Bipolar management is a balancing act that requires an individualized plan.
The balancing act of symptom management with bipolar disorder is complex because your needs will change as your symptoms fluctuate and you will need to develop your own strategies to monitor and respond to these changes.
Remember that when managing shifts in your symptoms you should respond to symptoms as soon as they come to your attention (self-observations and/or feedback from trusted others, which hopefully includes your partner and healthcare professionals specializing in bipolar disorder).
Up to 2/3 of individuals diagnosed with bipolar disorder experience symptoms between full-blown mood episodes (or periods of mania). The quicker you notice and respond to symptom fluctuations the more likely you can stop the progression of symptoms early. As your symptoms escalate in number, frequency, and/or intensity, you will need to match these with more restrictive management strategies.
Remember that when managing shifts in your symptoms you should respond to symptoms as soon as they come to your attention (self-observations and/or feedback from trusted others, which hopefully includes your partner and healthcare professionals specializing in bipolar disorder).
Up to 2/3 of individuals diagnosed with bipolar disorder experience symptoms between full-blown mood episodes (or periods of mania). The quicker you notice and respond to symptom fluctuations the more likely you can stop the progression of symptoms early. As your symptoms escalate in number, frequency, and/or intensity, you will need to match these with more restrictive management strategies.
What types of strategies are needed?
I recommend you develop three distinct management strategies for yourself, an ongoing symptom and schedule management strategy, a strategy in response to manic symptoms, and a strategy to respond to depressive symptoms.
1. Ongoing Symptom & Schedule Management – this strategy should focus on creating consistency in your daily routines – regulating your sleep, a structured schedule with a fair amount of overlap day to day, stress management skills, and basic self-care practices (exercising & eating regularly, etc.). This strategy is most appropriate for long-term symptom management and periods of euthymia.
2. Strategy in Response to Manic Symptoms – this strategy is needed when you feel yourself moving toward the manic side of the spectrum. You want to utilize these strategies as soon as the following changes, or a combination thereof, come to your attention.
***NOTE: the more manic symptoms escalate the less receptive you will be to feedback to others, and the less motivated you will be to engage in management strategies, so plan ahead, include trusted others in your plan, and work to increase communication about symptoms during periods of euthymia***
Key changes to make in your ongoing routines when responding to manic symptoms should address careful monitoring and active strategies to ensure you are getting adequate sleep (insufficient sleep is one of the strongest triggers for a hypomanic or manic episode), engaging in self-soothing, relaxation, and emotional regulation strategies, limiting activity levels during the day and increasing the number of breaks when working on a task or project.
3. Strategies in Response to Depressive Symptoms – these strategies are needed when you feel yourself moving toward the depressive side of the spectrum. You are more likely to start to notice dips in your mood and activity levels, and to be more responsive to feedback from others when experiencing depressive symptoms compared to when you experience manic symptoms
Key changes to make in your ongoing routines when responding to depressive symptoms should include ways of increasing your activity levels, making sure the number of hours you sleep is adequate, but not excessive (beware of naps!) and increased engagement in self-care to promote healthy moods.
1. Ongoing Symptom & Schedule Management – this strategy should focus on creating consistency in your daily routines – regulating your sleep, a structured schedule with a fair amount of overlap day to day, stress management skills, and basic self-care practices (exercising & eating regularly, etc.). This strategy is most appropriate for long-term symptom management and periods of euthymia.
2. Strategy in Response to Manic Symptoms – this strategy is needed when you feel yourself moving toward the manic side of the spectrum. You want to utilize these strategies as soon as the following changes, or a combination thereof, come to your attention.
- Elevated mood
- Increased agitation/irritability
- Increased sensitivity to your environment (noises, sounds, light)
- Decreased need for sleep
- Increased energy
- Increased activity
***NOTE: the more manic symptoms escalate the less receptive you will be to feedback to others, and the less motivated you will be to engage in management strategies, so plan ahead, include trusted others in your plan, and work to increase communication about symptoms during periods of euthymia***
Key changes to make in your ongoing routines when responding to manic symptoms should address careful monitoring and active strategies to ensure you are getting adequate sleep (insufficient sleep is one of the strongest triggers for a hypomanic or manic episode), engaging in self-soothing, relaxation, and emotional regulation strategies, limiting activity levels during the day and increasing the number of breaks when working on a task or project.
3. Strategies in Response to Depressive Symptoms – these strategies are needed when you feel yourself moving toward the depressive side of the spectrum. You are more likely to start to notice dips in your mood and activity levels, and to be more responsive to feedback from others when experiencing depressive symptoms compared to when you experience manic symptoms
Key changes to make in your ongoing routines when responding to depressive symptoms should include ways of increasing your activity levels, making sure the number of hours you sleep is adequate, but not excessive (beware of naps!) and increased engagement in self-care to promote healthy moods.
Getting support.
Remember that the specific plan for your schedule management is highly individual and does not remain consistent over time. As such, becoming a careful observer of your symptoms and how well you respond to specific adjustments in your schedule management plan. This takes time to develop and often requires you to keep a daily record or work with a mental health professional to individualize each of these strategies for you.
Your partner can be an invaluable resource (along with other important supports) in monitoring your symptoms and giving feedback around how effective your strategies to manage your symptoms are.
Many couples struggle with this type of collaborative illness management, especially if:
Your partner can be an invaluable resource (along with other important supports) in monitoring your symptoms and giving feedback around how effective your strategies to manage your symptoms are.
Many couples struggle with this type of collaborative illness management, especially if:
- Communication is a struggle in other areas as well
- If one or both partners are experiencing significant distress in the relationship
- If the bipolar diagnosis is new to or unfamiliar to one or both partners
- If it has been a significant struggle managing bipolar symptoms with little or no success
How can we help you?
Dr. Bordieri is one of only licensed marriage and family therapists who specializes in bipolar disorder. She is not only an expert in providing therapy to couples and families but also in the treatment of bipolar disorder. She also holds a doctorate degree with research focused on the influence of bipolar symptoms and relationship functioning on partners’ individual well-being.
Contact us for more information about individualized services, groups, and educational programs for bipolar disorder and collaborative illness management between partners. For those in need of reduced fee services you can also receive one-on-one individual or couple's therapy from a therapist in training who is closely supervised by Dr. Bordieri.
Contact us for more information about individualized services, groups, and educational programs for bipolar disorder and collaborative illness management between partners. For those in need of reduced fee services you can also receive one-on-one individual or couple's therapy from a therapist in training who is closely supervised by Dr. Bordieri.