4 Essential Steps to Managing Bipolar Disorder
What is bipolar disorder?
Bipolar disorder or manic depression is a mental health condition affecting about 45 million people worldwide. People who suffer from it go through depressive and manic (or hypomanic) episodes where they can spend prolonged periods of time unable to function well in many areas of life, such as jobs and relationships. Almost 6 million Americans are reported to have bipolar disorder.
Out of all mood disorders, bipolar is the most damaging, with the highest likelihood of causing “severe impairment” (83%). Studies show that people who have bipolar disorder have less gray matter in areas of the brain that control inhibition and motivation. Typically, bipolar symptoms can start showing up at around 25 years of age, with people aged 18 to 29 most at risk.
Bipolar Disorder Type I
There are three types of bipolar disorder. Type I is what people usually think of when they hear “bipolar” – it is characterized by manic episodes where the person feels unreasonably ecstatic, overly self-confident, and extremely impulsive, with little care for consequences of risky behaviors. There are over 3 million sufferers of bipolar type I in the United States.
People with type I bipolar can have delusions or hallucinations when they go through mania, imagining themselves to be someone else or seeing and hearing things that are not there, leading to hospitalizations. The opposite of mania is depression – a state of extremely low energy and motivation with feelings of deep sadness and suicidality.
Bipolar Disorder Type II
Bipolar disorder type II is characterized by hypomania instead of mania – a milder but still potentially damaging state where the person sees themselves as being on top of the world regardless of actual circumstances. Hypomania does not typically lead to delusions or hallucinations, but still causes the person to act impulsively.
People who suffer from bipolar type II also go through depression where they can experience extremely low mood and an inability to perform basic tasks or enjoy pleasurable activities. These depressive episodes can last weeks or months, significantly reducing the person’s quality of life.
Cyclothymia
The third type of bipolar disorder is cyclothymia. This condition is characterized by milder hypomanic and depressive symptoms lasting for at least 2 years. People who have cyclothymia tend to cycle between episodes more rapidly than those who have other types of bipolar disorder. While symptoms tend to be less severe, cyclothymia can be just as debilitating as type I and II.
What Causes Bipolar Disorder?
Bipolar disorder is affected by genetic and environmental factors. Having a family history of bipolar makes it more likely that a person will suffer from the condition. Hormonal and chemical imbalances are also thought to contribute to the development of the disorder. People with bipolar have differently structured brains, but it seems that the disorder can be triggered by periods of high stress or excessive substance use in additional to physical and biological differences.
Can bipolar disorder be cured?
As heartbreaking as it is, there is no “cure” for bipolar disorder. It is a lifelong condition that can reduce life expectancy by up to 9 years, especially if not treated properly. The good news is bipolar disorder can be managed and symptoms can be improved with a proper approach.
How do I manage bipolar disorder?
Bipolar disorder is tough to handle, there is no question about that. It is especially hard to deal with it knowing that it is not going away – the idea of having to constantly control some aspects of your life can be overwhelming. Still, many people with bipolar are able to live full, balanced, and productive lives.
While there are many factors that affect a person’s bipolar symptoms, there are 4 main steps that people should take to increase their quality of life and decrease the likelihood of both manic and depressive episodes occurring. There is nothing magic or “sexy” about these steps, but they really do hold the key to managing bipolar disorder.
1. Treasure Your Sleep
Sleep is one of the most important pillars of maintaining sanity for people with bipolar disorder. Both mania and depression can wreak havoc on one’s sleeping schedule, with mania leading to a drastically decreased need for sleep without loss of energy and depression often leading to sleeping too much or experiencing middle-of-the-night insomnia.
Research shows that there is an undeniable link between quality of sleep and quality of life for people with bipolar disorder, who have biologically-coded irregular circadian rhythms. Disruptions to the regular 24-hour circadian rhythm lead to a higher chance of both manic and depressive episodes.
Maintaining proper sleep hygiene is a must: keep a regular schedule, make the environment comfortable, set a bedtime routine, turn off devices 2 hours before you go to sleep, avoid caffeine after noon, avoid eating big meals or performing strenuous exercise before bed, and use breathing exercises or progressive muscle relaxation to aid in falling asleep.
2. Reduce or Eliminate Substance Use
Between 50% and 60% of people with bipolar disorder also suffer from drug and alcohol disorders – the second highest co-occurrence among all major mental health illnesses. Using substances heavily can lower the social functioning of a person with bipolar to that of a person with schizophrenia, which is usually considered the most socially debilitating mental condition.
While many people who have bipolar claim that alcohol or cannabis helps them manage symptoms, research says otherwise, showing that both substances make manic episodes worse. Excessive substance use can make both manic and depressive episodes more frequent, increase their intensity, and worsen the person’s ability to cope with symptoms.
What’s more, using drugs and alcohol reduces grey matter in the same areas of the brain as bipolar does. Finally, substance use leads to a higher chance of having mixed and rapid-cycling episodes, both of which are much tougher to manage and experience than regular episodes. The science is clear – it is best to avoid all mind-altering and addictive substances in bipolar.
3. Get Serious Social Support
Social support from friends, family, and partners can make a huge difference in the life of a person suffering from bipolar disorder. People with low support have longer episodes and take more time to recover from them. These positive effects are especially strong for depression. People close to those with bipolar should take the time to learn more about the disorder so they can recognize the signs and offer support when needed.
Not everyone is lucky enough to have a close-knit network of loved ones. This is where online and offline communities of fellow people with bipolar disorder come in. Having support from a forum, a subreddit, an online support group, or a group in your town can make a huge difference in accepting the bipolar diagnosis and managing it with self-compassion.
4. Get Medication and Therapy for Bipolar Disorder
Medication for Bipolar Disorder
It’s the truth – many people with bipolar disorder absolutely have to take medication to keep the symptoms at bay. There is no shame in using prescriptions to manage bipolar disorder – it is a serious and complex condition leading up to 20% of those affected by it to suicide. There are many medications for bipolar disorder – your psychiatrist can work with you on creating the right treatment plan.
It is incredibly important to be evaluated by a psychiatrist and not just a general care doctor for bipolar medication. General care practitioners misdiagnose bipolar over 90% of time, have little training in mental health, and should not be used as a primary source of medical care for people with bipolar.
Research shows that adding therapy to medication can significantly improve symptoms, leading to lower hospitalization, fewer depressed days, reduced antidepressant use, and higher overall functioning. While combining medication and therapy for bipolar disorder seems to be the most effective method, therapy alone can certainly help in managing bipolar disorder.
There are several well-researched types of therapy for bipolar disorder, including cognitive behavioral therapy, interpersonal and social rhythm therapy, and psychoeducation. Some of them can be combined for improved outcomes. Outcomes are also better when decisions about the type of treatment are made together by the client and their therapist.
What if I don’t want to take medication and can’t afford therapy for bipolar disorder?
I’ve got one word for you: self-care. Make intensive self-care a priority in addition to following the other advice in this article. This means maintaining a healthy diet, exercising regularly, avoiding or reducing stress, engaging in play and mindfulness, giving yourself time to rest, and stimulating your senses with pleasurable activities.
Tracking daily mood symptoms, identifying triggers for both manic and depressive episodes, and learning coping skills for both mood extremes are other “musts”. If you know an episode is coming on, you are more likely to use your psychological tools, prepare your loved ones, and make yourself safe.
Whichever route of treatment you choose, high-quality sleep, abstinence from substances, social support, and self-care all play a critical role in managing bipolar disorder. Sure, it is easier said than done to comply with all of the advice in this article, but the results are worth it. Life can be full of promises and possibilities once again if bipolar disorder is managed effectively, bringing untold relief to those diagnosed with it.
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