How to Recover from Bipolar Disorder (Manic Depression)

Step-by-Step Guide

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   Step 1: Your goal is to live a meaningful

   As with any major life change, you may have to renew your personal definition of meaningful, productive and happy to include your condition and genuine restrictions it imposes.
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   Step 2: productive and happy life.

   However, talk to your psychiatrist if the side effects are overwhelming.
   
   There are many medications and possible combinations.
   
   You may need to experiment for a long time to find the right combination. , It carries many essential benefits (health insurance).
   
   Talk to HR (discretely) about your disability rights. , Consult a lawyer who specializes in employment law. , The definition of disability is NO WORK.
   
   Focus on medical treatment.
   
   For bipolar, rest and relaxation are likely to be a big part of this. , All of us have artistic, creative or intellectual abilities.
   
   Use this opportunity to explore. , This impresses your supervisors (too many volunteers don't take this seriously).
   
   From here you can obtain recommendations and apply for positions in the organization if they open up. , You are not a list of symptoms.
   
   You are a whole person with interests and talents.
   
   Don't say, "I'm bipolar." Say, "I have bipolar disorder."
   
   We don't know why, but some people as they age, such as Ruth Deming, co-author of this piece, reach a full recovery from bipolar disorder and do not need medications.
   
   This is documented in the book "A Mood Apart"
   
   Medication and therapy are essential tools for mood management. , It creates new neural pathways for new learning, older pathways are no longer so tightly wired.
   
   However, you never lose them.
   
   It is possible to recover "lost pathways".
   
   By engaging in pleasant activities and changing your outlook, you can permanently alter your depressive mood and keep it at bay by re-wiring your brain.
   
   It can take months but it will happen if you continue. , Use the Internet, read books and ask questions to your family doctor, psychiatrist, therapist and fellow support group members.
   
   It enhances your ability to talk to your psychiatrist meaningfully.
   
   In turn your psychiatrist can develop more effective treatment approaches. , It's great to talk to people and learn how they cope with their illness. , If you have the website for other locations, please add it by clicking 'edit'. , These include pleasurable activities (to manage depression), tracking daily activities and mood (to detect mania), exercises designed to enhance your ability to change your behavior.
   
   Goals such as "I'm going to set my kitchen timer for an hour and make phone calls looking for a job." can be used to control mania (restricting the desire to make phone calls until you collapse).
   
   Alternately that same goal is appropriate to treat depression, building momentum and reinforcing confidence. , Have someone you trust recommend one if possible.
   
   Support groups can be a starting point.
   
   Also, if you like a particular university hospital, call that hospital and ask for a referral, or ask for a referral to that hospital from your family doctor. , Most of the time, you can only see them while they conduct a clinical trial.
   
   They will not have time to see you after the research is completed.
   
   Ask them about aftercare. , Most psychiatrists are too busy to train patients especially with complex conditions like this one.
   
   Therapists often conduct classes on skills for mood management, are knowledgeable about local resources, such as support groups, can give advice about additional therapies or approaches that you might try (nutrition, exercise). , Give each group a try (4-6 sessions), them move on if you aren't getting anything out of them.
   
   You may need to get referrals from your psychologist to enter the group. , Then try out the psychiatrist.
   
   Do you feel you trust this doctor? You can try another psychiatrist if the trust issue isn't working out.
   
   How do you feel about communication? Do they understand you when you describe how you feel? If it's communication, then most likely you need to learn some medical jargon to get the relationship going.
   
   You can't pop the right pills if the doctor doesn't know what's going on. , A psychiatrist must be readily accessible to you.
   
   If you can't reach a psychiatrist in an emergency, you need to check in at a hospital or intensive care unit. , Telephone appointments if you need an appointment fast? Voicemail for urgent but not emergency questions? Secure email for more routine questions? Some questions about medications can be answered by your pharmacist. , Others you can't touch without your doctor's permission ever.
   
   Talk to your psychiatrist about how to manage this process. , Doctors especially in HMO's don't have time to answer questions like valproic acid can take six months or even a year to take effect.
   
   You may have idiosyncratic side effects.
   
   These are so rare that it's all hit or miss.
   
   Ask everyone. , List them under ICE (in case of emergency) in your smart phone. , Visits are short.
   
   Come with a list of questions.
   
   Also bring your version of a "mood chart," which tells how you've been feeling between visits.
   
   These are available FREE online by entering the words Mood Chart. , This includes: extreme behaviors you've engaged in, mood patterns, triggers, average length of time of mood stabilization.
   
   Have this info typed up beforehand so you won't waste time or forget important information. , Don't depend on your psychiatrist to keep all the notes.
   
   In this folder, keep records of your lab tests, per below. , Call your psychiatrist immediately if you feel your depression is worsening or you're getting manic.
   
   Most HMO's should have a psychiatrist on call 24/7.
   
   Get the number.
   
   Ideally, you'll learn, with your psychiatrist's help, how to medicate yourself should you or a loved one perceive the arrival of mania. , If you are hallucinating or psychotic (it's very hard to self-diagnose this) don't drive.
   
   Get an ambulance. , Keep track of when you need the tests done. , Drink plenty of water, wear sunscreen with an SPF rating of 15 or more, as your skin is especially sensitive to the sun.
   
   Watch for lithium toxicity (dizziness, confusion, altered gait) and if you have symptoms go to the ER immediately. , It will list the most common side effects.
   
   Some these medications have rare but lethal side effects.
   
   You will have a short window of time to get help.
   
   You need to know what to look for! , If you are treatment resistant you have options such as the newer more precise electroshock treatments (ECT) as described by Kitty Dukakis in her book: "Shock:
   The Healing Power of ECT." Vagus nerve stimulation is also helpful. ,, This approach is becoming more popular. , Just be aware that many of these approaches have not been clinically tested for effectiveness on bipolar depression.
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   Step 3: The most stringent requirement is to stay with the medications unless they are so intolerable your condition deteriorates.

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   Step 4: Protect your job.

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   Step 5: If you become unemployed

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   Step 6: you may still have rights with your employer.

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   Step 7: If you are on disability

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   Step 8: your new job is to get well.

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   Step 9: If you are unemployed

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    Step 10: volunteer.

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    Step 11: As a volunteer

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    Step 12: show up regularly and put your heart into your work.

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    Step 13: Your illness is a part of you but does not define you.

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    Step 14: Have faith in your ability to recover.

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    Step 15: Your chances of permanent recovery are greatly enhanced if you can keep your mood swings small.

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    Step 16: The brain re-creates itself constantly.

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    Step 17: Educate yourself about the illness.

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    Step 18: Attend a support group in your area with like-minded people.

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    Step 19: DBSAlliance.org lists many support groups for mood disorders in the US

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    Step 20: and Mood disorders.on.ca lists groups in Ontario

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    Step 21: Canada.

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    Step 22: Well managed support groups will set appropriate goals designed to control your moods.

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    Step 23: Choose an excellent psychiatrist.

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    Step 24: Be aware that some psychiatrists are research doctors.

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    Step 25: While seeing a psychiatrist

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    Step 26: see a therapist (social worker

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    Step 27: psychologist) as well.

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    Step 28: Not all support groups are created equal.

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    Step 29: To choose a good psychiatrist

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    Step 30: get a referral from a psychologist or other relevant health care professional.

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    Step 31: Establish your emergency crisis plan early in your treatment.

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    Step 32: Figure out the different ways to reach your doctor.

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    Step 33: Some medications can be adjusted based on your experience and judgement.

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    Step 34: If your psychiatrist hasn't found the right medication

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    Step 35: ask more questions

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    Step 36: especially from other patients.

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    Step 37: Keep your psychiatrist's name and number on a small piece of paper in your wallet

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    Step 38: or one of their business cards.

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    Step 39: During sessions

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    Step 40: be prepared.

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    Step 41: Tell the psychiatrist everything you think is important for her/him to know about you.

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    Step 42: Keep a folder at home with the above info.

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    Step 43: Crisis Plan.

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    Step 44: If you're feeling suicidal

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    Step 45: call your local suicide hotline or 911.

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    Step 46: You must get regular lab tests if you're on certain drugs such as lithium

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    Step 47: Depakote and Tegretol.

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    Step 48: Hot weather may be hazardous to people on lithium

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    Step 49: Lamictal and antipsychotics.

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    Step 50: For once

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    Step 51: read that insert in 4 point font that comes with every medication.

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    Step 52: Medicines help approximately 80 percent of all patients.

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    Step 53: Research centers work on treatment resistant cases such as the Depression Clinic at University of PA under Jay Amsterdam

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    Step 54: A radical new approach is described in "Healing Depression and Bipolar Disorder Without Drugs

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    Step 55: " by former bipolar sufferer Gracelyn Guyol.

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    Step 56: Explore the use of binaural beats

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    Step 57: acupuncture

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    Step 58: herbal medicine

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    Step 59: meditation

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    Step 60: and or do something not fun

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    Step 61: but intriguing

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    Step 62: like a Rubix cube or a puzzle.

Detailed Guide

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