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September 19, 2007

Strategies for Living with a Mental Illness Tip #1

October 10, 2007 12:54 AM EDT (Updated: July 24, 2008 09:13 PM EDT)

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Going online is one way of searching for strategies for living with a mental illness. Since my diagnosis of bipolar disorder about 14 years ago, I have spent quite a bit of time researching for more information. I realize a lot of you have done the same thing. Some of you have shared with me that what you find online is not very helpful.

Here's what I usually found online:

Articles written by doctors about keeping our physical bodies healthy
Lists of symptoms for mania and depression
Some type of discussion about the availability of medications because often these articles are sponsored by some pharmaceutical company
More information about medications and their effectiveness and sometimes even their side effects (if they are being honest with us)
A short description defining what bipolar (manic/depression) is
Some general advice such as eating right, getting enough sleep, and exercising (which advice you see for just about every ailment under the sun!)
Very little practical advice on living with bipolar (or other mental illness) day in and day out.

Here is a sample article, which I'll admit is very good, but all too typical of online searches, written by Dr. Caroline Apovian M.D.:

Q: Can bipolar disorder cause weight loss and stomach problems?

— Alisha, Martinsburg, WV

A: Absolutely. A whole spectrum of symptoms are associated with bipolar disorder, an illness involving episodes of serious mania and depression that affects more than 2 million Americans. People with bipolar disorder have a biochemical imbalance caused either by irregular hormone production or by a problem with chemicals in the brain called neurotransmitters, which act as messengers to the nerve cells. This imbalance can indeed cause reduced appetite and weight loss — or increased appetite and weight gain — as well as persistent physical symptoms (such as digestive disorders) that don't respond to treatment.

It's important, however, to check with your doctor to make sure there aren't any underlying medical causes for your weight loss and stomach problems before attributing the symptoms to bipolar disorder. When it comes to medication, many side effects fade after a few weeks of treatment. If yours do not, tell your doctor, who may change your dosage, add another medicine to control the side effects, or try a different medication altogether.

In addition to seeing your doctor and fine-tuning your medication, there's a lot you can do to stabilize – or even improve – your health.

Exercise. Studies show that regular exercise can improve your mood and your sleep patterns.
Eat right. No diet will cure you, but eating nutritious foods – fruits, vegetables, and whole grains — can help you feel better and stay healthy.
Get a good night's sleep. Being overtired can trigger manic episodes, so try to establish regular sleep habits. Relax. Anxiety also acts as a trigger, so try to include calming activities in your day, such as yoga or meditation.
Avoid caffeine, alcohol, and drugs.
Stick to a schedule. You can help control your mood by incorporating all of the above into a pattern you follow every day.
Get support. Depression and Bipolar Support Alliance (DBSA) groups can help you stick with your treatment plan and connect with people like you. For information on a DBSA support group in your area, contact DBSA at (800) 826-3632.

Dr. Apovian is director of the Nutrition and Weight Management Center at Boston Medical Center and associate professor of Medicine at Boston University School of Medicine. About Dr. Apovian.

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Now, I don't want to minimize the advice given in this typical article. Those things are important. Especially the last item: get support. But let's face it, those suggestions would work in preventing and overcoming the common cold! This particular article came from a website called, Every Day Health. Its address: http://www.everydayhealth.com/emotional-health/bipolar/index.aspx

There, you will find the Bipolar Disorder Center. You'll be able to find some helpful information such as the article I enclosed above. Most of it falls into the categories I bulleted at the beginning of this article. Generally helpful, but not specific enough.

My point being that what we need is something more practical and relevant to our particular mental illness diagnosis. Here is a page taken from the above website. This article offers something slightly more practical to do at the very end. http://www.everydayhealth.com/special-report/bipolar-disorder/part3.aspx

This is quoted from the above article:

"Keep an ongoing mood chart or mood journal.
Create a list of your prodromal, or warning, symptoms, both for mania and for depression. Give a copy to at least one other person who can watch for outward signs of your disorder while you patrol your internal corridors."

This tip is more practical than any other bit of information on the entire Every Day Health website.

So this is my first tip for you. Go buy a spiral bound notebook or a diary/journal type book. Devise a way to journal your feelings, symptoms, thought patterns, eating habits, sleeping habits, exercise habits, medication taking habits for each day. Be brutally honest with yourself. Some people may want to write it out. Some may want to make this into a graph. Whatever works for you. The important thing is to be consistent even when you don't think this is helping you. Be determined to make this work for you!

Take my word for it, patterns do exist. The trick is finding them. The breakthrough for me was listening to the way I was talking to myself during my depressive and manic episodes. As I mentioned in another article I've written, I believed what I was telling myself. That perpetuated my depressed or manic moods. I only saw improvement when I realized that what I was saying was false. I had to "re-program" the way I thought with truthful statements.

I had to stop telling myself that I was stupid, that no one loved me, that I wasn't productive anymore and I might as well die. So on and so forth. When my manic phase hit, I had to isolate the hateful thoughts and correct those too. The whole process was painful and difficult. During my manic phases I really thought what I was saying was right. That's the whole problem with the manic phase anyway. We tend to think we are right and everyone else is wrong.

I used to just sit and listen to these thoughts and let them wash over me. I let them make me angry. I allowed myself to make hurtful, hateful statements to people I loved. It took me a long time to realize that I could confront those thoughts and challenge them with more positive thoughts. I had to learn to argue with myself. That took energy and persistence. It was hard work. Overcoming mood swings is not for cowards!

And it's not over when the manic phase is over. The next time the manic phase hits me I have to start over and do it again. Positive thoughts for negative thoughts. It does get easier with practice. What I was doing was establishing good habits to replace the bad habits. The way we think is a habit. It is learned behavior for the most part. Habits can be broken. Better habits can be established in place of the bad habits.

Once you have journaled enough to recognize what you are saying to yourself, you can begin your plan of action. Hey, that's a lot better than sitting around letting your thoughts beat you up.

Don't get discouraged if this takes a long time--months and even years. This is where a great support team would come in handy. Get someone who is with you on this self-improvement program and allow them the privilege of walking with you step by step through the process. They can keep you on target when you feel like giving up.

The point I'm making here is that even if our mental illness has a physical component, we don't have to be victims of it. We do have some degree of ability to overcome and have victory over certain aspects of it.

If you are reading this and are a supporter of a friend, or of someone in your family with a mental illness, be an encouragement to them to keep going on their program. It's a tough task. They could use all the help and support they can get.

Tags: ocd, social acceptance, self-improvement, addictions, support group, positive attitude, delusions, supporter, anxiety, mania, education, self-worth, encouragement, beverly t, sleep, mental illness, medical reports, blame, clinical depression, life, thoughts, anger, attitudes about mental illness, self worth, doctor, supporters, bipolar, manic, depression, diagnosis, self help, rage