Any journey that feels like a mountain conquered is savoured that much more!
Ask any Bipolar Disorder afflicted and you’ll hear about the difficulty she or he is have in coping with the condition. BD affects one in insidious ways. The unpredictability of mood swings erodes confidence as one is often left guessing.
The good part is, many have conquered the demon and are leading successful lives.
To overcome any serious illness we must understand the basics first.
The cause of BD is not yet established although genetics plays a big role. The most common types of BD are~
Bipolar 2 Disorder (reportedly more prevalent in India) is marked by deeper and longer depressive phases with hypomania in between. Such patients struggle with low energy, lack of motivation and drive and even suicidal tendencies in extreme cases. During Hypomania, high energy levels and confidence can drive one to reckless behaviour.
Bipolar 1 Disorder is considered the more serious of the two and indicates more of manic phases and also phases of depression. Here, recklessness, overconfidence and spending beyond one’s capacity can ruin families.
The condition tends to subjugate the affected into surrender. Even those trying their best often flounder. So how can one cope with this dreaded illness?
Here is a handy list of coping tips~
1) Psychiatric Treatment
This should be a no-brainer but stats suggests otherwise. So many either don’t seek treatment or drop out midway. You just have to be under the care of a Psychiatrist! (If you are not seeing one, God help you!). This illness is far too complex for us to Google search for self medication~ that’s a short cut to disaster. Bipolar meds are complex and are in various dosages: Mood Stabilisers, Antidepressants, Antipsychotics and tranquilisers. Each person reacts to meds differently. Since the meds can have serious side effects, your Doctor is best qualified to decide what works with you best. Also, the meds might need tinkering as per mood fluctuations. We must keep visiting our Psychiatrist as per appointment schedules and strictly adhere to the treatment prescribed.
Persisting with the treatment despite the side effects and even if results are not visible immediately is also critical.
2) While a Psychiatrist primarily handles the brain part of the illness, a Psychotherapist takes care of the mind issues.
BD wreaks havoc with the emotional state of anybody who has to deal with it. A skilled Psychologist can help increase your confidence and assist in recovery, CBT (Cognitive Behavioural Therapy) is known to be particularly helpful in correcting erroneous thought processes and thereby, altering moods. The caregivers in the family of a patient also need counseling and family therapy is therefore recommended. Also, a Psychologist and Psychiatrist can work as a team, exchange notes to make monitoring of progress more precise.
Walking is known to elevate mood, in addition to being great for overall health. Form a habit of walking daily, preferably in daylight. A Peer Support member said to me that she felt too tired to walk. So I suggested to her that a ten minute walk should not be too taxing for her and she could then increase the duration as she regained her strength.
Yoga is a super power! It is known to help balance mind, body and spirit. Practitioners of yoga claim that they feel calmer and I too can endorse that. Pranayam is easy to do on a daily basis. I have taken a liking to vigorous workouts in the Gym every morning. Have been a regular since a year and this has also helped increase my fitness & energy levels as well as confidence. The dopamine release after exercise reduces stress and is a mood elevator, hence the ‘Feel Good’ factor.
4) Sleep timings
Drastic changes in sleep patterns are a key indicator of mood changes.
In mania, persons have been known to go for weeks without sleep or very little sleep. During depression, getting out of bed can be challenging and mornings are troublesome. Energy levels also fluctuate along with need for sleep~ high energy, less sleep during mania and vice versa for depression. Report such changes to your Doctor with accuracy. It is needs great self restraint to switch of all lights at 10 pm and get up at 6.30 am day in, day out. However, maintaining regularity in sleep cycle helps reduce mood fluctuations.
You can hardly be blamed if, succumbing to pressure, you seek the easy way out by experimenting with alcohol and drugs. A strict NO NO! Drugs and alcohol just don’t mix with BD meds. Also even occasional indiscretion can quickly precipitate to addiction with a virtual no-return. Managing BD by itself is quite a handful. We don’t need to complicate thing further.
No matter how much we ‘think’ we know about ourselves and the condition, during hypomania and esp. mania, only someone else can notice the alarm signs. So, firstly, a close relative who is constantly around has to take responsibility of being the watchdog and reporting any alarming symptoms to the Doctor. Such a person needs to have be trained about basic symptoms and how to react. The patient in turn, must cooperate, which is such a tough ask during mania.
7) Strong Relationships
Spare a thought for those who support you day in day out and who live in uncertainty, just like you do. Be supportive and grateful, for without them, getting anywhere is a tall order. During hypomania and mania, our behaviour can drive the most patient people up the wall! To compensate, let’s acknowledge their contribution and sacrifices. I know of a few BD afflicted who do not have the required support of even their parents. Supportive relationships are so crucial~ so let’s learn to nurture them and pay them back with our gratitude and commitment.
8) Nothing is permanent, not even our problems!
We would do ourselves a great favour by believing in this famous saying. Far too often are we overwhelmed by our immediate, seemingly impossible to overcome issues. The illness itself is such that it knocks our confidence hollow. Our self belief takes such a beating that we begin to think we are incapable of hauling ourselves up from the dark pit we are in. To you, I would say this~ I too was caught in that trap some years ago. You need to inculcate the belief that you too will climb this seemingly insurmountable mountain to recovery. That this is just a matter of time, patience and perseverance.This element is so, so crucial to our maintaining our focus and inner drive! ‘I might be in doldrums today but that’s not where I am going to remain forever’ is the attitude one must inculcate with conviction.
9) Join a Peer Support Group
In September 2016, we held our first ever Peer Support Group Meeting in Mumbai. The attendance was a grand four of us! Since then, our Group has grown in number and there’s a bonding like that in a family. The way the deepest secrets are shared by first time participants is amazing~ the trust that a new member has in his fellow warriors empowers him to narrate his story and feel lighter. Also, he knows that the listeners know what he is talking about because they too have walked his path, braved the same agony and fought similar battles. Many of them tell us things which not even close family members know about their condition. This is the power of Peer Support. In India, unfortunately we do not have a network of such Groups across even our Metros. To my knowledge ours is the only one operating anywhere in India. I call upon Peers to come forward for guidance~ let’s make this a nationwide movement to isolate isolation. As Psychotherapist H’vovi Bhagwagar said at one of our functions~ ‘One Peer Support Meet is equivalent to ten sessions of therapy’. Meanwhile, if you are in Mumbai, you may join us by commenting on this post or by sending a mail to us .For those of you who do not have an opportunity to participate in such meets, use the forums here to voice your doubts and have your queries answered. You Are Never Alone!
10) Self belief
Fear and doubt are the biggest barriers on the path to success in life. As BD afflicted, we seem to have these in abundance. ‘I am feeling so happy and positive over the last few months! Wish this lasts for some time’ or ‘Wait a minute, am I heading towards mania?’
Such uncertainty plagues us at almost all stages of our journeys. While it is necessary to be guarded and cautious, somehow we need to overcome these undermining doubts. I too had this perennial problem. ‘I am planning these career moves but what if I hit a low again?’. The answers come from experience and maturity. My solution was, ‘If I have been able to handle the worst of lows and scary highs, why worry about a mild low that might or might not materiarilse? Surely I can cope with it as I have done so many times in the past!’. This resolve has subsequently stayed with me and I have learnt to trust myself more, and more importantly live in the moment rather than brood too much about what’s in store for me.
‘Let the worry of what might never happen steal the joys of today’ as the saying goes.
Let’s also learn to look at the bigger picture~
‘There’s so much more to me than Bipolar Disorder. I shall not allow it to become my identity!’