. I've seen people that couldn't get up to take a shower, couldn't get up out of bed. I have helped people in the deepest depths of depression, get up, take them to a shower, help bathe them, and then.
Put them right back to bed because that's all they could do for the day. And, people don't understand. They think it's just, oh, get over it, but you can't. And with bipolar it's,very different because you do have, I actually know someone with, if bipolar, a young woman and she is hypomanic all the time.
that's her level. She's very loud. She's, has She's boisterous. She's, but she's smart and she tries, she's studying to be a nurse and she works really hard at it because. The way she learns is she's gotta, it's not just audio and visual, but she actually has to physically do things.
And it takes her a little longer 'cause her concentration levels are there, but she's committed to doing things, so she set goals. But, I haven't, she's never had, in the few years that I've been around her, she's never had a really bad depressive state. She's been really blessed that way.
she's, her depression is, very mild compared to what I've seen in the past, but then her highs aren't really high.
Stephen: Yeah. There's that cyclo, themic, that kind. You're in the middle.
Diane: Yes.
Stephen: Yeah. Working with that kind stuff. Yeah. It can present in different ways. Yes.
Diane: So I find that, very interesting the way you've explained it, because it makes sense and, Go ahead.
Stephen: And that whole dealing with depression, not being able to pull yourself out of it, that's real.
Diane: yes,
Stephen: for my master's degree, I hiked bike, sailed and canoe for eight months from Buffalo, New York, down to Key West Florida. I built it, I gave presentations over a thousand youth, did over 230 hours of community service.
Started the geology along the way. 'cause I was working on being a teacher and it was awesome. So I built this and I had my ups and downs during it, but I was able to work myself through it. the months leading up to my hospitalization with depression, I could not pull myself out of that tailspin.
Yeah. No matter what I did.
Diane: Yes.
Stephen: And that was very difficult. And then when I was hospitalized, I felt hopeless. I felt broken and I felt ashamed.
Hopeless because nothing I did could pull me out of that state.
Diane: Yes.
Stephen: Broken. I was 27 years old with a master's degree and had no idea how to live. And a shame because now all that stigma associated with mental illness yes, came crashing down upon me.
it was rough. I
Diane: understand that. Yeah. I've worked in senior behavioral health and I have seen, seniors that are just for months in the hospital and they've tried everything, to bring, to get them to a level and they have to seek, other treatments like ECT or whatever. But, I don't wanna go into that part of the caregiving right now.
One of what I wanna talk to you about is, how caregivers can better support loved ones who are struggling, with mental illness. or how does the caregiver who's providing care that has a mental illness, keep themselves, balanced in some way?
Stephen: Sure. And I would even throw this out there, caregiver stress is a real thing.
Diane: Oh yes.
Stephen: And caregiver burnout is a real thing.
Diane: Yes.
Stephen: So even if you don't have an atypical mental illness diagnosis, you are still going through a an internal challenge.
Diane: Yes.
Stephen: And so many of the techniques, what I have found is that there are skills and tools that are good for everybody. It's just that the need for certain skills and tools becomes more evident given the situation that you're in.
So for example, diet and exercise are good for everybody.
Diane: Yes.
Stephen: If you're an athlete, the need for that diet and exercise is more evident.
Diane: Yes.
Stephen: negative self-talk, what I've learned is everybody can have negative self-talk.
Diane: Exactly. Yes.
Stephen: Now, if you're dealing with depression and anxiety and things. That negative self-talk can scream.
And, but like when I proposed to my wife, I was nervous. And you know what if she says no and am I good enough? And all this kind of stuff was going on.
Diane: Yeah. Yeah.
Stephen: when I went for job interviews, can I get this? Am I good? Like negative self-talk and doubt can creep in regardless. So the causes can be different, the intensities can be different.
But from a functional point of view, it's the same. So the skills that can address them are the same. So regardless of where you are, one big thing that I have found to be really helpful, whether you are experiencing the mental illness yourself, you have the mental illness and you're caring for another, or even just you're caring for somebody and getting tired and dealing with that journey.
Diane: Yeah. There was
Stephen: this. Program I was exposed to called the Wellness Recovery Action Plan, and the Wellness Recovery Action Plan was actually developed by people with mental illness that were trying to, that were like, where's life Beyond not being in the hospital?
And so they were just talking about how do you live with this thing?
And so what it starts with is list out and brainstorm all the activities that you can do that are free or low cost. That bring connection with yourself or others or bring wellness for yourself. So things like walking a dog or playing with your cats, listening to music, taking a warm bath, bird watching, I don't know, whatever it is, what playing the guitar, whatever, but brainstorming.
What are all those things that you can do? And keep it as a running list, keep adding to it. Someone says something, oh, I like that. I'm gonna add it to it. Or I would like to try that, add it to it. So now you have this list, because the one thing that I have found is when you're dealing with depression, when you're dealing with anxiety, when you're dealing with stress, it's harder to figure things out.[00:17:00]
Diane: Yes.
Stephen: So when you have that to-do list, it's hard to start something.
But if you have, things already identified. You can pick one of those and do them easier than sitting with that in that state of stress or exhaustion or burnout, trying to figure out what to do.
Diane: I love that.
Stephen: The second thing is starting to understand what are those key three to five things that if you tend to do these every day, you tend to have a better day.
So it could be, you know what? Getting up and walking my dog every morning or going for a walk with my dog is something that's helpful. Taking a shower either in the morning or at night helps me relax or wake up, whatever it is. But identifying what are those core three to five things that if I tend to do those, I tend to have a better day.
And make sure you do those. And if you're feeling off and you have your list, do go back to doing those. The next thing is understanding triggers. What are those external things that if they happen, they can set me off?
And either induce a symptom or trigger a pet peeve or get frustrated or whatever.
It's, what's that external event? Then once you've identified those, when you're in a balanced state, when you're in a relaxed state, problem solve, what are some things that you can do to address it in a healthy way? for example, my stepson had a chore of doing the dishes because I don't like it when the dishes build up on the counter and I will come home and sometimes the dishes would be built up 'cause he wouldn't have done them.
So in the beginning I would get frustrated. I'm like, come on, you gotta do the dishes. But then what happens is you know, as teenagers, they don't always listen joyfully do it. It doesn't always help things. So what I've learned, and by the way, my relationship with my stepson is really important to me.
Diane: yes.
Stephen: So if I'm just creating frustration, I'm not building relationship.
Diane: Correct.
Stephen: So what I realize is when I see that I'm gonna count to ten first. So that way I get that initial
Diane: Yeah.
Stephen: Tempered down and then I ask him about his day or something that he enjoyed doing. 'cause that's relationship first, Uhhuh.
And then I'll say, come on, let's do the dishes. So that way it's building relationships and still addressing what needs to be done.
Diane: yes.
Stephen: Now does, did that work every time? No. 'cause sometimes he still didn't do the dishes. 'cause he is a teenager, but. It still addressed it in a healthier way, and it happened better than when I just came off and we're done.
So here's my point, is when you have a plan, when that shows up, you can do the plan without just instinctively reacting. And the fi And then the final part about it that I wanna share is that the, is understanding what my experiences feel like. Like when I'm starting to get burnout, what does it feel like inside?
When I'm starting to feel stressed, what does it feel like inside? So the idea is I know I have these feelings, and when they show up, what can I do about them so that I can feel better? When all that stuff is going on. So the whole idea is wisdom. You understand yourself, you understand how things show up, and you have a plan to address them when they show up.
So you can do that for yourself as a caregiver. If you're a caregiver, you can have those conversations with a person who's experiencing those things.
Or having the ebbs and flows and just working through creating that plan. Once again, it's called the Wellness Recovery Action Plan. It was developed by Mary Ellen Copeland and her team of people that have come, that came together to talk about how do you live with this thing and stay outside of the hospital.
And if you Google it, WRAP, wellness Recovery Action Plan information will pop up.
Diane: Oh, I like that. I'll put that on. I create a. Permanent page on my website with this podcast and your information, and I'll make sure I click, put a link in there to that as well, so my listeners will be able to find that after they listen to your podcast.
Stephen: Excellent.
Diane: Yeah, I like that. can you share a moment when you're paying transformed into purpose and something that helped redefine your outlook on life?
Stephen: Absolutely. My journey with Bipolar that brought me to having that pain, purpose to pain was actually a journey of four perspectives. And those four perspectives also help me develop a tool that I call the Acceptance Ladder, which is how do you help, how do you help work on accepting things you don't like and don't want, and help you have a more empowered relationship with it.
So the first thing I wanna do is talk about my four experiences and my four perspectives. So when I was first, discharged from the hospital, my relationship was coping with symptoms of an illness.
It was really focused on how do I feel better and how do I address this illness that I, this lifelong illness that I now have.
Medication helped some talk therapy stuff helped and it helped soften the intensity of things, but it was still there and it was still illness based and it was still, f focused on feeling.
Diane: Yeah.
Stephen: I ended up joining a vocational program and that introduced me to occupational therapy. And when I went to school for occupational therapy, there was a shift that happened.
It sh because in occupational therapy, what we really focus on is helping people do what's important to them.
Diane: Yes.
Stephen: How do you find fulfillment and meaning in the activities that you do so that you can have a quality of life that extends beyond just coping with symptoms? So that got my focus to what I was doing.
So it shifted from feeling to doing, it shifted from coping with symptoms of an illness to managing the needs of a condition. Then I got involved with occupational therapy, connected with the peer movement in mental health. The peers are people with lived experience, with diagnoses that are sharing that, that are advocating for better treatment, that are sharing ways to live well and using their story to help provide hope and support for other people who are going through the journey.
When I did that, when I was introduced to wrap the program that I shared, and what I was able to do was set down the label. I was able to set down the diagnosis and it started to focus on getting to know who Steve is, understanding what this journey is like. For me, it shifted it from focusing on what I was doing and managing a condition to a personal growth process and wisdom development.
Yes, the symptoms were still there. And yes, they could be uncomfortable, but it was no longer, these are wrong and I'm broken and I need to be fixed. It became, these are just my challenges. How do I get to know them so I can develop the skills and supports necessary to address them to be my best self given the situation that I have?
And then as I was doing that, I was sharing my story, and then I started to find that. My pain full experiences, my challenges started to become a resource that I could tap into to provide hope and support for others. And so my four perspectives that I went through was coping with symptoms of an illness when I was first discharged from the hospital, and I was focused on how I was feeling to managing the needs of a condition when I was going with occupational therapy and focusing on what I was doing.
To personal growth and development. Which focused on who I was, become, who I was, and what it was like being me and the wisdom of it. And then I started to tap into finding purpose to pain. And that became what I was doing and who I was becoming. So that journey brought me through those different perspectives and inside of that it really tied in and I really learned that Perspectives is so powerful.
Diane: Yes. Yes.
Stephen: And so the Acceptance Ladder is, is five levels.
Diane: You
Stephen: and the bottom level is cursed. That's where I'm hopeless. There's nothing I can do. The universe is stacked against me. I'm a complete victim of the situation. And sometimes like when I was hospitalized for depression, I was there because nothing I did worked.
Diane: Yes,
Stephen: that's the bottom rung. The next rung up is difficult. There's a negative judgment of the experience. It's not fair. It's a fight. It's work to address. It should. Is a big word. I should not have this.
Diane: Yeah.
Stephen: So that's the next level. It's better than curse. But it's still really challenging and that negative judgment is associated with it.
The third rung up is what it is. That's why I set down the negative judgment of it, and it just is the experience that I'm dealing with. It can still be uncomfortable. It can still be unfair. It can still suck, but it's, but I'm accepting it as the reality that I'm addressing. So there's an acceptance piece to it.
It does not mean giving into it, it just means understanding. This is the reality that I'm working with. Then the fourth rung, the next rung up is teacher. What is it that I'm learning from the experience, or what do I need to learn to address the needs of the experience? So there's a growth piece to it, and then the final level is gift.
What can I now do that I never would've been able to do if it wasn't for the journey that I went through? I'm not saying the situation is a gift. What I'm saying is the journey that we've gone through allows us to do things now that we never would've been able to do. It could be increased empathy to support people.
It could be a greater gratitude and appreciation for things. It could be understanding skills that can support when I'm going through challenges or supporting others, what those are, the gifts. And so all we can ever do is recognize what rung am I on today? And am I willing to go one rung up? So if I'm in difficult mode, don't talk to me about being a gift, but maybe just maybe I can set down the should not have happened and just say, okay, this is just what I have to deal with and then once you reach that level, you can then entertain the next rung.
So again. It doesn't make all the yucky stuff go away.
Diane: Yeah,
Stephen: it doesn't fix the situation, but what it can do is give us a different perspective to live through when facing the situation, to be more empowered dealing with it.
Diane: That's a nice approach. I, I suffer from treatment resistant depression. I'm not bipolar and I've never had a really low.
but I did have a son, my oldest son was a soldier, Korean linguist, and, developed a serious pain condition, and he. Completed suicide 14 years ago, and the challenges he went through were overwhelming for him. dealing with the medical delivery system of the military was challenging.
And one of the things I learned through all of this is you change your perspective, you change your life. And, one of the things that you, one of the first things you said is, you have to have certain things in your life that you have to do every day to stay out of that, that lower rung. I, so to speak, and I know I get up and I walk every day.
I'm near the beach. If I can go to the beach, I've got I dog walk to make myself have a reason to get out of bed to. I make that and, I have people say, oh, it's too cold, the weather's too bad. You shouldn't get out there. I have to do it. I absolutely have to do it if I want to have a good day, and I don't wanna start going down that rabbit hole.
I love the way you explain this, Because if you put it in simplistic terms that people can understand, although it's not always easy to do. Correct. Now, when you created this acceptance ladder, what inspired you to develop it? Because I'm very impressed with this tool.
Stephen: Thank you.
one of the things that, there's two components that. Help me create this. One is my presentation of bipolar is more of a rapid cycling state. Okay. So I can go through and one of the symptoms or those experiences, it can last a couple days, two to three days
And then I come out of it or couple or maybe a week or so.
So it's not like I sit in that for weeks on end, it's days to a week on end. Okay. And that means I go through that process a lot. Of those symptoms. So it helps me understand, because I've traveled that road, it helps me understand what I'm going through, and as I understand what I'm going through, I get more proficiency with it.
Diane: Yes.
Stephen: The second part about it is those perspectives that I went through is I started to learn these different lenses that you can have that I had. And as I had those experiences, things started to come together and it just made sense because I was going through it a lot. And so I would experience it a lot.
And so having to figure out how do I deal with this stuff, for me was a necessity to be able to do the things that are important to me. So really I think it, it really came out of a, that personal growth of the overall journey of having the four perspectives, but then also the micro journey of having the symptoms a lot.
And the one thing I wanna throw out there is, as I said, with negative self-talk
Of how the, you can have different causes of it and different intensities of it, but negative self-talk is a human thing. Like the, heart beats blood, right? That's what it's supposed to do.
Diane: Yes.
Stephen: The mind thinks that's what it's supposed to do, so you can't turn off the thoughts, and sometimes when the thoughts are negative, they can be that downward spiral.
The biggest thing that I have found to address that is to take it on as an opinion rather than facts. Because I know when I get caught up in that, when that negativity starts going, I feel like it's all encompassing and it can be massive. But when I can express it, when I can accept it as an opinion, now it's gonna be a very loud opinion.
And it can be, and it requires intentionality every time I do it.
But to thank it for sharing, it's the mind sharing an opinion not fact. And then say the word and then come up with a fact that's positive, that maybe some, a compliment you have gotten for something that you've done, an appreciation you have for something.
Maybe something that you've felt proud of. So it becomes an opinion. And this fact, and I am grateful for the sunrise, and I've been told I'm a good communicator. And I have written a children's book that won the Mom's Choice Award that I'm really proud of. So it becomes one opinion of many things, and that softens the loudness of that negative thought.
It becomes one of many, and that's how I have found, I can't turn off the negative thought, but I can soften it. Then help me focus on other things and activities that help, again, bring it from the forefront into the background. Like the difference between listening and focusing on a music in the radio.
To having it going on in the background while you're working.
Diane: I love that approach. I will tell you right now, caregivers and those with mental illness, I've seen it all my life where they just do the negative self-talk. And I've never heard about how to, I know, change your perspective, change your life, and people go, yeah, but it's not so easy.
You just made it a very simple, simplistic tool. something that they can do in a matter of minutes, Family caregivers are always told, they don't do enough. they're not important. other people in the family are more important and they get caregiver stress, caregiver burnout, they're ignored.
so you've just turned it into a simple tool when they're feeling that negative self-talk to, yeah, maybe I'm not the best, I, maybe they think I'm not the best caregiver, but I'm really good at, Giving my dad, taking my dad for a walk or whatever. it just makes a difference when you add a positive, approach to it.
And, I know many people, years ago, I would've had a challenge doing that. I really would've, I'm, my dad was abusive and, I'm the oldest of four, so it was very challenging for me when I was growing up. ButI know now I don't surround myself with toxic people.
that's another, thing that many family caregivers can't stay away from. They can't just walk away from toxic people in their lives like they would like to because they're the family members that are abusing them and to keep them at a distance. So I love this acceptance ladder.
It's a new concept for me and I just love it. And, I can see how caregivers who feel overwhelmed or powerless in their role can utilize this to turn things around. So I really appreciate that. Now, when a senior has a mental illness, caregiving can become incredibly complex. What strategies can help families, manage these situations without burning out or resorting to crisis care?
Stephen: That's a great question and one of the things that I have found, 'cause when I was an occupational therapist starting in a senior living facility, it's amazing how much depression was in the experiences of people who were there.
Diane: Yes.
Stephen: and so that experience of depression, I think is much more common.
Than we would think. And if you allow yourself to sit in that little shoes for a minute,
There is a loss of identity that can happen because oftentimes we identify with what we do. I am a doctor. I am a garbage man. I am a guitarist. Like we identify ourselves with our activities and when physical abilities start to shift those.
Previous activities may not be there.
Or upon retirement, there can be a loss of work, but work can be very identifying for people. So if we don't replace that work with something, then all there is this loss. It can be a , When we're younger, we can live with this. Here's what I want to do in the future.
Here's what I want to build, here's what I want to get going.
When physical abilities start to shift. That perceived future starts to shift, and then maybe the memories become more significant.
So anyway, there's this shift that happens that if we're not understanding and giving room for then it can be difficult.
another example would be like,Alzheimer's or dementia.
Diane: Yes.
Stephen: Trying to, and again, I'm gonna go to the alcohol thing for in a minute. Have you ever tried to argue with someone who's drunk? It's not the easiest thing.
Diane: No.
Stephen: So trying to argue with someone with dementia doesn't help.
Diane: Correct?
Correct.
Stephen: Now, it doesn't mean you have to necessarily agree with everything, but if you can. Allow that real, allow that, that's the reality the person's having, and so work with it. It becomes a little easier. So instead of saying, oh no, you're 86, now you're not 14, you can talk about what were the things that you really enjoyed about that person or that experience.
you're allowing that. Experience of that situation to be there without fighting. Where did I learn that? I learned that a lot. I spent seven and a half years working in a psychiatric hospital, and I was working with a 27-year-old male who had the delusion that he was from another planet.
And he was talking about how frustrated he was that he couldn't get to a spaceship.
And when I talked with him about, I can see that you're frustrated about not being able to leave here. Then it was, yes, I'm stuck. So now we had a conversation about how frustrating it is feeling trapped in a hospital when you're 27 years old, which could be pretty understanding.
Diane: Yes
Stephen: and understandable. So I wasn't agreeing with his spaceship delusion, but I was agreeing with the,and understanding the frustration of being a 27-year-old trapped in a psychiatric hospital.
Diane: Yes.
Stephen: So same kinds of things can, I believe happen when you're working with people is what's the frustration, what's the emotional state that the person's experiencing, and how can we connect with that and be a release valve of that emotion without making the emotion wrong?
And sometimes you can't fix it.
Diane: yes.
Stephen: But we can appreciate the fact that there's a frustration there. We can appreciate the fact that you're not a burden.
Diane: Yeah.
Stephen: Because sometimes if people are used to being caregivers and now all of a sudden they're needing to be to receive care, there's an identity switch that happens.
Diane: Yes.
Stephen: and then I finally, what purpose can the person have? Wisdom is a big thing. You've learned things in your life. What can I learn from you? How can I, how can you teach me? Maybe share some of the experiences that you've been through that you've enjoyed, and what lessons can I learn? that can be something that a person can have.
So anyway, what you're looking at is what value or what purpose can that person have while they're existing? So they have a reason and they're contributing with what they're doing.
Diane: that's a really good point because people, I worked in long-term care and, what I see is, and I had a grandmother who was in her late nineties, ended up in a nursing home and it was devastating.
It changed her and with depression and sadness and what it is they a loss of total loss of independence. It's, they have to depend on somebody. And I see that as we grow older, that we're all dealing with that. as we grow older, we're losing our independence. And, another thing we have in our culture right now is we've lost our sense of community.
And, so we do feel like a burden wherein, like I worked at a Quaker facility in, outside of Philadelphia, and they have,this inter generational community where the nursing home had, can see into the daycare center. And the youth come in and they pass, the teenagers and stuff as part of their service to their community is to pass water and do things with the elderly, activities or something.
And that, that changed that facility that I worked in had a totally different approach to aging, and I didn't see. and I know you, you know what I'm talking about. I didn't see the sadness and the brokenness because they didn't feel like they were being a burden. And, in fact, I, one of the things that I, that touched me so much was people when they were dying, they, people, their community members came and sat vigil with that person until they passed, even if they didn't have a family member.
And I just thought that was beautiful because. Other communities I were in said,we don't have time to do that. And it makes me sad because we've lost our sense of humanity. Yeah. And, you're right. One of the things, and there is a sadness in every single nursing home and even some assisted livings with the memory care.
People un understand that they're not who they were, and it's hard to become a burden to our society. but you change your perspective, you change your life, and I love that. Steve, I really appreciate I'm so in, Impressed with your approach to mental health. you've made the hard, simple to understand and help my caregivers along their journey.
You've given them tools to not only be able to help themselves, but maybe implement. with their, family member. Even if they don't have a mental illness, they all have some form of depression. A lot of them do. we can't get away from it because of our culture. so I would like for, how do you, how do people find you?
Stephen: I have a website. It's Stephen Nawotniak.com. And, there I have just some information about me. I have connection. I have a YouTube channel where I just have some videos on mental health and what the bipolar experience is like. I have some, a link to, some of the books that I've written. handbook for Healthy Living with a Mood Disorder, as well as Bipolar Life Hacks, keys to Loving Life with a Bipolar Disorder and also my.
Mom's choice of word, move with a more of children's book. So it's just a fun way to connect with some of the things there. And there's an email that you can connect with me if that's something that you would find helpful.
Diane: I have, definitely will put all those links at the bottom of the page that we create for you.
And I think that children's book is gotta be incredible because we don't have enough of those kinds of tools to explain our mental health to our children. And. Go ahead.
Stephen: Yeah. Yeah. Thank you. And if I can take one minute,
Diane: absolutely.
Stephen: Share the beginning of the book. Is that okay?
Diane: Uhhuh Absolute, please.
Stephen: So it's called Mobu, the Morph Mobu,made many morphing mistakes, sometimes mad, sometimes sad, sometimes. Glad. Sometimes bad. He used the gifts that he had and always Moo grew. He grew in ways he did not know. He grew in ways that did not show. He grew in ways that made him go, though sometimes it was slow.
Sometimes when slow, he could not see where to go or who to be. Ski in the snow, climb up a tree, look down below, find you, find me. And so move and morphed.
Diane: Oh, it's wonderful. Wonderful. Oh, what a good way to end this podcast. to my listeners out there, my family caregivers, you are the most important part of the caregiving equation. Without you, it all falls apart. So please learn to be gentle with yourself, practice self-care every day because you are worth it.
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