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How to add exercise to your bipolar treatment plan

How to add exercise to your bipolar treatment plan

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Self-management techniques are things you can do on your own at home to help manage bipolar symptoms, in addition to therapy and/or medication. The following tools and activities were beneficial to our volunteers.

Exercise

Exercise can help boost your mood, it gets you out of the house and gets your blood pumping. If you are depressed, it can help kick start your energy level (an object at rest stays at rest, an object in motion stays in motion). If you are feeling anxious, it can give you something else to focus on. If you are in a manic state, it can be a positive way to channel the extra energy.

Some people exercise every day as part of their routine, while others exercise on an as needed basis as a way of coping with a particular mood. “It helps with my depression by getting me out of the house and doing something I enjoy. It helps my hypomania by helping to burn off some of my energy. And, in both cases, it gives my mind a break.” – Mary Alice Do

Exercising regularly doesn’t mean you have to go to the gym every day. There are types of exercise for all body types and interest levels. The most common type of exercise recommended by our volunteers was walking, usually around the neighborhood.

Some types of exercise have the added benefit of social interaction. Consider trying a new class like yoga, kickboxing, or water aerobics. “ I find water aerobic exercise classes very beneficial—lifts my mood, gets me out of the house, reinforces my self-esteem because I find it very difficult to just talk myself into getting ready and actually getting there! I have been open about being bipolar (especially when I’m depressed). Several ladies’ support and encouragement have led to developing friendships with mutual sharing. I would say this is the most successful support .” – Lee Patterson

Hobbies

Hobbies help keep your mind busy by giving you something else to focus on. They can connect you to other people with similar interests. And they can improve your self-esteem as you get better at a new skill.

Looking for a new hobby? Here are some suggestions:

  • Activities in Nature
    • Gardening
    • Hiking
    • Biking
    • Swimming
    • “ I need some sort of creative outlet . “- Nanieve G. Living with Bipolar 1 Disorder and PTSD
    • Painting, Drawing, Photography
    • Dancing, Singing
    • Writing, Blogging, Poetry
    • Cooking, Baking
    • Music
    • Volunteering
    • Sharing your story with others, public speaking
    • Pets – “ My dog also helps because I think that it’s beautiful that his love for me is so innocent and pure.” – Sarah DeArmond

    Sleep

    Many people with bipolar benefit from a consistent sleep schedule. “Consistent sleep has proven to be vital as far as maintaining stability. Too little or too much can both be a cause or an indicator of a swing in either direction.”- Marta Edmisten, living with Bipolar I

    “Not enough sleep is a disaster waiting to happen.” – E. Stone, mother of a son with bipolar disorder

    If you have trouble staying asleep because of light or sounds, you might want to try blackout curtains, sleep masks, ear plugs, or using a fan or other white noise.

    “When I do get the sleep that I am supposed to get, I feel like superwoman.” – Susanna Page, College Student living with Bipolar I

    Nutrition

    What you eat can affect your mood. Your body uses the food you eat as fuel for different functions, including the production of neurotransmitters. In general, eating better will help you feel better. But there may also be certain foods that can help specifically with mood. For more information on how nutrition affects mental health, visit these links:

    • Webinars
      • A Naturopathic Perspective on Treatment
      • Can We Prevent Depression By Improving Diet?
      • SNAP (Sleep, Nutrition, Activity, People): A Simple 4-Step Plan for Preventing Bipolar Relapse
      • How Sugar Affects Your Mood
      • How Food Changed Bipolar Disorder For Me
      • A Naturopathic Perspective on Treatment (blog version of above webinar)

      Some people use nutrient therapy as part of their treatment plan for bipolar disorder. To learn more about this, watch our webinar on Advanced Nutrient Therapies. Talk to your doctor before you begin a nutrient therapy plan.

      Online Tools

      There are many free online tools you can use to manage different bipolar symptoms. There are apps that will help you track your mood and identify your triggers, similar to journaling. There are also online support groups or other websites where you can learn more about bipolar and hear other people’s experiences.

      The following websites were recommended by our volunteers:

      • http://www.findingoptimism.com/
      • www.ibpf.org/blog
      • http://whatsmym3.com/
      • http://www.bphope.com/
      • http://notalone.nami.org/
      • http://www.supportgroups.com/
      • https://www.moodscope.com/
      • http://www.7cups.com/

      To learn more about online self-help tools, check out our webinar on Practical Self-Help Internet Tools.

      Religion

      If you are religious, you might want to get involved with a church or other religious group. “The support I get from my friends at church is very helpful, and I find comfort in the fact that God is always with me.” – Mary Alice Do, a retired minister

      To learn more about the role of religion in mental health, try these webinars:

      • Faith Communities and Mental Illness
      • The Role of the Church in Recovery
      • How Churches Can Promote Recovery

      You can also read more about these topics and other aspects of living with bipolar disorder by requesting a free PDF copy of our book, Healthy Living with Bipolar Disorder.

      This article was written by our Advice and Support Community, a group of about 50 volunteers who contribute their advice based on their experience living with or caring for someone with bipolar disorder.

      International Bipolar Foundation is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional advice or delay in seeking it because of something you have read or received from the International Bipolar Foundation.

      Bipolar disorder is a chemical illness of the brain. Therefore, medication management should be the foundation of your overall wellness plan. Exercise plays a vital role in this foundation.

      I use the word “foundation” because all of the coping skills you utilize on a daily basis are the building blocks for your overall treatment plan.

      Everyone who is diagnosed with bipolar disorder is unique in how their illness presents itself clinically. Yes, there are diagnostic criteria that are similar across the board. However, symptomology is as unique as each individual.

      Wellness Plan

      A wellness plan is a plan you follow daily to enhance your overall quality of life. As I mentioned, medication management should be the foundation of this wellness plan.

      The next level up should be exercise. When I speak of exercise, you should find something to increase your heart rate daily and simply get moving.

      Study after study shows how exercise not only improves mood but also cardiovascular endurance, sleep, and regulation of appetite. In addition, it reduces blood pressure and helps to naturally regulate blood sugar levels.

      Aerobic exercise is one of the best natural ways to help boost your mood. When you exercise, your body is flooded with endorphins and other good mood-enhancing hormones. Even going for a brisk walk for 20 minutes each day provides these positive benefits.

      Exercise Plan

      The important thing about exercise is to pick something that you like to do. This way, you will have a better chance of adhering to your workout program. If you do not like to run, then try walking. Maybe biking is a better fit for you. Some individuals enjoy swimming because it is low-impact, or perhaps an elliptical machine.

      Starting out, your goal should be to get active for at least 20 minutes during the course of a day. You may have to break it up until a couple of sessions throughout the day – and that is okay. As time moves forward, and you maintain consistency in your workout schedule, it will get easier.

      In managing my bipolar disorder, my primary goal is to improve my quality of life while successfully treating my illness. Exercise helps do this by making me feel better, improving my mood, and helping me support healthy mood regulation.

      If you are new to exercising, or if it has been a while, make sure to check with your doctor before starting anything new.

      An Example From My Own Experience

      One of my favorite activities is jogging. A few years ago, I sustained a back injury that sidelined my training. For a few months, I spent a large amount of time strengthening my back and core and working with a physical therapist.

      During that time, I performed a couple of sets composed of specific physical therapy exercises each day to help improve my back. I completed a 20-minute workout Monday, Wednesday, and Friday each week. On Tuesday and Thursday, I performed light resistance training. Lastly, I jogged for a minute, walked for a minute, and repeated until 20 minutes went by.

      The aforementioned workout was specific to my back issues. If I did not have those back issues, I would have adopted a different workout. That is why I stress the importance of chatting with your doctor before starting a workout program.

      The Pyramid

      It may help you to look at your overall treatment plan as a pyramid. The foundation of the pyramid supports everything else above it. In this case, the foundation of the pyramid is a metaphor for the medical model of treatment – medication management and therapy.

      The next level up from the foundation is exercise. I strongly believe, and it has been my own personal experience too, that following an exercise program each day is the next best thing after medication.

      From my own experience, I suggest starting an exercise program before you are in the midst of a depressive episode. Once you are exercising on a daily basis, it is easier to maintain consistency with your workout program once a mood episode shows its ugly face.

      After exercise, the next level up is comprised of coping skills and strategies. Just remember, everyone is different when it comes to the strategies that work for them and their situation. The best thing you can do is experiment and see what is most helpful. Keep a journal so you can track what works and what does not.

      The important take-home message here is to find something that works for you, whether it be running, walking, yoga, weightlifting, swimming, or anything in-between.

      I am a big supporter of taking preventative action. In fact, I’m a big supporter of taking any action, no matter how big or how small.

      There is no cure for bipolar disorder but it can be managed with the right treatment plan and support. There are a number of strategies I use to cope on a daily basis.

      I manage bipolar disorder by taking a collaborative approach from various treatment methodologies and daily coping strategies.

      I combine and use the following tools and methods together, to manage bipolar disorder both short-term and long-term.

      Tools to Manage Bipolar Disorder

      Tip #1 How to Manage Bipolar Disorder:

      Medication Management

      The medical model is the current treatment approach to manage bipolar disorder.

      Medication is one part of the medical model of treatment. It is based on scientific and documented evidence. I have used this approach from my initial diagnosis up through the present. I plan to follow it until current medical science changes.

      Currently, there is an abundant amount of research being conducted regarding all aspects of bipolar disorder. This being said, the medical model of treatment is what we have at the moment and is what I utilize as the foundation of my treatment.

      To get more information about medication management, click HERE.

      Tip #2 How to Manage Bipolar Disorder:

      Therapy

      Therapy is the second component of the medical model of treatment.

      Medication and therapy are the two components that make up the medical model.

      From my experience, finding a therapist is essential. Having an objective perspective is paramount to my journey through life.

      I have the support of close loved ones but it has always benefited me to have a professional perspective.

      To find further information regarding therapy, click HERE.

      Tip #3 How to Manage Bipolar Disorder:

      Exercise

      For me, exercise comes next in importance after the medical model of treatment.

      Remember, this is based on my own personal experience.

      I need to lift weights every day as part of my treatment plan. It does not take the place of medication but it helps increase my quality of life and the other struggles I face on a daily basis.

      Adding exercise to my treatment plan is part of the collaborative approach I use to manage bipolar disorder.

      Click HERE to read more about exercise as a tool to help manage bipolar disorder.

      Tip #4 How to Manage Bipolar Disorder:

      Keep a Mood Journal

      You need more than just a simple 1-10 numbered mood chart to keep track of your mood. Especially when you are first diagnosed.

      A mood journal is a great tool to help both you and your doctor. Create a mood journal to your own liking and functionality.

      To help you get started, I have a few suggestions of what sections to add to your mood journal:

      • Mood
      • Motivation
      • Energy
      • Functionality
      • Food
      • Exercise
      • Sleep

      Record the time and your observations regarding each of the previously mentioned topics. The more observations you can make, the better.

      Over time, you will notice patterns. Your doctor can work with you to pinpoint those patterns and find better treatment options.

      Remember, your mood journal is a tool to help you find better ways to manage bipolar disorder. Make sure you create in a fashion that is specifically for your own situation.

      Tip #5 How to Manage Bipolar Disorder:

      Routine

      It has been shown that those of us living with bipolar disorder function better by following a daily routine or schedule.

      Whatever your routine looks like, keep it simple and stick to it. This goes with all aspects of your bipolar disorder.

      Create a schedule to show the time you will get up, when you will take your meds, the times to eat your meals and when you go to bed at night. These are the core activities you should, at the very least, focus in on.

      You may want to add another column so you can put an “x” to show you completed the particular activity.

      Tip #6 How to Manage Bipolar Disorder:

      Sleep Hygiene

      Sleep hygiene is symptomatic of a bipolar mood episode and a predictor of an oncoming manic or depressive episode.

      At the very least, try to get to bed and wake up at the same time each night and morning.

      If it is possible, shoot for 8 hours of sleep each night.

      Click HERE to find more ideas related to sleep.

      Tip #7 How to Manage Bipolar Disorder:

      Support from Loved Ones

      Your loved ones can help support you by detecting changes you don’t see in yourself that could potentially lead to a manic or depressive episode.

      It is generally easier for your loved ones to notice changes in your mood, motivation, energy level and overall functionality than it will be for yourself. At least, that has been my experience.

      Sometimes, it is hard to notice changes in myself. Increased self-awareness comes with time, maturity and experience.

      Your mood journal can you key in on some of those changes and help you to become more self-aware.

      Improving your self-awareness will increase your ability to function, handle stress, maintain balance and empower yourself as a warrior against bipolar disorder.

      Last Thoughts

      Everyone is so different in the ways and approaches to treat and manage their bipolar disorder.

      I have found the stigma surrounding bipolar to be a huge deterrent to some people desiring help and support. Hopefully, you do not have to jump this hurdle.

      If things become problematic, do your best to accept your situation and move forward. I know, easier said than done, right?

      I know it is in your power to get the help and support you need and deserve.

      The progress you make in your journey with bipolar disorder will ultimately be up to you. If you are not willing or you deny the situation you are living in, your progress will ultimately be stalled.

      Accept your diagnosis and situation and move forward.

      My actual treatment plan is in a constant evolution of change. Sometimes I require a medication change, the need to sleep more, take more downtime, get more exercise or whatever activity I need to employ in order to manage.

      You see, there is no one size fits all approach.

      I can only offer you my insight into how I manage bipolar disorder and from my own life. Your ultimate success will depend on how you manage your own bipolar disorder.

      With bipolar disorder you have extreme emotional mood swings. This can include episodes of highs, called mania, and lows, called depression.

      During mania, you may feel very happy and full of energy, with racing thoughts. Then you can suddenly shift into depression, where you feel very sad and hopeless with little energy.

      Fatigue can come during both mania and depression. It’s more than being sleepy. It’s feeling so tired that you can’t do your normal things. You might feel like you can’t function or make it through your day.

      Fatigue can be very common during bouts of depression. You can feel exhausted because you have no energy and you’re struggling with sleep. But fatigue can also be a problem during mania. Your racing mind can bring insomnia. It takes a long time to recover from mania, so you can feel physically and emotionally drained during the recovery, as well.

      Although it can be crippling, there are things you can do to manage fatigue and feel better.

      Manage Your Disease

      It’s important that you work closely with your doctor to keep your moods stable. Limiting the number of manic and depressive episodes you have will help you function at your best each day.

      Managing bipolar disorder often means taking medication. If you take drugs, be aware of their side effects. Some medications can make you drowsy, so it’s very important that you don’t take too much. And if you take medicine for insomnia, take it only for as long you need to.

      Create Good Sleep Habits

      Get into a routine that includes:

      • Going to bed and getting up at the same time every day
      • Using your bedroom only for sleeping and sex
      • Limiting screen use close to bedtime
      • Keeping your bedroom at a cool, comfortable temperature

      Exercise Regularly

      You might not feel like you have the energy to move. But once you start an exercise plan, you’ll feel more energetic.

      Start slow. Too much exercise can make you tired, too.

      Ask your doctor for tips if you haven’t exercised in a while.

      Don’t work your body too hard right before bed. That can make it harder to fall asleep.

      Limit Caffeine

      It can be tempting to reach for a soda or coffee to give you more energy. But that can backfire when you’re trying to fall asleep at night. Try to limit caffeine — especially in the afternoons and evenings.

      Get More Sunlight

      If you can, get outdoors each day to get some sunshine. Light — especially sunlight — helps control your body clock, or what your doctor might call your circadian rhythms. That’s what tells your body when it’s time to sleep and get up each day.

      Check Your B12

      From fruits and veggies to lean proteins, make sure you eat a balanced, nutritious diet. A shortage of certain nutrients — particularly B12 — can lead to things like fatigue and weakness.

      You can find B12 in foods like:

      • Red meat
      • Dairy , such as trout, salmon, and tuna

      Stay Hydrated

      Make sure you drink enough water. It helps carry nutrients throughout your body. When you don’t have enough fluid, you can feel weak and tired. Don’t forget that water-based foods like fruits, vegetables, and soup can help you reach that goal, too.

      Sources

      Anxiety and Depression Association of American: “Bipolar Disorder.”

      American Psychiatric Association: “What Are Bipolar Disorders?”

      Cleveland Clinic: “Fatigue.”

      Mayo Clinic: “Fatigue.”

      Veerle Bergink, MD, PhD, director of Women’s Mental Health Program, professor, Department of Psychiatry, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai.

      National Sleep Foundation: “Sleep Hygiene.”

      National Health Service (U.K.): “Self-help tips to fight tiredness.”

      Cancer Nursing: “The relationship between light exposure and sleep, fatigue, and depression in cancer outpatients: test of the mediating effect.”

      National Institutes of Health Office of Dietary Supplements: “Vitamin B12.”

      Keeping your mood stable is key to living well with bipolar disorder. Find out how cognitive behavioral therapy can help.

      How to add exercise to your bipolar treatment plan

      How to add exercise to your bipolar treatment plan

      If you’re living with bipolar disorder, you’re probably well-accustomed to the unpredictable mood swings that are a hallmark of the condition. Not only can these highs and lows create tension in your relationships and career, but left untreated, the condition can lead to suicide.

      The good news is that bipolar disorder can be controlled. While medication plays an important role in recovery, adding cognitive behavioral therapy (CBT) to your treatment plan can help stabilize your mood and keep your life on track.

      CBT for Bipolar Disorder: How It Works

      What causes the highs and lows of bipolar disorder? According to a study published in January 2015 in the journal Psychology and Psychotherapy: Theory, Research and Practice, bipolar mood swings are influenced by your thoughts. The researchers found that having extremely negative thoughts may bring on what’s called “descent behaviors” (such as withdrawing from friends) associated with depression, while overly positive thoughts can lead to “ascent behaviors” (such as risk taking) associated with mania.

      Practicing CBT may be a way to level out these extremes. “Cognitive behavioral therapy capitalizes on the fact that our thoughts, actions, and emotions are all interconnected and can influence one another,” says Simon Rego, PsyD, director of the CBT Training Program at Montefiore Medical Center/Albert Einstein College of Medicine in New York.

      CBT teaches you how to catch, challenge, and change flawed thoughts as well as identify and correct troublesome behavior patterns. For example, imagine your boss emails you saying she wants to talk to you about your latest project. A negative emotional response, such as jumping to the conclusion that she hates your work and that you’re going to get fired, can take you down the path to depression. CBT teaches you to respond to situations with calmer thoughts, such as that your boss may simply want to ask you some questions about your work, which keeps your mood stable. “People often feel better emotionally and attain a better quality of life after undergoing CBT,” Dr. Rego says.

      A study published in January 2015 in The British Journal of Psychiatry supports adding CBT to bipolar disorder treatment. In the study, researchers compared two groups of people recently diagnosed with bipolar disorder. One group received standard treatment, which included medication and support from community groups, a psychiatrist, or a regular doctor. The other group received standard treatment and CBT. The researchers found that the latter group achieved a better, longer-lasting recovery than the group that didn’t receive CBT.

      6 CBT Techniques for Bipolar Disorder

      CBT teaches several important skills that target the core ways bipolar disorder affects you, Rego says. These include:

      1. Accepting your diagnosis. The first step is to understand and acknowledge that you have a disorder that's responsible for your symptoms. This is often difficult for people with bipolar disorder to accept, so teaching the signs, symptoms, causes, and course of the disorder is essential. It helps people embrace the idea of getting help while also knowing they’re not alone, Rego says.

      2. Monitoring your mood. This is often done using a worksheet or journal, which is kept up on a daily basis between sessions and then reviewed with your therapist. People are asked to rate their mood daily on a 0-to-10 scale, in which 0 represents “depressed,” 5 stands for “feeling OK,” and 10 is equivalent to “highly irritable or elevated mood.” The purpose is to become more aware of mood triggers and changes.

      3. Undergoing cognitive restructuring. This process focuses on correcting flawed thought patterns by learning how to become more aware of the role thoughts play in your mood, how to identify problematic thoughts, and how to change or correct them. The therapist teaches the patient how to scrutinize the thoughts by looking for distortions, such as all-or-nothing thinking, and generating more balanced thinking.

      4. Problem-solving frequently. This step involves learning how to identify a problem, generate potential solutions, select a solution, try it, and evaluate the outcome. Typically first taught in therapy, problem-solving is then practiced between sessions. Problems can be in any domain of life, from relationship distress to unemployment to credit card debt. All of these stressors, if not resolved, can put you at greater risk for a lapse.

      5. Enhancing your social skills. Some people with bipolar disorder lack certain social skills, which causes them to feel that they aren’t in control of a certain aspect of their lives. Learning skills such as assertiveness can help you manage interpersonal relationships better.

      6. Stabilizing your routine. Engaging in activities on a regular and predictable basis establishes a rhythm to your day, which helps stabilize your mood. Examples include exercising in the early afternoon, setting a consistent sleep and mealtime schedule, making social plans, and doing chores around the house.

      How to Maximize Bipolar Treatment

      For optimal results with your bipolar treatment plan, Rego suggests these steps:

      There’s a lot you can do to help manage your bipolar disorder. Along with seeing your doctor and therapist and taking your medicines, simple daily habits can make a difference.

      Start with these strategies.

      Set a schedule. Many people with bipolar disorder find if they stick to a daily schedule, it helps them control their mood.

      Pay attention to your sleep. This is especially important for people with bipolar disorder. Being sleep-deprived can sometimes trigger mania in those with the condition. It can also be a sign of a flare-up of your symptoms. For instance, just a few nights of less sleep may mean that a manic episode could be coming on. Or if you start to sleep a lot more than normal, it might mean you’re depressed.

      • Go to sleep and get up at the same times every day.
      • Relax before bed by listening to soothing music, reading, or taking a bath.
      • Don’t sit up in bed watching TV or scrolling through your phone.
      • Make your bedroom a calming space.
      • If your sleep patterns start to change, tell your doctor or therapist.

      Exercise. It may improve your mood whether or not you have bipolar disorder. And you’ll probably sleep better, too.

      If you’re not active now, check with your doctor that you’re healthy enough to get started. Keep it simple at first, such as walking with a friend. Gradually, work up to working out for at least 30 minutes a day on most days of the week.

      Eat well. There’s no specific diet for people with bipolar disorder. But just like anyone else, choosing the right kinds of foods can help you feel better and give you the nutrients you need. Focus on the basics: Favor fruits, vegetables, lean protein, and whole grains. And cut down on fat, salt, and sugar.

      Tame stress. Anxiety can worsen mood symptoms in many people with bipolar disorder. So take time to relax.

      Lying on the couch watching TV or checking your social media accounts isn’t the best way to go. Instead, try something more focused, like yoga or other types of exercise. Meditation is another good choice. An easy way to do that is to simply focus on your breathing for a few minutes, letting other thoughts come and go without paying them a lot of attention.

      You can also listen to music or spend time with positive people who are good company.

      Make adjustments athome and at work. Are there stressful things in your life that you might be able to change? Whether it’s in your family or on the job, look for solutions.

      For instance, could your partner handle more of the chores at home? Might your boss be able to cut down on some of your responsibilities if you’re overloaded? Do what you can to simplify your life and make it easier.

      Limit caffeine. It can keep you up at night and possibly affect your mood. So don’t drink a lot of soda, coffee, or tea. And take it easy on chocolate, too, because it has caffeine. You can even cut these items out completely. It’s often best to do that gradually so you don’t get headaches and other signs of caffeine withdrawal.

      Avoid alcohol and drugs.They can affect how your medications work. They can also worsen bipolar disorder and trigger a mood episode. And they can make the condition harder to treat. So don’t use them at all.

      Bipolar disorder can be a lot to deal with. Many people turn to alcohol or drugs and have a substance abuse problem.

      If you think that you have a problem with alcohol or other drugs, get help now. Bipolar treatment may not be enough. Substance abuse often needs its own separate treatment. You may need to tackle both conditions at the same time.

      Talk to your doctor or therapist about your options. Look into local substance abuse support groups. Consider calling the Substance Abuse and Mental Health Services Administration help line: 1-800-662-HELP (4357).

      Dealing with your alcohol or drug issues is a must for your recovery.

      Sources

      SOURCES:
      Diagnostic and Statistical Manual of Mental Disorders, 5th edition, American Psychiatric Association.
      National Alliance on Mental Illness.
      Depression and Bipolar Support Alliance (DBSA).
      American Psychiatric Association.
      National Institute of Mental Health.
      Practice Guideline for the Treatment of Patients with Bipolar Disorder.
      Compton, M. Depression and Bipolar Disorder, ACP Medicine.

      Successful management of bipolar disorder is largely dependent on having a well-thought-out plan and talking over any changes with your support team first.

      Since first being diagnosed with bipolar disorder at age 17, Kristin Finn has gone off her mood-stabilizing medications only twice — during each of her two pregnancies.

      Both times, Finn worked carefully with her health care team to develop a plan for managing bipolar disorder without the assistance of medications. The plan included journaling, exercise, stress management, and avoidance and awareness of the things she knew might trigger her depression or mania.

      Finn chronicled her journey in the book Bipolar and Pregnant, written because it was so difficult for her to find the information she needed to manage her condition during pregnancy anywhere else. And as a speaker for the Depression and Bipolar Support Alliance, she continues to share her experiences as a woman living with bipolar disorder.

      Bipolar Treatment Plan: Why Compliance Matters

      According to Ken Duckworth, M.D., medical director of the National Alliance on Mental Illness (NAMI), Finn's compliance with her treatment plan year after year is not the norm. A majority of people with the disorder — as many as 64 percent, according to some estimates — don't stay with their treatment plan throughout their lives, for various reasons.

      "For one, nobody wants to take medications for a long period of time," Dr. Duckworth says. "And people with bipolar disorder can go years between episodes, making taking the medication seem unnecessary." Other reasons that people report for discontinuing their bipolar treatment plan include missing the "highs" associated with mania, denial that they have the condition, a poor doctor-patient relationship, co-existing personality disorder, drug or alcohol abuse, and medication side effects.

      Unfortunately, Duckworth says that he's seen patients discontinue their treatments without a plan or support and then suffer great personal setbacks when their untreated bipolar disorder reemerges — including job loss, trouble with the law, broken relationships, financial catastrophes, and suicide attempts.

      Bipolar Treatment Plan: Plan Carefully for Changes

      Duckworth recommends that anyone considering a change to his or her approach to managing bipolar disorder follow Finn's lead; that is, make any modifications with the knowledge and assistance of their healthcare team, and be sure to have a well-thought-out plan of action.

      "Be in a dialogue with your doctor," he says. "Weigh the pros and cons that all the effects [of changing your treatment] will likely have on your life, and have a plan for managing that."

      According to Finn, there were two keys to her success. The first was writing her plan down on paper before discontinuing her medication. When she struggled with symptoms of her untreated bipolar disorder, like the inability to stop talking incessantly, she could refer back to her written plan and refresh her memory about what steps she had decided to take when they occurred. "I could look back on that, and reel myself in," she says.

      The second key component of Finn's plan was asking certain people in her life to be on the lookout for signs of a relapse. In fact, Finn actually signed agreements with her support team to resume taking her medication again if they thought she needed it.

      "When you're depressed or hypomanic, you can't see yourself clearly," she notes. "You can't see how you are behaving clearly."

      In short, the best way to managing bipolar disorder over a lifetime is to have a well- thought-out plan for managing bipolar disorder, to communicate it to those around you, to work with your support and health care teams to put it into play, and to be ready to make changes as needed. Duckworth says, "Whether or not taking a mood-stabilizing medication is better or worse than the effects of not taking one is a decision each person with bipolar disorder must decide for themselves. Doctors can't make people take their meds, we can only try to help them understand the consequences of not taking them."

      I have always felt different from everyone else, alienated, alone. As a young child, I would react to things, even tiny things, in such intense ways, and I would look at other people and wonder: did they feel things this strongly, too? Did they fall to the ground crying when they saw a dead butterfly on the sidewalk? Or have sudden intrusive thoughts of swerving and crashing their car in a wall?

      A Bipolar Diagnosis May Explain A Lot

      At some point, I became severely depressed. I don’t know how it happened, or when it snuck up on me, but it was there. This giant hard knot in the pit of my belly. Some days would be worse than others. Some days, it would swell up into my chest and prevent me from breathing, and other days I could push it aside. I, oftentimes, thought about suicide and hurting myself but at that age, I never acted on it. I only imagined.

      At some point after high school graduation, I stopped sleeping. It was hot and humid and sticky — like any other summer in Virginia — and without a single conscious thought and without understanding why, I started cleaning my bedroom. And then the hallways and spare bedroom, both bathrooms, linen closets. I cleaned the entire house from floor to ceiling over the span of a week, never sleeping. I feel as if I may have repressed some of the memories. I feel as if a huge chunk of time is just missing, clouded over by fog.

      It came as no surprise when I first sought treatment that I received diagnoses of bipolar II and obsessive-compulsive disorder.

      Emotions Attached to Bipolar Diagnosis

      How to add exercise to your bipolar treatment plan

      I think this feeling, this fog, is one of the most difficult things to work around when first beginning treatment. It’s hard sitting in your first therapist’s office and trying to figure out what to say when asked, “how are you feeling?” or “what brings you here?” How do you even begin to answer this? How do you describe that dark knot in the pit of your belly? Or the severe mania that sometimes makes you so explosive and impulsive that you drive dangerously, snap and yell at loved ones, or run on little sleep because you just don’t need it? If you’re like me, it’s incredibly difficult to even begin to identify your emotions.

      How to add exercise to your bipolar treatment plan

      These extreme shifts in mood swings are far more intense than the normal ups and downs we experience in our lives. This disorder should be treated with medical care. According to the National Institute of Mental Health, an estimated 4.4% of U.S. adults experience bipolar disorder at some time in their lives. Combining medication with unique therapy methods can help treat bipolar disorder, and everyone should have their own treatment plan that addresses their needs. Cognitive behavioral group therapy substantially contributes to the improvement of depression symptoms for individuals with bipolar disorder. Our mental health facility in Boca Raton explains how group therapy can help treat bipolar disorder. Depending on the severity of one’s disease, bipolar disorder can tremendously hinder daily activities and even relationships.

      Recent studies suggest that, when combined with pharmacotherapy, structured psychotherapy may modify the course of bipolar disorder. This is a combined effort in treatment, and patients are able to learn how to effectively manage their extreme symptoms in order to live a healthy lifestyle. Patients who have undergone group therapy have seen significantly fewer symptoms of mania, anxiety, and depression, as well as shorter mood episodes. At Banyan Mental Health, our treatment experts provide all patients with a personalized assessment in order to determine the proper bipolar disorder treatment plan moving forward. We understand the daily struggles that come with bipolar disorder, and you don’t have to fight this battle alone.

      If you or a loved one is struggling with mania and depression and you don’t know where to turn, Banyan Mental Health can help you truly live in recovery. Our group therapy can help treat bipolar disorder, and we guide you every step of the way.