A mother with bipolar disorder told her support group she was overwhelmed at home with two kids. The dishes piled up in her sink. Another member offered simple advice: use paper plates until your kids are out of school. No need to wash dishes right now.
She says that advice protected her kids. Dr. Ken Duckworth, a psychiatrist, shares her story and admits he never would have thought to suggest something so practical.
Dr. Duckworth trained at Harvard and spent 23 years at NAMI, the National Alliance on Mental Illness, where he served as chief medical officer. For his book, You Are Not Alone, he interviewed over 130 people with mental health conditions and their families. Dave Barney and I spoke with him on this week’s episode.
The people in his book learned to stay well because they had to. Most of our listeners are doing fine, so I asked Dr. Duckworth which of their lessons apply to the rest of us before we need them.
Experience Is Expertise
Dr. Duckworth’s father had bipolar disorder. As a child, he wanted to understand it and eventually became a psychiatrist. His medical training taught him a lot, but no one had asked everyday people what truly helped them.
So he asked. About 50 of the 130 people said their lives improved when they helped someone else.
He planned to write a chapter titled “The Power of Community.” After the interviews, he renamed it to focus on peers. Many people told him the most influential person in their recovery was someone who had been through it, such as a fellow patient or a mentor who had lived with bipolar disorder for years.
“You don’t need a medical license for that,” he says.
My co-host has a similar trick. Instead of stressing over lost reading glasses, he keeps a pair everywhere he might need one: on his desk, on his nightstand, in his car, in his backpack, and in a drawer full of spares.
“That’s exactly the kind of thing you would never learn in a randomized controlled trial,” Dr. Duckworth says.
Let Something Else Set Your Schedule
One man in the book has bipolar disorder and adopted a dog nobody wanted. Three or four people had given up on it, calling it untrainable. Its name is Coda, and its owner is a musician.
Coda set his routine. When the dog needed to eat, he got up to feed it. When the dog needed a walk, he went outside. He even came home from grad school at lunch to care for Coda. When the dog went to bed, he did too.
Dr. Duckworth noticed the pattern. People with bipolar disorder often have trouble keeping a regular schedule, and social rhythm therapy helps provide structure. This man didn’t know about the therapy; he just found his way through his dog.
You don’t need a diagnosis or a dog to use this idea. A set wake time or daily walk anchors your schedule. I wrote about wake times recently; this is a different way to look at the same concept.
Treat Sleep as an Early Warning
Dr. Duckworth calls sleep a harbinger. For people with bipolar disorder or depression, disrupted sleep is often the first sign of an episode. Over time, they learn to see it as an early warning.
He says paying attention to sleep helps everyone, whether or not you have a mental health condition. One bad night isn’t a big deal, but watch for patterns. If your sleep keeps slipping, try exercise. If that doesn’t help, talk to your doctor. You likely don’t need a sleep study yet.
Research backs this up. A review of 21 long-term studies found that people with insomnia, but not depression, were about twice as likely to develop depression later.
Choose Where Your Energy Goes
Dr. Duckworth’s favorite quote in the book comes from a man in Montana who lives with schizophrenia. He hears voices daily, receives good care, has a loving family, and takes the best available medications.
After about 10 years of fighting the voices, he accepted they would still be there every morning. He stopped spending energy on them and chose to focus on his best friend, his parents, the women on his Meals on Wheels route, and Friday night football games where he’s a local celebrity.
“You don’t need to be the CEO of Google to be a contented man and have a happy life,” he says. “You just need to accept what life has given you and move forward.”
Dr. Duckworth thinks of him during hard times. “If you’re spending 80% of your day fighting an experience that is out of your control,” he says, “you’re missing a lot of the music of your life.”
Most of us aren’t fighting voices, but we all battle something, like setbacks we can’t fix or jobs we can’t leave. Consider how much of your day that struggle takes.
Give a Little, Get a Lot
When I asked which lessons apply to people who are doing well, Dr. Duckworth’s first answer was service. Find purpose, and give to others in any way you can. He calls it “self-care through service.”
For him, it’s Mondays. He picks up his grandson from daycare every Monday and never makes other plans. “You give a little and you get a lot,” he says.
There’s research behind this. In one study, people were given five or twenty dollars to spend on themselves or others. Those who spent it on others were happier by day’s end.
The Boring Things Matter
Most of these ideas aren’t new. Paper plates, a dog’s schedule, steady sleep, a regular visit with a grandchild. None of these would sell as a trendy wellness hack. The most powerful habits are often the boring, ordinary ones we overlook.
Dr. Duckworth is clear: none of this replaces treatment. He calls these habits the three-dimensional side of recovery, the part he rarely learned in training.
Put it into practice
Try This Week
- Choose one anchor for your day, like a set wake time or a daily walk, and stick with it all week.
- Each morning, jot down one line about your sleep. At week’s end, look for patterns. If sleep keeps slipping, talk to your doctor.
- Find your “paper plates.” Identify one chore that drains you and either make it easier or drop it for now.
- Solve problems where they start. If you keep losing something, stash spares wherever you need them.
- Give someone an hour or do them a small favor. Notice how you feel afterward.
- Tell someone you love them, out loud.
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Say the Words
Before we finished, we asked Dr. Duckworth what he wanted listeners to remember most. His answer: love. People in his book who felt loved and could love others often described it as the root of their wellbeing.
When he meets a family after a loved one’s diagnosis, one of his first questions is whether that person knows they’re loved. Some families assume it’s obvious. They figure showing up is enough.
“Well, not exactly,” he says. “Say the words.”
Treatments aren’t perfect, he says, but making sure someone knows they’re loved is something a family can control.
You can start with a single sentence today.
