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- Find a good doctor
- Become an expert
- Manage your illness
- Plan for a crisis
- Find a community
- Practical matters - work, school, and federal
- Other Resources - coping with mania, depression,
and life with bipolar disorder
When we give lists of symptoms and medications for people with bipolar
disorder, the entire thing can seem disarmingly simple. But anyone who
has been there knows that there is nothing simple about accepting and
living with a chronic illness, and it's just as important to address the
emotional and practical issues of bipolar as it is to know the diagnostic
criteria and treatment guidelines. Those with other chronic diseases like
diabetes, cystic fibrosis, or multiple sclerosis go through a similar
process of grieving, accepting, learning, and adapting - and through this,
begin healing and recovery.
A helpful outline to guide a healing and recovery journey is described
in the acronym TEAR:
T = to accept the reality of loss. There are things that will
be different after a diagnosis of bipolar, and it's important to recognize
these things rather than denying or hiding them.
E = experience the pain of the loss. You are allowed to grieve
what you feel has been lost with the onset of this disease, both from
your own life and the lives of others. You are allowed to mourn previous
goals and aspirations that must be altered to this new reality.
A = adjust to the new environment without what was lost. Whatever
was lost with your diagnosis doesn't constitute the whole of your person.
The core of you is still the same, and knowing about your illness now
allows you to re-adapt to this new context of life.
R = reinvest in the new reality. Explore, create, engage, and
live as the person you are, managing your own life and your illness
as part of that life.
Below are some articles and resources that we hope will help you in your
1) Find a good doctor.
Even if you already have your diagnosis, your doctor will be your ally
and partner in treatment and recovery. It's important to have a doctor
you can speak openly with, who will listen to you as an equal and acknowledge
your expertise on your own body, who will offer helpful suggestions and
be invested in your recovery. Below are some resources on what to look
for in a good psychiatrist and/or health care provider, and how to find
one in your area.
2) Become an Expert.
Putting a name to what used to be a vague collection of debilitating
symptoms puts you in control. Knowing your disease as intimately as you
can gives you the tools to manage it effectively, rather than it managing
you. It can also make your situation seem much less frightening when you
can understand and recognize what is happening in your own body. Here
are some resources to get you started.
3) Manage your Illness - mood charting and meds.
One of the best coping strategies, suggested by professionals and patients
alike, is using a mood chart to track your own episodes and symptoms.
A mood chart can be a preventative tool to help identify early warning
signs for relapse, a record for physicians and family to help assess the
efficacy of different medications and treatments, and a therapeutic tool
to organize a person's daily routine and improve awareness of the illness.
The simplest method of mood charting is rating your mood (at the same
time each day) on a scale of 1-10, with one being very depressed and ten
being absolutely elated. A good place to keep a record is on a wall calendar
or in a daily diary. Other methods involve more elaborate charts, and
a more detailed rating scale (see the links below). Some people work better
with graphs, others with numbers, others with writing lists of words or
paragraphs to describe their feelings. The overall goal of the charts
is to have a reliable and consistent record of how greatly your moods
flucuate over a period of time, so develop the method that is easiest
for you to achieve this goal.
- Mood charting resources:
Mood Diary - gives an explanation of how to use the mood chart,
and has a blank and a completed example available for downloading
Mood Chart System - a patient describes how he developed a personal
system that worked for him, including examples.
Charting for Children - the Child & Adolescent Bipolar Foundation
provides examples and resources for charting your child's moods, and
eventually helping him/her to track it themselves.
Another excellent coping strategy is learning how to manage your medications
effectively. The first thing to do is know
about what you are taking - ask your psychiatrist what symptoms
your medication is treating, how long it might take to work, how much
and how often you should take it, what you should do if you miss a dose,
what side effects you might have and what you can do about them, and
anything else that is on your mind. Keep track of your own medication
information - names, dosages, how it makes you feel, what symptoms it
makes better or worse - in a journal or diary. Having this information
will help both you and your doctor find the medication regimen that
works the best for you, and allow you to adjust it effectively as needed.
It can be an extremely frustrating trial-and-error process to finally
find a medication that works for you. Please be patient and give the
medications adequate time to do their job. Most people won't feel better
right away - it can take four to six weeks for a drug to get into your
system and start noticeably helping. In the meantime, you can help yourself
by trying some of the suggestions on this page, or finding a support
group to help you through difficult times. By all means work with your
psychiatrist to switch medications if you are unhappy with your current
one; however, try to be realistic about what medications can and can't
do, and consider the relative benefits of staying on one versus trying
to adjust to a brand-new one.
Simplify your medications as much as possible by putting them in separated
daily pill boxes (you can purchase pill organizers with seven separate
compartments, one for each day of the week), taking them at the same
time each day, or taking them with a daily vitamin pill or something
else that you do religiously. If you have a lot of trouble remembering,
ask family members/roommates to help, or ask your doctor about the possibility
of switching to long-acting injectable medications instead of pills.
Help your medication do their job by keeping healthy habits in your
4) Plan For a Crisis
Your mood charts (see above) will help you recognize what particular
symptoms or behaviors tend to precede a manic or a depressive episode.
Having a plan ready for relapse situations will help you get the care
you need, and make sure other practical matters are taken care of, even
if you are in a place where you can't effectively make decisions. One
of the most difficult aspects of bipolar to deal with is the seductiveness
of mania - many people don't seek help during a manic episode because
they are feeling on top of the world. However, even though they can't
recognize it, they still present a danger to themselves or others via
reckless acts, excessive spending, uncontrollable behavior, etc.
You can take some precautionary steps while you are stable to help
get through a crisis situation as smoothly as possible. Put the following
information (along with anything else that might be helpful) into a
"crisis plan" folder, and distribute it to your doctor, your
family members, and other trusted people who can help you.
- Make a list of people you trust (close family members, friends in
the area, etc) who know about your disease and are willing to help
you. Have their names and phone numbers together on a "crisis
- List the names and contact info of your psychiatrist, general practitioner,
case worker, or any other professional that helps you manage your
- Write out the particular signs that indicate a manic or a depressive
episode, to help others recognize when you need help. (See some of
warning signs compiled by bipolarsurvivor.com to use as a guide
in making your list).
- Make another list of all your medications, what dose you take, and
what side effects you experience. Note any medications you are allergic
to or do not want to take under whatever circumstances.
- Leave directions for the care of your house, your pets, your plants,
etc., in case you are hospitalized.
- Write down your insurance plan information
- Leave the names and numbers of family members and/or employers that
need to be contacted in case of an emergency or an extended hospital
- Leave any detailed instructions of what kind of care you do and
do not want to recieve if you are unable to make your own decisions
(the legal document for this is called a psychiatric
5) Find a Community
Having a supportive community is important for anyone, but particularly
for someone dealing with a chronic illness. A support group of friends
and peers can relate to what you go through like no one else can, offer
support or a sympathetic ear, and give practical advice and solutions
for difficulties as they come up. For the times when you are not feeling
particularly social, an online discussion group or chatroom is a great
option to keep yourself connected with others.
National U.S. support groups for people who have mood disorders:
Online Support Community:
International Support Organizations:
6) Practical Matters - work, school, and federal aid issues:
7) Other Resources - coping with mania, depression, and life with