Help Myself?! Is that legal??!

Although bipolar disorder is a lifelong, recurrent mood disorder, we’re far from powerless when it comes to controlling our own least favorite bipolar symptoms. Beyond gobbling our prescribed medications and accepting psychiatry or therapy, there are a whole bunch of simple lifestyle changes we can make to help ourselves. And the great thing about self-help techniques is that WE are the ones in the driving seat. (And since most of us thoroughly, and wrongly, enjoy aspects of our mania symptoms, that fortuitously means we only have to help ourselves as much as we want to.)

The article below suggests some simple lifestyle changes that can help us manage our moods and stay balanced. These articles do not provide a miracle cure for bipolar disorder. Nor do they clump everybody together, suggesting everyone with bipolar disorder has the same basic DNA, uniform personality or emotional make-up. We all have our own individual tolerances for things like stress, so it’s important to remember that what works for one person may make zero, or negligible, impact on another.

Most of us enjoy the ups to a point. We just want rid of the downs. A recent survey based on Stephen Fry’s earlier survey in his illuminating documentary Secret Life Of The Manic Depressive confirmed 8 out of 10 people with bipolar said they would still choose NOT to press a button that would eradicate them of their mood disorder.

This article is adapted from an article on Facebook, Chrissie’s Bipolar. However, injected with my own skepticism, it occasionally wanders so far from Chrissie’s points, you would be wise to download Chrissie’s original article (link sub article). Remember, what works for me, or the fragrant Chrissie, may not work so well for you. So arm yourself with as much information as you can realistically endure. There are some points Chrissie makes that I’ve deleted, just because I didn’t personally agree with them. There are other points I’ve left in because I partly agree with them, but not to the same extent Chrissie does. Like most of you, I enjoy my manic periods. (For ease of digestion, I’ve tried to keep my own pithy thoughts and observations in brackets.)

For some (all) of us, living with bipolar disorder post-diagnosis requires adjustments. Like recovering addicts or diabetics, it’s important we make choices for ourselves that keep us healthy. Making these healthy choices will help us to keep our symptoms under control, minimize mood swings, and empower us to take control of our lives.

Usually, diagnosis starts with psychiatry and medication, but there are plenty of daily decisions we can make to help control unwanted bipolar symptoms, whether they improve or worsen; and help us predict how quickly our moods typically shift.

Chrissie’s Key Recovery Concepts

• Hope. With good symptom management, it is possible (probable) to experience long periods of wellness between bipolar extremes. Believing that you can cope with your mood disorder is both accurate and essential to recovery. (We can hope that the Hong Kong Observatory got the fine 9-day forecast correct, but the chances are a great deal of unfounded optimism went into predicting anything beyond Day 3. But we’ll still enjoy Day 3 a lot more if we wrongly assume Days 4-9 will also be fine.)
• Perspective. Depression and manic-depression often (always) follow cyclical patterns. Although we go through some painful times when it’s hard (impossible) to believe that things will get better, it is important not to give up hope. (If we abandon all hope that the sun will ever shine again, it probably won’t, just to spite us.)
• Personal Responsibility. It’s up to us to take action to keep our moods stabilized. This includes us asking for help from others when we need it, taking our medication as prescribed, and keeping appointments with our health care providers. (If we routinely sleep through the day, how can we possibly expect to receive the necessary sun to photosynthesize effectively?)
• Self-Advocacy. Become an effective advocate for ourselves so we can get the services and treatment we need, and make the life we want. (Rain-dancing works. But only if you’re really committed to it, and know all of the moves.)
• Education. Learn all we can about our illness so we can make informed decisions about all aspects of our lives and treatment. (Ignorance is next to Godliness. It’s perseverance in education, not luck, that inspired the Sistans to build the first windmills.)
• Support. Working toward wellness is up to us. However, support from others is essential to maintaining our stability and enhancing the quality of our lives. (Don’t think you can change the weather on your own. You need the support of your friends, the sun and the wind, if you’re ever going to get anywhere on that score.)

Sources: Depression and Bipolar Support Alliance, Chrissie’s Bipolar Express, Stephen Fry’s weather analogy and my disturbed mind.

Chrissie’s Bipolar Support Tips

Get involved in your treatment

• Be full and active participants in our own treatment. It’s important to learn everything we can about our disorder through self research and ask careful questions to our psychiatrists and doctors. (When your shrink asks you how your week was – a week in which you told your boss he was a ****, deliberately burned down your school, mutilated your own body with 109 DIY tattoos and drank half a bottle of Toilet Duck – don’t just reply, “Fine.”)
• Become an expert on your own illness (or, at least, a lapsed enthusiast). Study your symptoms, so you can recognize them, and research your available treatment options. The more informed you are, the better prepared you’ll be to deal with symptoms and make good choices for yourself. (Or if your memory’s anything like mine, you’ll open and close your mouth, goldfish-style.)
• Using what you’ve learned (assuming you’re not a goldfish), collaborate with your doctor or therapist in the treatment planning process. Don’t be afraid to voice your opinions or questions. The most beneficial relationships between patient and healthcare provider work as a partnership.
• You may find it helpful to draw up a treatment contract outlining the goals you and your provider have agreed upon. (Steady on there, Chrissie! I think turning up three weeks late to our appointment is an achievement of sorts! One small step for man, one giant leap for a bipolar person!)

Other tips for bipolar disorder treatment:

• Be patient. Don’t expect an immediate and total cure. Have patience with the treatment process. It can take time to find the right program that works for you.
• Communicate with your treatment provider. Your treatment program will change over time, so keep in close contact with your doctor or therapist. Talk to your provider if your condition or needs change and be honest about your symptoms and any medication side effects.
• Take your medication as instructed. If you’re taking medication, follow all instructions and take it faithfully. Don’t skip or change your dose without first talking with your doctor.
• Get therapy. (If you’re anything like me, you’ll need it.) While meds may be able to manage some of the symptoms of bipolar disorder, therapy teaches you skills you can use in all areas of your life. (Like how to part with large sums of cash. Although this is a life skill we don’t usually need much help with.) Therapy can help you learn how to deal with your disorder, cope with problems, regulate your mood, change the way you think, and improve your relationships. (And if you can’t afford therapy, attend HK’s first English-speaking bipolar support group and benefit from free peer mentoring from people who are in therapy.)

Monitor your moods

In order to stay well, it’s important we are closely attuned to our moods. By the time the full blown psychotic symptoms of mania or depression appear, it’s too late to intercept a mood swing and we live with the consequences. Watch for subtle changes in your mood, sleeping patterns, energy level, and thoughts. If you catch the shift early and act swiftly, might be able to prevent a minor mood change from turning into a full-blown episode of mania or depression.

Know your triggers and early warning signs

It’s helps if we try to recognize the early warning signs of an oncoming manic or depressive episode. Make a mental list of early symptoms that preceded your previous mood episodes. Also, try to identify the triggers, or external influences, that have led to chaos and destruction in the past.

Common triggers include:

• Stress
• financial difficulties
• arguments (you started it!) with your loved ones
• problems at school or work
• seasonal changes (when all else fails, always be sure to blame the bloody weather!)
• lack of sleep (from insomnia or chronic sleepwalking – see Cuckoo Sleep-Disorders)

Chrissie’s Source: BHI Clinicians Guidebook: Bipolar Spectrum Disorders, Chrissie’s Bipolar Express

Chrissie’s wellness toolbox 

If we do spot any warning signs of mania or depression, it’s important we act swiftly. In such times, it’s helpful to have a wellness toolbox to draw from. A wellness toolbox consists of coping skills and activities you can do to maintain a stable mood or to get better when you’re feeling “off.”

The coping techniques that work best will be unique to your situation, symptoms, and preferences. It takes experimentation and time to find a winning strategy. However, many people with bipolar disorder  have found the following tools to be helpful in reducing symptoms and maintaining wellness:

• try to talk to a supportive person
• get a full eight hours of sleep (ha!)
• cut back on your activities (depends on what those activities are, I guess, and also on your energy levels)
• attend a support group
• call your doctor or therapist (but try not to become dependent on them for decisions like, “I’ve got a very important meeting today – I need a look that screams powerful and independent! Should I wear the dark gray suit, or the light gray suit?”)
• do something fun (we are known for our creativity so use yours! Don’t waste your time trying to find the mysterious box people talk of thinking outside of – you won’t find it.)
• take time for yourself to relax and unwind
• write in your diary or journal (I’m assuming you gave those up when you were 9)
• exercise (or at least sit outside crying so you can boost essential Vitamin D)
• ask for help from loved ones (but don’t expect to always get it immediately)
• cut back on sugar, alcohol (avoid booze altogether if possible) and caffeine
• increase your exposure to light
• increase or decrease the stimulation in your environment
• Create an emergency action plan

Chrissy then writes: Despite your best efforts, there may be times when you experience a relapse into full-blown mania or severe depression. Having a crisis plan in place allows you to maintain some degree of responsibility for your own treatment.

A plan of action typically includes:

• A list of emergency contacts (your doctor, therapist, close family members)
• A list of all medications you are taking, including dosage information
• Information about any other health problems you have
• Symptoms that indicate you need others to take responsibility for your care
• Treatment preferences: who you want to care for you; what treatments and medications do and do not work, who is authorized to make decisions on your behalf