Breaking Bipolar Disorder’s Back


These days I hear the spring birds singing in the morning, and my response is, “winter’s back is broken.” I know that no matter how much snow can pile upon us, winter’s back is truly broken Even if the weather twists into a cold snap, my refrain is that winter’s back is certainly broken.


No matter how long our winters have been, early signs of spring give hope that we will soon see the ground’s paint bucket tipped over to expose shades of green accented by every color nature can imagine.  The back of winter is broken and can no longer cast its darkness.


And what of bipolar disorder? Can its back be broken in our lives? How do we come through the storms of mood without losing hope for the coming springtime of wellness?


Getting through rough times in our illness is crucial in finding wellness. Often the rough times tend to be the last thing we expect or prepare for, yet they come whether or not we are prepared. The first time we hit the winter of our illness—whether that winter be mania or depression—we most likely lack any basic preparation.


Its like going to the north pole without knowing we should rub blubber on the runners of our sleds so they will slide through the snow and ice. When the British party that first made their way to the North Pole spent time with the Inuit people, the Inuits’ conclusion was that the foreigners to the land of snow and ice were lacking in basic life skills.


Likewise, those of us with bipolar disorder may lack the life skills to live successfully in the harsh climate of bipolar disorder. We are ill prepared when we first are struck with the need to go into survival mode. But we can also learn skills to take us beyond survival mode and into wellness mode. Wellness mode takes us through the rough times.


Two life skills that can put blubber on the runners of our sleds are taking care of ourselves and communicating accurately.


Taking Care Of Ourselves


Taking care of ourselves would seem so obvious to us if we were dealing with diabetes or cancer. We would soon be taught the role of healthy nutrition, exercise and getting plenty of sleep. But with bipolar disorder, it sometimes takes years of experience to apply the concept of caring for ourselves.


Depression tells us we are not worthy of self-care. Thus if we are cold, we don’t put on more clothes. If we are lonely, we don’t seek out friends. Depression’s lack of energy saps our strength, so if we are hungry, we gobble the carbohydrates we crave instead of adding fruits and vegetables to our chocolate-laden diets.


In depression, let’s work toward taking better care of ourselves. Write down three or four small things you can start with. Here are a few ideas to get you started:


Taking care of yourself in mania or hypomania can be challenging because it’s difficult to see your needs. No matter where mania takes you, your greatest need is to slow down. Perhaps too much blubber makes your sled so fast you slide right past your dog team. Slow down in small ways, and intersperse your productive activity with calming skills:

·      Sit still for five minutes.

·      Match the speed of your speech to that of a friend’s.

·      Walk quickly, then walk deliberately slowly, then resume your speed.

·      Set a timer and stop what you are doing for a five-minute break every twenty minutes.

·      Quiet your environment by turning off music, TV, video games and other distractions for at least fifteen minutes every hour. Try to have longer periods of decreased environmental stimulation.


Communicating Accurately


When you are facing the hardest times of bipolar disorder, you need to call upon your best communication skills. Let’s consider communication with your doctor or therapist.


When you have taken a turn for the worse, the sooner necessary adjustments are made in you life activities and medications, the sooner you will get better. If your next appointment is in three weeks or three months, don’t wait around and get worse before you communicate your needs. Call within three days of getting worse. Even when your doctor is on vacation, you can talk with the doctor on call to put a game plan in place.


Can’t sleep for three nights? Feeling so down in the dumps you can’t get out? Winding up like a spinning gyroscope? Why wait for things to get worse before intervening? There are things you can do for yourself, and there are things only your doctor can do—like change your medications or dosing to stave off a more severe episode. Better to get help early than to wait until you are all in a kerfuffle.


Think your doctor won’t help? Clarify your communication first. Make a detailed list of what you perceive to be happening. Choose representative symptoms so you can clearly describe them. For instance, stating that you aren’t sleeping well might not get your doctor’s attention. Stating that it has taken you two hours to fall asleep and that you only slept for three hours each night for three nights in a row helps your doctor understand that you are headed for trouble.


When preparing to speak with your doctor, be sure to write things down, and then check them off as they are addressed. A few minutes of advance preparation will help prevent your realizing on your way home that you forgot to discuss the sleep issue that is a major concern. Remember that you doctor and clinicians work for you, and it is your responsibility to make certain they have the information they need to help you most efficiently.


When the wintry blasts of bipolar disorder catch up to you, be prepared as much in advance as possible. Wellness skills can help you stave off or work through the tough times. And for wellness skills to be most effective, you will want to continue using them, as well as learning new ones, even when you are feeling well.


Winter’s back can be broken by springtime, and bipolar disorder’s back is broken by practicing wellness skills and actively participating in your treatment.



Ten Tips for Tough Times


  1. Realize that your current mood will not last forever.
  2. Communicate struggles clearly to your doctor or clinician.
  3. Pay attention to sleep by keeping your hours regular and by telling your prescriber if you are having difficulty.
  4. Reach out to one person who will encourage you and carry your hope through times of struggle
  5. Deal with suicidal thoughts once and for all by making a lifetime decision that you will never suicide. When a suicidal thought comes, do not embrace it or argue. Instead say, “NO! I don’t have to consider that because the decision has been made.”
  6. Choose and practice a wellness skill that you will continue when you are feeling better as well as during the tough times.
  7. Seek support from others who have bipolar disorder.
  8. Plan how you will address the struggles you are having.
  9. Bounce your ideas off a trusted friend, relative or clinician to test their validity in your current circumstance.
  10. Pay attention to your energy level. When it is low, mobilize in small ways; when it is high, slow down a bit.