To start, how do we think about bipolar disorder? It is a severe and persistent mood disorder, which can be a confusing and scary. However it is worth remembering that we each have our own personal identity which is not defined by a bipolar disorder diagnosis. While it can be a harsh teacher, it does encourage us to pay diligent attention to our health, our routines, etc.
It can be challenging to diagnose, it can often take approximately 8-10 years to get an accurate diagnose. The illness may not appear ‘fully formed’ the younger the person is when the first present with symptoms. Around 50% may have “other issues” presenting alongside, such as anxiety or alcohol misuse and approximately 60% may get a misdiagnosis of depressive disorder. An incorrect diagnosis means incorrect treatment and poorer outcomes for the individual who is experiencing bipolar disorder.
It is true the medical community needs to up our game when it comes to diagnosis. Information that helps form a diagnosis includes family history, a detailed course of the illness to date, treatment responses, inventory of mania/hypomania via questionnaire and a willingness to probe deeper.
Let’s look at the stigma surrounding “coming out” as having bipolar disorder. It is important to remember it is neither your fault, nor your identity, please do not feel judged or at fault. If it helps, remember you are in good company, 1 in 5 of us will have mental illness at some point and for 1 in 25 it will be a serious illness. While there may be some misconceptions about bipolar disorder, it shouldn’t mean we don’t ask for help. In reality, only a few close people around us need truly understand our experience. Being a positive role model for yourself is your main responsibility.
It is important to know the rules, the monitoring and purpose of any medication you are. It can be helpful to proactively note effects of medication, both good and bad, especially if you are on antidepressants. Medications ideally should be effective, tolerable and safe in long term; immediate efficacy isn’t enough. Please be patient, it can take numerous medication trials and even combinations may be necessary to find the right fit for each individual. Remember the golden rule – medications are not perfect, but they can make the illness manageable. Please persist with what is working for you and always consult with your mental health professional or GP in relation to medications.
Part of accepting your diagnosis will come from actively participate in treatment of your bipolar disorder. It is very helpful to monitor your mood on an ongoing basis and this is something you can share with your clinician or therapist. We all need to consider thought restructuring – we all get distortions and we can all benefit from the skill of balanced thinking. Try to catch, challenge and change unhelpful thoughts. Discussing with an external person, can sometimes help with this. With this condition, and sometimes the reactions of other people, you may need to problem solving frequently, so therapy can assist here. Above all else, we need to work to stabilise our routine, in particular sleep, social life, everyday expectations, self care, etc.
“What supports do you need and what can they do for you? It can be helpful to get encouragement and learn coping skills from someone who experiences the condition, a capacity to share concerns, etc. Peer support can help to accept the diagnosis and reduce isolation associated with the illness. Family and friends also can build their own understanding and learn to be more supportive stance. Support networks can be a great forum for education of symptoms, triggers and crisis response.
This is a take home wellness mnemonic, that was created by Ellen Forney, a Seattle based artist.
Tools for coping
Support system that is solid
This post is some highlights from Dr Declan Lyons’ segment on Aware’s webinar “Living well with bipolar disorder” on 10 March, ahead of World Bipolar Day on 30 March. You can watch it back and hear the full version, which includes more details, responses to questions and the personal experiences of Rick and Sinead, by clicking here.
Declan is a Consultant Psychiatrist at St Patrick’s Mental Health Services and a voluntary board member on Aware’s Board of Directors.