Living With Bipolar Disorder

Self-Care: Living With Affective Disorders

Good Health: It’s Not a Cure But It Helps!

Don’t underestimate the importance of safeguarding your overall health. Factors that contribute to mood disorders include poor sleep habits, vitamin deficiencies, stress, other illnesses and their treatments, drug interactions, food sensitivities, improper metabolism, and social isolation.

Every body is different. You may find it helpful to keep a journal to chart your activities, nutrition, and health to determine possible contributing factors to your mood disturbances. This gives women with depression and manic depression a special reason to chart their menstrual cycle.


Drink, Drugs ‘n’ Rock ‘n’ Roll: Don’t Do It

People with mood disorders may develop unhealthy habits as quick fixes to their depressed mood, or in response to a manic mood. Abusing alcohol, over the counter or prescription medications, illegal substances, and even food, are often means to "self medicate." Such abuse can cause other health problems, increase or decrease the effects of carefully prescribed medication, cause severe or even lethal interactions, and lead to destructive activity. Exclusive of the presence of clinical depression, drugs and alcohol on their own can sufficiently alter the body’s chemistry and bring about episodes of depression or mania.

A depressive illness may be masked if another disorder, such as substance abuse, is present. For instance, a person may be seen as depressed because he drinks too much, rather than dependent on alcohol to alleviate a depressed mood. Comorbidity (the presence of two or more disorders) can be very difficult to treat. No matter how well a person is treated for the alcoholism, he or she may fail to get well if the
affective disorder is not treated as well. 

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Suicide: Finding Help, Responding Effectively

Although alarming, suicidal ideation is not unusual in cases of depression. These thoughts represent the distorted thinking that results from this treatable medical condition.

If you are thinking about suicide, inform your doctor immediately just as you would of other severe symptoms. Identify close friends or family members who may act as confidants so that when you are feeling desperate, you will already have a support system of people who understand this aspect of your illness. Prepare a list of phone numbers for your physician, preferred hospital and trusted friends. Keep it handy and share it with someone you trust so that they may be able to act quickly if you are in danger. If you do reach a desperate state when you are alone, call 911 or go the nearest emergency room for help. Don’t be afraid of "bothering" the authorities; they are there to help you just as they are there for people with other medical emergencies. Hopefully, you will be able to head-off potential tragedy by learning to recognize personal warning signs and common "triggers" such as drugs and alcohol which exaggerate suicidal feelings and can severely impair your judgment.

You can help a suicidal person by learning warning signs and taking threats very seriously. If someone is "winding up" his or her affairs, frequently discussing methods of follow-through, or is exhibiting increased feelings of despair, step in. Ask direct, thoughtful questions and point out specific patterns of behavior that concern you. This may help restore the person’s perspective before professional help can be found. Keep
communication going until you find help, but don’t promise confidentiality! When a life is at stake, there should be no secrets between a patient’s doctor and family or trusted friends. Encourage the person not to feel ashamed of the way he or she is feeling because suicidal thinking is symptomatic of a treatable medical illness. Stress that the person’s life is important to you and to others. After the patient has been in treatment
and the severe depression seems to be abating, beware that as mood lifts, a still-depressed person may be better able to plan and attempt suicide with the improvement of energy and functioning capabilities. 

Don’t try to handle this crisis alone. Calling for help from other key individuals will not only help the suicidal individual, it will offer you the emotional support you need.

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Like a Bad Penny: Handling Recurrences

As with diabetes, heart disease, asthma, or even food allergies, people with affective disorders should see themselves as "managers" of their illness, rather than as "survivors" of a terrible event that absolutely won’t happen again. Because it can. If it does, don’t panic. Your experience with previous episodes puts you one giant leap ahead in the process of recognizing symptoms and getting help. Some people are treated for only a few months before their therapist or doctor releases them with proper instructions. For others, daily medication and periodic visits to the psychiatrist become a fact of life. By continuing treatment as needed, the chances of recurrence are greatly reduced.


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DID YOU KNOW . . . ?

Here are some interesting facts from a 1993 survey of people with manic-depressive illness.

Fourty-one percent abused alcohol or drugs when their illness was not being successfully managed, compared to 13% when the illness was being managed.


Supportive relationships with family members (including spouses) is key to the day-to-day management of manic-depressive illness, according to 90% of those surveyed.


On average, correct diagnosis of manic-depressive illness is made eight years after seeking treatment and 3.3 doctors later.


Fifty-nine percent of manic-depressive patients reported symptoms of their illness during or before adolescence; however, half did not receive assistance for their illness for five years or more.


Twenty-one percent have at one time discontinued use of medication due solely to financial constraints.


In addition to the almost universal use of medication in the treatment of bipolar disorder, one-on-one psychotherapy was reported as a type of treatment used by 82% at some point during their illness. Support groups have been used by 73% of those surveyed, and group therapy was used by 52%.


J.D. Lish, et al., (1994). "The National Depressive and Manic Depressive Association survey of bipolar members." Journal of Affective
Disorders, 31, 281-294.











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Helping Yourself, Helping Others: The Value of Support Groups

Now . . . spending an evening with a group of depressed people may not sound like a barrel of laughs at first . . . but you’d be surprised! Support groups provide a forum for mutual acceptance, understanding, and self discovery. Your involvement with a group gives you something proactive to do while you may be waiting for a new medication to take effect or while you’re ticking off the days until your next therapy session. Buoyed by the bond of depressive or manic-depressive illness, you may find yourself rediscovering strength and humor which you’d thought you’d lost. As with any chronic illness or serious injury, we can sometimes fall into the mistaken belief that we are inherently defective people. In a support
group, where you have the opportunity to reach out to others and benefit from the experience of those who have "been there," it becomes a little easier to remember that depression or manic depression does not define who you are.


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Coming Out: Telling Others About Your Illness

While a support group is an ideal environment to share your experiences with depressive illness, you may be concerned about "coming out" in public. It is your personal choice whether or not to disclose your diagnosis with anyone other than your doctor or therapist. Discuss with him or her how and what to tell people. Most people will appreciate your honesty, and you will help them understand how to respond to your fluctuations in mood and behavior. Because your illness or medication side effects may impair your functioning, teachers may need to be alerted and in some cases, your employer–especially if your job involves the safety of others. Print this booklet and share it with them or contact National
DMDA for other resources.

The Americans with Disabilities Act (ADA) prohibits employment discrimination on the basis of a physical or psychiatric disability. Through the ADA, an employee may request that reasonable accommodations be made through modifications to the employee’s schedule or job environment. Reasonable accommodations may be required to minimize functional limitations for workers with psychiatric disabilities. These
limitations may include difficulty in maintaining concentration, managing time pressure and deadlines, initiating interpersonal contact, or maintaining stamina throughout the workday. 

Disclosure may be especially difficult for people with psychiatric disabilities. An employee is not required to disclose all the details of his or her illness–only those necessary to demonstrate eligibility for an accommodation under the ADA, and only if an accommodation is needed. Moreover, the employee may request confidentiality, a right protect by the ADA. It is in your company’s best interest to safeguard your mental health and to offer reasonable accommodations necessary to help you on the job. Untreated depression leads to absenteeism, work-related injuries and lost productivity. Your illness is a medical problem, not a personal shortcoming.



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