Bipolar II Disorder

Management and Resources

At home

The following tips for managing the condition on one's own may help improve symptoms when combined with therapy and medications, over time:

Tracking moods

Individuals may wish to create a mood chart to track their moods every day for at least a week or two. This chart will help them detect patterns in their moods and may offer clues on actions one should take. Note not only how one felt but also what is going on in their life at the time, such as changes at work or in their social life, or changes in their daily life pattern. Tracking moods will help individuals determine possible early indicators of mood changes and may also help them 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 after just two drinks and a late arrival home may have affected her ability to get to sleep: 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 that would mean getting enough sleep. She tracked her moods, and noticed a marked reduction in instances of depression! It usually isn’t this easy; But, sometimes it is.

Checking in with others

Individuals 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. Individuals 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 hypomania.

Alternatively, if individuals become extremely prickly, agitated, and nervous, they may be headed into a hypomania 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 others think that their friend or family member may be moving into a major mood change, particularly a depressive episode, a first step is to ensure the individual takes their medication consistently, and it may also be a good idea to call their medical provider to see if their medication should be adjusted. Do NOT, however, ever change dosages without the guidance of a medical provider as that could be very dangerous.

If the symptoms from bipolar disorder seem to be running out of control, contacting a medical provider is best. Whether it’s the beginning of a mood change, or the middle of it, their medical provider will often have good ideas on what to do and not do.

Exercise

While many are aware of the vast, proven benefits of diet and exercise, taking these steps can be particularly difficult while depressed. However, our bodies needs movement, sunshine, and non-processed foods (especially vegetables). Start small: Eating one vegetable or fruit per day; Walking one lap around the block, etc... Tiny changes, over time, can make a real difference.

At work

Although individuals don’t have to, they may wish to tell a trusted colleague or their supervisor that they have bipolar disorder and that they are taking medication for it. In some cases, individuals might need to take time off from work. The Americans with Disabilities Act and other legislation covers psychiatric disabilities as well as physical disabilities, as does the Family Leave and Medical Act.

At school

If individuals with Bipolar are attending a school, especially if they are living on campus, it would be wise to let the college or university clinic be aware of their diagnosis and the medication they take. They can’t tell anyone else about their medical problems without their permission, so don’t worry that every student will know that they’re the person who is bipolar. They won’t know.

In relationships

Bipolar disorder can have an impact on relationships in many ways. If their partner or friend does not have bipolar disorder, it can be difficult for them to understand what the individual is going through. Opening up about their experience can help bridge the gap in understanding, although sharing their experience is not always easy. It is common to feel like one is burdening others with their sadness or experience, but this is not the case. In order for their partner or friend to have their full partnership and feel trusted, they need to be able to share and even ask for help.

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

For some people, having bipolar disorder, plus taking psychiatric medications, can impact their sex lives or cause low libido, dryness, or erectile dysfunction. The first step to addressing this issue is to acknowledge it; but sharing this type of sensitive information with a partner or provider is not always easy.

Steps that might improve the effects of antidepressants on sexual satisfaction:

Try having sex either before taking the medication, or much later so that the levels of the medication in the body are at their lowest.
Try a new routine such as exercising before sex, or incorporating new types of stimulation into the process.
Address/reduce depressive episodes. It is possible that when depressive symptoms of bipolar disorder improve, libido will also improve: Research has shown that depression can cause these effects with or without taking an antidepressant.
Discuss with a medical provider if they are a candidate for adjusting the medication dose so that is both effective but with less impact on sexual functioning. Their medical provider can also determine if hey are a candidate for an alternative medication, with less potential sexual side effects, or if they are a candidate for a medication to help with sexual dysfunction.

Bipolar disorder can cause impaired self-esteem, which can also be hard on relationships. Individuals may find themselves needing extra reassurance or outside validation during this time. Consider keeping in mind and accepting that this time will be difficult and that this is just something individuals will need.

When a partner with bipolar disorder stops engaging in activities that their partner wants to do, often because of a depressive state, this can be difficult for the other partner to understand and to navigate. In addition, a hypomanic state can be difficult for partners to understand and cope with because suddenly the highly energized person wants to engage in activities that are not the norm for them, like skydiving or drag racing. In such cases, partners and other family members may actively resist participating in such activities. It is important for both parties in the relationship to remember that properly treating their bipolar disorder with therapy and the right medications can help individuals feel like engaging in normal life again, and that this lack of interest or extreme behavior is only temporary.

Organizations & resources

National Institute of Mental Health American Psychological Association

Depression and Bipolar Support Alliance