Education
as prevention:
Learning
to cope with bipolar disorder
What if
you feel like quitting your treatment?
How often should I talk with my doctor?
How can I monitor my own treatment progress?
What can families and friends do to help?
Is there
anything I can do to help my treatment?
Another important part of treatment
is education. The more you and your family and loved ones learn about
bipolar disorder and its treatment, the
better you will be able to cope with it.
Since bipolar disorder is a lifetime condition, it is essential that you
and your family or others close to you learn all about it and its treatment.
Read books, attend lectures, talk to your doctor or therapist, or even
research on the Internet. You can use my links
page as a start. It also contains a list of interesting books
to read.
You can often help reduce
the minor mood swings and stresses that sometimes lead to more severe
episodes by paying attention to the following:
- Maintain a stable
sleep pattern. Go to
bed around the same time each night and get up about the same time each
morning. Disrupted sleep patterns appear to cause chemical changes in
your body that can trigger mood episodes. If you have to take a trip
where you will change time zones and might have jet lag, get advise
from your doctor.
- Maintain a regular
pattern of activity.
Don't be frenetic or drive yourself impossibly hard.
- Do not use alcohol
or illicit drugs. Drugs
and alcohol can trigger mood episodes and interfere with the effectiveness
of psychiatric medications. You may sometimes find it tempting to use
alcohol or illicit drugs to "treat" your own mood or sleep
problems-but this almost always makes matters worse. If you have problem
with substances, ask your doctor for help and consider self-help groups
such as Alcoholics Anonymous. Be very
careful about "everyday" use of small amounts of alcohol,
caffeine and some over-the-counter medications for colds, allergies,
or pain. Even small amounts of these substances can interfere with sleep,
mood or your medicine. It may not seem fair that you have to deprive
yourself of a cocktail before dinner or a morning cup of coffee, but
for many people this can be the "straw that breaks the camel's
back".
- Enlist the support
of family and friends.
However, remember that it is not always easy to live with someone who
has mood swings. If all of you learn as much as possible about bipolar
disorder, you will be better able to help reduce the inevitable stress
on relationships that the disorder can cause. Even the "calmest"
family will sometimes need outside help dealing with the stress of a
loved one who has continued symptoms. Ask your doctor or therapist to
help educate both you and your family about bipolar disorder. Family
therapy or joining a support group can also
be very helpful.
- Try to reduce stress
at work. Of course,
you want to do your very best at work. However, keep in mind that avoiding
relapses is more important and will, in the long run, increase your
overall productivity. Try to keep predictable hours that allow you to
get to sleep at a reasonable time. If mood symptoms interfere with your
ability to work, discuss with your doctor whether to "tough it
out" or take time off. How much you discuss openly with employers
and co-workers is ultimately up to you. If you are unable to work, you
might have a family member tell your employer that you are not feeling
well and that you are under a doctor's care and will return to work
as soon as possible.
- Consider entering
a clinical study.
What
if you feel like quitting your treatment?
It is normal to have occasional
doubts and discomfort with treatment. If you feel a treatment is not working
or causing unpleasant side-effects, tell your doctor straight away, don't
stop or adjust your medication on your own. Symptoms that come back are
sometimes much harder to treat. Don't be shy about asking your doctor
to arrange for a second opinion if things are not going well. Consultations
can be a great help.
How
often should I talk with my doctor?
During acute mania
or depression, most people
talk with their doctor or consultant at least once a week, or even every
day, to monitor symptoms, medication doses, and side-effects. This is
important when having bipolar disorder because your situation can easily
change from day to day. As you recover, contact becomes less frequent.
Once you are well you might see your doctor for a quick review every few
months.
Regardless of scheduled appointments
or blood tests, call your doctor or Community Psychiatric Nurse(CPN) if
you have:
- Suicidal or violent
feelings
- Changes in mood,
sleep or energy
- Changes in medication
side-effects
- A need to use over-the-counter
medications such as cold medicine or pain relief medicine
- Acute general medical
illnesses or a need for surgery, extensive dental care, or other changes
in the medicines you take
How
can I monitor my own treatment progress?
Keeping a mood chart is a good
way to help you, your doctor, and your family to manage your disorder.
A mood chart is a diary in which you keep track of your daily feelings,
activities, sleep pattern, medication and side-effects, and important
life events. Its up to you what you enter each day. For instance you can
just simply fill in the Mood and Sleep scales. This way you will be able
to notice changes in sleep and any fluctuations in mood. Thus giving you
early warning signs of mania or depression. You will also be able to find
out what triggers lead to episodes. Keeping track of your medicines over
many months or years will help you to figure out which ones work best.
What
can families and friends do to help?
If you are a family member
or a friend of someone with bipolar disorder, become more informed about
the patient's illness, its causes, and its treatments. Talk to the patient's
doctor if possible. Learn the particular warning
signs for that person which indicate that he or she is becoming manic
or depressed. Talk to the person, while he or she is well, about how you
should respond when you see symptoms emerging.
- Encourage the patient to
stick with treatment, to see the doctor, and to avoid alcohol and drugs.
If the patient is not doing well or is having severe side-effects, encourage
the person to get a second opinion, but not to stop medication
without advice.
- If your loved one becomes
ill with a mood episode and suddenly views your concern as interference,
remember that this is not a rejection of you but rather a symptom of
the illness.
- Learn the warning signs
of suicide and take any threats the person makes very seriously.
If the person is "winding up" his or her affairs, talking
about suicide, frequently discussing methods of suicide, or exhibiting
increased feelings of despair, step in and seek help from the patient's
doctor or other family members or friends. Privacy is a secondary concern
when the person is at risk of committing suicide. Call 999 or a hospital
emergency department if the situation becomes desperate.
- Share the responsibility
for taking care of the patient with other loved ones. This will help
reduce the stressful effects that the illness has on caregivers and
prevent you from feeling resentful.
- When patients are recovering
from an episode, let them approach life at their own pace, and avoid
the extremes of expecting too much or too little. Try to do things with
them, rather than for them. This way they are able to regain their sense
of self-confidence.
- Treat people normally once
they have recovered, but be alert for telltale symptoms. If there is
a recurrence of the illness, you may notice it before the person does.
Indicate the early symptoms in a caring manner and suggest talking with
a doctor.
- Both you and the patient
need to learn to tell the difference between a good day and hypomania,
and between a bad day and depression.
Patients with bipolar disorder have good days and bad days just like
everyone else. With experience and awareness, you will be able to tell
the difference between the two.
- Take advantage of the help
available from support groups.
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©
Mark Hannant
Published 2nd May 2001 |
