Bipolar I Disorder

Management and Resources

At home

Some basic suggestions which may help improve one's bipolar disorder over time:

Creating mood charts

Individuals may wish to create a mood chart to track their moods every day for at least a week or two. This chart can help individuals detect patterns in their moods and may offer clues on actions one should take.

Note not only how you felt but also what is going on in your life at the time, such as changes at work or in your social life, or changes in your daily life pattern. Tracking one's moods will help to determine possible early indicators of mood changes and may also help to find likely causes of these changes. For example, Laura tracked her moods and what she was doing before and after a mood change to hypomania or depression. She found that when she went to a bar with people from work, on the next day, she was depressed. Laura didn’t get drunk at the bar but she realized that just two drinks and getting home late may have affected her ability to get to sleep because she tossed and turned all night on these occasions, and a mood change was imminent. Laura resolved to have just one drink when she went out and to leave early if need to get enough sleep. She wanted to see if this change made a difference to her moods. It did! Problem solved. It usually isn’t this easy; But sometimes it is.

Early symptom tracking

Learn your own personal early symptoms of a manic or depressive state. As just discussed, a mood chart can help. An individual may also ask others who know them well if they have noticed symptoms of increased energy or other behaviors reflective of bipolar II disorder such as a sudden decreased need for sleep. One may learn that if they tend to start using grandiose terms about how everything is so wonderful, so beautiful, and so great, and this is not their usual behavior, they may be heading into a mania. Alternatively, if one becomes extremely prickly, agitated, and nervous, they may be headed into a mania or even a depression.

Often the person with bipolar disorder does not realize they are headed into a mood change, but others around them may see it–if they know what to look for. Also, if an individual thinks they are moving into a major mood change, particularly depression, they should be sure to take their medication and call their doctor to see if they should take a higher dosage or a different medication. An individual should never change their dosage on their own. That could be really dangerous.

Staying in contact with a doctor

If one's symptoms from bipolar disorder seem to be running out of control, be sure to contact their doctor, whether it’s the beginning of a mood change or the middle of it. The doctor often will have good ideas on what to do and not do.

Exercise

Get enough exercise. Exercise generates endorphins which are natural antidepressants. Getting some fresh air and moving one's body often can improve a mood state, calming down a hypomania or improving a depressive state.

At work

Bipolar disorder tends to affect all parts of one’s life, including life at work. It can lead to tardiness, missing details, and lower productivity. In some cases, work scenarios can contribute to one’s depression. Unsupportive work cultures, or demanding environments can contribute to burnout, which can amplify the symptoms of depression. When an individual is in a depressed state, it is important to remember that getting treatment might make their work feel more manageable.

In the meantime, there are a couple ways individuals can move forward:

Check with the human resources person or team at one's company to find out whether they have an employee assistance program or partner that offers mental health services. This is a benefit many organizations have begun to offer.
Give oneself grace: while depressed, simply keep in mind that everyone needs a break every so often, or perhaps a day off in order to maintain their spirits. While taking breaks can seem disruptive, this strategy may be effective in protecting one's wellbeing and providing perspective.
Individuals do not ever need to tell anyone at work about having depression, nor do they need to keep it a secret. The amount of information shared is a personal choice, though some people find it useful to share that they are having a rough patch with a colleague or supervisor. Well trained managers understand that individuals experiencing depression might need a modification in their work responsibilities for a period of time.
Find support: Having a friend, preferably at work, can lend many benefits. Getting the support of friends, family, and even online support groups can be a powerful way to listen to others and share one's stories in a confidential and dignified way.

Some people find themselves in an unsupportive work environment, where continued productivity is inconsistent with protecting mental health. In such cases, individuals may wish to consider whether a job change in the future is right for them. It can be difficult to make life-changing decisions one is ultimately happy with while they is depressed. If possible to treat the depression before making a move, one can be sure the decision was made with a clear mind. This applies to work and personal relationships.

At school

Depression and mania tend to affect all parts of one’s life, including life at school when individuals are furthering their education as adults. When depressed, it is important to remember that getting treatment might make a school scenario feel more manageable. In the meantime, there are a couple ways to move forward:

Colleges likely offer student counseling services. Given the abundance of stress related to exams, and school performance, in addition to the challenges faced by a pregnant woman or new parent, it is common to feel overwhelmed, depressed, and in need of support. Reach out to a dean or student services for information if needed.
For some with depression, it may help to recall that everyone makes mistakes, and goes through rough patches at some point or another.
Find support: Having a friend, preferably at school, can lend many benefits. Getting the support of friends, family, and even online support groups can be a powerful way to listen to others and share one's stories in a confidential and dignified way.

Individuals do not ever need to tell anyone at school about having depression, nor must they keep it a secret. The amount shared is personal choice, though some people find it useful to share that they are having a rough patch with a professor or teaching assistant (TA). Teachers often understand that individuals experiencing depression might need a modification in their coursework for a period of time.

In relationships

Bipolar disorder can have an impact on relationships in many ways. If the individual's partner or friend does not have this disorder, it can be difficult for them to understand what the other is going through. They may expect the other to be able to “snap out of it,” which can add to one's feelings of loneliness or sadness. Their manic states may also be difficult for others to understand or cope with. Even so, opening up about one's experience can help bridge the gap in understanding -- although, sharing one's struggles is not always easy. One may feel like they are burdening others with their sadness or complaints, but this may not be the case. Sometimes being open during these struggles can fortify one's relationships.

The *symptoms* of bipolar disorder may also bring challenges to a relationship. If someone is depressed, they may be less likely to want to plan activities together or socialize with others, They may want to sleep more and eat less. Conversely, if they are manic, they may think they can accomplish amazing feats in record time, even when these accomplishments seem impossible to everyone else (and are impossible).. It is critical that both parties in the relationship focus on treatment, and to remember that this lack of interest is temporary. In most cases, the right combination of therapy and medication can restores a person.

Depression can cause impaired self esteem, which can also challenge relationships. You may find yourself needing reassurance or outside validation during these episodes. Keep in mind that periods of depression will require tenderness in your relationships.

Couples counseling can be a fantastic tool for improving a relationship quality when one or more partners struggles with depression. It can help both parties empathize with the other, and to find ways to best support one another.

For some people, having bipolar disorder, and also taking medications such as mood stabilizers, antidepressants, or antipsychotics can impact their sex lives. If you are experiencing low libido, erectile dysfunction, etc... There is hope: The first step to addressing this issue is to acknowledge it, but we know that sharing this type of sensitive information with your partner or provider is not always easy. Also keep in mind that people in a manic state of bipolar disorder or even a hypomanic state, may want a lot *more* sex than they normally choose to engage in.

A couple steps one might try in the case of low libido include:

Try a new routine with your partner such as exercising before sex, or incorporating new types of stimulation into your routine.
It is possible that when your depression improves, your libido will also improve: Research has shown that depression can cause these effects with or without taking an antidepressant.
Your provider may adjust your dose of medication to find a level which balances effectiveness with libido.
Some of the commonly known medications for erectile dysfunction (Viagra, Cialis, etc..) can be helpful to antidepressant induced sexual dysfunction in men. If these recommendations don’t work, a different type of medication that has fewer sexual side effects might be the next step.

Within the family

Mania and depression have a genetic component, and it can look different within the family. In children; for example, depression can manifest as anxiety or fear, and develop into depression after hitting puberty. Mania may present as euphoria. Parents who have struggled with their own depression can be vigilant of their children. Getting early treatment for them will eliminate years of potential suffering.

Organizations

National Institute of Mental Health American Psychological Association

National Alliance on the Mentally Ill (NAMI)

National Institute of Mental Health

Depression and Bipolar Support Alliance