A man puts an arm around his wife as they look at the gray sea.Bipolar is a mood condition that affects millions of people each year. If you have bipolar, your mood issues may range from fairly mild to very disruptive. The good news is there are many effective treatments for bipolar. A treatment regimen often includes both therapy and medication. Lifestyle changes and support from loved ones can also help recovery.

PSYCHOTHERAPY FOR BIPOLAR

While bipolar cannot be cured, it can be managed effectively. Psychotherapy can help you understand your condition so you can manage it better. A therapist may also help you develop strategies to reduce emotional distress.  

In therapy, you may work on goals such as: 

  • Educating yourself about bipolar; letting go of harmful or untrue beliefs.
  • Spotting signs of oncoming mood episodes and learning how to counteract them.
  • Improving relationships which may have been affected by bipolar.
  • Re-entering the workforce at a healthy pace.
  • Practicing mindfulness and relaxation techniques.

Since many people experience gaps between mood episodes, there may be periods when you go to therapy without having any symptoms. That is okay. In fact, you may find it simpler to learn new habits when your mind is in a stable place. By practicing coping skills during rest periods, you can put them to use more easily during mood episodes. A consistent therapy regimen will likely work better than therapy you only use in emergencies.

MEDICATION FOR BIPOLAR

Medication is commonly used in the treatment of bipolar. Some regularly prescribed medications include:

  • Mood stabilizers: These medications can stabilize your mood to avoid the highs and lows typically associated with bipolar. Lithium is the most commonly used mood stabilizer for bipolar. It can drastically reduce a person’s suicide risk. However, lithium has potentially serious side effects and may cause kidney or thyroid issues. People taking this medication are encouraged to have their blood monitored regularly.
  • Anticonvulsants: These medications are typically used to treat seizures, but they have been found to be effective in mood stabilization as well. However, these medications may increase one’s risk of suicidal thoughts and behaviors. People taking these medications should be closely monitored for new or worsening signs of depression.
  • Atypical antipsychotics: These medications are often used in the treatment of schizophrenia. Yet they have also been found to be effective for treating bipolar (especially manic symptoms). 
  • Antidepressants: Antidepressants can be used to treat depressive symptoms of bipolar. However, these medications can also cause a manic or hypomanic episode. For that reason, these medications are typically used in combination with a mood stabilizer.

There are many myths about medication for bipolar. People taking these medications should know that they do NOT change your core personality. They do not cause addiction or create artificial “highs” either. 

Some people taking antidepressants or mood stabilizers do report emotional numbing. However, this side effect will likely go away if you switch to a different medication. A mental health professional can help you change medications or alter doses as needed. 

HOSPITALIZATION FOR BIPOLAR 

If your bipolar symptoms grow severe enough, you may need hospitalization. Contrary to what popular culture suggests, psychiatric hospitalizations are typically brief (7-13 days on average). In general, the hospital staff only needs to monitor you until your mood stabilizes.

Hospitalizations are also more common than many people realize. For American adults age 18-44, mood issues (including bipolar) were the third most common cause of hospitalization. Seeking care is a productive, healthy act: there is no shame in getting help if you need it.

Hospitalization may be necessary if you have the following symptoms:

  • Psychotic symptoms such as hallucinations or delusions.
  • Insomnia that persists for several days.
  • Extreme fatigue that leaves you unable to perform daily tasks like getting dressed.
  • Thoughts of hurting yourself or others.

In some cases, going to the hospital may save your life. Roughly 1/3 of people with bipolar I or II will attempt suicide in their lifetimes. People with bipolar are 15 times more likely to die by suicide than the general population. 

During a hospital stay, you can expect to follow a schedule for meals, bedtimes, and so on. Hospital staff may check on you throughout the day to watch for symptoms, especially if you are trying a new medication. You may participate in group therapy or brief, daily check-ups from a clinician. However, intensive individual therapy is usually reserved for after the hospital stay when your mood has stabilized.

After hospitalization, you will likely be referred to outpatient therapy. Like other forms of health care, therapy and hospitalization are confidential. Employers and friends have little way of knowing about your treatment unless you share the information yourself. The only people who need to know about the hospital stay are you and your health care providers.

SELF-HELP FOR BIPOLAR

Therapy for bipolar often involves lifestyle changes. These strategies may include: 

  • Sleep hygiene: Habits such as having a set bedtime or keeping your bedroom dark can help you get adequate sleep. Restful sleep can in turn help you keep your energy levels stable.
  • Mood journaling: By writing your symptoms down, you and your therapist can find patterns in your mood changes. With practice, you may be able to recognize an oncoming mood episode and prepare yourself for it.
  • Building positive, supportive relationships: There may be times when your symptoms affect your ability to function at work or at home. A support network can be invaluable in helping you get through a severe mood episode. 
  • Managing stress effectively: Stress is often a trigger for mood episodes. You may wish to avoid taking on too much responsibility at work or school. If you are constantly pushing your limits, you may not have energy left to cope with symptoms when they come.
  • Developing a healthy daily routine: Keeping a schedule for meals, sleep, and exercise can help your body know what to expect each day. A routine can also make it easier to tell when your mood is due to your mind or your environment. 

SUPPORTING LOVED ONES WITH BIPOLAR

If you have a family member with bipolar, you may feel confused or overwhelmed by your loved one’s behavior. While you cannot cure their condition, you can help them manage their symptoms.

Siblings take a break from their bike ride to have a serious talk.One of the most important things you can do with your loved one is to create a crisis plan. A crisis plan is a written agreement of what actions the family will take in an emergency. You and your loved one may discuss how severe their symptoms can get before you take them to the hospital. You might also write a list of preferred treatment centers or medications. 

During a mood episode, your loved one may be reluctant to accept treatment. You may find it helpful to have your loved one sign the crisis plan beforehand. The individual may be more willing to accept help if they know they are following their own instructions.

Even during milder mood episodes, a loved one may still benefit from your help. During a depressive period, you can support your loved one by making sure they follow a daily routine (even if they would rather sleep all day). You can also remind the person that they are valuable and that they will not feel this bad forever. 

During a manic phase, you may need to watch your loved one to make sure they do not take actions they will later regret (such as quitting a job they love.) If your loved one insists everything is under control, you may ask them to put the plans off for a week. If their plan truly comes from their heart, they will probably still want to do it even after the mood episode ends.

Remember that you do not have to support your loved one on your own. There are professionals who can take on much of the work. If you and your loved one would like to start bipolar treatment, you can find a therapist here.

References: 

  1. Bipolar disorder. (n.d.). National Alliance on Mental Illness. Retrieved from http://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder
  2. Flanigan, R. L. (2017, July 6). A safe space—what to know about going to the hospital. Retrieved from https://www.bphope.com/bipolar-what-to-know-about-going-to-the-hospital
  3. Geddes, J. R. & Miklowitz, D. J. (2013). Treatment of bipolar disorder. Lancet, 381(9878). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3876031
  4. Helping a friend or family member with depression or bipolar. (n.d.). Depression and Bipolar Support Alliance. Retrieved from https://secure2.convio.net/dabsa/site/SPageServer/?pagename=education_brochures_helping_friend_family
  5. Is it just a mood or something else? (n.d.) Depression and Bipolar Support Alliance. Retrieved from https://secure2.convio.net/dabsa/site/SPageServer/;jsessionid=00000000.app214a?NONCE_TOKEN=A8F08E5C26DB52451B99413D94AD4F7A&pagename=education_brochures_just_a_mood
  6. Smith, M., Segal, J., & Segal, R. (2015). Bipolar support and self-help. Retrieved from http://www.helpguide.org/articles/bipolar-disorder/bipolar-support-and-self-help.htm
  7. Understanding hospitalization for mental health. (n.d.). Depression and Bipolar Support Alliance. Retrieved from http://www.dbsalliance.org/site/PageServer?pagename=urgent_help_for_patients