Onika L. Dainty

The Connection Between Spirituality and Mental Health

Spiritual practices can have a positive and long lasting effect on emotional and psychological well-being as they promote a sense of purpose, connection to community and inner peace. This can lead to reduced anxiety, stress, depression and substance use as well as enhance overall emotional stability and wellness. 

Spiritual practice can help an individual define purpose and meaning in their lives which can help them avoid feelings of emptiness and despair. This sense of purpose can foster resilience when dealing with challenges in life and promote positivity. Spirituality can also be a catalyst for forgiveness when dealing with difficult interpersonal relationship dynamics. It can also connect you to your community providing you with social support and a sense of belonging. Oftentimes people feel isolated when dealing with mental illness and through the exploration of spirituality you can gain a connection to others which is vital for mental and emotional well-being.

Spirituality and religious practices can be used as coping mechanisms for individuals struggling with mood disorders offering respite from some of the negative aspects of the illness by providing a positive outlet for addressing periods of depression or anxiety. Spirituality can provide various tools such as prayer, meditation or guidance from religious leaders which can help with symptom management and emotional well-being. Research suggests religious and spiritual practices are associated with lower levels of anxiety, depression and negative mood states attributing this to the sense of purpose, meaning and community support often derived from regular spiritual or religious practices. 

It is important to note however, that although spirituality and religious practices are valuable coping mechanisms that can promote emotional stability and emotional well-being, it is not a replacement for professional mental health treatment for severe mood conditions like Bipolar disorder. It can be considered a supplementary resource that can enhance psychological and emotional wellness rather than a singular resource for complex mental illness. It has been my experience that the community connection, structure and routine that my spiritual practices provide me has enhanced the overall treatment plan for Bipolar disorder that I currently follow.          

The Connection Between Spirituality and Psychosis: A Woman’s Lived Experience

I remember my first manic-psychotic episode like it was yesterday rather than 20 years ago. I was living in Gatineau, MTL, working as a hostess at a local restaurant and still dating my university partner. I woke up one morning  and I felt different, almost superhuman with boundless energy. I could not sit still, my thoughts were racing, I was hallucinating and hearing voices that were telling me I was on a mission from God to save the lost souls of the world. I somehow made it to work that morning but when my manager realized I was behaving erratically and telling my fellow staff members God was coming for them to punish the unholy, he called the police for what would be my first wellness check.

The police took me to the local Emergency Room where I received a psychological assessment. After a few hours I was released into the care of my partner with the instruction to eat and get rest. However, when we arrived back at my apartment I was unable to be still, the hallucinations were worse as now I imagined I could connect with the Holy Spirit though my computer and the TV which my partner had to unplug because I was rapidly flipping through the channels looking to find messages from Jesus Christ.

When my partner realized I wasn’t getting better he called my mother to tell her I was very unwell and she needed to come and get me. My parents drove the four hours to Quebec and found me reading the Bible and screaming random scriptures at the top of my lungs. From what I can recall by the time they arrived I believed I was Jesus Christ, my father was the devil and my mother and aunt who had accompanied them were my disciples called to help me fulfill my holy destiny. After much struggle, my parents were able to get me into their car and we drove a harrowing four hours back to Toronto, my aunt in the drivers seat, my father in the passenger seat and my mother with me in the back seat trying to stop me from jumping out of a moving vehicle. 

My religious ideations didn’t end there, over the next 20 years of episodes I would continue to have God-related delusions and hallucinations believing I was either the second coming of Christ or that the devil was controlling my thoughts. During my last episodes of psychosis I would have conversations with someone I believed to be the devil and I would even speak in religious tongues. I continued to connect with my spirituality by attending church but would often disrupt service by falling in the aisles and speaking to myself in an non-audible manner that concerned the other members of the congregation. 

I can’t say why my psychotic episodes are God-centred other than that in my wellness I feel a deep connection to my spirituality and my religious beliefs have always provided me comfort in dark times. For example, When I was experiencing suicidal ideations it was Psalm 23 as well as the steadfast prayers of several family members that saved me from completing my attempt. Also, during my periods of unwellness I rely on the daily scripture 2 Timothy 1:7 “For God did not give you a spirit of fear; but of power, and of love and of a sound mind.” This became and still is my daily affirmation which reminds me that no matter my condition I should never let fear dictate my actions on my journey to mental wellness. My connection to my spirituality whether based in psychosis or remission/recovery reminds me that my spirit is powerful, full of love and my faith encourages me to hold onto a mind that is sound even when it's not always sane.           

Common Spiritual Practices for Mental Wellness

Spirituality is a unique experience for everyone. Some people find spirituality through prayer and religious practices like reading spiritual texts; others find that meditation and mindfulness help with emotional regulation. Whatever spiritual practice you choose, it has been proven that incorporating some practice into your daily routine can have a positive effect on your mental well-being. Below are some options for spiritual practices that may be worth exploring.

Meditation: Focusing on the present moment by quieting your mind. You can explore guided meditation practice or simply use medication soundscapes to create an environment of relaxation and calm. Some apps that are available are Insight Timer, HeadSpace or Youtube. This practice can reduce stress, anxiety and improve focus.

Mindfulness: Paying attention to thoughts and feelings without self-judgement. Practicing mindfulness can be done by doing almost anything. For example, you can eat food mindfully focusing on every bite and chew and connecting it to your thoughts and feelings. You can brush your teeth mindfully thinking about the feeling it evokes in you as you do it. Lastly, you can listen to music mindfully, really tuning into the words and sounds you hear and how they resonate with you on an emotional level. Mindfulness can increase self-awareness as well as emotional regulation.

Gratitude: Focusing on the aspects of your life you are grateful for can create a sense of well-being and positivity. Start a gratitude journal and make it a daily practice to first write down one thing you are grateful for and overtime you can increase the list. Before you realize it the growing list will foster a sense of contentment within you and help you start or end your day with joy.

Forgiveness: This is not always the easiest practice but it may be the most beneficial. Letting go of anger and resentment towards others has been proven an effective way to foster healing, personal growth and reduce stress and anxiety. Remember forgiveness is for you not others and it may be easier to practice writing letters of forgiveness and throwing them away when you are ready to let go and move on.  

Prayer: Engaging in prayer can act as a connection with something outside of yourself. Whether it's personal or communal prayer this practice can provide you with a sense of comfort, peace, strength and connection.The practice of prayer can occur anywhere at anytime, out loud or in your head, this practice can be uniquely yours as you can allow the words to flow like a conversation or you can look to spiritual texts to guide you in your prayer practice. Remember there is no right or wrong way to pray as it is your internal connection to a force outside of yourself that may help you gain peace and deeper understanding of your journey. 

Affirmations: Daily affirmations can boost your self-esteem, reduce stress and anxiety and promote positivity increasing both emotional and mental well-being. They can help overcome negative thoughts, increase resilience and help with self-worth, motivation and personal growth. Some apps to consider are Iam, ThinkUp, Mantra, GoodMind.  

Connect with Nature: Spending time in nature can enhance feelings of connectivity, relaxation and calm. Grounding also known as earthing is a practice where you intentionally connect your body to the earth for example, your feet to grass, the theory states that earth is energy and you can get an energetic charge that has been shown to benefit sleep, enhance mood, reduce stress and anxiety, feelings of overwhelmedness and general well-being.  

Challenges and Misconceptions About Spirituality and Bipolar Disorder

There are several challenges and misconceptions about spirituality and mental illnesses like Bipolar disorder. For women with Bipolar disorder the experience of stigma, finding a support system within their spiritual community and potentially a hindrance to treatment and recovery are all challenges that can be faced when spirituality and mental health collide. Stigma and lack of support from spiritual and religious communities has been seen as an issue due to lack of understanding of mental illness and the invalidation of experiences when dealing with a mood disorder like Bipolar disorder. Oftentimes the invalidation comes in the form of spiritual communities seeing manic-psychotic episodes as “demons”, lack of self-control, substance use or personality issues within their faith community. Rather than seeking help for the individual they practice the idea of “Praying-the-Cray-Away” , certain that the power of prayer or other religious ceremonies is the solution.   

There can also be a misinterpretation of religious experience when some individuals experience Hyper-religiosity during Mania. Some individuals with Bipolar disorder may experience an increase in religious beliefs during a manic episode which faith communities interpret as a normal response to having an illness rather than a symptom of the illness. In some cases a symptom of Bipolar disorder can be religious delusions which include the belief they are Christ reborn or that they have demons watching them which can be difficult for the individual, their families and their faith-communities to understand. During depressive episodes people can feel like “God has abandoned them” or that “There is no God” which again can be a symptom of the illness rather than a reflection of their spiritual faith. 

The fear of experiencing stigma from both healthcare professionals as well faith communities can act as a barrier to seeking help. A great challenge lies in people’s inability to fit their illness into the realm of their spiritual beliefs. When you experience mental illness for the first time but you have had a spiritual connection and been a part of a faith community for a length of time it is difficult to imagine there is no spiritual explanation for what is occurring in their mind. This can lead to feelings of isolation and confusion. It is important to find a balance between faith and professional mental health care. Anyone who has spiritual faith may go through this challenging transition but remember getting help for your mood disorder does not mean you are walking away from your belief system or faith community. Rather, you are taking the necessary steps to integrate spirituality into your mental health plan. 

Integrating Spirituality into a Mental Health Plan

When integrating spirituality into your mental health treatment plan consider the holistic method which focuses on the interconnectedness of mind, body and spirit, addressing the whole person rather than just the symptoms. Working with a mental health team that considers your spiritual and religious beliefs and practices can be key to remission/recovery outcomes. Maintaining an open dialogue about spirituality and mental health with your care team can make you feel understood and supported. Creating structure, routine and habits around spirituality can keep you grounded and stable in your mental health and spiritual journey. Finally, building a supportive community based on your spiritual and mental health needs will enhance your experiences in both realms creating an environment that fosters understanding and personal growth.

Final Thoughts

Spirituality can be a powerful tool for women with Bipolar disorder, offering hope, comfort, and resilience. The journey of spirituality and Bipolar disorder do not need to reside separate from one another, they will intersect and sometimes intertwine and it will be up to you how these two journeys compliment each other. Spirituality with its unique benefits can enhance the journey to better mental health. It’s important to find a balance and seek professional guidance when needed. Lean on all the communities that are available to you for both your spiritual and mental health needs because it is these circles that will lead you to better health spiritually and in your Bipolar disorder management.  Every woman’s journey is unique—exploring what works best for personal growth is key.

Have you experienced the connection between spirituality and mental health? Share your story in the comments or connect with a support community. Let’s continue to have conversations that take us beyond the stigma to a place where spirituality and mental health can become two halves of a unique and holistic plan toward better wellness.

Aging with Bipolar disorder can significantly impact women’s mental health, oftentimes leading to more depressive episodes, increased rapid cycling and mixed episodes and a higher likelihood of co-occurring disorders like anxiety or substance use disorder. As women with Bipolar disorder age they may experience a shift in their symptoms from hypomanic and manic episodes to more frequent and longer depressive episodes, and a possible increase in the number of mood episodes especially around perimenopause. 

Perimenopause and Bipolar Disorder 

Perimenopause is the transitional period leading up to menopause, characterized by fluctuating hormone levels and changes in menstrual cycles, potentially causing symptoms like hot flashes, irregular periods, and mood changes. Perimenopause has been linked to a higher risk of developing Bipolar disorder or experiencing the exacerbation of existing symptoms related to the mood disorder due to the hormonal shifts that occur specifically the decline in estrogen. For women with pre-existing Bipolar disorder perimenopause can lead to more intense and frequent mood episodes.

Depressive Episodes and Aging

As women with Bipolar disorder age there is a shift toward more depressive episodes and fewer manic episodes however these depressive episodes may be more prolonged. Some research has shown with the passage of decades in the Bipolar disorder illness there is an increase in the predominance of depressive symptoms including lowered motivation, changes in sleep patterns and appetite changes. Some women may also experience cognitive issues as they age in this illness. There is also the possibility that symptoms become resistant to medications that worked previously. If you are noticing any of these changes in your Bipolar disorder illness it's important to consult your medical team for support during this time of transition.    

Understanding Your Needs

Aging with Bipolar disorder is a part of the process that is sometimes overlooked. Just like aging is different for men as for women, transitioning from decade to decade with a severe mental illness will also look different. As women there is more to consider such as perimenopause, menopause, mood fluctuations due to hormonal shifts and how the illness of itself ages with you. It’s important to know your needs when dealing with mental illness and be aware of the changes in your cycle. Relying on your past knowledge of Bipolar disorder can help you understand who you were in your illness rather than where your mood disorder is going as you age and what your unique needs are as you transition.    

Emotional and Psychological Impact of Aging with Bipolar Disorder: A Woman’s Insight

When I was in my 20s and 30s dealing with my illness my focus was on medication and symptom management. Because I deal with Bipolar I disorder, I have always focused on the emergence of manic symptoms as my baseline leans toward hypomania. I’m now in my 40’s and I have started to experience several depressive episodes, though temporary in nature they surprised me. My lack of understanding of what I need psychologically and physiologically in this next phase of my Bipolar disorder journey has led me to start doing my research on what this mood disorder looks like in this season of my life. 

I recently went to see my OBGYN regarding irregularities in my menstrual cycle. In my 30s I was advised due to my medication regime I was experiencing fluctuations in my cycle and after a few months my period stopped completely. A week or so before my 40th birthday my cycle returned but it was irregular and caused concerns. For the past two years though, I have felt almost normal with the return of my cycle. I have also experienced emotional and psychological ups and downs including rapid cycle manic episodes and major depressive episodes. My OBGYN said the irregular cycle is due to my age and because he is not an expert in mental health he was unable to address the psychological changes that were occurring. 

It was an older friend in her 50s that mentioned I could be experiencing perimenopause, the transitional period leading to menopause. So, I began to do my research and discovered the emotional and psychological complexities of Bipolar disorder can become more challenging during this transitional period as well as during menopause. It is well known that Bipolar disorder is derived from chemical imbalances so when women age there are fluctuations in body chemistry that affect the way mood episodes occur. For example, I find myself crying more often and experiencing days when I’m unable to get out of bed. My energy is high one minute and low the next. Recently, I went on vacation and experienced a two day manic episode, one of the shortest I’ve ever had which was brought on by lack of sleep. I have also experienced moments of visual hallucination in the past few months. 

After speaking with my psychiatrist, he advised that we shorten the time between our sessions and that I continue to monitor these fluctuations in mood. He also ordered a full blood work-up to determine whether or not there needs to be adjustments made to my treatment plan. He recommended that if unexplainable mood episodes occur to contact him right away to schedule an appointment. I have been fortunate to work with a healthcare provider that listens to my concerns, keeps an open mind and provides proactive treatment solutions. 

Bipolar disorder is a continuous rollercoaster of emotional and psychological challenges but managing your symptoms is key especially as we age. Oftentimes when you feel you have a handle on this illness life will throw you a curve ball and everything feels brand new again. It's important to remember that you have the strength and resilience to manage your mood disorder regardless of the challenges that come your way. Through self-care, support, psychoeducation, medical management and self-compassion aging with Bipolar disorder will become a phase in life you conquer rather than one that defeats you. If you are currently dealing with symptoms of aging with Bipolar disorder consult your healthcare professional for information on how you can proactively manage these new challenges.       

Medication and Treatment Adjustments for Older Women with Bipolar Disorder

When you are aging and dealing with a mental illness like Bipolar disorder it's important to remember that the illness changes as you change, psychologically, physically and emotionally therefore medication and treatment adjustments may need to be made. If you are noticing a difference in medication effectiveness or treatment strategies contact your healthcare provider to discuss adjustments that can help you continue to manage your mental illness effectively. For example, there are several medications in the categories of mood stabilizers, anti-psychotics or anticonvulsants that may currently be in your medication regime that require careful monitoring to mitigate side effects or toxicity. In other words, the medications that previously worked to manage your symptoms may need readjustment in dosage or frequency as you age to remain effective. 

Lifestyle changes should also be considered to promote mental health, physical health and to avoid developing other health concerns like diabetes, high cholesterol and blood sugar or blood pressure issues from arising and creating further health challenges. A healthy lifestyle, including regular exercise, a balanced diet and adequate sleep can play a significant role in managing Bipolar disorder especially as one ages. Also seeking the counsel of a therapist, groups or peer support can prove valuable as they have knowledge and understanding of the challenges you may face during this transitional phase.

Whichever route you choose as you grow and change in your Bipolar disorder journey it's important to remember there are supports in your community and on your team to assist you in understanding how to navigate the new path of aging and managing Bipolar disorder. The complexities of managing a severe mood disorder along with the process of aging with your illness will have its challenges but with time, research, support and continued resilience you can overcome the physical, psychological and emotional trials that often come with aging and Bipolar disorder.        

Practical Strategies for Coping with Aging and Bipolar Disorder

Coping with aging and Bipolar disorder can be challenging. Below are some practical strategies for maintaining a balanced lifestyle while dealing with this new transition and managing your mood disorder.

Establish and Maintain Structure, Routine and Good Habits

• Sleep Hygiene: Aim for a consistent sleep schedule, wake-up and go to bed at the same time daily even on weekends as disturbances in sleep can trigger mood swings.

• Structured Daily Activities: Incorporate a daily routine of activities such as exercise, regular meals and social activities like groups or meeting with friends.

• Medication Management: Take your medication daily and/or as prescribed and discuss side effects or concerns with your healthcare provider as issues arise. 

Physical and Mental Health

• Nutrition: Limit processed foods and incorporate a balanced diet rich in vegetables, fruits and whole grains. Instead of take-out food consider cooking meals daily based on your budget.  

• Exercise: Engage in physical activities you enjoy like hiking, cardio workouts, daily walking or yoga. Exercising releases endorphins and dopamine, the feel good chemicals that can combat feelings of stress or depression. 

• Stress Management: Incorporate relaxation practices like medication, breathing exercises or grounding in the morning or before bedtime to release stress. 

• Mental Stimulation: Engage in activities that stimulate the brain like reading, puzzles or learning a new skill such as refinishing furniture or crocheting. 

Build a Strong Support System

• Connect with Others: Build and maintain relationships with family, friends and support groups who can support you during difficult times.

• Professional Support: Seek the help of professionals such as psychologists, counselors or psychiatrists who can address mood fluctuations and help you develop coping skills.

• Self-Advocacy: Communicate your needs to your healthcare team and support network. Openly share your experiences to find circles of support from like-minded individuals.  

More Strategies

• Address Age-Related Changes: Monitor potential age-related changes in your emotional and psychological cycle to address with your healthcare providers. 

• Manage Chronic Conditions: If you have any other chronic conditions such as diabetes or blood pressure concerns, work with your healthcare team to manage them effectively. 

• Stay Active and Engaged: Continue to do activities that bring you joy and fill your life with purpose. 

• Memory Aids: Use tools like calendars, to-do lists, daily planners, reminders and alarms to help keep track of medications and appointments. 

Final Thoughts

Aging with Bipolar disorder presents unique challenges, but with the right strategies, support, and self-awareness, women can navigate this journey with confidence. From understanding how symptoms change over time to adjusting treatment plans and nurturing relationships, the key is to remain proactive and practice self-compassion. When you grow and change so will your Bipolar disorder and how you manage your symptoms. Aging has never been an easy process with everyday, year or decade that passes so does the emotional and psychological needs of women. Remember Bipolar disorder is a lifelong  and complex condition. How you handle the challenges and pitfalls of this complicated mood disorder is up to you. Through psychoeducation and vigilant observation of your changing Bipolar cycle it's possible to maintain control of your journey to wellness especially during the aging process.   

If you or a loved one are facing aging with Bipolar disorder, it’s essential to seek out professional guidance, stay connected with supportive networks, and develop practical coping mechanisms. Remember every day is an opportunity to do something you’ve never done before, so today embrace the process of aging with Bipolar disorder and prioritize your mental health  and wellness every step of the way.

 “You treat men like disposable objects, like trash, you hurt them, men like me who want love and relationships with your destructive behaviours. You made up this stupid word ‘situationships’ to exempt you from being responsible for how your actions affect the other person. You hate men, you use them and abuse them and I’m sorry you were raped so much but maybe you should deal with your problems before you engage in another relationship, maybe you should try being a worthwhile person who deserves love…” 

Michael, which is not actually his name but for the sake of confidentiality it’s what I am going to call him, had so much more to say and he said it with a certain and violent anger as if he and I had been engaged in one of these situationships and he was the man I had hurt, used and abuse instead of meeting in January 2025 online for the first time  at least that's how it came across to me. I have been in a Cognitive Processing Therapy group for the last 10 weeks attempting to understand how my past trauma has affected my present life and interpersonal relationships. I was told in my intake last December 2024, that an unusual occurrence had happened in this intake where there were more men wanting to address their trauma than the organization had seen in many years. My psychotherapist realized because of the nature of my trauma, Gender-Based Violence, I may experience some discomfort with their presence. I was determined to join however not 100% comfortable with the idea but willing to explore it.

For the first 5 or 6 weeks I barely said anything, I just sat in my big red  chair, well mannered and well groomed, listening to the other group members share some of the most horrific traumas outside of my own that I had ever heard. I empathized with all of them but I kept quiet only speaking when asked to share my weekly emotions during check-in and my group take-away during check-out. I realized around session seven that I was not only afraid to share my trauma with the men in the group I was terrified of their judgement and rejection. 

Every week a member of the group would go over our homework worksheet where the three facilitators would help us understand our “Stuck Points” (the elements of the trauma that was keeping us in the trauma rather than moving forward and healing). Every week I would try to do some of the homework and I would fail, not because I didn’t find it relevant or useful but because I had avoided and covered up my pain and trauma so long it was like it was never even there like a picture you hang over a giant hole in your wall instead of fixing the wall, you know there is damage there but the pretty picture covers it so well you forget. I feel with my lack of engagement in the group perhaps Michael could only see the pretty picture I presented and not the giant empty and hollow hole of trauma that lived inside me. 

By week eight I made up my mind to share my homework and thus share my story with the group. I can remember the day of group, March 17, 2025 and what my stuck point was: “When there are too many men in a room with me, especially if they are intoxicated, I can’t control the situation and I will be attacked and raped because all men are dangerous and capable of rape.” When my group facilitator asked me why I felt this way, a watershed of emotional blockage came unstuck and I told the group everything. I was molested as a child, I was gang-raped at 14-years old by five boys in highschool, I was raped at 18-years old by my boyfiend and I was drugged and raped at 27-years old by a stranger I met at a club. This is the trauma I carry inside of me and the narrative that goes with it is: 

“All men are dangerous and even if you are attracted to them, the minute you lose control of the situation aka situationship run far, run fast, do something destructive to push them away because they will destroy you anyway so don’t give them your power ever again.”  

I didn’t realize I felt this way until week eight when I shared my trauma with the group. I believed these feelings were in the past and I could explain all my self-destructive behaviours related to men by placing the label of Mania or Psychosis in Bipolar disorder on it. The truth is however, as angry, hurt and embarrassed as I was over what Michael screamed in my face during group last week there is also a sense of release and self-discovery because for the first time since therapy started I had a breakthrough. I don’t agree with most of what he said or how he said it but I must honour the mirror he put up to my face. 

When I look at myself in that mirror I see a woman with decades of unaddressed trauma who avoids relationships because she is afraid and does not feel worthy of love because she is damaged. I see a woman who doesn’t feel safe anywhere, not even in her own home; I see a woman that sexualizes herself so men will find her worthwhile; lastly I see a little girl who got dealt a bad hand but has grown into a strong person who is trying to release the lifetime of pain she's been carrying in her mind, body and spirit. I don’t know where my trauma healing journey will lead me and I don’t know if my fellow group member is correct in saying stay away from men until you heal (kinder way of rephrasing). I do know everyday I fall a little more in-love with myself, everyday I feel a little stronger, everyday I feel a little more worthy and at peace with myself and everyday I feel closer to the ultimate goal of self-love and forgiveness. I may never heal to the point of being in a loving partnership, it may be me and all my journals for the rest of my life (I have no animals yet) either way I’m excited to find out.

If this self-reflection was as hard for you to read as it was for me to write, reach out, leave kind comments as its been a hell of a week, let’s connect, let’s have a conversation that takes us beyond the stigma of trauma to a place of healing, forgiveness and self-love.  

In this article I will examine why boundaries are essential to women with Bipolar disorder, explore signs of unhealthy friendships, and actionable strategies for setting and enforcing boundaries while maintaining meaningful relationships.

Understanding Boundaries: Why They’re Essential for Women with Bipolar Disorder

Defining Boundaries

Boundaries are the limits and guidelines that define acceptable behaviours and interactions in relationships and personal life, helping individuals feel safe, respected, and in control of their own well-being. Boundaries are also considered as the “invisible lines” that dictate what behaviours, thoughts, and actions are acceptable and unacceptable in a given situation or relationship. Types of boundaries include the following:

Physical boundaries: These relate to personal space, touch or physical needs. For example, you may find yourself in a situation where you are uncomfortable being hugged by your friend so it's important to communicate your physical boundaries to avoid invasion of your personal space. 

Emotional boundaries: These involve protecting your feelings, thoughts, and emotional needs, and separating your emotions from those of others. For instance, if you are developing a new friendship with someone but you worry about oversharing because they are very open with their thoughts and feelings, setting emotional boundaries is a way to maintain balance in the friendship while still developing trust. 

Intellectual boundaries: These relate to respecting your own beliefs, ideas, and opinions. For example, It is important to maintain your intellectual boundaries  in your friendships without allowing others to overshadow or diminish your beliefs, ideas and opinions with their own 

Time boundaries: These refer to the limits you set on how you spend your time, protecting your energy and ensuring you have enough time for what’s important, whether it’s work, personal life, hobbies, or self-care. When managing your mental health, sleep hygiene is very important so giving people a specific window to connect with you in the evenings can limit interruptions to self-care practice.  

Sexual boundaries: These involve respecting your own and other’s right to consent and communicate preferences around intimacy. When dealing with a friendship where there is a possibility of sexual boundaries being crossed it is important to address and clarify what your preferences around intimacy are within the relationship. 

Financial boundaries: These relate to setting limits on how much you spend or lend to others. Money can be a breaking point in any friendship when financial boundaries are not defined from the onset. You can feel disillusioned or taken advantage of if your friendship develops into a financial exchange rather than a mutually beneficial connection. 

Spiritual boundaries: These involve protecting your own beliefs and values. Maintaining spiritual boundaries can involve saying ‘no’ to a friend or walking away from a relationship that compromises your core belief or value system.   

The Impact of Poor Boundaries on Mental Health

Now that you have an understanding of what boundaries are and the different categories they exist in it’s important to examine the impact of poor boundaries on mental health. Increased stress, emotional burnout and mood instability can be the result of not setting and managing your boundaries in friendships. Because women with Bipolar disorder often exhibit people-pleasing behaviours in their friendships, stress, emotional and mood instability can increase due to their inability to say ‘no’ when they are feeling overwhelmed. Although setting boundaries is key to managing friendships these limits are considered poor boundaries when you allow them to be crossed without attaching a consequence.

There is the fear that when a boundary is crossed and you address the violation the friendship will end. This may be the case for some relationships depending on the boundary, how badly it's been violated and the resulting consequences but it is not true for every circumstance. When you set boundaries in a valued friendship this allows opportunities for open communication and understanding. Boundary-setting helps with mood regulation and emotional balance for women experiencing Bipolar disorder. We should not be afraid to say ‘no’ rather we should focus on the  outcome for our mental well-being when we don’t adhere to the boundaries we set for ourselves in friendships. All action or inactions come with consequences so it is up to you to decide if the relationship is important enough to compromise my mental health journey.    

Signs You Need to Set Boundaries in Your Friendships

Re-evaluating your friendships is always challenging. Deciding which relationships are healthy and beneficial for your journey to wellness and better mental health can be difficult but an important part of personal growth and self-care. Friendships go through ebbs and flows over the course of a lifetime. There is a saying that captures the nature of relationships: “Some people are in your life for a reason and others for a season.” 

If you are feeling any of the following in your friendships perhaps it's time to consider setting healthy boundaries that speak to your mental well-being.

Signs You Need to Set Boundaries

Feeling Resentful or Irritated: 

If you constantly feel resentful, irritated, or hurt by your friend’s actions, words or behaviours it's a sign that you need to set boundaries.

Feeling Overwhelmed or Emotionally Drained:

If you are constantly feeling overwhelmed or emotionally drained after interactions with a friend it is important to consider setting emotional boundaries.

Lack of Respect for Your Time, Feelings or Personal Space:

If your friend regularly disregards your feelings, time or personal space it's an indication that they are violating your intellectual, time and physical boundaries. 

Difficulty Saying No or Expressing Yourself:

If you are having trouble expressing your feelings, beliefs, values or saying “no” to a friend consider evaluating your feelings around spiritual boundaries in your relationship.

Over-Relying On You:

If your friend relies too heavily on you for emotional or financial support and you are feeling unappreciated or  de-valued, your emotional or financial boundaries need to be prioritized.

Gossip or Betrayal:

If your friend is constantly gossiping about other people or you have a healthy fear that they may betray you to others in the same way, it's important to set limitations to protect yourself and your personal information, consider setting intellectual or emotional boundaries.

Lack of Empathy:

If you have a friend that does not show empathy when you are sharing the challenges you face with your mental health, if they ignore or attempt to minimize your experiences perhaps it's time to set boundaries protecting your core beliefs and values. 

Jealousy and Possessiveness:

If you have a friend that is jealous of your time with others or possessive of your attention this often leads to a violation of your personal time and time you need for self-care. It is important to address this issue by setting healthy time boundaries.

Anxiety and Stress Provoking:

Some friends can provoke anxiety or stress in you and you may not be sure why. I call these “The Walk on Eggshell” friendships. Perhaps they are emotionally volatile, substance users or experience mood instability. Whatever the reason they can trigger mood instability in you and therefore it's time to re-evaluate your boundaries within this friendship.  

If you are experiencing any of the above in your friendships they are signs that you should consider establishing healthy boundaries or re-consider the current boundaries that you have set in your relationships. Setting boundaries will not be easy but they will benefit your mental wellness and the long-term health of your friendships by promoting open communication, empathy, understanding and mutual respect. 

How to Set Healthy Boundaries in Friendships

Setting boundaries within a friendship can be challenging, especially if the relationship has already established norms and expectations that new limitations go against. It is important to remember boundary-setting is for both parties to maintain the long-term growth and health of the relationship. Below are a few guidelines you can use when establishing healthy boundaries in your friendship. 

Communicating Boundaries Clearly and Kindly

• Use "I" statements: Expressing needs without guilt or blame. Starting a conversation with “I feel,” “I think,” or “I believe” can go a long way in opening the line of communication for setting clear and kind boundaries.

• Be direct yet compassionate: Balancing honesty with empathy. It is important to speak your truth in a direct and compassionate way. Using words like “Understand,” “Appreciate,” or "Realize" can help lay the groundwork for an open, direct and honest conversation about your need for boundaries.  

• Practice boundary-setting scripts to help you navigate difficult conversations. An example of a boundary-setting script can be “I appreciate that you are a night owl and would prefer to talk after 10pm, however I have trouble staying awake that late and often lose the thread of our conversations because I’m exhausted. I feel a better time for us to connect is after 7PM and before 10PM so we can both enjoy each other's company and get the rest we need.” 

Maintaining Boundaries Over Time

• Consistency is key: It is important to stay consistent when reinforcing your boundaries. Over time and in certain circumstances you may forget your boundary and its importance to your mental health. Writing your boundaries and their importance to you and the friendship might be helpful. Reviewing them regularly with your friends may also be beneficial for their respect and understanding.  

• Make Adjustments: Making adjustments to your boundaries as friendships evolve is essential. The friendships that you had in adolescence will evolve in adulthood and as you go through changes in your mental health journey the support you need and can give will change.   

•  Self-check-ins: It is important to check-in with yourself to ask are your boundaries still serving you? It's not uncommon for boundaries to change as they are not meant to remain unmoving. As you grow, so will your wants and needs in your friendships. By re-evaluating the benefit of the boundaries you are allowing yourself to be flexible in the relationships. 

•  Respect and honour your limits: Supportive friendships will always respect and honor your limits. These pillars of a relationship should be a continued indicator of whether or not your boundaries are being maintained.

• Therapy and Support Groups: Connecting with a therapist, councillor or joining a peer support group is a good way to help you define your boundaries in friendships and gain valuable tools on how to maintain them over time. 

Dealing with Pushback: How to Handle Resistance from Friends

Once you set your boundaries in a friendship there is no guarantee they will be followed to the exact letter. It takes time to establish long-lasting limitations and guidelines in a relationship as oftentimes your friend may not be used to you asserting yourself and the things you need within the friendship. On one hand, you should take pride in the fact that you voiced your wants and needs from your relationship but on the other there will be a feeling of guilt the minute you are required to enforce your boundaries. 

There may be push-back from your friends because boundaries can sometimes feel like a punishment. More likely they are in a space of mental transition from who you used to be in the relationship and who you are becoming with the new boundaries. There are three things to remember when implementing your boundaries:

• “No” is a complete sentence: It’s okay to say ‘no’ to the requests that cross your new and healthy boundary. Your friend may not like hearing the two-letter word but the more you use it to protect your boundaries the more you show that you value yourself as well as the health of the friendship. 

• Healthy Compromises vs. Overextending Yourself: It’s important when enforcing your new and healthy boundary that your friend may try to get around it. Ask yourself,  will making a healthy compromise de-value my boundary or am I overextending myself and therefore violating my own boundary? Sometimes in friendships making healthy compromises are necessary but if you believe your boundary is being crossed with the concession you may have to re-evaluate and re-establish your boundaries later on.  

• Overcoming Disappointing Others: Everyone fears disappointing others when establishing boundaries but it's important to remember that disappointment is a natural part of life. No one can please everyone 100% of the time so thinks about  maintaining your healthy boundaries so you do not  disappoint yourself or compromise your mental, emotion, physical or spiritual well-being  

The fact is once you set a boundary there is no guarantee it will be followed. You can examine the friendship, re-evaluate whether or not boundaries are necessary, set new and healthy boundaries following the advice set out in this article and you can enforce your boundaries changing the dynamic of the friendship. However, there is a possibility that your friend may respond with guilt-tripping, manipulation or dismissiveness. Recognizing when a friendship is no longer serving your mental health may be the next step in your boundary setting journey. Not all friendships are built to last and oftentimes boundary-setting can highlight the pitfalls in a relationship. 

So when is it time to re-assess or walk away from toxic relationships? The answer for me has always been when I’m sure I’m ready to let go and allow healthier relationships to take their place.  

Final Thoughts

Setting boundaries in your friendships can be hard, especially when there is already an established understanding of the norms and expectations you both have in the relationship. Boundary setting to some feels like a punishment or a negative limitation being introduced into a dynamic that previously seemed to work for both parties. However, the need for establishing healthy boundaries protects your mental health, energy, emotional stability and the longevity of the friendship. A healthy dynamic between friends honours your needs as well as allows you to manage Bipolar disorder symptoms like stress, emotional exhaustion, people-pleasing  and mood instability.  

So, when setting boundaries on your friendship journey, start small because one boundary at a time can lead to powerful changes. Remember every day is a new opportunity to do something you’ve never done before so today start creating boundaries that will serve your mental well-being and protect your peace.