What is Your Bipolar Treatment Plan?

treatment plan

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. 

Yes…

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.

…and No

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.

Proactive Therapy

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.

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. 

Mindfulness Meditation

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.

Self-care

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)
  • Yoga
  • 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!

Bipolar Disorder: The Kanye Effect

Kanye West has been in the media a lot lately. Every other day there is a story about the latest outrageous thing he has done or said. We all have a front row seat to watch his life imploding. It’s painful to watch. But the thing that has been the most frustrating for me about all of this is the emphasis in the coverage about Kanye’s bipolar disorder. 

This has been an issue I have struggled with for decades watching the media’s portrayal of bipolar disorder, in news stories and in movies and television. It is almost without exception focused on people who are very sick. They are not managing their bipolar disorder effectively and the world witnesses a disorder that is out of control and thinks that it is representative of bipolar disorder broadly. It’s the Kanye Effect.

Physical vs. Mental Illness in Media

As I thought about this I struggled to think of any physical illness where the media consistently, persistently sensationalize the illness at its worst. In fact the opposite seems to be true. The media loves to tell the stories of people overcoming their physical illnesses or disorders and living fulfilling lives by effectively managing them. So why not with mental illness?

The effect of this obsession with focusing on the worst of bipolar disorder is that it perpetuates the stigma of the illness. Anyone who doesn’t have personal experience with bipolar believes that people with the disorder are crazy, irrational lunatics. It also prevents people from seeking treatment or sharing their diagnosis for fear of being viewed in that same light.

What we are seeing in Kanye West is a man with bipolar disorder who is clearly manic. His disorder is not being effectively managed and he and those closest to him are suffering because of it. But that does not mean that all people who have bipolar disorder are like that. It also does not mean that a lifetime of dramatic mood cycles is the end of the story.

Could you imagine the hopelessness a diagnosis of type 1 diabetes would bring if the only thing you ever saw were people with diabetes being rushed off in an ambulance because their blood sugar was dangerously low? Or someone who was in a diabetic coma? Or blind or with limbs missing? 

If the news was only telling you horror stories of people suffering the worst effects of diabetes it would feel like a diagnosis of type 1 diabetes was a death sentence. Why try learning to manage it if your life is over anyway? You would feel hopeless and helpless, like a victim to your disorder.

Yes, all of those terrible things are potential risks if you have diabetes, especially if you are not managing it proactively. However, hundreds of thousands of people live active, healthy, fulfilling lives every day with diabetes. A person can learn to manage it effectively. The same is true for living with bipolar disorder. You can learn to effectively manage it and live a healthy, balanced, productive life.

How do you counteract the negative portrayal of bipolar in the media?

Awareness vs. Normalizing

First, it’s important to recognize the difference between raising awareness for bipolar disorder and the symptoms of mania and depression versus normalizing these symptoms. Raising awareness of the symptoms of mania and depression can be useful if it is done with a view to help people recognize the disorder and seek diagnosis and treatment. 

We should not seek to normalize the symptoms that indicate a mood imbalance, however, because the symptoms of a disorder are indications that there is something wrong or out of balance and treatment is needed.

We don’t seek to normalize the symptoms of diabetes–like normalizing diabetic comas. Even saying that sounds ridiculous. If someone passes out because their blood sugar is dangerously low, you recognize it for what it is, a symptom of a body in distress. You respond to that symptom by seeking immediate treatment.

The same needs to be true for the symptoms of a mood cycle–mania or depression. The symptoms of your manic or depressive episodes are indications that your mind is in distress and needs treatment.

When I see people on social media trying to normalize the symptoms of bipolar it is frustrating because it perpetuates the Kanye Effect. It further stigmatizes the disorder by showing people who are in mental distress who need treatment. It also can cause people to feel like there is no hope for living well with bipolar. If it appears that for the rest of your life you will struggle with dramatic mood cycles it will cause discouragement and make it hard to want to seek help.

Effective, Proactive Treatment

It is possible to live a healthy, balanced, productive life with bipolar if you learn how to treat it effectively. So how do you treat bipolar effectively?

Recognize the Symptoms

First, learn to recognize the symptoms of your manic or depressive episodes so that you can recognize when you are either entering or are in a mood cycle. When you are first diagnosed with bipolar disorder you will likely not recognize all of the symptoms of your mood cycles. The symptoms of a mental illness really are “all in your head”, and they can feel normal to you. 

You can change that by beginning to track your mood. As you track your mood you will start to recognize the symptoms that are indicators that you are entering or in a manic or depressive episode. The more familiar you become with the symptoms you have the earlier you will recognize your mood shifting and be able to treat or proactively manage the mood imbalance.

Proactively Manage Mood Cycles

Second, learn to proactively manage your mood cycles. You can begin by developing a Mental Health Emergency Response Plan (ERP). This plan will help you:

  • Identify the people you can ask for help when you’re struggling in a mood cycle.
  • Learn the symptoms and triggers of your mood cycles.
  • Develop a plan for self-care to aid in recovery.
  • Plan for getting back to health and balance.

For a free guide to create an ERP click here.

Treating the Mood Imbalance

Next, learn how to effectively treat your bipolar disorder. Bipolar is a complex disorder that requires an integrated approach to treat effectively. The first step is to treat the imbalance in the brain. 

When I was first diagnosed I was told that I just needed to find the right combination of medications and I would be able to live a normal life. That turned out to be wrong. Like many people I did not respond well to medication. I continued to experience mood cycles–with terrible side-effects from the medications–and over the first decade after my diagnosis my disorder got progressively worse. 

The treatment that finally gave my brain what it needed to start to heal was a micronutrient treatment my doctor and I discovered. This helped my brain begin to be more chemically balanced and gave the other tools I was learning a chance to work.

Therapy

The next step was therapy. When you have bipolar–especially if you live with the mood cycles for a while–you develop unhealthy thought and behavior patterns that can trigger mood cycles even if you are on the right medication or micronutrient treatment. 

Many people with bipolar also have unhealed trauma and don’t understand healthy boundaries. Therapy is a tool that will help you uncover those unhealthy triggers and aid in helping you heal and learning to interact with the world in a healthy and balanced way. 

Self-care

It is also necessary to develop a self-care routine that keeps your body and mind healthy. This includes tools like mindfulness meditation, yoga, exercise and consistent, restorative sleep. The health of your body is interconnected with the health of your mind. In order to help your mind heal and stay balanced you need to care for both your mind and body.

Changing the Conversation

Spreading awareness about bipolar disorder can be beneficial if the goal is to cultivate compassion and hope for those with the disorder. Don’t contribute to the Kanye Effect by further stigmatizing those with bipolar by sensationalizing or normalizing the symptoms of the mood cycle. 

For years I thought that the goal with bipolar was to learn to suffer well with it. I believed that dramatic mood cycles with all of the horrible life damaging symptoms would be my “normal” for the rest of my life. Over the past decade, however, I have discovered that isn’t true. You can learn to live a healthy, balanced, productive life with bipolar.

There is a growing community of people with bipolar disorder who are living well with it. Seek support from others who have learned to effectively manage their disorder. Let’s show the world what living well with bipolar disorder looks like together!

If you are a mom (or prospective mom) with bipolar disorder join our Facebook group Bipolar Moms Learning to Live Well.