How do you cope?

How do you deal with being bipolar?  How do you fight the hopelessness and despair that goes along with the depressions?  What can you do about the uncontrolled energy of a manic episode?  There’s no easy answer, at least not for me.  The good news though is that with the right combinations of medications, therapy, and support it is possible to keep it at bay. 

Medications are most likely to be key to a successful treatment plan.  While there’s no clear cause for this illness, there is a good understanding of how the body and brain function for those who have this disease.  Certain chemicals in the brain such as dopamine, Noradrenaline and serotonin are known to affect brain activity as it relates to bipolar disorder.  Further studies have indicated that physical characteristics of the brain also play a part.  This is where medications can help.  These chemical and neurological imbalances and activity can be influenced chemically, and reduce the severity of symptoms.  Over time, these medications have evolved as there is a better understanding of the underlying factors and the ability to develop more effective ways to address them.  The first major medication was of course lithium.  I’m not sure how accurate the story is, but I do know that lithium, which is a salt, was being used as a substitute for table salt.  In the mid 1800’s it was noticed that some of the institutionalized patients who were using this as a substitute had significantly reduced occurrences of episodes. By the 1880’s lithium carbonate had been developed in a pill form and was in use as a treatment for depression.  In the early 1940’s lithium began to be used to treat mania’s as well, but was not approved by the FDA for this treatment until the early 1970’s.  The 1950’s, the class of drug known as Tricyclics were being used to treat depression.  Over the years the evolution has included Selective serotonin reuptake inhibitors (SSRI), mood stabilizers and antipsychotics.  The early treatments, many of these medications came with severe side effects that were debilitating or even fatal.  Lithium in particular has an extremely small therapeutic range that if exceeded can lead to overdose or death.  As these medications evolved however, the incident of side effects and the ability to monitor therapeutic ranges has greatly reduced the negative effects.  Chemical treatment of both depression and mania continues to get better and better, and in most cases is critical in managing this disease. 

Therapy also can play a critical role in the effective treatment of bipolar disorder.  While there is no question that this is a physical disease, there are emotional and hereditary factors to consider as well.  It is very likely that a parent or grandparent also suffers from bipolar disorder, and can have a direct impact on one’s upbringing.  Therapy can help identify and deal with the effects of being raised in a bipolar environment.  Other factors include childhood development and external influences that come along with this disease.   Speaking for myself, growing up bipolar set me apart from my peers and had a large impact on my self esteem and interpersonal interactions.  Therapy again can help address these issues through understanding and acceptance.  Therapy can also help develop coping skills needed to deal with the day to day impact on your life.   There are many different methods and personalities in a therapist, and the effectiveness of a treatment plan depends on finding one that fits a particular need. 

Having a good support system is also a good way to cope.  Bipolar can be such an individual disease it frequently leads to isolation and loneliness.    It’s just so difficult for non-sufferers to understand.  Even though symptoms, degree of severity and individual coping skills can vary greatly, just being around others who are also dealing with their own version can be comforting and supportive.  There is nobody who can possibly understand the lifelong impact of being bipolar better than a fellow sufferer.  Individuals who know just how difficult it is to deal with this disease, often have empathy and a desire to help others that can’t be found anywhere else. 

So my own treatment is a three pronged approach.  While situations are different for each individual, this method may or may not be effective.  And of course, this is all my opinion only.   There are no facts here to support or prove any of this information.  I am not a health care expert or scientist.   These however are my truths, and help me to manage my illness as best I can.  Everyone has to find their own way.   I hope you find yours.

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