Managing the ups and downs of Bipolar Disorder
by Anne Chambers, LCSW, Missouri Lawyers’ Assistance Program
Bipolar disorder is a mood condition defined by mood fluctuations. Those living with it may experience distinct peaks and valleys, known as manic or depressive episodes. Between episodes, there are periods of little or no symptoms lasting days, months, or years. The condition affects sleep, energy levels, thinking, and behavior. People impacted by bipolar disorder may sleep excessively or have a decreased need for sleep. Energy levels can range from too much to fatigue and exhaustion. Thought flow can speed up or down. Rapid thoughts, flight of ideas, and jumping from topic may accompany elevated moods. Slower flow of thoughts can accompany depression. Behavior may be impacted by impulsivity or risk-taking during periods of elevated mood.
There are four variations of bipolar disorder:
Bipolar I disorder is characterized by manic episodes lasting about a week or with symptoms serious enough to require hospitalization, depressive episodes that often last two weeks or more, or a mix of simultaneous mania and depression.
Bipolar II disorder is characterized by depressive and hypomanic episodes, without full mania.
Cyclothymic disorder features less-extreme high and lows.
The last variation is bipolar disorder caused by another medical condition or substance use disorder. People sometimes refer to symptoms as mixed, when manic and depressive symptoms occur simultaneously. Those with rapid cycling experience quick shifts between extremes of mood.
The National Alliance on Mental Illness reports that bipolar disorder impacts 2.8% of the U.S. population, and symptom severity varies. Left untreated, symptoms can worsen over time. Thanks to advances in mental health care in the past several decades, most people, with effective treatment, live and manage well with bipolar disorder. Treatment usually includes medication, psychotherapy, healthy lifestyle, a regular schedule, and early response to symptoms. Medication adherence and managing mood shifts are some of the challenges in managing bipolar disorder. Brian Cuban’s 2018 Above the Law article titled The Bipolar Lawyer features an inspiring story of a lawyer’s journey from diagnosis to activism, and what he learned along the way.
Here are some tips for coping with bipolar disorder:
Make your mental health a priority.
Medication is a key tool in managing bipolar disorder. Be open with your doctor about your concerns, symptoms, and side effects.
Educate yourself about the condition and its management.
Select a strong care team.
Take time for self-care.
Build a trusting relationship with your mental health providers.
Communicate regularly and take an active role in your care.
Obtain counseling following a new diagnosis and as needed over time.
Get support in times of crisis.
Synchronize your workflow with your energy level to your best advantage.
Identify tasks that flow well at a quick pace and those that require slow, calculated thought.
Track your mood cycles to recognize and managing subtle changes.
Use a journal, self-care planner, or app to note your mood, sleep, and energy levels.
Respond early to warning signs of concern.
Maintain health insurance.
Build a wellness toolkit.
Create a crisis management plan.
Defer long distance travel where possible during a manic episode.
Include a trusted family member on your support team who is familiar with bipolar disorder and its management.
If there are areas of well-being you would like to address, please call the Missouri Lawyers’ Assistance Program at 1- 800-688-7859 to talk now or set an appointment for a face-to-face session on our virtual platform. MOLAP is a free, confidential counseling program that serves lawyers, judges, law students, and their immediate family members.
HelpGuide.org. Living with Bipolar Disorder. https://www.google.com/search?q=managing+bipolar+disorder&rlz=1C1CHBF_enUS863US863&oq=managing+bipolar+disorder&aqs=chrome..69i57j0l5j0i22i30l4.10344j0j4&sourceid=chrome&ie=UTF-8, site last visited 3/12/21.
Cuban, Brian. The Bipolar Lawyer. Above the Law, https://abovethelaw.com/2018/05/the-bipolar-lawyer/, May 16, 2018.
National Alliance on Mental Illness. Bipolar Disorder, https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Bipolar-Disorder/Overview; site last visited 4/5/21.
National Institute of Mental Health. Overview: Bipolar Disorder, https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml, site last visited 3/31/21.