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10 LESSONS LEARNED
1. STAY ON YOUR MEDICATION
This is the most important lesson I have learned. I know of no case where a
person with bipolar disorder has been successful in long-term stability without
medication. In fact, I know of several cases where loved ones were lost to
suicide because they went off their medication. In my own case, this was a hard
lesson to learn, as I found out that every time I went off my medication, I went
into an episode. Now I am religious about taking it every day.
Never get too:
This is a reliable, easy to do, self-check method to keep yourself from going
into an episode. Any time you feel a little "off balance," or
"off center," check to see if you are experiencing any of these
things, and take care of it. I have usually found that when I do that, I am at
least one of these things (usually 2 or even 3), and when I meet that need, I
feel much better.
3. GET ENOUGH SLEEP
Even though this is one of the items in the HALT self-check method, it is so
important as to be a lesson itself, right up there in importance with taking
your medication. In virtually every case of a manic episode, it has begun with
losing sleep. In fact, one of the checklist symptoms of having bipolar is the
decreased need for sleep. Although the hours needed for sleep is different for
each person, it is absolutely crucial to maintain an adequate amount of sleep
every night to maintain stability.
4. HAVE A GOOD TREATMENT TEAM
Although medication and sleep are crucial for stability, and people have been
able to avoid episodes with just those two things in place, the best and longest
periods of stability have been achieved by also having a good treatment team in
place as well. The best treatment team consists of a primary care physician, a
psychiatrist, and a therapist or other type of professional counselor, who
follow you on a long-term basis. I even include my pharmacist as part of my
treatment team, having kept the same one for the past 3 years, so that he is
familiar with me, my disorder, and all my medications, whether psychiatric or
medical. This way, when a new one is added, he will warn me of any possible drug
interactions with medications I am already taking, as well as any side effects
of a new medication.
5. KNOW YOUR TRIGGERS
Unfortunately, this is only learned by trial and error, and over time, as you
learn your triggers by having had episodes in the past and discovering what led
up to them. In my own case I now know that indisputably, even going one night
without sleep is an absolute trigger to an episode. The same with not taking my
medication-I might get away with it for a couple days, but any more than that,
and an episode is inevitable. Another trigger in my case is getting "too
excited". I have to watch myself, and keep myself from getting that way as,
in my case, that leads to mania. Also, in my case, doing too much leads to
feeling overwhelmed, and that feeling of being overwhelmed triggers a depressive
episode. Triggers are different for different people, but loss of sleep, stress,
fear, anger, overdoing things, and getting "too excited" are examples
of triggers to watch out for.
6. BIPOLAR IS CONTROLLABLE
Unfortunately, there is no cure for bipolar disorder. But bipolar is
controllable. People who suffer from the disorder have been able to go many
years without an episode. My mother, who also has bipolar, has not had an
episode for 8 years now. How has she done it? By taking her medication
religiously, always getting the right amount of sleep, having a good treatment
team in place, avoiding her triggers, etc. Basically, by doing all the things I
have listed in this "Lessons Learned" article. These are not difficult
things to do, but you do have to put forth the effort to do them on a consistent
basis, however much you hate to sometimes.
7. STOP TRYING TO BE NORMAL
Although I was diagnosed with bipolar only 3 years ago, looking back I can see
that I probably had the disorder all my life. All I know was that I never felt
"normal," always felt a little out of sync with the rest of the
world-and, especially since being diagnosed, all I've ever wanted was to be
normal. I envied everyone else, who seemed so much more capable of handling
stress, of dealing with the daily ups and downs that were crises to me. That
changed for me, however, when my sister committed suicide because of not taking
her bipolar medication. I attended a Survivors of Suicide meeting not too long
ago, and expressed in that meeting that I just wanted things to be normal again
(implying that they had been normal before, forgetting for a moment that they
actually never had been normal for me). Someone said, "Things will never be
the same again. You will have to find a new normal." A new normal. It made
me think. And it showed me a way to apply it to my bipolar. What is normal for a
person with bipolar? It is different for each one of us. We cannot compare our
normal with someone who does not suffer from mental illness. What we can do is
accept our normal for what it is, and accept ourselves for who we are.
8. BE GOOD TO YOURSELF
Sometimes we get so caught up in the daily struggles of coping with bipolar that
we neglect ourselves, our needs, and even our hopes and dreams. Yes, we have the
same right as anyone else to dream! And the same chance as anyone else to
achieve our dreams! We are not "less than," or "not as good
as," or "damaged goods." We are not broken people, we just have
broken brains. Be good to yourself-give yourself the same breaks that you would
give anyone else. Be kind to yourself-do things for yourself that you would do
for a friend. Take care of your needs-do not neglect them.
9. YOU ARE YOUR OWN BEST ALLY
You need to speak up for yourself. You are your own advocate. You cannot expect
your doctor, or anyone else on your treatment team, to be able to read your
mind. They only know what you tell them. If you are on a new medication, and you
are feeling "funny," you need to call and tell your doctor or
psychiatrist. If you are feeling as though you may be cycling into an episode,
you need to tell your psychiatrist or therapist. It may be necessary to change
the dosage of your medication, or to change medications. Only you know what is
happening inside you, and you need to speak up. You need to speak up when you
are out of medication, also. Never, never, go without medication for any reason.
10. STABILITY IS YOUR RESPONSIBILITY
Although there is help for you in controlling your bipolar, when all is said and
done, long term stability is ultimately your own responsibility. It is up to you
to take your medications. It is up to you to self-check using HALT. It is up to
you to get the right amount of sleep. It is up to you to put a good treatment
team together. It is up to you to know your triggers and avoid them. It is up to
you to accept who you are. It is up to you to be good to yourself and to take
care of yourself and your needs. It is up to you to speak up for yourself and to
communicate with your psychiatrist and treatment team when something is not
right. It is up to you to keep your bipolar under control.
Although I am not a doctor or psychiatrist, and cannot guarantee that if you
follow these lessons learned that you will never have another bipolar episode, I
can assure you that if you do, you stand a better chance of long-term stability
than if you don't.
About the Author
Michele Soloway has dealt with bipolar disorder from a very young age. Her
grandmother, mother, brother, herself, and her teenage son all have the
disorder. She also lost her sister to suicide because of bipolar disorder.
Michele has a blog for bipolar survivors at
and is also a contributing writer to
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