Bipolar

While dealing with Bipolar isn’t always easy, it doesn’t have to run your life. But in order to successfully manage Bipolar, you have to make smart choices. Your lifestyle and daily habits have a significant impact on your moods. Read on for ways to help yourself:

• Seek support. It’s important to have individuals you can turn to for help and encouragement. Try joining a recovery group or talking to a trusted friend.
• Monitor your moods. Keep track of your symptoms and watch for signs that your moods are swinging out of control so you can stop the problem before it starts.
• Make healthy choices. Healthy sleeping, eating, and exercising habits can help stabilize your moods. Keeping a regular sleep schedule is particularly important.
• Keep stress in check. Avoid high-stress situations, maintain a healthy work-life balance, and try relaxation techniques such as meditation, yoga, or deep breathing.
• Get educated. Learn as much as you can about Bipolar. The more you know, the better you’ll be at assisting your own recovery.

What you can do to help yourself—

Living well with Bipolar requires certain adjustments. Like recovering alcoholics who avoid drinking or diabetics who take insulin, if you have Bipolar, it’s important to make healthy choices for yourself. Making these healthy choices will help you keep your symptoms under control, minimize mood episodes, and take control of your life.

Managing Bipolar starts with proper recovery, including drugs and therapy. But there is so much more you can do to help yourself on a day-to-day basis. The daily decisions you make influence the course of your illness: whether your symptoms get better or worse; whether you stay well or experience a relapse; and how quickly you rebound from a mood episode.

Get involved in your recovery—

Be a full and active participant in your own recovery. Learn everything you can about Bipolar. Become an expert on the illness. Study up on the symptoms, so you can recognize them in yourself, and research all your available recovery options. The more informed you are, the better prepared you’ll be to deal with symptoms and make good choices for yourself.

Using what you’ve learned about Bipolar, collaborate with your psychiatrist or therapist in the recovery planning process. Don’t be afraid to voice your opinions or questions. The most beneficial relationships between patient and healthcare provider work as a partnership. You may find it helpful to draw up a recovery contract outlining the goals you and your provider have agreed upon.

Other tips for successful Bipolar recovery:

• Take your prescription as instructed. If you’re taking drugs, follow all instructions and take it faithfully. Don’t skip or change your dose without first talking with your psychiatrist.
• Get therapy. While drugs may be able to manage some of the symptoms of Bipolar, therapy teaches you skills you can use in all areas of your life. Therapy can help you learn how to deal with your disorder, cope with problems, regulate your mood, change the way you think, and improve your relationships.
• Communicate with your treatment provider. Keep the lines of communication open with your psychiatrist or therapist. Your recovery program will change over time, so keep in close contact with your provider. Talk to your provider if your condition or needs change and be honest about your symptoms and any drugs side effects.
• Be patient. Don’t expect an immediate and total cure. Have patience with the recovery process. It can take time to find the right program that works for you.

Monitor your symptoms and moods—

In order to stay well, it’s important to be closely attuned to the way you feel. By the time obvious symptoms of mania or depression appear, it is often too late to intercept the mood swing, so keep a close watch for subtle changes in your mood, sleeping patterns, energy level, and thoughts. If you catch the problem early and act swiftly, you may be able to prevent a minor mood change from turning into a full-blown episode of mania or depression.

Know your triggers and early warning signs – and watch for them—

It’s important to recognize the warning signs of an oncoming manic or depressive episode. Make a list of early symptoms that preceded your previous mood episodes. Also try to identify the triggers, or outside influences, that have led to mania or depression in the past. Common triggers include:

• arguments with your loved ones
• financial difficulties
• lack of sleep
• problems at school or work
• seasonal changes
• stress

Knowing your early warning signs and triggers won’t do you much good if you aren’t keeping close tabs on how you’re feeling. By checking in with yourself through regular mood monitoring, you can be sure that red flags don’t get lost in the shuffle of your busy, daily life.

Keeping a mood chart is one way to monitor your symptoms and moods. A mood chart is a daily log of your emotional state and other symptoms you’re having. It can also include information such as how many hours of sleep you’re getting, your weight, meds you’re taking, and any alcohol or drug use. You can use your mood chart to spot patterns and indicators of trouble ahead.

Develop a wellness toolbox—

If you spot any warning signs of mania or depression, it’s important to act swiftly. In such times, it’s helpful to have a wellness toolbox to draw from. A wellness toolbox consists of coping skills and activities you can do to maintain a stable mood or to get better when you’re feeling “off.”

The coping techniques that work best will be unique to your situation, symptoms, and preferences. It takes experimentation and time to find a winning strategy. However, many individuals with Bipolar have found the following tools to be helpful in reducing symptoms and maintaining wellness:

• ask for extra help from loved ones
• attend a recovery group
• call your psychiatrist or therapist
• cut back on sugar, alcohol, and caffeine
• cut back on your activities
• do something fun or creative
• exercise
• get a full eight hours of sleep
• increase or decrease the stimulation in your environment
• increase your exposure to light
• take time for yourself to relax and unwind
• talk to a supportive person
• write in your journal

Create an emergency action plan –

Despite your best efforts, there may be times when you experience a relapse into full-blown mania or severe depression. In crisis situations where your safety is at stake, your loved ones or psychiatrist may have to take charge of your care. Such times can leave you feeling helpless and out of control, but having a crisis plan in place allows you to maintain some degree of responsibility for your own recovery.

A plan of action typically includes:

• A list of all meds you are taking, including dosage information
• A list of emergency contacts (your psychiatrist, therapist, close family members)
• Information about any other health problems you have
• Symptoms that indicate you need others to take responsibility for your care
• Recovery preferences (who you want to care for you; what treatments and meds do and do not work, who is authorized to make decisions on your behalf)

Reach out to other individuals—

If your loved one has Bipolar, you can be an instrumental support throughout the recovery process.

Having a strong recovery system is vital to staying happy and healthy. Creating a supportive environment includes not just who you surround yourself with, but who you choose to avoid. In order to take care of yourself, it’s necessary to limit your contact with individuals who drain your emotional energy or leave you feeling discouraged, ashamed, or guilty. Instead, spend time with individuals who truly value you and make you feel better.

• Build new relationships – Isolation and loneliness make Bipolar worse. If you don’t have a recovery network you can count on, take steps to develop new relationships. Try taking a class, joining a church or a civic group, volunteering, or attending events in your community.

• Join a Bipolar recovery group – Spending time with individuals who know what you’re going through and can honestly say they’ve “been there” can be very therapeutic. You can also benefit from the shared experiences and advice of the group members. To find a recovery group in your area, use the Depression and Bipolar Support Alliance’s Support Group Locator or contact your local branch of the National Alliance on Mental Illness.

• Turn to friends and family – Recovery for Bipolar starts at home. It’s important to have individuals you can count on to help you through rough times. Isolation and loneliness can cause depression, so regular contact with supportive friends and family members is therapeutic in itself.

Develop a daily routine—

Your lifestyle choices, including your sleeping, eating, and exercise patterns, have a significant impact on your moods. There are many things you can do in your daily life to get your symptoms under control and to keep depression and mania at bay.

• Keep a strict sleep schedule. Getting too little sleep can trigger mania, so it’s important to get plenty of rest. For some individuals, losing even a few hours can cause problems. However, too much sleep can also worsen your mood. The best advice is to maintain a normal sleep schedule, going to bed and waking up at around the same time each day.

• Exercise regularly. Exercise has a beneficial impact on mood and may reduce the number of bipolar episodes you experience. Aerobic exercise is especially effective at recovering from depression. Try to incorporate at least 30 minutes of activity five times a week into your routine. Walking is a good choice for individuals of all fitness levels.

• Build structure into your life. Developing and sticking to a daily schedule can help stabilize the mood swings of Bipolar. Include set times for sleeping, eating, socializing, exercising, working, and relaxing. Try to maintain a regular pattern of activity, even through emotional ups and downs.

Keep stress to a minimum—

Stress can trigger episodes of mania and depression in individuals with Bipolar, so keeping it under control is extremely important. Know your limits, both at home and at work or school. Don’t take on more than you can handle and take time to yourself if you’re feeling overwhelmed.

• Appeal to your senses. Stay calm and energized by appealing to the five senses: sight, sound, touch, smell, and taste. Listen to music that lifts your mood, place flowers where you will see and smell them, massage your hands and feet, or sip a warm drink.

• Learn how to relax. Relaxation techniques such as deep breathing, meditation, yoga, and guided imagery can be very effective at reducing stress and keeping you on an even keel. Studies show that a daily relaxation practice of 30 minutes or more can improve your mood and keep depression at bay.

• Make leisure time a priority. Do things for no other reason than that it feels good to do them. Go to a funny movie, take a walk on the beach, listen to music, read a good book, or talk to a friend. Doing things just because they are fun is no indulgence. Play is an emotional and mental health necessity.

Watch what you put in your body—

From the food you eat to the vitamins and drugs you take, the substances you put in your body have an impact on the symptoms of Bipolar – both for better or worse.

• Avoid alcohol and drugs. Drugs such as cocaine, ecstasy, and amphetamines can trigger mania, while alcohol and tranquilizers can trigger depression. Even moderate social drinking can upset your emotional balance. Substance use also interferes with sleep and may cause dangerous interactions with your meds. Attempts to self-medicate or numb your symptoms with drugs and alcohol only create more problems.

• Be cautious when taking any drugs. Certain prescription and over-the-counter meds can be problematic for individuals with Bipolar. Be especially careful with antidepressant drugs, which can trigger mania. Other drugs that can cause mania include over-the-counter cold medicine, appetite suppressants, caffeine, corticosteroids, and thyroid drugs.

• Eat a healthy diet. There is an undeniable link between food and mood. For optimal mood, eat plenty of fresh fruits, vegetables, and whole grains and limit your fat and sugar intake. Space your meals out through the day, so your blood sugar never dips too low. High-carbohydrate diets can cause mood crashes, so they should also be avoided. Other mood-busting foods include chocolate, caffeine, and processed foods.

• Get your omega-3s. Omega-3 fatty acids may decrease mood swings in Bipolar. Omega-3 is available as a nutritional supplement. You can also increase your intake of omega-3 by eating cold-water fish such as salmon, halibut, and sardines, soybeans, flaxseeds, canola oil, pumpkin seeds, and walnuts.

Bipolar: Key Recovery Concepts—

• Support. Working toward wellness is up to you. However, support from others is essential to maintaining your stability and enhancing the quality of your life.
• Self Advocacy. Become an effective advocate for yourself so you can get the services and recovery you need, and make the life you want for yourself.
• Perspective. Depression and manic-depression often follow cyclical patterns. Although you may go through some painful times and it may be difficult to believe things will get better, it is important not to give up hope.
• Personal Responsibility. It’s up to you to take action to keep your moods stabilized. This includes asking for help from others when you need it, taking your drugs as prescribed and keeping appointments with your health care providers.
• Hope. With good symptom management, it is possible to experience long periods of wellness. Believing that you can cope with your mood disorder is both accurate and essential to recovery.
• Education. Learn all you can about your illness. This allows you to make informed decisions about all aspects of your life and recovery.

Common Red Flags for Bipolar Relapse—

Warning signs of depression:

• I crave chocolate.
• I don’t care about anybody else.
• I no longer want to be around individuals.
• I quit cooking meals
• I start having headaches.
• Individuals bother me.

Warning signs of mania or hypomania:

• Friends tell me that I’m crabby.
• I can’t concentrate.
• I feel irritable.
• I find myself reading five books at once.
• I find myself talking faster than usual.
• I need to move around because I have more energy than usual.
• I’m hungry all the time.

10 tips for reaching out and building relationships—

1. Accompany someone to the movies, a concert, or a small get-together.
2. Ask a loved one to check in with you regularly.
3. Call or email an old friend.
4. Confide in a counselor, therapist, or clergy member.
5. Go for a walk with a workout buddy.
6. Have lunch or coffee with a friend.
7. Help someone else by volunteering.
8. Meet new individuals by taking a class or joining a club.
9. Schedule a weekly dinner date
10. Talk to one person about your feelings.

Healthy sleep habits for managing Bipolar—

• Avoid exercising or doing other stimulating activities late in the day.
• Avoid or minimize napping, especially if it interferes with your sleep at night.
• Go to bed and wake up at the same time each day.
• No caffeine after lunch or alcohol at night. Both interfere with sleep.

BORDERLINE PERSONALITY DISORDER

While BORDERLINE PERSONALITY DISORDER is a serious condition that requires treatment by qualified mental health professionals, there are also sources of self-help (or self-guided strategies for symptom reduction) for individuals with BORDERLINE PERSONALITY DISORDER. These self-help strategies should be used in conjunction with formal treatments for BORDERLINE PERSONALITY DISORDER (such as psychotherapy and medication).

The symptoms of BORDERLINE PERSONALITY DISORDER, including erratic mood shifts, self-harming behaviors, suicidality, intense emotional experiences, sensitivity to problems in your relationships and problems with impulsive behaviors, may all be related to one core feature: emotion dysregulation, where individuals have very strong emotional responses, difficulty managing those responses and often engage in harmful behaviors in attempts to escape from these emotions. Recovery strategies can help to reduce emotion dysregulation and the other symptoms of BORDERLINE PERSONALITY DISORDER.

What are Recovery strategies?

Since emotion dysregulation is such an important feature of BORDERLINE PERSONALITY DISORDER, many treatments for BORDERLINE PERSONALITY DISORDER emphasize the importance of building recovery strategies to better manage emotions when they arise. What exactly are recovery strategies? They are healthier ways of addressing situations and their resulting emotions.

Why Learn New Recovery strategies?

Why is it important to learn new, healthier ways of coping? By using healthful recovery strategies you may:

• Build confidence in your ability to handle difficult situations
• Improve your ability to be able to continue to function well even when in stressful circumstances
• Reduce the intensity of the emotional distress you feel
• Reduce the likelihood that you will do something harmful (e.g., engage in self- harming behaviors) to attempt to escape from the emotional distress
• Reduce the likelihood that you will engage in behaviors that destroy relationships (e.g., physical aggression) when you are upset
• Ultimately reduce your overall experience of emotion dysregulation

What are Some Different Types of Recovery strategies?

There are literally thousands of different recovery strategies that individuals use to manage stressful situations and the emotions that result. Here are a few types of recovery strategies that work for many individuals:

• Active Problem-Solving. Consider the problem at hand: Is there a way to solve the problem directly?
• Behavioral Activation. Engage in an activity that might take your mind off the stressful situation for a little while.
• Grounding. Practice grounding exercises that are designed to keep you "grounded" in the present moment, rather than caught up in replaying events in your head, worrying about the future or zoning out.
• Mindfulness Meditation. Practice mindfulness meditation, which helps you to observe and describe your experiences without judging or rejecting them.
• Relaxation Exercises. Practice a relaxation exercise, such as deep breathing or progressive muscle relaxation.
• Social Support. Talk to others who may understand what you are going through.

How To Learn Healthier Recovery strategies—

Ready to learn some new, healthier ways of coping? One way to do this is by seeking treatment. Many psychological treatments for BORDERLINE PERSONALITY DISORDER, including cognitive behavioral treatments such as Dialectical Behavior Therapy (DBT), focus on teaching healthier recovery strategies to manage strong emotions. There are online resource pages that can help you find a cognitive behavioral therapist or a DBT provider.

When you are having an intense emotion, it can be hard to know what to do. Unfortunately, many individuals with BORDERLINE PERSONALITY DISORDER turn to unhealthy behaviors in an attempt to cope with emotional pain (e.g., self-harm, substance use, or aggression). Want to replace unhealthy habits with new, healthier skills? Try some of the recovery strategies listed below.

1. Be Mindful— Practice mindfulness of your emotion. Notice the emotion you are having, and let yourself experience it as a wave, without trying to block it, suppress it, or hold on to it. Try to accept the emotion for what it is.
2. Breathe Deeply— Sit or lie somewhere quiet and bring your attention to your breathing. Breathe evenly, slowly, and deeply. Watch your stomach rise and fall with each breath.
3. Call Someone— Reaching out to others can really help when you are struggling with strong emotions. Call a supportive friend or family member. If you don’t have someone in mind that is supportive, call a helpline (for example, in the U.S. you can call the National Suicide Hotline at 1-800-273-TALK).
4. Do Something— Engage in a highly engaging activity. Television or computer activities do not count here -- these are too passive. Instead, take a walk, dance, clean your house, or do some other activity that gets you engaged and distracts you from your current emotions.
5. Ground Yourself— When emotions seem to be taking you out of the current moment (e.g., you are starting to feel “zoned out” or can’t see anything else going on at the moment), do something to ground yourself. Grab an ice cube and hold it in your hand for a few moments, snap a rubber band against your wrist, “snap yourself back” into the moment.
6. Help Someone Else— Do something nice for someone else. It doesn't have to be something big; you can walk to the nearest store, buy a pack of gum, and give the cashier a smile and say "have a great day." It may sound silly, but small gestures like this can really reduce emotional pain.
7. Play Music— Play music that creates an emotion that is the opposite of the one you are struggling with. For example, if you are feeling very sad, play happy, upbeat music. If you are feeling anxious, play slow, relaxing music.
8. Pray— Are you a religious or spiritual person? If you are (or even if you’re not but have considered trying), praying can be tremendously helpful in times of extreme stress.
9. Ride It Out— The peak of most strong emotional reactions (and the urges to engage in harmful activities, like self-harming or drinking, that can go along with these reactions) last for a few minutes and then begin to subside. Grab an egg timer from the kitchen, and set it for 10 minutes. Wait the 10 minutes, and practice riding out the emotion.
10. Take a Warm Bath or Shower— Try to lose yourself in the sensations of the warm water, the smell of the soap, etc. Allow the sensations to distract you from the situation you are upset about.

What is Mindfulness Meditation?

Mindfulness meditation has been defined in many ways, but perhaps one of the most widely-used definitions comes from Jon Kabat-Zinn, Ph.D., (the creator of a treatment for stress and chronic pain called “Mindfulness-Based Stress Reduction”), who defines mindfulness as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.”

When you practice mindfulness meditation, you practice being in the present moment, and noticing all of your experiences. You practice being aware of things happening outside of yourself (e.g., things you see, smell, hear), and things happening internally (e.g., your thoughts, feelings and sensations). Importantly, mindfulness meditation involves being aware without judgment. So, you are paying attention to all of these experiences, without labeling them as good or bad.

Mindfulness is a concept that comes from the Buddhist spiritual tradition. For almost almost 3,000 years, Buddhist monks have practiced mindfulness meditation -- but in recent years mindfulness practice has become increasingly widespread and applied outside of the Buddhism. In fact, most Eastern practitioners who use mindfulness think of it as a skill that can be used separately from any kind of religious or spiritual practice. So, no matter what your religious background, mindfulness meditation may be helpful for you.

What Does Mindfulness Meditation Have to Do With BORDERLINE PERSONALITY DISORDER?

Marsha Linehan, Ph.D., who created Dialectical Behavior Therapy for BORDERLINE PERSONALITY DISORDER was one of the first to apply mindfulness meditation training to the recovery of BORDERLINE PERSONALITY DISORDER. Often, individuals with BORDERLINE PERSONALITY DISORDER not only experience intense emotions, they can become “stuck” in these emotions and judge both the emotions and themselves (e.g., “This is a terrible feeling and I am such a weak person for feeling this way”).

Unfortunately, this can end up making the emotion feel even more intense. And, judgmental thoughts can add other emotions to the mix — if you tell yourself you are weak for feeling sad you may end up feeling both sad and ashamed.

Mindfulness meditation training can help individuals with BORDERLINE PERSONALITY DISORDER to feel less “stuck” in their emotions, and less judgmental of the emotions and themselves. Mindfulness meditation training may also help individuals with BORDERLINE PERSONALITY DISORDER be more effective in applying healthy recovery strategies in the midst of emotional pain, because mindfulness skills allow you to get just a little bit of space to be able to notice the emotion and be more strategic in terms of how you will act in the face of the emotion.

For example, imagine being in a verbal argument with someone you love. During the argument you may feel very intense feelings, such as anger, fear and rage. Without mindfulness skills, you are more likely to act on these feelings without being able to see the consequences -- maybe you yell at your loved one, throw something or storm out. With mindfulness meditation practice, you may be able to notice the emotions you are having (e.g., you may think to yourself “I’m feeling really angry, hurt, and afraid right now”), and you may be able to step back and chose your behavior (e.g., “I am too upset to talk about this and I am may say or do something I’ll regret later. I need to take a time out from this discussion”).

How to Practice Mindfulness Meditation—

There are a variety of ways to begin practicing mindfulness meditation. Usually you can begin practicing mindfulness by trying some exercises that promote mindfulness.

Self-Help Emotional Processing and Expression—

Some individuals find that processing or expressing emotions on their own can be a very useful way to engage in self-help. For example, some individuals write in a journal or blog, others draw or paint -- and some find other creative, healthy ways to express their emotions. There is some research that suggests that expressive writing, for example, can have a variety of positive consequences, including better physical health and reduced psychological symptoms.

It is important to note that for some individuals, engaging in these types of strategies can feel overwhelming or triggering. If you feel you do not have the recovery strategies needed to manage the emotions that come from emotional processing activities, then you probably need to start with some recovery strategies training. However, if you and your therapist think you are ready to try emotional processing exercises, you may find that writing in a journal can be a good place to start.