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Whether you have no experience with mental illness or you have multiple family members who are struggling with it, hearing a medical provider tell you that you have bipolar disorder is disorienting at minimum, it may even feel devastating. What does it mean if you've been told you have bipolar disorder? Does this mean you have to quit your job or never have children? Does this mean you'll have to take medications for the rest of your life? How do I hide that I'm a "crazy person" from my family, friends, co-workers?
Ways to help you understand, manage, and thrive with a diagnosis of bipolar disorder.
1. Get educated about bipolar disorder.
Read reputable online resources and books that will tell you about the different kinds of bipolar disorder, various symptoms, types of treatments, and ways to help you manage it. Take notes about any questions to ask your treatment team. Be aware that many people who have bipolar disorder are misdiagnosed, there is no one test to take to give you a definitive diagnosis.
2. Have a good treatment team.
Finding a good psychiatrist and psychotherapist are arguably the most important tasks when you receive a diagnosis of bipolar disorder. If your primary care doctor is guessing at your diagnosis and can't answer your questions, or your therapist isn't too familiar with helping people manage symptoms of bipolar disorder, ask them to refer you to someone who specializes in treating bipolar disorder. There is often a huge disparity in the availability of mental health professionals. This is when advocating for yourself comes in, and if you're not functioning well, asserting yourself may be extremely difficult. Find a support person to help you (see #4) if you need to seek other providers. You need a treatment team that takes the time to answer your questions and treat you as a whole human being, not just a set of symptom check boxes.
3. Write down all your questions about bipolar disorder and get them answered by your doctor, psychotherapist or counselor.
You have the right to ask the professionals to explain bipolar disorder to you and your support person. Keep in mind that bipolar disorder is unique to every person, so if you are diagnosed with Bipolar II, it doesn't mean that your moods will follow the exact patterns out of the DSM (Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the most used guide book for mental health professionals for diagnosing mental illnesses. While you may or may not fit into the "textbook" definition of your diagnosis, you deserve to have all your questions answered by the professionals. If they won't take the time or don't know the answers, ask them for resources that will answer your questions.
4. Create a support network.
I mentioned above to bring a "support person" with you to doctor appointments, so let me explain more about why this is crucial. Often the diagnosis of bipolar disorder comes when you are severely depressed or struggling with racing thoughts and other manic symptoms that may be interfering with your ability to function. To help you process all the information needed to start appropriate treatment, find a support person to help you. Choose someone you trust, is reliable, and willing to be there for you to take notes, ask questions and even contact your treatment team when you aren't able to. Sign a release of information for your doctors and therapists so your support person can attend appointments and ask questions on your behalf.
In addition to a designated support person, do your best to build a network of people who know what it's like to deal with having bipolar disorder. Finding others who are struggling with some of the same issues as you helps to not feel so alone. Look up bipolar support groups in your community and attend a couple of different ones to see if you can find someone you relate to, even make some positive and supportive friends. Listen to guest speakers that can answer questions, and find group facilitators that can help you locate resources. The Depression and Bipolar Support Alliance (DBSA) offers in person and online groups, as well as National Alliance for Mental Illness (NAMI).
5. Learn about all of your medications.
Ask your doctor what symptoms each medication is targeting, the manner in which symptoms may be alleviated, most common side effects to watch for, dosages and time of day to take each one. Write all this information down, or have your support person do so because it's a lot to try to remember, especially if you're not functioning well.
6. Keep a log.
One of the most helpful tools to track mood changes is to keep a daily (or at least weekly) log of your mood ratings, hours of sleep, meals, activity level, medications, and other factors such as menstrual cycle or other stressors. There are many cool phone apps that have mood trackers, or you can find one online. Mood charting is very helpful for taking a look at what medications may be helping or exacerbating specific symptoms, as well as how sleep and nutrition habits and outside stressors are being managed. If you're feeling especially anxious or more depressed lately, you can take a look back at the last couple of weeks or months and see if there is a pattern of less sleep or more stressful events, and make a plan to get back on track to start feeling better.
7. Create a daily routine and follow it.
There are thousands of studies indicating that following a consistent healthy lifestyle routine can improve and maintain balance in people with bipolar disorder. Going to bed and getting up at the same time, eating healthy meals around the same time every day, getting regular exercise, and stress management skills are all emphasized in the majority of these studies. Terms like circadian rhythm and sleep hygiene may be included in many scholarly as well as casual articles about managing bipolar disorder. These are referring to regulating your body clock to help even out any other physiological changes that affect your overall health. This is a great place to start helping yourself by developing a routine that fits into your life. Ask your family, friends, and support network to help you stay on track with your daily routine.
8. Learn coping skills to manage depression, anxiety, mania and stress, and create balance.
Whether it's drawing pictures, listening to music, exercising, or keeping a daily log of negative thoughts using cognitive behavioral therapy, find a good therapist or counselor who is well versed in helping you create an individual treatment plan to address your symptoms. Stress is pretty much universal in today's multi-tasking world, but people with bipolar disorder may be more easily triggered by stressful events than others. Learn new ways to cope with daily stress as well as flare ups of symptoms that get in the way of living your life. Learn to create balance in your life by developing and practicing healthy boundaries and limiting the demands on you.
9. Addressing shame, embarrassment, guilt, stigma.
Feeling ashamed of having a mental illness, which is a brain disorder, is very common unfortunately. In addition to dealing with the symptoms of bipolar disorder, a flood of uncomfortable feelings may arrive including shame, embarrassment, and sometimes guilt for any disruptions the illness has created in our lives with families, friends, or co-workers. Working with a competent therapist or counselor who can help you peel away those negative feelings to uncover or rediscover your strengths and assets can be immensely helpful to your overall health. It's extremely difficult to manage symptoms and try to return to healthy functioning when we have poor self-esteem and low self-confidence. Feeling ashamed of who we are and hiding a part of ourselves usually results in feeling badly about ourselves. You deserve love, happiness, health, and are worthy just as you are.
10. Find hope with fun and laughter.
Don't give up hope when the latest medication gave you bad side effects or didn't work. Don't give up hope when your depression feels like it's smothering you. Don't give up hope if your support person bails on you and you have to find someone new. Hang on to the fact that there is a light at the end of the tunnel, even if you can't see it right now. Trust that it's around the bend, and find someone to hold that hope for you if you're struggling to hold it. Sometimes hope is found in laughter, even when you're depressed.
I try to find little ways to experience joy, have fun and laugh every single day. Whether it's watching a silly video, marveling at how little kids use their imagination, enjoying nature, or making fun of myself, smiling and a few giggles give me hope that things will get better. Let yourself play, find a slinky or get some crayons and a coloring book, or go on the swings at a local park and be goofy. Just changing your environment often helps to get out of a negative state and create a smile that can have a positive effect on you for the rest of the day.