In the article 'Bipolar Disorder Treatment', we discuss the potential role of hospitalization and intensive out patient (IOP) therapy. If you have already participated in these therapies you likely have established a 'working diagnosis' or 'symptom cluster' and, if needed, you have discovered medications and therapies that help. Medications (Yes, frequently more than one!) will likely be adjusted at each visit with your doctor for at least the first year. Maybe you have joined the National Alliance on Mentally Illness (NAMI) and are attending one of their local groups. These groups can be helpful particularly for family members and others who have questions and want to understand and provide the support you need. There are very few places where you will find people who truly understand what you are going through.
By this time, hopefully many of your family members are on board although there are often a few hold outs who may feel particularly hurt. You are also hopefully beginning to see a little light at the end of the tunnel. Equally as likely, everyone, including your chosen buddy, is still asking you if you have taken your medications! Don’t worry; this will eventually cool down as you continue to make progress. And…to be honest…you likely need the reminders. You likely haven’t taken medications before and everyone forgets to take their medications at first. But…in your heart of hearts you know… “Never again do you want to go through this!” and maybe you are even looking forward to helping others who are just bringing this journey.
There are a few battles yet to be won and you want your life back, all of it! This is ‘Incantation Time’. (Please see under ‘Engaged Highest Intent’) An incantation is an affirmation of your intent, spoken out loud, with power, over and over until you feel it in your soul! Exercise to it, do it while driving your car, change it up until it feels right and feels real! For example, "I am strong. I am healthy and I will do whatever it takes to remain this way!"
And...if you just joined us, and haven't needed to go to the hospital, we can start from here. You have seen your psychiatrist, therapist, and nutritionist, are doing yoga each morning and now want to learn more about where to go from here...to ‘take names and move on with your life!’
Begin by Cultivating Good Habits
Incantations are a good place to start. Since this illness or ‘symptom cluster’ seems to emanate from our highest mind, you need to do everything you can to nourish and grow this part of your mind. Your neurons (brain cells) are very active, so much so, that some (In the hippocampus) are able to replicate when there is a need. And as we want to repair as quickly and completely as possible we have a need for more neurons! Your medical doctor will likely check your thyroid status, B12, Folate, Iron and vitamin D levels as these are all required for vibrant repairing and replicating nerves. If you don't eat much fish remember your Omega 3!
Sleep, particularly REM sleep, is absolutely necessary and your sleep patterns will likely be one of the first questions your doctor and therapists will ask you about. Review and optimize your sleep hygiene remembering the value of daily exercise. (Much of this is available in more depth under 'Engaging Your Highest Intent') Also, know that changes in your sleep pattern may be one of the first signs that your illness may be returning or worsening. Please call someone on your support team as soon as possible should you notice this.
Nerves are sensitive to dehydration so drinking ½ of your weight in ounces of water throughout each day is a good daily habit. Remember caffeine is a diuretic so you may actually be losing water if you drink a lot of caffeine. Also remember, when you go on a weight loss diet you naturally dehydrate. You know that feeling you get when you first stand up particularly on a hot day or in the morning? Yes, that is low blood pressure and you are dehydrated! And, for those who care, a hydrated face is a younger looking face!
For many there is a need to pick back up the healthy habits that were dropped during a mood episode. If ever there was a time to consider one of the ‘anti-inflammatory’ diets, now would be a good time. The Mediterranean diet is a good example. Any form of daily aerobic exercise, particularly in the morning, will be tremendously helpful and lower you stress hormone, cortisol. Cortisol is highest in the morning and needs to be engaged in muscular activity or it will remain in your blood potentially making you feel heavy and sore or 'spent' the rest of the day.
Add Psychotherapy for Bipolar Disorder to Your Routine
The specific psychotherapy for you will depend on what you and your supports feel serves you now. Here are just a few worth considering:
Supportive therapy - This is helpful in many ways, particularly during the first six months as you re-assemble the healthy aspects of your life. As a part of this therapy, consider looking at the ‘Two Planes, One Purpose’ article. Learn everything you can about your symptom cluster (diagnosis), your medications, the importance of each healthy habit, and the first signs of re-occurrence (usually sleep or some specific thought and related feeling). Choose a therapeutic buddy who you agree to allow to let you know when it seems you are not doing well. (They can also let you know when you are doing great!)
Marital or relationship therapy - Intimate relationships are usually the first to struggle in Bipolar Disorder. Marital therapy can speed up the educational process about the diagnosis so both partners can be on the same page. It can help you both grieve whatever losses you both sustained. As you ‘get on the same page’ you will be re-establishing the love and rapport of the relationship and further accelerate healing. Through ‘mirror neurons’ this is one of the most direct ways you can re-establish the sense of your ‘highest self’. This is ultimately what you want to do as this is where ‘Bipolar Disorder’ affects people most. (See ‘Oneness Therapy’)
Cognitive-Behavioral therapy - This will look for influences on the thoughts, feelings and behavioral patterns that may be hanging on from your last period of time in a mood episode. Long after the mood has ended we often still hold onto resentments and other, less than optimal, thought patterns. We also may be standing, walking, talking and otherwise behaving in ways that don’t work for us. (Look at that posture! What does it say?)
Oneness Therapy - I have noticed that people with this cluster of symptoms struggle with who they believe they are and how they appear to others. Any therapy that helps re-establish your reason for living and your connection with your Higher Power will help re-establish your internal home. When therapy includes building your compassion for others and helps you live out each moment of your life on purpose it marries your internal home to your life purpose. The reverberations between these two forces creates the wisdom that allows you to heal, grow and live a life of sustained happiness and contribution. (Please see these therapies under ‘Oneness Therapy’ and ‘The Wholistic Approach’)