Bipolar Disorder: Treatment and Coping Strategies

Treatment and Management of Bipolar Disorder

Hello Dr.
Chiu, last year I was involuntarily hospitalized for a week due to experiencing auditory hallucinations and delusions that affected others.
At that time, I was diagnosed with schizophrenia.
After being discharged, I felt that someone was out to harm me while I was resting at home for a month, which caused disturbances to my neighbors.
I then consulted a psychiatrist and started medication, and since then, I have not experienced any more hallucinations or delusions.
The doctor diagnosed me with bipolar disorder, and my health record indicates bipolar disorder with current manic episode, severe with psychotic features.
However, I feel that for the past three months of resting at home, I have not been enthusiastic about anything, which is not typical of a manic episode.
I spend my days waiting to return to school.

At home, I find it difficult to sleep; I usually have to go to bed early, around 7 or 8 PM, to wake up around 10 AM the next day.
I don’t know what to do.
Will this illness get better? This week, during a follow-up visit at a clinic near my school, I was told that my condition is still unstable.
What should I do? I cannot feel happiness, I lack a sense of accomplishment, and being idle makes me anxious, leaving me feeling empty and lost.

Heihei, 20~29 year old female. Ask Date: 2024/01/28

Dr. Qiu Junda reply Psychiatry

Hello.
Generally, bipolar disorder stabilizes with treatment.
It is recommended to continue medication management to maintain long-term stability and reduce the risk of relapse.
If your current condition is still unstable (and you may be in a depressive phase), it is even more important to continue follow-up appointments and cooperate with treatment to facilitate a quicker recovery.

Reply Date: 2024/01/28

More Info

Bipolar disorder, also known as manic-depressive illness, is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). Understanding this disorder is crucial for effective treatment and coping strategies.

Understanding Bipolar Disorder
Bipolar disorder can manifest in various forms, with the most common being Bipolar I and Bipolar II. Bipolar I is defined by manic episodes that last at least seven days, or by manic symptoms that are so severe that immediate hospital care is needed. Depressive episodes occur as well, lasting at least two weeks. Bipolar II, on the other hand, is characterized by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes typical of Bipolar I.

Your experience of hallucinations and delusions, which led to a diagnosis of schizophrenia, is not uncommon in severe cases of bipolar disorder, particularly during manic episodes. The presence of psychotic features indicates that the disorder can significantly impact your perception of reality, making it essential to seek appropriate treatment.

Treatment Options
1. Medication: The cornerstone of bipolar disorder treatment is medication. Mood stabilizers (like lithium), antipsychotics, and antidepressants are commonly prescribed. Since you mentioned that you are currently in a manic phase with psychotic features, your psychiatrist may adjust your medications to stabilize your mood and alleviate symptoms. It’s crucial to adhere to the prescribed regimen and communicate any side effects or concerns with your healthcare provider.

2. Psychotherapy: Alongside medication, psychotherapy (or talk therapy) plays a vital role in managing bipolar disorder. Cognitive Behavioral Therapy (CBT) can help you identify and change negative thought patterns and behaviors. Other therapeutic approaches, such as interpersonal and social rhythm therapy, can assist in stabilizing daily routines and improving relationships.

3. Lifestyle Modifications: Establishing a stable routine can be beneficial. Regular sleep patterns, a balanced diet, and consistent exercise can help regulate mood. Since you mentioned difficulties with sleep, consider implementing good sleep hygiene practices, such as creating a calming bedtime routine and limiting screen time before bed.

4. Support Systems: Engaging with support groups or connecting with others who understand your experiences can provide emotional support. Family therapy may also be beneficial, as it helps loved ones understand your condition and how to support you effectively.

Coping Strategies
1. Monitoring Symptoms: Keeping a mood diary can help you track your mood changes, triggers, and the effectiveness of your treatment. This information can be invaluable for your healthcare provider in adjusting your treatment plan.

2. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, yoga, or deep-breathing exercises can help reduce anxiety and improve emotional regulation. These techniques can be particularly helpful during periods of stress or when you feel overwhelmed.

3. Avoiding Triggers: Identifying and avoiding potential triggers for mood swings, such as stress, substance use, or significant life changes, can help maintain stability.

4. Education: Learning more about bipolar disorder can empower you and reduce feelings of isolation. Understanding that this is a chronic condition that requires ongoing management can help set realistic expectations for recovery.

Conclusion
Bipolar disorder is a complex condition that requires a multifaceted approach to treatment. While it may feel overwhelming at times, many individuals with bipolar disorder lead fulfilling lives with the right combination of medication, therapy, and lifestyle adjustments. It’s essential to maintain open communication with your healthcare provider and to seek support from friends, family, or support groups. Remember, recovery is a journey, and it’s okay to seek help along the way.

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