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Disclaimer: All information below was compiled and reviewed by members of the Adult Support Group of the Metro Louisville DBSA. None of the members are credentialed professionals, and information should be taken as personal advice rather than recommendations from a professional. With that said we hope that this information can help you as it has helped many of us.
Duplication and distribution of this brochure is welcome and encouraged.
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These suggestions are intended to help people suffering from depression and bipolar disorder help themselves. While medicine is critical to recovery and stabilizing the highs and lows, this information can be used to help limit the effects of triggers to depression and mania. The suggestions were compiled from people with bipolar disorder who shared their experiences and what helped them improve their surroundings to promote a healthy atmosphere.
Psychiatrist | Medication | Exercise | Nutrition | Therapy | Groups | Alternative
Write | Sleep | Relax | HALT | Music | Socialize | Laughter | Pet | Start | Spirituality
Your psychiatrist is a well-intentioned health care provider and should be listened to regarding medicine, advice, counseling and consultation. Work with your psychiatrist toward a recovery program. Be honest when relating symptoms as they are necessary for your doctor to evaluate your condition. When possible, bring a family member or close friend to your session to present a different perspective and possible conditions that you may miss when talking to your doctor. Prepare a written list of questions. Speak up about the questions you have about your treatment. Encourage frequent testing for adequate medicine levels in your blood. Keep a mood swing chart to show your psychiatrist your progress toward recovery.t is very important that you have a rapport between you and your psychiatrist. If you feel uncomfortable, or if you feel your doctor is not addressing your needs, Try another doctor. It may be necessary to try more than one in order to find one that addresses your needs.
Be compliant with your medication. The doctor knows best about medical treatment for your condition. Stopping and starting your medicine without the approval of your doctor can lead to more severe symptoms. Consult with your doctor regarding any changes in your medication including starting and stopping. Ask your psychiatrist what should happen if you miss a dose of each of your pills: whether you should double your next dose, make it up in some way or wait till your next dose. This is important to know to prevent undesirable effects, especially if you take a number of medicines for depression or bipolar disorder.
Research your medicines and know how they work. Some good references include:
- The package insert accompanying sample medicines you receive from your doctor.
- WebMD
- Physicians Desk Reference (PDR)
- Nursing Drug Reference Book
- The Mind/Mood Pill Book - search prices at pricegraber.com
Synopsis: For millions of Americans who will take a psychiatric drug in the course of their lives, this unique guide to the most widely prescribed of these medications is an invaluable handbook that provides uniform, comprehensive profiles of each drug.
Be patient when trying a new regimen of medicine. Medications can take several weeks to produce their effects. Discuss symptoms, side effects and your courses of action with your doctor. Certain medicines must be started and stopped slowly to avoid undesirable side effects or bad reactions. Consult your doctor on how to change your medicines if need be.
Do not mix illicit drugs, alcohol or mind-altering substances with your prescribed medicines. These drugs can interfere with psychoactive medicines and can defeat their effectiveness.
Exercise reduces your risk of relapse and keeps you fit. Exercise regularly: twenty minutes of brisk exercise four or five times a week is recommended. Walk, swim, jog, lift weights or do other kinds of exercise for up to an hour a day if possible. A kick bag and boxing gloves can be used to work off frustration and anger. Dancing is also great exercise. It helps pull you up when you are down, and it can burn off manic energy in a safe, constructive fashion.
Eat healthy: eat plenty of fruits and vegetables. Drink plenty of liquids. Some medicines?in particular, lithium?require you to drink more water than average. Avoid carbohydrates alone such as white bread, starches, potatoes, sugar, pasta, etc. Know what is in the food you eat. Take a multiple vitamin with folic acid and a B-complex. There are several medicines which can deplete vitamins. Read about your medicines and talk with your doctor about them.
It is shown that medicine coupled with therapy maximizes recovery. Different forms of therapy such as cognitive therapy, Gestalt or talk therapy are available. Carefully select your therapist and pick one who will communicate closely with your psychiatrist. Be honest when talking about your condition. Bring a friend or family member to shed light on possibly overlooked significant behavior. Stay with your therapy at least six weeks to determine how effective it is. It is important that there be a good rapport between you and your therapist, and a little ?shopping around? may be necessary to ensure a good fit.
Support groups help avoid isolation and give perspective to one?s situation. Sharing your activities and concerns in a group like DBSA can produce ideas and alternatives to recreate one?s environment to be more positive and supportive. They also give an arena to air problems, concerns, feelings and other aspects one cannot share with friends and family. Keeping in touch with other people from support groups can aid in times of stress, depression or mania to regain perspective and to vent feelings which may be making the symptoms worse.
Alternative and Additional Therapies top of page
Light therapy is especially good for people with Seasonal Affective Disorder (SAD). Sunlight is optimum when available, or a psychiatrist-approved sun lamp may be employed. Incandescent light also is preferable to fluorescent light when treating the effects of SAD which may accompany depression or bipolar disorder.
Other additional therapies can include yoga, massage, chiropractic, meditation and visualization, and martial arts. Aromatherapy combats ill moods with a number of remedies. For example, sandalwood is sometimes suggested for a depressed mood. The combination of spearmint and rose is a historic ?remedy for melancholy?.
In addition to specialized therapies, put your environment at ease. For example, people often visit their families as a social obligation and stay for what they feel is necessary to complete the obligation. A better idea is to ?get while the getting is good.? If you do visit your family or other people you feel obliged to, limit your visit. When do you leave? Leave while the atmosphere is still ?up?. Don?t wait for it to go sour first. Even if the visit seems unusually short, it will put you at ease and be less likely to pull you down. It has the added benefit of putting your hosts at ease as well, and future visits will be easier, too.
Journal your thoughts and feelings. Keep a record of your ups and downs. Keep a calendar of your activities.
Write positive affirmations for yourself: for example, ?This too shall pass?, ?It is always darkest before the dawn?. Look in the mirror and say out loud, ?I am a good person and I love myself today.? until you mean it. Make a list of everything you are grateful for in your life.
Keep a ?Things to Do? list. Write down the things you do throughout the day and use a highlighter to cross off each item that has been done. Include daily things like, ?do the dishes?. If you have done something and don?t have it on the list, write it on there and highlight it off. At the end of the day you can look at the list and see the highlighted things you?ve done. This shows how much you?ve accomplished that day and can bolster your mood.
Break down your projects into manageable pieces to accomplish. Schedule them on a calendar. Organize your tasks by way of a priority code:
- Important and Urgent?(Do these first)
- Important but not Urgent
- Urgent but not Important
- Neither Urgent nor Important?(do these last)
Alternatively, prioritize your tasks into A, B, and C tasks:
- Most important tasks
- In between least and most important tasks
- Least important tasks
Take the ?B? group and divide them into ?A??s and ?C??s. ?A? tasks are done before ?C? tasks.
Write down the day you will do a task, like ?Go to the garage for an oil change?Tuesday, May 5? If this day comes around and the task is not done, change the day to the next day you can do it or to a day you feel is a better one to get it done.
Make a list of goals for that day. If ?do the kitchen? is too large a goal for you, break it down: ?fill the dishwasher?, ?wipe off the stove?, ?store leftovers? may be more manageable tasks. Use the list as something to work toward. Be careful not to let it become an absolute. Don?t beat yourself up if there is something on the list you did not accomplish for that day. It can be set as a goal for the next day.
Get a routine?for example sleep 11pm to 7am?and try to stick to it. Try not to oversleep. Count your sleep in a 24 hour cycle. If you take a nap in the afternoon, count that as part of your sleep cycle, too.
Keep track of your sleep, as too much or too little can indicate mania or depression. Share this information with your doctor.
Give yourself permission to relax. Do those things which give you pleasure. If you are dealing with depression, try doing those things you enjoyed before you had the depression. These things may help your mood lift.
Read a book just for fun. Exercise with a friend. Play a chess game; some say it activates pleasure centers of the brain. Devote time to taking care of plants. Do gardening.
Stay away from cable network news shows. Keep your television out of the bedroom if possible. Take a ?news fast?. A recent study suggests this can ward off depression. Instead, try watching comedy channels or channels with old, wholesome re-runs.
Change your place. Get out somewhere. Go visit someone. Monotony can cause depression no matter what setting you are in.
Create a stress-free world about you, one as calm and peaceful as possible. Stress triggers depression or mania. If you get really angry or otherwise stressed, breathe in through your nose and out through your mouth ten times. It promotes focus, releases stress and allows for a more even perspective.
Develop your creativity: painting, weaving, welding, sculpture, woodwork, silk screening, interior decorating, car customizing, linoleum block printing, web design, cooking, air brushing, needlework, leatherwork or other creative outlet. Create your own medium. Associate with others who are expanding their creativity and create a ?colony? where everybody encourages each other in their creative path.
The advice given by 12-step groups is fundamental. Never allow yourself to get:
Hungry
Angry
Lonesome
Tired
Each of these can unbalance a person and trigger depression or mania.
Listening to music is a way to avoid the extremes. Change your mood by playing music of the mood you want to be in. Learn an instrument: guitar, piano, flute, horns or other instruments. Performing music provides enjoyment and creates a focus away from stress. Drumming can work off extra energy or anger and frustration while providing focus. Singing and playing wind instruments are forms of aerobic exercise. Sing even if you can?t carry a tune. Your voice is the one instrument you carry with you at all times.
People who are depressed often do not wish to see anyone else but prefer a dark room with shades drawn and phone unplugged. They often don?t answer the door for this becomes a perceived enemy.
First, start by plugging the phone back in. Take calls and make calls even if the phone seems to weigh 50,000 pounds. Have a depressed or bipolar friend establish a daily check-in phone call with you. A good place to find a friend to check in with is at a support group meeting.
Go out a little at a time. Perhaps start by going with your best friend to a movie. The movie will be in the dark and will be the object of focus. Therefore it can take a lot of the burden of socializing off of you. This can be a first step to socializing.
Talk to everybody you can. Talk even to the people at the drug store or grocery store. E-mail your friends. Seek intellectually stimulating discussions with friends.
Plan an event with someone. Make it part of your schedule. Put it on your calendar. This way it will be less likely to overwhelm you. It can be something you can anticipate, an event to look forward to.
Laughter can do much to lighten your spirits. Cable TV?s comedy channels can provide good humor to laugh at. Watch a good cartoon or a sit-com. Invite over the funniest person you know to entertain you. Go to a comedy night club. Just for fun, laugh at yourself in front of the bathroom mirror. Try making faces at the mirror?you might laugh a little harder.
It has been shown that the companionship and loving devotion pets provide fight depression. Pets help lower heart rate and blood pressure, and they provide unconditional love.
It is often very difficult for a depressed person to start the day, or a manic person to stay focused. Here is a suggested regimen for getting started every day:
- Rise out of bed
- Make the bed
- Shower
- Eat Breakfast
- Get dressed
- Get out the door
The last is very important to keep depression from keeping a hold on you.
Spirituality is very important?often the one thing that keeps many people from the brink of suicide. Many people follow the tenets of the religion that they learned as a child. If this works for you, stick with it. Prayer has been shown to be a powerful force in general and can be a powerful force in one?s life.
Spirituality can be based on major religions such as Christianity, Judaism, Islam, Hinduism and Buddhism, but it can also be an internally developed practice. While many look to God, Yahweh or Allah as their supreme deity, there are people who connect with their ?higher power? in whatever form that is personal to them. It could be Nature. It could be the Great Spirit or Wankantanka. It could be the Holy Spirit. Some people claim no religion but acknowledge a higher power in their life. If a person has no higher power to acknowledge, one could acknowledge the ?power of the [support] group?. The group, made up of many people, has a power in and of itself from which to gain spiritual support.
Spiritual scripture and ritual can be tailored to address the condition of depression or bipolar disorder. One such suggestion uses ?The Lord?s Prayer? or the ?Our Father? to speak to it by saying, ??Give us this day our daily bread and mental health?? Reading and studying scripture helps unfold spiritual growth and develop personal strength. Attending services puts us in the company of others seeking spiritual growth; this also promotes spiritual growth. Meditation, contemplation, chanting, prayer and the rosary all focus spiritual energy for gaining strength and perspective. Spirituality and spiritual practices have helped people throughout history deal with life difficulties and gain insight into how to right things in their lives.
Some suggestions for spiritual practices include this Buddhist chant: ?Nam myoho ringe kyo?. Another mantra to chant is, ?God is Good, God is Great, God is Gracious?. Chanting or singing single words of ideals such as ?Love? or ?Peace? or ?Om? or any name of God or Holy Spirit or Creative Spirit can give spiritual upliftment. Meditative practices of clearing the mind and removing focus from any thought can achieve spiritual ends.
Another technique of spiritual upliftment some call bibliomancy. It is kind of like a personal fortune cookie that speaks to a particular personal concern. Using a book of scripture or a book of spiritual inspiration, one thinks of a particular concern then opens the book randomly. A random passage on the page is read. This passage is what addresses the concern. Some people do this more than once in order to get another perspective on the ?fortune cookie?. Some people do it twice to address a ?positive? and ?negative? aspect of the passages to get a ?balanced? idea of the message.
The Book of Changes or I Ching uses this kind of technique. Six objects such as shells, coins or other objects are thrown and sorted into an order of broken and unbroken lines (topside/underside of a shell; head/tail of a coin). These lines are matched to passages which show the changes and what they can mean.
Spirituality is the internal expression of a person and it can make the difference between life and death for a person. Associating with others in a spiritual setting is a way of bolstering and increasing personal spirituality by combining the collective spirituality of many people. This includes ritual, group meditation and chant, religious ceremonies, pow-wows, gatherings, prayer meetings, worship services, group song and more.
Above all, do what works for you. Depression and bipolar disorders are chemical disorders, but heading off and avoiding the triggers of depression and mania can make the episodes less severe and less debilitating.
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