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How can I help myself if I have bipolar disorder?

Where can I go for help?

How can I best take care of myself?

What can people with bipolar disorder expect from treatment?.

How can I tell my (friends, family, coworkers)? Should I?

Coping hints from readers and participants

Can carers get support?

Can I get somebody to look at legal or representation  issues related to my illness?

What if I, or someone I know, is in crisis?

 

How can I help myself if I have bipolar disorder?

It may be very hard to take that first step to help yourself. It may take time, but you can get better with treatment.

To help yourself:

  • Talk to your doctor about treatment options and progress
  • Keep a regular routine, such as eating meals at the same time every day and going to sleep at the same time every night
  • Try to get enough sleep
  • Stay on your medication
  • Learn about warning signs signaling a shift into depression or mania
  • Expect your symptoms to improve gradually, not immediately.

Where can I go for help?

If you are unsure where to go for help, ask your family doctor. Others who can help are listed below.

  • Mental health specialists, such as psychiatrists, psychologists, social workers, or mental health counselors
  • Health maintenance organizations
  • Community mental health centers
  • Hospital psychiatry departments and outpatient clinics
  • Mental health programs at universities or medical schools
  • State hospital outpatient clinics
  • Family services, social agencies, or clergy
  • Peer support groups
  • Private clinics and facilities
  • Employee assistance programs
  • Local medical and/or psychiatric societies.

You can also check the phone book under "mental health," "health," "social services," "hotlines," or "physicians" for phone numbers and addresses. An emergency room doctor can also provide temporary help and can tell you where and how to get further help.

 

How can I best take care of myself?

The most important GENERAL guideline for self-care is to establish a sound therapeutic relationship with one or more doctors: a  psychiatrist or psychopharmacologist for drug therapy, and, if you prefer not to use this person for more traditional forms of therapy but want a professional to talk to, a psychologist, licensed  clinical social worker, or similar licensed counselor.

Bipolar Disorder is a lifelong, chronic medical condition.  It cannot  be cured, but it can in almost all cases be managed to at least some extent.

You can have the finest medical team in the world working on "your case," but if you don't first accept that you *have* a chronic medical condition and take responsibility for doing what it takes to manage it, you're wasting time and money.  Obviously, if you're in the throes of an incapacitating depression or mania, this can be hard if not impossible to do, and someone else may (temporarily) need to make these sorts of decisions for you; also, people respond in different ways to various kinds of medication and therapy.

But in general, remember: you're the boss, you're the one calling the shots and deciding which resources to utilize (or not.)

The key thing to remember is that there's a LOT of help out there if you want to get things under control--but you have to decide to seek it  out, and you have to decide that you will commit to a healthy course of action.

 

  • Work with your doctors, not against them--and insist that they work with you.

It's vitally important that you be able to communicate with the doctors and health-care professionals that you choose to use as resources. 

If you're not comfortable talking with someone, or if they don't listen to you, look for another therapeutic relationship.  Period.  It's *vital* that you and your doctor(s) listen to and respect each other.

 

  • Develop a survival mentality.

A few of us who start medical treatment for Bipolar Disorder are pretty much asymptomatic afterwards--in other words, we never, ever have another
flare-up.  A few of us don't seem to respond satisfactorily to ANYTHING we try.  Almost all of us fall somewhere in-between-- we get some measure of
control over our bipolar disorder, but we still experiences ups and downs, and still have tough times that must be endured.

A "survival mentality" means, first of all, deciding that there's life after diagnosis.  Getting the news that you have a medical condition that you'll be dealing with (in all probability) for the rest of your life can be a major shock to the system!  Recognize that there are literally *millions* of people around the world dealing with this disorder; you're not alone, and there are many resources available to help you cope.

Second of all, it means that when times DO get tough, you do what it takes to get through it.  In extreme cases, this may involve voluntarily checking yourself in to a hospital under a doctor's care.
This isn't an experience that most people would seek out for themselves, but when things get badly out of hand, it can literally be a lifesaver.

Remember: your first goal is to *survive*--to take care of yourself. Your secondary goal might be to contribute as much as you can to the lives of your friends, family, loved ones, co-workers, etc... or it might be something else entirely. 

But if you don't take care of the first goal, the other ones are utterly meaningless.

 

  • Become aware of your mood states.

At first glance, this seems like a really stupid thing to say.  If you're depressed, you know damn well that you feel awful... though you may not identify "depression" as the cause at the time.  Hypomania and mania can be harder to recognize when it's happening to you, but as you gain more experience in dealing with this disorder, you'll become more sensitized to your moods and their cycles.

If you become more aware and conscious of your mood states, however, you may find that you can spot trends earlier and head off potential problems.

Many bipolar folks chart their moods on a calendar or in a diary; this helps them understand their cycles better, and can also provide important clues about possible environmental stimuli that might either be causing problems or giving relief.  For instance, if you note that your mood is generally better for a day or two after you work out vigorously, you might want to consider making exercise a regular part of your coping strategy... or if you notice that you feel especially depressed after a certain activity or eating/drinking certain foods or beverages, you might consider limiting that sort of thing.

One simple way to do this is to choose some kind of arbitrary numeric scale... let's say that "1" is severe depression, "5" is "normal," whatever that eans, and "10" is severe mania.  Something as simple as jotting down a number reflecting your own assessment of your mood state *at roughly the same time every day* can give you very important information about the length and quality of your mood cycles.

Also, many bopilars establish "contracts" with trusted friends or family members--they work out ways in which the trusted outside observer can communicate to them, in a friendly, loving, and nonthreatening way, that they think that you are becoming depressed or (hypo)manic.

Finally, remember that even though you have a mood disorder, you're almost certainly still prone to everyday, ordinary moodiness!  If you wake up in the morning feeling bad, it might be a precursor to a serious depression, or you might just be having a bad hair day.  If you wake up feeling on top of the world, you might be getting (hypo)manic, or you might just be having, um, a good day. ;-) 
Watch the overall *trends* over time, and try not to watch yourself under a microscope and obsess over the tiny details. ;-

 

  • Structure your life to the best extent possible.

Without becoming fanatical about it, many bipolars find that sticking to as regular a schedule as possible of eating, sleeping, working, and so forth is helpful in stabilizing their moods.  Sleep deprivation can DEFINITELY precipitate (hypo)mania, for one thing.

 

  • Educate yourself about this illness.

Ignorance and fear are the Big Enemies.  Educate yourself about your condition.  At a minimum, know what your diagnosis is and what the symptoms are, and know what meds you're taking and what the side-effects are likely to be.

 

  • Exercise regularly and vigorously, if you're physically able.

Regular exercise really helps you to stay on an even keel.

 

  • Avoid artificial stimulants and depressants.

Some bipolars tolerate caffeine (stimulant) and alcohol (depressant) just fine in moderation--though both substances can potentially interact in nasty ways with commonly used medications, alcohol especially.

Some find that they need to avoid these substances entirely.

If you ARE going to drink espresso and Scotch (hopefully not at the same time!) make sure that your doctor(s) know(s) about it, and that you're not setting yourself up for a nasty drug interaction...

...and remember that moderation, as in so many things, is key, and abstinence might very well be the best choice.

 

  • Enlist the support of family and friends.

The importance of having a good support structure cannot be overemphasized.

Sadly, sometimes friends and family members can't handle the idea of a loved one with a "mental illness."  This is usually ignorance and fear
talking, and often these people can be educated and brought around.

If there are people that you can really trust and talk to, let them know about what's going on with you.

 

  • Join a support group.

Check the "Resources" section of the FAQ for information on how to find a "real-world" support group near you... but don't neglect the many online support groups that are available.

 

What can people with bipolar disorder expect from treatment?

Bipolar disorder has no cure, but can be effectively treated over the long-term. It is best controlled when treatment is continuous, rather than on and off. Treatment may be more effective when people work closely with a doctor and talk openly about their concerns and choices. Keeping track of mood changes and symptoms with a health diary or chart can help a doctor assess a person's response to treatments. Sometimes the doctor needs to change a treatment plan to make sure symptoms are controlled most effectively. A psychiatrist should guide any changes in type or dose of medication.

How can I help a friend or relative who has bipolar disorder?

If you know someone who has bipolar disorder, it affects you too. The first and most important thing you can do is help him or her get the right diagnosis and treatment. You may need to make the appointment and go with him or her to see the doctor. Encourage your loved one to stay in treatment.
To help a friend or relative, you can:

  • Offer emotional support, understanding, patience, and encouragement
  • Learn about bipolar disorder so you can understand what your friend or relative is experiencing
  • Talk to your friend or relative and listen carefully
  • Listen to feelings your friend or relative expresses-be understanding about situations that may trigger bipolar symptoms
  • Invite your friend or relative out for positive distractions, such as walks, outings, and other activities
  • Remind your friend or relative that, with time and treatment, he or she can get better.

Never ignore comments about your friend or relative harming himself or herself. Always report such comments to his or her therapist or doctor.

Support for Carers

Like other serious illnesses, bipolar disorder can be difficult for spouses, family members, friends, and other carers. Relatives and friends often have to cope with the person's serious behavioral problems, such as wild spending sprees during mania, extreme withdrawal during depression, poor work or school performance. These behaviors can have lasting consequences.
Carers usually take care of the medical needs of their loved ones. The carers have to deal with how this affects their own health. The stress that caregivers are under may lead to missed work or lost free time, strained relationships with people who may not understand the situation, and physical and mental exhaustion.
Stress from caring can make it hard to cope with a loved one's bipolar symptoms. One study shows that if a carer is under a lot of stress, his or her loved one has more trouble following the treatment plan, which increases the chance for a major bipolar episode. It is important that people caring for those with bipolar disorder also take care of themselves.

Can I get somebody to look at legal or representation  issues related to my illness?

Some relavent Victorian authorities are:-

  • Victoria Legal Aid  www.legalaid.vic.gov.au 03 9269 0234 or  Toll free 1800 677 402
  • Mental Health Review Board  www.mhrb.vic.gov.au 03 8601 5270 or  Toll free 1800 242 703
  • Community Visitors Program  www.communityvisitors.vic.gov.au 03 9819 6087
  • Office of the Chief Psychiatrist - Department Human Services  03 9616 7777
  • Office of the Public Advocate  03 9603 9500

 

What if I, or someone I know, is in crisis?

If you are thinking about harming yourself, or know someone who is, tell someone who can help immediately.

  • Call the toll-free, 24-hour hotline - Lifeline on 13 11 14.
  • Call your doctor.
  • Call 000 or go to a hospital emergency room to get immediate help or ask a friend or family member to help you do these things.
  • Make sure you or the suicidal person is not left alone.