What is your bipolar treatment plan? When I was initially diagnosed with bipolar the treatment plan my doctor gave me was to find the right combination of psychotropic medications. I actively pursued this treatment plan for over a decade but became progressively worse, culminating in multiple hospitalizations, electroconvulsive therapy–which caused memory loss and migraines–and multiple suicide attempts.
One of the most challenging issues with the generally accepted approach to treating bipolar disorder is that it does not treat the cause of bipolar, it treats the symptoms. This is because there is no consensus as to what causes bipolar. There are a number of theories, but none have been proven to be true for every person who displays the symptoms of the disorder.
Bipolar is a disorder that is diagnosed based on mental and emotional symptoms. It is in many ways a subjective diagnosis with subjective criteria that can vary from person to person.
Is Bipolar Like Diabetes?
Many people like to compare bipolar disorder to type one diabetes. I had a doctor use this comparison with me years ago to help me accept my diagnosis. It was easier to understand diabetes because it is a clearly defined physical disorder with measurable physical criteria and a universally accepted and generally effective treatment protocol.
When the comparison was first given to me I latched onto it because it was something concrete to help me understand something abstract. The comparison also helped my diagnosis feel more legitimate. It has been a helpful analogy over the years in some aspects.
I use this comparison with diabetes to help explain why mood and symptom tracking is so important with bipolar. When someone has diabetes they need to monitor their blood sugar on a regular basis to make sure they are proactive in keeping it in a safe range.
Even though you cannot track your bipolar through blood levels it is helpful to track your symptoms and triggers. The more information you gather the more effective you can be in treating and managing your disorder.
It is also helpful to understand that even though you cannot measure the imbalance in your blood does not mean you are not experiencing a very real emotional and mental imbalance in your mind.
This comparison also helped me recognize the importance of having a plan to successfully manage my mood swings. A friend of mine who has diabetes told me once about the response plan she had for when her blood sugar was out of balance. It laid out a clear plan of action to manage her diabetes and what she and her loved ones would do if she was in a medical crisis. It saved her life on more than one occasion.
I recognized the importance of developing a plan for managing my mood cycles successfully. I call it the Mood Cycle Survival Guide. Its purpose is to help me proactively manage my mood swings to:
- lessen the impact of my mood cycles on me and my family and
- shorten the duration of the cycles.
The comparison to diabetes doesn’t work, however, when it comes to treatment plans. Diabetes has a clear, definable cause, and a consistent, generally effective treatment plan that addresses the underlying cause. The plan is the same for every person with diabetes–it doesn't change from person to person.
The generally accepted treatment plan for bipolar, however, is not clear, consistent or generally effective. This is because it does not address the cause of the disorder, only the symptoms. Psychiatrists play guess and check with medications in an attempt to manage symptoms.
At best someone with bipolar disorder may find some relief from symptoms with the first try, but it is much more common to have to try a number of different medications over many years.
Medications can become ineffective over time and medications are considered effective if the symptoms are brought into a “manageable range”. If someone is unable to find medications that will help them manage the symptoms of their disorder they are considered to be “treatment resistant.”
Most medications come with side-effects. Side-effects can range from mild irritations like fatigue and brain fog to more serious issues like major weight gain, loss of libido, long term damage to vital organs and sometimes even suicidality. Many people develop additional physical or mental health issues as the result of prolonged use of psychotropic medications resulting in additional medications being prescribed.
The general consensus with bipolar treatment seems to be the goal of helping the patient learn to suffer well with their disorder. I believed that for years. I didn’t have anyone to tell me anything different.
Creating My Own Treatment Plan
Beginning in 2010 I began to discover tools and resources that addressed the causes of my bipolar disorder. As I developed this new treatment plan my brain began to heal.
Medication to Micronutrients
The first part of the plan was figuring out what my brain needed to function in a healthy balanced way. My doctor and I found a non-profit company in Canada called Truehope that developed a treatment to address a suspected underlying cause of bipolar symptoms in many people–micronutrient deficiency in the brain.
With the help of my doctor and Truehope’s customer support I went through the challenging process of titrating off of my medications–with the horrible withdrawal symptoms–and transitioning to the micronutrients. It was rough for a few months, but I woke up one day and it felt like I was truly awake for the first time in over a decade.
It still took years for my brain to completely heal from the effects of long-term psychotropic medication use, but eventually my mind became healthy and balanced.
The second part of the plan was therapy. I learned through study that it is common for people with bipolar to have experienced trauma. The more I researched the link the more I began to suspect that unhealed trauma was contributing to my mood swings. When I finally began to utilize therapy diligently I learned the role that:
- unhealed trauma
- unhealthy thought and behavior patterns,
- unhealthy coping mechanisms, and
- unhealthy boundaries
played in triggering mood cycles. I also learned how to be proactive in utilizing therapy as a tool for healing.
Some valuable tips that will help you get the most out of therapy as a tool to heal your bipolar are:
- Find the right therapist for you.
- Give your therapist something to work with–they are not mind readers.
- Use therapy proactively, not reactively.
- Focus on healing not blaming.
- You get out of therapy what you put into it.
- Therapy takes time, be patient with the process.
- (For more in depth explanations of each of these tips check out my post “Six Tips for Getting the Most Out of Therapy.”)
Over the years I have identified and resolved the triggers of mood cycles. It became easier to recognize trauma responses and anxiety for what they were and work with the therapist to heal.
The next part of the treatment plan was mindfulness meditation. When you have a mental illness your mind feels like your enemy. You feel like a victim to racing, intrusive, irrational thoughts and become unsure of reality, afraid to trust yourself. Mindfulness meditation enables you to become friends with your mind again and puts you back in the driver’s seat of your life.
Many people learn some basic mindfulness techniques in therapy or during hospitalizations but do not gain the full benefit of mindfulness practice because they lack true understanding of why it works and how to practice it effectively.
This was the case for me for many years. I had learned a few mindfulness techniques that had some minor impact as a “coping skill” for managing episodes of anxiety. When I really understood what mindfulness was and how to utilize it effectively it stopped being just a coping skill. Mindfulness meditation is a powerful tool that can aid in healing your mind.
The final element to the treatment plan was learning how to put together a self-care routine that aided healing and helped me maintain balanced mental and emotional health. The basic elements of self-care for bipolar include:
- Exercise (keep it simple, easy and accessible)
- Healthy, consistent sleep habits
- Good nutrition
- Hygiene habits
- Carefully evaluating and managing stressors
Why did I have to figure this out myself???
After over 10 years putting together my treatment plan and learning how to live a healthy, balanced, productive life with bipolar I began to wonder why I had to figure this out for myself? None of the pieces in my plan are really unique or mysterious, so why was I left to discover it on my own? This was the inspiration for starting my blog.
It shouldn’t have taken me over twenty years to learn how to live well with bipolar! I shouldn’t have been led to believe that the best I could expect from a life with bipolar was just suffering well. I should have been given a treatment plan to treat the causes of my bipolar, not just medication to manage the symptoms.
I created the Map to Wellness to teach the treatment plan I use so that you can learn how to live well with your bipolar, too! If you:
✔️commit to the path,
✔️choose to take the steps, and
✔️recommit yourself each day to continue the journey,
you can live a healthy, balanced, productive life with bipolar.
If you’re tired of being controlled by your disorder and are ready to live well, then let’s get started!