Living with Bipolar Disorder.

Jason Brien.

Bipolar disorder refers to a group of related mental health conditions which result in extreme mood shifts. Bipolar I disorder for example involves at least one MANIC episode with or without at least one major depressive episode. Bipolar II disorder involves at least one HYPOMANIC episode WITH at least one major depressive episode. To reiterate, you DO NOT have to experience a major depressive episode to be diagnosed with bipolar I disorder, but you DO have to experience at least one major depressive episode to be diagnosed with bipolar II disorder. Cyclothymic disorder also involves emotional ups and downs, but these mood shifts are nowhere near as intense or extreme as the emotional ups and/or downs of bipolar I & bipolar II disorders.

Mood disorders unrelated to bipolar disorder can include major depression, dysthymia and mood disorders caused by medical conditions or mood disorders caused by alcohol or substance use/misuse. Living with mood disorders can be quite challenging. To live effectively with mood disorders, one has to become quite good at predicting and recognising mood shifts. Being aware of emotional changes along with being aware of when emotional changes are likely to occur, gives a person with a mood disorder greater control and freedom over their life. Imagine if someone, at random intervals, snuck into your bedroom at night while you were sleeping and injected you with powerful stimulants or depressants which affected you for days, weeks or months on end.

You would feel pretty scared, powerless and helpless right. All you can remember was feeling ‘normal’ one moment and then suddenly and without warning you’re either bouncing off the walls and/or you can’t seem to get yourself out of bed. Imagine how disruptive this would be to your life. How would you ever plan anything? This is why people who are diagnosed with Bipolar and other mood disorders must become adept at understanding the how’s, why’s and when’s of their mood states. People diagnosed with bipolar and mood disorders may also need to take medication frequently and see a mental health professional or therapist on a regular basis. There are a lot of ways though you can support yourself though at home and in the community. Let’s explore some of the ways.

Learn about your diagnosis and what it means to be diagnosed with the condition: This is an extremely important step in learning how to live with your diagnosis. Think of your diagnosis like an intimate relationship. If you want the intimate relationship to go well, you ideally want to know your intimate partner inside and out. The same goes for a diagnosis. You are now in a relationship with your diagnosis and the health of that relationship can depend greatly on how well you know it and interact with it. Thinking of a diagnosis in terms of a relationship may also help you to not self-identify with the diagnosis if you do not want to. If you choose not to self-identify as bipolar, you may choose instead to view it as just currently being in a relationship with bipolar. Whether this relationship is permanent or not will depend on a variety of factors but so long as you are in a relationship with it, you may as well make your life as comfortable, fulfilling and meaningful as possible.

Know thyself, be honest with thyself and be honest with others: Just as it is important to know your diagnosis, it is just as important to know yourself. You want to be able to recognise what is ‘normal’ or typical for you so that you can notice when things are not ‘normal’ or atypical for you. You also want to be honest with yourself and others if you want any realistic chance of managing your symptoms and their impact upon your mind, body, emotions, behaviours and relationships. If you are not honest with others about certain aspects of your condition and your symptoms (e.g., hypersexuality – a common symptom of both mania and hypomania), how can people support you properly? If trusted others know that you are likely to become hypersexual and promiscuous when you are experiencing mania or hypomania, they may support you by respectfully reminding you of sexually transmitted diseases. Or they might respectfully purchase condoms for you when they know you are a bit short of funds. If you have a habit of spending money recklessly, a trusted other may hold onto your money or credit card. The point is, other people can only truly support you if they truly understand you.

Seek support: Having a strong and healthy support network is important for anyone regardless of whether you have a mental health condition or not. Humans are by nature social creatures and the vast majority of humans feel safer and more content knowing that others are there for us should we need them. This is why humans don’t survive too well in invalidating and abusive environments. Whilst we are on the topic of validation, you want to create a support network which is supportive and accepting of your needs, wants, etc. Ideally, you want friends, family and employers to understand your diagnosis and its impacts upon you. Ideally, you would want an employer to understand that when you are experiencing low moods for example, that is not the best time to present you with a tonne of work.

Use emotional safety plans: As we all know, moods can sneak up on us pretty quickly and the longer they set in unawares, the harder they can be to manage. We also know that when we are flooded with emotions, our thinking brain shuts down making it harder for us to think and rationalise properly. This is why emotional safety plans can be quite effective. An emotional safety plan can include information such as what feelings you are likely to have (sad, angry, etc), the types of thoughts you might have (F them they don’t deserve me, nobody appreciates me, etc), certain behaviours to look out for (hypersexuality, reckless spending, gambling, drug use, etc), who to avoid (people who encourage bad habits), who to approach (people you know who can support you) and what actions you can take to support yourself (positive self-talk, relaxation, visiting therapist, etc).

Create structure and routine: We all struggle without structure and routine. Without knowing what we need to do and when and how, we might wander around aimlessly doing this that and everything else, but not really achieving anything at all. Or procrastination may set in. Having external structure and routine can help provide internal structure and routine. Internal and external structure and routine can really help you to stabilize your moods. Your routine and structure need to be somewhat flexible though. You may need an ‘up’ and ‘down’ routine and structure schedule. Obviously when you are feeling ‘up’, it is easier to exercise than when you are feeling ‘down’. Likewise, you may need a sleep schedule specific to whichever mood state you are experiencing. There is no point in having a rigid ‘8 hours of sleep’ schedule because you are possibly going to get less when you are up and more when you are down and you don’t want to be berating and demeaning yourself because you didn’t get 8 hours of sleep. Again, know thyself, be honest with thyself and be honest with others.

Being diagnosed with any mental health condition is not the same as receiving a terminal diagnosis within the medical profession. Mental health diagnoses are more like physical injuries and physical disabilities, Sure they may limit what you can and can’t do for a short period of time or a long period of time but that doesn’t mean that you cannot live a rich and fulfilling life. The more you understand your condition and the more support you have from yourself and others, the better and more productive, fulfilling and rewarding your life can be. You also don’t have to self-identify with your condition if you don’t want to. Like I expressed earlier, you can view yourself as just being in a relationship with your condition with no fixed expiry date.