The Bipolar Disorder Manual

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Foreword

So, you’ve just been diagnosed with bipolar disorder, aka Manic Depression. The first thing I want to tell you is that the world is not over. Life does continue. Even though you are probably looking through this booklet while in a psychiatrist’s office or a hospital room, life does go on – and happily, I might add. The fact that you are Bipolar is simply another challenge to deal with, and should be regarded as such. Of course, being Bipolar is a special challenge. It’s not like studying for a test or performing well in a sporting event. It comes with a whole new batch of emotions and situations. What this booklet will do is help you get through the next few months of your life. Even though you may only read these pages once, feel free to refer back to certain passages or to earmark pages that you find especially helpful. You may need them again in the future.

Initial Feelings

Well, here you are. You have just been told by a doctor that you are Bipolar. Its an illness that affects your emotions, your thoughts, your mood, and your life in general. You will now be dealing with medications, therapy, and regular visits to the doctor’s office. Is it a big problem? Yes. Can it be turned into a little problem? Yes. Will it destroy your life? Definitely not. And here’s why.

You are angry. You don’t know why you have to deal with what you’re going through. You’re probably pissed about the whole experience and you feel like you’d rather just rewind to a few months ago before you discovered that you are a little different than the mainstream population. You may have missed a little school or a little work time because of a hospital visit that probably lasted a week or two. Now you need to know how to deal with the overwhelming emotions going through your mind. Well, here’s the good news – nowadays there are a number of solutions for patients with bipolar disorder. There is a whole slew of therapies, medications, and job opportunities that are available to folks who need them. So stop being angry. Help is definitely available.

You are probably feeling relatively helpless. Lately the thoughts that have been going through your mind have been some of the worst things you’ve ever imagined. You’ve been suicidal, angry, sad, and exuberant all in the breadth of a few minutes. They have been an incredibly tough combination of emotions and you’re wondering how you’re going to deal with all of them for the remainder of your life. Plus, you’re probably losing a lot of sleep and you’re wondering if you’ll ever be able to relax again. Well, I have some good news for you. There are many of us that have done it. But I can’t lie to you, we lose some folks. In extreme circumstances where the stress gets too high and the medical and social support isn’t strong enough, some patients die. But I’m one of the survivors, and I can show you how to be one too.

Take all of the feelings that have been flying through that noggin of yours…and share them. Tell everybody about them. Tell your doctors, your friends, your family. Let everybody know what’s going on. The #1 rule to being bipolar is NOT KEEPING THINGS IN. Let everything out. And don’t spare a single feeling. Let everybody know everything. Even if you’re a secretive person, learn to share. Sharing your feelings is the most important lesson to successfully living with bipolar disorder. You will be using this technique for your entire life, so you might as well get good at it now.

Relax. Don’t do stressful activities. Put everything on hold. Let go of the world for the next week or two. Give yourself some time to come down from everything you’ve just been through. Being in the hospital or going through several doctor’s visits is extremely hard for ANYBODY. Don’t bother stressing yourself out with extra duties. Take a break and get back to work after you have recovered.

Have some fun. Don’t take this to mean go out and get liquored up. At this point in your life the one thing you don’t need is drugs/alcohol. Not only can they interfere with your medications, but folks with Bipolar Disorder can experience a TRUE loss of control when they are high/drunk. When I say have fun I mean that you should do things you like to do. Whether its fishing, playing ball, travelling, whatever….just do it. Just like Nike says. Go out and have some fun. With the new adjustments you’re going to have to make, you’re going to have to offset them with an additional amount of recreation. Odds are that some of your medications will create some unpleasant side-effects. The more time you spend doing things you enjoy, the less brainpower you’ll waste focusing on your new situation.

Being In The Hospital

You either already have been, or eventually will be, in the hospital. Even if it is only for a day or so to sleep off a bad episode, bipolar folks tend to spend some time in the hospital. The biggest thing to remember is that its not a big deal. Being in the hospital can even be fun. It is boring every now and then, but being able to talk to the other patients, getting their perspective on life and mental illness, can be extremely enlightening. While you’re in the hospital the best thing to do is make friends, sleep as much as you need to, and participate in as much therapy as possible. Remember not to be violent, listen to the facilitators, and let your doctor in on everything that’s going through your mind.

The ability to deal with your doctor is a skill that is acquired over time. After being in the hospital five times and dealing with several doctors, I’ve realized that there is one key ingredient to establishing a wonderful relationship with him/her – the truth. Speak nothing but the truth to your doctor. Let him know absolutely everything. He’s there to help, he’s there to help you avoid having to come back, and he’s there to improve your life in the long run. If you choose to lie to your doctor you are making a big mistake, mainly because it will probably result in him/her setting you up with the wrong medication and therapy regimen. Trust me… what you want more than anything is to get treated properly. Walking out of the hospital with the wrong treatment program is a TERRIBLE thing. This is a road you definitely don’t want to go down, so tell the truth.

Make friends! There’s nothing that the hospital staff wants more than seeing you getting along with all of the other patients. Not only does this improve your image to the people who are in control, but it’s fun! Being able to talk to everyone and have converations about your lives is a very important component to enjoying your time in the hospital. Patients not only want to open up, but you can LEARN from them! Most of the patients will probably be older than you, so they will usually have some decent insight into mental illness. Plus, it will give you an opportunity to TALK ABOUT YOUR OWN PROBLEMS!!! And there is nothing better while you’re in the hospital than talking about your problems. You will only get 15 or so minutes with your doctor each day, so talking to others will give you more opportunities to get things off your chest. There will be other therapies each day, but one on one with another person is always helpful.

SLEEP!!!! If you need to lie down, do it! Take a nap! Take two naps! Guess what, you’re in the hospital, it doesn’t matter! That’s what they want you to do, anyway! They want you to rest and get better. And sleep often does that for bipolar patients. Often times you need opportunities to physically adjust to new medications or to just recover from a really bad episode. And the beds are usually pretty comfortable. So, if you need some rest, take it.

Do the therapy! Every single opportunity you get to participate in a theraputic session, TAKE IT! Participation is part of the success formula for getting out of the hospital as soon as possible. The facilitators and your doctor keep track of all the times you go to therapy and participate in that therapy, so the more you do, the better. Plus, the therapy is usually quite fun. Remember that the key to getting out of the hospital is GETTING BETTER!! And therapy is a main component of getting better. I noticed during my first couple of trips to the hospital that there were numerous patients who “refused” to participate in the therapy. Well, a few days later they weren’t refusing, mainly because they were watching patient after patient leave the hospital and go home because of the progress they had made in therapy. So don’t waste any time and go to as much therapy as they offer.

Getting Out Of The Hospital

There are two simple things you need to remember when it comes to successfully being released from the hospital. The first is telling the truth. Each and every time you have a therapy session or meet with your psychiatrist, you have the option of telling the truth or not. Many patients believe that the best thing to do is cover up their problem. So they go into therapy meetings and lie, and then they go into their doctor’s and lie. Their assumption is that by lying about their feelings, making themselves look healthier than they are, they will improve their chances of getting released. Now, while there is some sense in that, it is still not the best thing to do because it hurts your LONG TERM recovery chances. The fact is that if you aren’t feeling well, TELL THEM. If you think you’re not better yet, TELL THEM. Don’t put yourself in the position of ending up back in the hospital two weeks later because you lied about your mental stability. Trust me, it’s not fun. Been there done that. Its much better to focus on making your first trip to the hospital your last one.

The second bit of advice that will help you get out of the hospital is STAYING OUT OF THE QUIET ROOM. The Quiet Room, as you might already know, is a room with a bed – with restraints. That is where they put patients who are disorderly. Coming from a man who has spent more than a few nights in the Quiet Room, it is definitely best to avoid it altogether. Don’t cause trouble, don’t get into arguments with other patients, and DON’t BE VIOLENT. Some patients have trouble getting this into their heads, either because they are too busy trying to kill themselves or because they don’t understand that the more time they spend in the Quiet Room the longer they’ll be in the hospital altogether.

Be patient, be passive, learn what you can, take your meds, and you’ll be out of the hospital in no time.

Going To Therapy

“Oh Wizened Bipolar Veteran… knower of all ways to deal with the disorder that disorders us, what do we do after we’ve gotten out of the hospital?”

“Don’t fret, child, for this world’s mental experts have it all worked out. And the first thing on the agenda is to start in with some regularly scheduled therapy!”

Yep. The movies and the books don’t lie. Therapy fixes lots of things, and it definitely can take the edge off of being Bipolar. Odds are that after you get out of the hospital you will be required to go to a daily/weekly group therapy session for a couple of weeks. These sessions are not only therapeutic, but they are also extremely fun, believe it or not. You see, when you go around every day existing amongst other people that DON’t have Bipolar Disorder, it is EXTREMELY comforting to spend an hour or so a day with some folks that DO know how you feel and DO know what you’re talking about. Granted, they won’t all be your age, and they probably won’t be people you’d really want to hang out with on a regular basis, but the INSIGHT that some of these folks have will just clean knock your socks off. A good portion of the folks in the room will tell you that they’ve been dealing with this illness for years. Their help, as well as the social worker or psychologist assigned to facilitate the group, will truly make a difference in your life. So don’t blow off your therapy appointments! They are important! And they can definitely keep you from having a… dare I say it?… . relapse.

Taking Medication

“But I’m feeling much better now! I’m not depressed, I’m not hyper. I can go to work, I can take care of my daily responsibilites. Why should I have to take regular medication?”

Oh, my young naïve Bipolar outpatient, you are new to the ways of this disease. The reason you take the medication is to avoid a relapse, and I’ll tell you why.

With Bipolar Disorder, everything can be going absolutely peachy. Life can seem like one big box of chocolate. Then, in comes the dreaded beast… STRESS. Something can happen in your life, like a relative dying or losing your job, or possibly marital stress. And then the walls come crashing down. All of the work you have put into managing your emotions and watching your behavior don’t mean a hill of beans because now you’re flying again. Your emotions are going up and down like Space Mountain and its only a matter of a couple sleepless days and then you find yourself in the hospital again, even if its many years since your last visit.

However, guess what. There’s a number of wonderful medications that can keep that sort of thing from happening, as well as help you enjoy life a little more on a daily basis. These medications have TRULY changed my life and allowed me to do a host of things that I never thought possible right after I was diagnosed. I take a few pills in the morning, a few pills in the evening, and even when life gets EXTRA hairy, I still don’t get so out of wack that I have to go to the hospital. And trust me, if I never have to go to the hospital for the rest of my life… .that is fine by me.

So take your meds. They help. And if you feel like your meds aren’t working for you, talk to your psychiatrist. In today’s world there are many different options and if one med isn’t working for you another can.

Working With Your Support System

Who’s your support system? Your friends, your family, your doctor, your pets, your priest, your rabbi, your kids, your bed, your bathtub, your books, your computer… .ANYTHING AND EVERYTHING that makes you feel good about yourself. When you’re Bipolar, you may need help at any given time. You never know when something will kick in and an episode might occur. So utilize anybody and anything that might be able to calm you down and help you get stable again.

Over the years I’ve run the whole spectrum. I’ve been to my psychiatrist, I’ve had late night talks with my parents, I’ve spent four hours in a bathtub, I’ve hugged my dog, I’ve slept 12 hours a day… WHATEVER WAS NEEDED to feel balanced again. Remember that there are two main goals for the average Bipolar patient: don’t commit suicide and don’t get in a position where hospitalization is necessary. Now, you might laugh at that statement. You might be someone who has only been in the hospital once, or maybe never, and you don’t think something like that will happen. Well, I’m sorry to burst your bubble. There will probably be times in the future where you will think back on those two goals and realize why I mentioned them.

For me, whenever I get really stressed or worried, or when I lose sleep… I start thinking about suicide. It is not fun, and I don’t consicously choose to do it, but the thoughts are there. So, a long time ago I set up a PRIME DIRECTIVE for myself – no suicide. No matter what happened, no matter how bad things got, even if I had to spend months in a hospital – I still wasn’t going to kill myself. You need to make it a goal for yourself, too. Bipolar Disorder is a nasty illness, and the 20% death rate doesn’t come from heart attacks.

So, use what you’ve got. And if you feel like you don’t have enough of a support system, create one! Make more friends! Get a hottub! Get some pets! Get a girlfriend or a boyfriend! What I’m trying to say is that you need to do what is necessary to stay well. This illness can be conquered, but not without help.

Having Fun

Having fun sounds easy, huh? Well, its not, not if you’re in the middle of a bad depression. You may already know what I’m talking about. Nothing sounds interesting, people that usually make you laugh are making you cry, your sleep schedule is either nonexistent or completely switched around, and working is next to impossible. So, ya know what you have to do to take care of all that? WORK at HAVING FUN.

I know it sounds kind of silly. The idea of actually putting effort into having fun does sound silly, but you have to do it. You have to deliberately inject enjoyable activities into your normal routine in order to keep that big bogeyman called depression out of your life. Get used to it because this is going to be necessary for the rest of your physical life. Don’t let a single day go by without some fun. Whether it be watching one of your favorite movies, calling a friend, or taking a three week trip to Australia to scuba dive, DO IT! This is actually one of the most important lessons in this entire manual, so clue in while you can. There will come a time when you will go a few days without some real in-your-face fun and then you’ll remember what you read here and immediately go out and enjoy yourself in order to alleviate whatever problem is circulating in your mind.

Schedule fun regularly. Trust me, you’ll need it.

Getting Back To Work/School

Oh boy, now this is a toughie. If you are a student you will find this especially challenging. I say this because fellow employees and bosses are more inclinded to appreciate what you’re dealing with than fellow high school students. In my junior year of high school I returned from a two week stay in the hospital and discovered that life had truly changed. Everybody looked at me differently, my friends acted differently, and dealing with everything became quite challenging. I was still at a point where my medications weren’t working correctly, and at that point in my life it was taking so much energy just to handle my own mind that to ask me to deal with constant undue pressure at school was too much. I battled with this issue for months, packing an additional two week hospital stay in between four more months of school. Eventually, it got to be too much, and I took the equivalency exam. But next fall I entered college and now I have a bachelor’s degree in Information Technology. My story aside, the advice I’m going to give in regards to this situation is pretty basic and that is Realize There Is An Alternative.

In life there is ALWAYS another option. Even if you can’t comprehend it at this very moment, there is ALWAYS another path to take. If you can no longer deal with the situation at your school or your job, you can always negotiate another situation. And, as with everything in human life, you can always start over. If school problems get too deep, you can always change schools. If job problems get too stressful, change jobs. Understand that no matter how tough things are in your current situation you can always switch things around. While I was trying to figure things out in high school, my school’s principal allowed me to switch my schedule around as well as give me special privledges in order to better facilitate my own healing.

At one of my jobs, one day things just got to be too much and I started crying in front of one of my supervisors. A six foot seven inch computer technician started weeping, all because of a bad situation with my then girlfriend. But it didn’t matter. My boss understood that sometimes adults have problems that overwhelm them. He wasn’t even bothered by it. He told me to do whatever I had to do to feel better and that if I needed time off I could have it. The fact of the matter was that I was a valued employee and if I had a little problem that required some attention, it didn’t bother him. Employers constantly deal with this kind of stuff. Its normal. Don’t worry about it. And you know what? If your boss goes crazy when you need to deal with some personal issues, you probably shouldn’t be working there anyway. The day of the super anal boss is gone. In today’s working environment the atmosphere is much more tailored to keeping valuable employees happy. Happier employees means more efficiency, and that’s what the game of business is all about. So don’t stress.

Remember, the people in charge are usually willing to help. And if they’re not, this world always has another path to walk down. Don’t worry if you need to take one.

Progressing With Life

Oh, the joy of life. Sometimes fun, sometimes not, but always progressing. Whether you like it or not, you’re always moving along. Until the Lord calls you home, you’ve got to keep on going. And absolutely the best advice to give to a Bipolar patient about progressing with life is this – let go.

That’s it. Let go. Let go of your problems, let go of your preconceived notions about life… let go of stress. Learn to drop things at the tip of a hat. Learn to drop fights and learn to makeup. Learn to drop your pride, drop your ego, and drop everything you thought you knew. Unfortunately, or maybe fortunately, once you’re Bipolar you don’t have time to get caught up in unnecessary junk. You’ve got to learn to ebb and flow and fly and run all without petty junk creeping up on you. So let go, give in to Love, and let the fear slide off of you. It’s a great world, but you’ve got to open your eyes to it. It’s a little tougher when you’re Bipolar, but trust me, it CAN be done.

Relapses

Oh the joyous world of relapses. I know quite a bit about these because I’ve had five hospitalizations in the first six years after I was diagnosed. Each time I thought I was never going back. However, at the moment its been almost four years since I was hospitalized, and hopefully I won’t be back for a while. But, in reality, when you’re Bipolar I such as I am, there’s always the possibility. Major stress tends to beat you up quite a bit, and bad timing can always create another few days sleeping off some unfortunate life circumstances. So be ready for them.

Remember that relapses aren’t a big deal. They happen. You can do your best, take all your meds, go to therapy, but you may still have to be hospitalized. So don’t beat yourself up if that happens. There’s no point in putting any extra worry into the situation. If you have to go you have to go. The important thing to remember is that it is better to be in the hospital if you need it than out of the hospital causing extra damage to your life. Also, an experienced Bipolar patient can bring in the reins on him/herself pretty quickly. So if you need to get some help, it will usually only result in three or four days of attention.

Also… .keep up your medical insurance. I can’t stress this enough. When you’re Bipolar you have GOT to have medical insurance ALL the time. You need it to pay for your meds, you need it to cover hospital costs, you need it to get therapy when necessary. NEVER let your medical insurance slide. There are many folks in some bad, BAD situations because they couldn’t afford help when they needed it.

Sleep

I cannot even begin to tell you how important sleep is to a Bipolar patient. The amount of sleep you get will make or break your life. Go to bed too late, get up too early, and suddenly the next day is SO MUCH harder than it normally would be. This is true for lots of people, even those who are not Bipolar, but for those of us with the illness the effect is tremendously magnified.

Feelings kind of rule your world when you’re Bipolar. When your feelings are positive, life is a bowl of cherries, but when you feel tired, stressed out, or anxious… man, life sure does get hard. So, make sure that to avoid undue problems – get your sleep. I’m not exaggerating when I say that it can mean the difference between life and death. The suicidal thoughts pop up with much more frequency and with higher intensity when sleep is escaping you. So if you’re tired during the day, take a nap. If you have things to do early in the morning, go to bed when you should. Go through life as happy as possible. Get enough sleep.

How To Explain What It Is Like To Be Bipolar

So, you have friends, you have family, and none of them really knows what Bipolar Disorder is. That’s okay. When you explain it to them, keep it simple. Tell them that it means your emotions are intensified and that your highs are higher than most people but your lows are also much lower than most people. There’s nothing wrong with telling them that you’re on medication. Heck, all of us have to take medication at some point in our lives. And feel free to explain to them that you have gone to some therapy. In this new century, therapy is now a typical thing. Lots of people do it. Nobody is really going to judge you for it.

Make sure to keep things in a positive light. Don’t go into the really horrible side of this illness unless you truly feel like enlightening someone. Most people don’t need to know that suicidal thoughts are typical and that if things get too stressful you could pop. Just give them the basic facts and if they really want to research more you can send them to the information webpage of your choice. Or, I guess you could give them this booklet.

Helping Others

Along with everything else you’re doing to help yourself, start by doing some volunteer work. I don’t necessarily mean structured volunteer work where you go somewhere for a certain number of hours and do work you don’t like. I mean other stuff like spending time with your kids, helping out your parents, being a good friend and spouse. Be generous with yourself. For Bipolar people especially it is important to share yourself. We don’t necessarily get along too well if we’re not constantly opening ourselves up to other parts and people of the world. You’ll find that opportunities will come along each and every day to show someone else you are a spectacular person. Don’t pass them up.

The Miracle of Faith

Now, I’ve given you the lowdown on just about every important part of being Bipolar: the hard stuff to handle, the easy stuff, the postives and the negatives. Now I’m going to give you a little tip that has truly helped me – believing in God. Those of you that are agnostic or atheist may balk at this sort of thing, but let me fill you in on something. When you are at your worst, when you are in bed fighting off a bad episode, you are going to need a light at the end of the tunnel. Without that light, without that love, the world could easily crater in on top of you. Believing in God has saved lots of people from ending their life prematurely, and it can do the same for you. If you’re skeptical about this, then I suggest you try it and if it doesn’t work for you then give it up. But trying it should be first on your list. I should know – without my belief in God you wouldn’t be reading this.

About The Author

Shay Villere was born in New Orleans, Louisiana. At the age of 11, his family moved to Sacramento, California. He experienced a normal childhood performing well in academics, sports, and acting. He also enjoyed having many friends.

At the age of 16, Shay was diagnosed with Bipolar Disorder. It occurred during his junior year of high school and eventually proved to be so severe he was forced to leave school and eventually take the California High School Proficiency Exam. Between the ages of 16 and 22 Shay was hospitalized five times for psychotic episodes. While sometimes being hospitalized for depression and mania Shay never attempted suicide.

Over the years Shay’s doctors have prescribed several medications to treat his illness. At various times he has taken Lithium, Haldol, Paxil, Tegretol and Stelazine. Due to some of these prescriptions his weight has fluctuated between 180 and 310 lbs. Shay estimates it took four years to find the right combination of medications. He is now 27 years old and has carried 230 lbs. on a 6′ 7″ frame for the last five years.

Shay considers himself to be a successful Bipolar Disorder patient. While dealing with his illness he has still managed to complete a four-year college degree program in the computer field, hold well-paying, fulfilling jobs, buy a home, and marry a wonderful woman! He has continued to enjoy an extended network of friends and cites his parents as the most important aspect of his support system. He has also created a charitable website dedicated to helping others.

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