Living With Bipolar Disorder: 15 Self-Help Tips For Managing Bipolar Disorder
Winston Churchill, Lord Byron, Virginia Woolf, Napoleon Bonaparte, Ernest Hemingway and Vincent van Gogh are only a few of the politicians, writers, and artists who, despite having bipolar disorder, have reach great success.
2.8% of U.S. adults have bipolar disorder according to a diagnostic interview data from National Comorbidity Survey Replication (NCS-R).
In this article you’re going to learn symptoms and diagnosis of bipolar disorder and how to live with it.
Ready? Let’s get started!
Bipolar disorder is a mood disorder caused by an abnormality of brain chemistry.
It has been shown that if there’s an imbalance in the levels of 1 or more neurotransmitters, an individual may develop symptoms of bipolar disorder.
Neurotransmitters are the chemicals responsible for controlling the brain’s functions, and include noradrenaline, serotonin and dopamine.
Bipolar disorder can also be linked to genetics. Family members of a person with bipolar disorder have an increased risk of developing it themselves.
An individual with bipolar disorder may experience periods of an extremely elevated or irritable mood (manic episodes) as well as episodes of depression.
The depressed phase can be merely gloomy or it can be profoundly despairing.
The manic phase can be an enthusiastic glow or it can be transcendental fervor or delirious psychosis.
Bipolar disorder is often called the chameleon of psychiatric disorders because its symptoms change from one patient to the next and from one episode to the next in the same patient.
The disorder tends to hibernate. Symptoms may spontaneoudly disappear for years. This adds confusion to the diagnostician and makes the person with bipolar disorder wrongly assume he doesn’t need treatment.
Symptoms of Bipolar Disorder
Bipolar disorder is a mood disorder whose main symptom is an abnormality of mood.
Before understanding the illness, it’s important to understand the word mood. Our mood is a set of feelings that expresses our sense of emotional comfort or discomfort.
When individuals are in a good mood, they are optimistic and confident. They feel energetic and have a sense of physical well-being. When someone is in a good mood, the world seems a wonderful place to live in.
When individuals are in a low mood, the opposite set of feelings takes over. They feel sad, but also there may be a sense of emptiness and loss. It is difficult to think about the future without feeling pessimistic or even intimidated by it. Energy is low and it’s difficult to be sociable.
It’s normal for individuals to experience mood changes especially when facing sudden changes such as moving to a new community, achieving a success, getting married, giving birth to a child, etc. Such changes of mood can be extreme, but we wouldn’t call any of these moods “abnormal”.
The ups and downs of an individual with bipolar disorder are far outside the range of normal.
Abnormal mood states of bipolar disorder are accompanied by changes in thoughts and bodily functions that further distinguish them from normal mood.
But the symptoms of bipolar disorder include more than abnormal moods. The symptoms also spill over to other areas of functioning including:
- Changes in appetite,
- Impaired concentration and memory, and
- Problems with motivation and energy level.
Persons afflicted with bipolar disorder experience periods of sever depression as well as period of mania – a mood state that is the opposite of depression to some extent)
While not many individuals with bipolar disorder experience a full-blown manic episode, mania is the most unmistakable of the abnormal mood states which makes it a good place to start when diagnosing bipolar disorder.
Symptoms of mania
|Mood symptoms||Bodily symptoms|
|* Elated, euphoric mood|
* Irritable mood
|* Increased energy level|
* Decreased need for sleep
* Erratic appetite
* Increased libido
|Cognitive (thinking) symptoms||Symptoms of psychosis|
|* Feelings of heightened concentration|
* Accelerated thinking (“racing thoughts”)
|* Grandiose delusions|
Stages of Mania
There are three stages of mania that an individual with bipolar disorder may experience.
1. Hypomania (stage I).
During the early stages of manic, individuals with bipolar disorder report thinking more clearly and more rationally than usual. Such mental state is not likely to make the individual suspect that something is wrong.
Mania usually starts gradually and then becomes more extreme and more unpleasant, sometimes taking weeks to develop fully.
In the early stages of mania, the mood states of the individual with bipolar disorder, gradually moves “upward”, and the person finds himself filled with a sense of well-being and confidence that eventually evolves into euphoria.
The feelings of overconfidence that characterize mania can lead to several behavioral patterns, such as spending sprees, sexual promiscuity, and overuse of alcohol and other intoxicating substances.
Other symptoms include:
- Increased rate of speech and increased physical activity,
- Irritability when the individual’s demands are not instantly satisfied,
- Increased interest in religion.
2. Acute Mania (stage II).
Eventually the thinking process increasingly accelerates until it becomes “racing”. This is what psychiatrists call flight of ideas – where thoughts ran with lightning-like speed from one subject to another.
This jumping from one thought to another becomes even more unpleasant as the episode develops.
As the episode develops, the feelings of grandiosity increase. Fears disappear altogether, and reckless behaviors take over. This is one of the points at which the manic person can begin to lose touch with reality. He might become convinced that he is the president or prime minister or a rock star.
Other symptoms include:
- Pressure of speech and activity increased still further,
- The irritability experiences surig the first stage progresses to open hostility and anger,
- Racing thoughts progress to increasing disorganization,
- Preoccupations became more intense,
- Grandiose becomes delusions.
3. Delirious Mania (stage III).
As the thinking patterns spin even faster, consciousness becomes clouded, hallucinations may develop, and delusions can increase even further.
Other symptoms include:
- A desperate, panic stricken, hopeless state, accompanied by frenzied and frequently even more bizarre activity,
- Thought became incoherent.
During the first stage of mania, individuals with bipolar disorder experience a state of mild euphoria and hyperactivity. The individual experiences increased energy level, rapid thinking and speaking and sometimes a bit of irritability.
Because individuals in the hypomaniac stage do not experience the severe mental disorganization of mania, they’re unlikely to seek treatment and might stop taking their medication to recapture the wonderful feelings that accompany hypomania.
However, hypomania can nevertheless have unpleasant consequences can wreak havoc on individuals’ lives.
* Feelings of overconfidence can lead to foolish investments in real estate or the stock market, and risky business ventures.
* Increased sexual feelings can lead to extramarital affairs or promiscuity.
* The irritability of hypomania can lead to arguments and disagreements with family, friends and colleagues that can sour relationships, sometimes irreparably.
The depression of bipolar disorder is a more familiar set of feelings than mania. Everyone, whether suffering from bipolar disorder or not, has gone through periods of depressed mood.
At the same time, the depression of bipolar disorder is a very different experience from “normal” depression.
The Symptoms of depression
|Mood symptoms||Bodily symptoms|
|* Depressed mood|
* Dysphoric mood (depression and mania at the same time)
* Diurnal variation of mood (early-morning depression, mood improving as the day goes on)
* Guilty feelings
* Loss of ability to feel pleasure (anhedonia)
* Social withdrawal
* Suicidal thoughts
|* Sleep disturbance (insomnia, hypersomnia)|
* Appetite disturbance (weight loss, weight gain)
* Loss of interest in sex
|Cognitive (thinking) symptoms||Symptoms of psychosis|
|* Poor concentration|
* Poor memory
* Slowed thinking
|* Delusional thinking|
* Catatonic states
Individuals who do not suffer from a mood disorder, experience temporary depressed mood after romatic disappointments, the loss of a job, the loss of a loved one, a period of homesickness, etc.
They’re depressed but they retain the normal reactivity of mood – the ability to dispel the feelings of disappointment or bereavement.
Mourners can relax after the funeral service and reminisce about good memories of the person who has died. They can still enjoy catching up with family and friends.
With individuals suffering from bipolar disorder, the depressive mood is constricted and not reactive.
The mood of the bipolar disorder depression is a relentless, pervasive gloom that continues from one day to the next and from which the afflicted person cannot rouse himself.
Ruminations on themes of guilt, shame, and regret are especially characteristic of depression in individuals with bipolar disorder. Feelings of inadequacy and worthlessness are similarly significant.
Another typical symptom of depression in individuals with bipolar disorder is the loss of interest in usually pleasurable activities and unablity to derive any pleasure from these activities – also called anhedonia.
Just as mania infuses the individual with bipolar disorder with feelings of inexpressible joy, the depressive mood of the disorder brings indescribable anguish.
Hallucinations occur in severe depression, but not as frequently as inmania.
3. Mixed States
Mixed state, or mixed affective state, is another type of abnormal mood can be seen in bipolar disorder. It’s the combination of both the frenzied intensity of mania and the horrors of deep depression.
Symptoms of depression and mania seem to exist almost simultaneously in the individual. The accelerated thinking and hyperactivity, typical of the manic state, are present, but instead of a euphoric mood, the individual experiences a depressed, despairing, desperate mood.
Just as hypomania can be difficult to distinguish from an elevated but normal mood, milder mixed states can be difficult to recognize. Individuals suffering from bipolar disorder might describe having mild mixed states as “anxiety”, although it is not the fearful fretfulness of ordinary anxiety. It’s more total despair made even worse by terrible agitation.
The mixed state can be very dangerous. This negative energy puts the individual at high risk for hurting themselves with suicidal behaviors or a variety of self-destructive behaviors that are not immediately life-threatening, such as cutting themselves, in an attempt to shift the inner pain to “the outside”.
Another type of mood “mixture” called ultra-rapid cycling, occurs when there is rapid alternation between mania and depression, rather than a true mixture of the two states simultaneously.
The Diagnosis of Bipolar Disorder
Diagnostic classification has two purposes: make predictions about the course of the disorder, and help the clinician in selecting the treatment most likely to be effective.
Classification systems are mostly derived from studying different combinations of symptoms of groups of patients.
1. Bipolar I
Bipolar I is the designation for the classic variety of bipolar disorder. It is characterized by full-blown manic attacks and deep, paralyzing depressions.
The pattern of abnormal mood episodes seems to vary widely. During the course of the illness, its symptoms come and go, which makes it difficult to diagnose and treat.
Features of Bipolar I
|* Fully developed manic episodes|
* Fully developed depressive episodes
|* Untreated episodes average six months|
* Hallucinations and delusions are frequently seen
* Three-phased episodes (depression, mania, depression)
* Relapses more frequent as patient ages
2. Bipolar II
Bipolar II is characterized by fully developed depressive episodes and episodes of hypomania.
Individuals suffering from bipolar II don’t have history of fully developed manic episodes. They would have severe depressions, but their “highs” never develops into mania.
Although individuals suffering from bipolar II don’t experience full blown manic episodes, this doesn’t mean that doesn’t make it a milder form of bipolar I.
In fact, individuals suffering from bipolar II tend to be more symptomatic and long periods of depression tend to be even more debilitating than the dramatic, but shorter-lived, depredssive episodes of bipolar I.
Features of Bipolar II
|* Hypomanic episodes|
* Fully developed depressive episodes
|* Increased sleep and appetite during depressions|
* More chronic depressions
* Bipolar II history in family members
* Possible increased risk for alcoholism
3. Cyclothymic Disorder
Cyclothymic disorder is characterized by frequent short periods (days to weeks) of hypomania and of depressive symptoms, separated by short periods of fairly normal mood.
Individuals with cyclothymic disorder don’t experience fully developed depressive episodes or fully developed manic episodes. They seem to constantly oscillate between the two opposite poles of mood.
Because of the mild, but frequent ups and downs of mood, cyclothymia can be mistaken for a personality problem rather than a disorder caused by an abnormality of brain chemistry.
Features of cyclothymic disorder
|* Frequent alternation between mild depression and mild hypomania * Short, irregular cycles (days)|
* Short periods of normal mood
|* Patients often wake up with mood changes|
* Frequently mistaken for problem with “personality”
* Sometimes develops into bipolar I or II
4. Bipolar Spectrum Disorders
Some individuals seem to have symptoms of mania or hypomania that are too few in number or too short in duration to meet the diagnostic criteria for bipolar I or II or cyclothymia.
For this group of individuals, a fourth category exists called “bipolar disorder not elsewhere classified” (also, simply, “bipolar NEC”).
Individuals suffering from bipolar NEC have one of the “soft” bipolar disorders with a baseline mood that is a bit “higher” than that of most people. While they have high energy level and are confident and socialble, they tend to become irritated easily and can be impulsive, even reckless at times.
They usually have a family history of bipolar disorder and suffer from recurrent depressions.
Antidepressant medication alone can make them more irritable and miserable or provoke a manic or hypomanic episode, but mood stabilizers can be very helpful.
Features of bipolar NEC
* Family history of bipolar disorder
* Habitual short sleeper—less than six hours per day
* Cheerful, optimistic personality style
* Extroverted and sociable
* Tendency to become irritable easily
* Recurrent depressions
Schizoaffective disorder is an illness with features both of mood disorders (depression, hypomania, or mania) and of a very different psychiatric illness: schizophrenia (hallucinations, delusions, and other bizarre mental experiences typical of schizophrenia).
Although many individuals with bipolar disorder develop delusions (false beliefs and ideas) or hallucinations (false sensory perceptions such as the hearing of voices), in the mood disorders, these symptoms arise out of the mood state.
For example, an individual in a severe depression might have the delusional belief that he has a terrible illness like AIDS or cancer.
Individuals suffering from schizophrenia, on the other hand, have bizarre delusions and hallucinations that don’t usually seem to bear any relation to a change in mood.
More importantly, Individuals suffering from schizophrenia do not experience episodes of sustained abnormal changes in mood.
When an individual suffering from bipolar disorder has bizarre delusions or hallucinations during times when they do not seem to be in an episode of abnormal mood, the diagnosis of schizoaffective disorder is often made.
Treatment options for bipolar disorder
Most individuals suffering from bipolar disorder can be treated using a combination of different treatments.
* Medicine to prevent episodes of mania and depression – these are known as mood stabilizers (Lithium, anticonvulsant medicines, and antipsychotic medicines) taken on a long-term basis
* Medicine to treat the main symptoms of depression and mania when they happen.
* Psychological treatment – such as talking therapies to help you deal with depression and improve relationships.
* Lifestyle advice – such as exercising regularly, planning activities you enjoy, and advice on improving your diet and getting more sleep.
Living With Bipolar Disorder
Although medical treatments such as medicines and psychological treatment are the primary treatment of bipolar disorder, self-help techniques are also important, perhaps indispensable to improve your life quality.
Even when someone is responding well to mood stabilizers, it’s still possible that they might find themselves edging toward hypomania or even full-blown mania. The relapse might appear with or without obvious triggers.
The following are some ways to help you reduce the chances of a relapse:
#1. Be Prepared
Protect yourself from real crises by recognizing specific triggering events or patterns that might increase the likelihood of mania. Do your best to avoid these triggers, or learn how to manage them better if they can’t be avoided without a major impact on your life.
#2. Slow Down
There are sometimes challenges that can make you rush, such as meeting a deadline at work, cooking Thanksgiving dinner for your entire family, etc. These situations can’t be avoided. However, there are a lot of things that you can do to make your life more peaceful and less likely to be interrupted by manic episodes:
Avoid highly stressful jobs – Jobs that involve a lot of last-minute deadlines or waiting on many customers, or less-than-enlightened boss or fellow employee, might not be right for you.
If you have a disability due to bipolar disorder, you may be entitled to certain on-the-job considerations thanks to the Americans with Disabilities Act.
Avoid highly stressful situations – Plan your day to avoid unnecessary rushing. Avoid putting things off until last minute. Don’t take on unnecessary work or responsibilities that will burden you and ssk for help when you appropriate.
Take short breaks whenever possible – Pause at times to look around you. Get some fresh air. Meditate. Listen to some music.
#3. Pay Attention to the Calendar
Some dates or events might trigger manic episodes. You need to be aware of mania patterns especially when it’s triggered by the following:
* Cycles – This is when your history of manic or depressive episodes tends to run in cycles. For example, if your mania tends to follow depression, you need to be prepared for the possibility of mania or hypomania if you have recently been feeling down.
* Seasons – This is when seasonal changes cause dramatic mood swings for you. Avoid high-energy behavior during such times.
* Anniversaries – Memories of events, especially ones associates with a loss of some kind such as divorce, death of a loved one, etc, can contribute to an episode.
* Forthcoming events – This could be something stressful (such as a court date) or even a potentially positive event (such as marriage). It’s important to discuss in advance with your therapist how to deal with significant changes and events.
#4. Warning Signals
Becoming mindful of your mania symptoms can help you manage mania better. Make a list of changes that you suspect precede your mania episode. These could be changes in your thinking patterns, feelings, the way you act, etc.
Respond right away by slowing down and getting help from your therapist or doctor.
The following are some marked changes that might indicate a potential manic episode:
- Speech patterns: talking more rapidly than normal, voice louder than usual, feeling compelled to send e-mails, or talk on the phone so you can keep communicating nonstop.
- Eating and sleeping: eating and/or sleeping patternsdramatically changing.
- Busy without productivity: always active, yetaccomplishing little, taking on some tasks that have no purpose.
- Irritability: being easily irritated more than usual, getting annoyed more than usual by small things.
- Lavishness: suddenly spending more money, giving moregifts, and/or taking more trips, suddenly living beyond your means.
Other people in your life (coworkers, friends, or family) can give you feedback when they notice that you seem to be edging toward an episode. If they comment that you seem much more agitated or ask you to slow down, then perhaps you should get some extra help.
#5. Protect Your Assets
There many things you can do to minimize damage to your finances, property, or other assets should you have a manic episode.
Consult with an attorney about protecting your assets through co-signature of a spouse – or even a neutral third party – before spending, selling, or giving away money or assets that exceed a predetermined amount.
Consider consulting with an attorney to set up a system that provides you with an allowance – a predetermined amount of cash per week or month or year.
Dealing with Depression
Treating a depressive episode before it becomes incapacitating is easier and more ideal than treating it when it hits in full-swing.
However, spotting an oncoming depressive episode is more difficult than anticipating a manic one. This is why it is important to spend time studying how bipolar disorder affects you, in particular to determine if you have a specific pattern of depression warning signs.
#6. Distinguish Between Sadness, Mild Depression, and Chronic Depression
It is important to distinguish between serious chronic depression and mere sadness.
Occasional sadness is part of the balance of a life and they don’t keep people from functioning in other ways. It does not cause you to lose all interest in people and activities, or to withdraw from society. It does not wreak havoc on your eating and sleeping habits. Most important of all, it does not make you suicidal.
If you have bipolar disorder and feel sad for a day or so, you may not be showing a symptom of a disorder. However, if you are not sure, check with your doctor or therapist.
Mild and Chronic Depression
Sometimes minor or mild depression can follow specific events such as a loss of a loved one, a divorce, a loss of a job, etc. Mild depression allows people to function, but half-heartedly.
Mild depression should be treated if it affects a person’s quality of life. Lifestyle changes, therapy, and some medications can relieve symptoms and prevent the condition from getting worse and further affecting the person’s life.
Major, chronic depression goes far beyond sadness. Sufferers might find themselves crying uncontrollably, without an obvious cause. Joy, motivation, and a reason for living seem to be sucked out of them.
“Major depression is not something you can snap out of by remembering an upbeat saying or forcing yourself to smile. It requires medical intervention.”
Antidepressants are not an appropriate treatment if you have bipolar disorder. They can make things much worse by sending you into full-blown mania. This is one more reason it is so important to be under a doctor’s care for bipolar disorder.
#7. Stay Active and Eat well
A healthy diet, combined with exercise can help reduce symptoms of bipolar disorder, particularly the despressive symptoms.
It can also help limit weight gain, which is a common side effect of medical treatments for bipolar disorder.
Running, for example, has been reported to ease the symptoms of depression.
Many people benefit from taking up meditation, yoga or other relaxation techniques. Take charge and fill your time with healthy habits.
#8. Break the Cycle of Self-Defeating Thoughts
When negative thoughts become dominant, you increase your chances of having depression. Breaking the cycle of negative thoughts and beliefs can increase your resilience and your ability to cope with stress.
Cognitive behavioral or other therapy may help you with this.
Spirituality has different meanings. It can refer to a religious belief, or an attitude— a conviction or belief that you have a definite reason for living. Some people feel most spiritual while meditating, or enjoying nature.
Having a spiritual orientation is proven to help you cope with stress and give you the strength to help you deal with everyday challenges.
#10. Dealing with Loss
Experiencing a major loss, such as that of a loved one through death or divorce, or loss of a job can increase the risk of depression and sometimes even mania.
When dealing with a major loss, seek professional support to help you consider whether a different counseling, therapy, or medication would be appropriate.
Loss is a part of life. Make an effort to use any type of personal philosophy or spiritual foundation that you built up during your recovery to cope with crises as they come along.
#11. Keep It Organized and Clean
A cluttered environment will add to your stress and make it harder for you to relax. No one wants to spend hours digging through a mess just to locate something they need or coming home to a depressing mess.
Living in a mess reinforces notions of unworthiness and prevent you from relaxing in your own home or getting the job done in your office.
#12. Write to Alleviate Feelings of Depression
Whether it is simply to vent or to create something of interest to other people, writing your unhappy thoughts down can alleviate feelings of depression.
This can be a journal, a poem, or novel. The insights you discover while writing, may give you a better perspective and sense of satisfaction. It doesn’t have to be publishable material, although the first Harry Potter novel was written with the author in the midst of a depression.
#13. Talk About It
Individuals suffering from bipolar disease might not find it easy to talk about their condition to family members and friends.
This is why many organizations run self-help groups that can help people feel less alone and provide them with helpful ideas to cope with their disorder.
Some useful charities, support groups and associations include:
#14. Avoid drugs and alcohol
Some people suffering from bipolar disorder use alcohol or drugs in an attempt to ease their distress.
However, alcohol and drugs are well-known for their harmful physical and social effects, and can not substitute treatment and good healthcare.
#15. Dealing with suicidal feelings
Suicidal thoughts are a common depressive symptom of bipolar disorder.
Studies show that the risk of suicide for people with bipolar disorder is 15 to 20 times greater than the general population.
If you’re having suicidal thoughts, go to your nearest A&E department as soon as possible.
You can also call 911 and explain that you are feeling dangerouslydepressed.
Unlike other diseases that afflict humankind, bipolar disorder does not have a beginning, a middle and an end.
The symptoms of the disorder can develop in an individual, and then, without any treatment, the symptoms may go away for years at a time.
This is why it’s difficult for patients and their families to understand that the symptoms can go into remission after treatment, or even spontaneously.
No matter how well the symptoms are treated, the disorder does not end but instead seems merely to hibernate and symptoms can come back at any time.
Effective medication conbined with psychological treatment and self-care practices, individuals with bipolar disorders can lead a rich, fulfilling life.
Wondering what to read next?
- How to Treat Your Anxiety Using Cognitive Behavioral Therapy (CBT)?
- How to Treat Depression Using Cognitive Behavioral Therapy (CBT)?
- Self-Loathing: How to Stop Self-Hatred and Start Loving Yourself?
- Overcome Social Anxiety: How to Defeat Social Anxiety and Create Confidence?
- Raising low self-esteem: 18 Ways to Build High Self-Esteem
- How Indoor Plants Make You Feel Better? (11 Healing Powers of Plants)
Like This Post? Please Consider Sharing It On Facebook, Twitter, and Pinterest!
- Portions of this article were adapted from the book Bipolar Disorder: A Guide for Patients and Families, © 1999 by Francis Mark Mondimore. All rights reserved.
- Portions of this article were adapted from the book The Everything Health Guide to Adult Bipolar Disorder, © 2010 by Dean A. Haycock. All rights reserved.