How to Manage the Highs and Lows of Bipolar Disorder

Bipolar disorder is a mental disorder marked by a dramatic change of moods in the affected individual. It is a chronic condition wherein the individual deals with unpredictable emotional upheavals ranging from intense happiness and energy to extreme sadness and depression.

These wavering thoughts and emotions can cripple the person mentally, often making him vulnerable to suicide.

Bipolar disorder can affect both men and women irrespective of their belonging. About 1 in every 100 individuals is diagnosed with bipolar disorder at some point throughout his life.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), defines bipolar disorder as a “clinical course of recurring mood episodes consisting of one or more major depressive episodes and at least one hypomanic (bipolar II disorder)” or manic episode (bipolar I disorder).

Bipolar disorder is a common disease that can occur at any age. It can develop mostly between the ages of 15 and 19 and around the age of 40 in rare cases.

People suffering from bipolar disorder go through a rollercoaster of moods that can be experienced as:

  • Mania: A manic episode is a period of temporary euphoria. It lasts for at least 4 days to weeks and can stretch for months at a time. During this distinct period, the affected person experiences an abnormally persistently elevated mood or irritable mood with increased activity or energy. The person may be hyperactive, working for long hours, indulging in risky endeavors, or taking up new projects.
  • Hypomania: Hypomania is somewhat similar to mania. However, it is a less severe event.
  • Depression: During a depressive episode, the person may experience feelings such as sadness or loneliness, loss of interest, lack of energy, overthinking, and sleeping a lot. This can create a gap in their personal and professional lives.

Bipolar disorder can have a significant impact on the life of the patient and his family as well. With all that a person experiences, bipolar can shatter professional lives, decimate personal relationships, and even interrupt education.

Causes of Bipolar Disorder

The exact cause of bipolar disorder is not yet known. Some of the possible causes of and risk factors for this mental disorder are:

  • A genetic predisposition
  • Stress
  • Hormonal imbalance
  • An imbalance in brain chemicals
  • Physical changes in the brain
  • Drug or alcohol abuse
  • Some traumatic experience

Signs and Symptoms of Bipolar Disorder

The episodes of high and low moods in bipolar disorder do not follow a fixed pattern.

Symptoms associated with the low phase (depressive period) may include:

  • Feeling sad, hopeless, or worthless
  • Loss of energy
  • Having trouble concentrating
  • Loss of interest in things
  • Indecisiveness
  • Crying
  • Wanting to sleep more
  • Insomnia
  • Irritability
  • Losing or gaining weight
  • Thoughts of suicide or death

Symptoms experienced during the high phase (mania) may include:

  • Restlessness
  • Impulsiveness
  • Alcohol or drug abuse
  • Inability to make sound decisions or poor judgment
  • Feeling excessively happy, excited, or hopeful
  • A sudden switch from being joyful to angry or irritable
  • Increase in energy levels
  • Poor concentration
  • Rapid speed
  • Sleep issues
  • Abnormally high sex drive
  • Flirtatiousness

Diagnosing Bipolar Disorder

It is imperative to seek professional help for anyone who observes the signs of bipolar disorder in him.

It is difficult to diagnose the condition as there are no laboratory tests or scans to determine its presence in the affected individual.

Bipolar disorder can inadvertently be diagnosed as other depressive disorders and mental disorders such as attention deficit hyperactivity disorder (ADHD), posttraumatic stress disorder, and schizophrenia. To rule out this error, your doctor will take a record of your past and present experiences to analyze your condition.

Friends, neighbors, and family members can give an insight into the affected individual’s behavior. A proper diagnosis is required for any mental disorder to sidestep from adverse effects that can threaten the life of the affected individual and his family.

Standard Treatment for Bipolar Disorder

Although bipolar disorder is not curable, it can be managed with a blend of therapy, social support, prescribed medications, and lifestyle changes.

Bipolar disorder is an illness that requires lifelong treatment to monitor the moods of the affected individual. Even though the patient feels fine, he should continue the treatment to prevent a relapse or an episode of the disease.

Prescribed Medications

  • Mood stabilizers such as lithium are used to stabilize the moods of the patient.
  • Anticonvulsant medications that sometimes work in a similar way to antidepressants and antipsychotics.

Psychotherapy

This treatment is aimed at empowering an affected individual in the presence of a professional on how to tackle his situation by coming up with strategies to cope with the symptoms, suggesting ways to fight a depressive episode, and hearing out the individual.

Psychotherapy includes:

  • Cognitive behavioral therapy
  • Behavioral couples’ therapy
  • Family-focused therapy
  • Group psychoeducation
  • Interpersonal therapy
  • Psychodynamic psychotherapy

Talk therapies have been a successful approach in helping people with bipolar disorders to encourage mood stability, identify warning signs, and promote overall health.

Electroconvulsive therapy (ECT)

This therapy is tried in extreme cases when an individual’s body fails to respond to medication and talk therapy. ECT makes use of low electrical currents to stimulate the brain. It is mostly performed to tend to severe episodes of depression and at times to maniac events as well.

Hospitalization

People with bipolar disorder may require hospital admission in very critical situations. These include:

  • Having a long period of experiencing depression or mania.
  • Having psychosis or suicidal thoughts.
  • Having a tendency to harm other people close by.
  • The treatment demands intensive support.

Seek emergency care in the cases mentioned above.

Self-Care for Bipolar Disorder

Living with bipolar disorder can be devastating, but it doesn’t have to reign over your life. Although you can’t handle the workings of your brain, you can take steps to make changes in your lifestyle and habits. This can help you fight and manage your moods to a great extent.

Note: It is imperative to consult a specialist for proper diagnosis and treatment of this condition. Aside from standard procedures, self-help and support can make it easier for you to manage the symptoms associated with bipolar disorder.

1. Self-Awareness

It is essential to understand the reasons behind your behavior and educate yourself on the condition to help yourself better. Going through all that bipolar disorder is about will arm you with the proper knowledge.

Go through trusted web resources and books that can shed some light on the disorder and help you process your situation.

This will give you an insight on how to manage your symptoms, the reason behind your behavior, and the path to living a normal life despite the illness.

2. Track Your Moods

Keep a watch on your symptoms. Once you have identified your triggers, it will be effortless for you to monitor your mood consciously.

This will help you overcome the changes in your mood much before they overtake you. It will be a slow and steady process, but you will start feeling better once you have caught a grip on your moods.

3. Cross off the Stress Box

Stress can have adverse effects on your mind and body that can reflect in your life. Managing stress is of primordial importance when it comes to staying healthy.

Engage yourself in activities such as regular deep-breathing exercises meditation, yoga, and talk therapies to combat your stress.

4. Seek Social Support

Reaching out to your friends, family, and support groups can encourage you to share your apprehensions and get clarity on your condition. Your friends and family will be your support pillars throughout. Turning to help and confiding in your near and dear ones will cement your relationship all the more.

These people will be unquestionably caring and lend you a helping hand during your difficult experiences. This might take a lot of effort, but it will be worthwhile.

5. Make Healthy Choices

Taking care of your health is important while your body struggles internally with the chaos of the bipolar disorder. It is essential to incorporate healthy sleeping and eating habits and a regular exercise regimen to improve or maintain your physical health.

a. Sleep Adequately

Individuals with a bipolar disorder should take just the requisite sleep of 8-9 hours, which restores the brain to function normally.

Sleep deprivation can trigger an episode. Sleeping for fewer hours has been identified with a worsening of related symptoms. This can often trigger mania in affected individuals. Sleeping for fewer hours can be indicative of an upcoming episode, whereas sleeping more than the required number of hours is related to depression.

b. Exercise Regularly

Regular exercise can help your mood swings by releasing endorphins that help balance your mood. Physical exertion induces the release of cortisol hormones that are known to keep tabs on stress. Regular exercise can help alleviate bad moods, anxiety, and depression and can help you sleep better.

An exercise regimen of 30 minutes can help serve the purpose. Indulge in activities such as running, swimming, and aerobics to stabilize your mood.

c. Choose Healthy Foods

Eating a healthy wholesome diet can help uplift your mood and clear your thoughts. Make sure that you take regular meals. Skipping meals can worsen your situation.

  • Include fish oil in your diet to boost your brain and help you manage depression.
  • Eat magnesium-rich foods. Magnesium works along the same lines as lithium. The advantage is that magnesium-rich foods do not have side effects like those of lithium.

d. Avoid Triggers

Restrict the consumption of food items, drugs, and beverages that can trigger an event. Smoking, sugar intake, soft drinks, and alcohol have been associated with adverse effects on the symptoms of bipolar disorder.

6. Do Not be Impulsive

Bipolar disorder can lead you into making big decisions that you might regret later as a result of mood changes. Any impulsive decision or action might change the direction of your life.

Make sure not to overload yourself with work. Set your priorities and work accordingly.

It is in your best interest to take the advice of your close ones before making critical decisions pertaining to your work, job, and personal and professional relationships.

7. Stick to a Schedule

Following a set routine can help control your moods as experienced by many people suffering from bipolar disorder. If you are experiencing an emotional high, a routine will help you keep your calm. During your low times, the need to follow your routine will keep you going.

Your routine includes your daily activities, such as meal times, medicines, time for social gathering, hobbies, exercise, and meditation.

Types of Bipolar Disorder

There is no set pattern for the mood swings in an individual, and it may vary from person to person. Some people may experience several events, whereas some may undergo a few episodic interventions during their life.

Bipolar disorder can be distinguished into four types based on the behavioral patterns of an affected individual:

  1. Bipolar I disorder: This type is marked by a few maniac episodes. Although not necessary for diagnosis, a depression phase may accompany a mania in people affected by this type of bipolar disorder. For a definite diagnosis of this type, the duration of a manic episode must be severe, either lasting for 7 days at a stretch or resulting in hospital admission of the affected individual.
  2. Bipolar II disorder: People with bipolar II disorder have gone through at least one major depressive episode and hypomanic episode. Those with this type of bipolar disorder do not experience manic episodes.
  3. Cyclothymic disorder: This involves experiencing episodes of depression and hypomania. The symptoms experienced by people with the cyclothymic disorder are not as long or severe as the mania and depression experienced by those suffering bipolar I or bipolar II.
  4. Bipolar disorder, “other specified” and “unspecified”: This type is diagnosed when an individual’s behavior and symptoms do not agree with the criteria for bipolar I, II, or cyclothymia, but he has been experiencing mood changes that are significant enough to require a medical review.

How can Friends and Family be of Help?

With so much stigma attached to mental disorders, the need to offer constant family support is indispensable.

Bipolar disorder is a struggle per se. It can also affect the people living with an individual suffering from bipolar disorder.

Friends and family can play a major role in helping a bipolar patient through their efforts:

  1. Try to understand the moods of the person and help him control the highs and lows of their feelings.
  2. Battling bipolar disorder can be straining for the individual and his family as well. Family-focused therapy can help family members have an understanding of the disorder.
  3. Prepare an action plan with the psychiatrist to control an impending manic episode.
  4. Because the patients have a tendency to inflict self-harm, be vigilant of red flags. Help them manage the warning signs that can result in an episode. Maintain a journal to track the patient’s behavioral patterns. You can write about how the individual has been feeling, the intensity of the feelings, and the irrational or risky behaviors as observed throughout the day. Share this information with the support group and health care provider to create a treatment plan ahead of a manic episode.
  5. If, despite all the efforts, a persistent risky behavior is observed in an affected individual, consult the doctor to adjust his medications accordingly.
  6. Make sure that the patient gets enough sleep to help clear his mind of any toxic and negative thoughts.
  7. Triggers such as alcohol and drugs are toxic to an individual suffering from bipolar disorder. These can intervene with the treatment and should be avoided.
  8. Bipolar disorder can be challenging at all levels for the patient’s family members, spouse, friends, and other caregivers. To help them stay calm, they too need to find support and take care of themselves to reduce stress.
  9. Coping with a mental disorder can be exhausting with all the tribulations going inside the patient’s head. It is advised to be patient and caring towards the affected individual. You can pitch in your contribution towards his recovery by:
  • Trying to engage in conversations with the person and listening to what he would like to say.
  • Keeping a positive mindset. This will help you handle the mood swings of the person. Be patient in your care. Accept that the reason behind this is the disorder and not the person himself. Losing patience or calling out the patient will only worsen the situation.

When to See a Doctor

Consult immediate medical review if you observe any signs of a manic episode in your near or dear ones. Getting treatment at the right time will prevent the symptoms from aggravating and make a significant contribution to a person’s mental health.

Several people are oblivious to the illness residing in them and would be reluctant to consider a visit to the doctor. It is necessary to drive them to a consultant’s office to get a diagnosis for the same. They might be thankful to you for your efforts later on.

Any person living with bipolar disorder should seek immediate medical help in case of long periods of depression to evade the risk of self-harm and suicide.

Final Word

Being diagnosed with bipolar disorder is not the end of the world. Family involvement can help you accept your situation, process the need for treatment, and recognize your mood changes.

Being down with this disorder can render an individual emotionally challenged. If you are a family or friend of an affected individual, try to understand his situation and be calm in your responses.

Besides regular medical treatment and psychotherapy, family support, regular checkups, medications, and consistent self-help efforts are your arsenal to fight the battle against bipolar disorder.

Resources:

  1. Anderson IM, Haddad PM, Scott J. Bipolar disorder. The BMJ. . Published December 27, 2012.
  2. Hilty DM, Leamon MH, Lim RF, Kelly RH, Hales RE. A review of bipolar disorder in adults. Psychiatry (Edgmont (Pa. : Township)). . Published 2006.
  3. G JW, Isaac S. Bipolar disorder: diagnostic issues. The Medical Journal of Australia. . Published August 16, 2010.
  4. McCormick U, Murray B, McNew B. Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses. Journal of the American Association of Nurse Practitioners. . Published September 2015.
  5. Gold AK, Sylvia LG. The role of sleep in bipolar disorder. Nature and science of sleep. . Published June 29, 2016.
  6. Huang J, Yuan CM, Xu XR, et al. The relationship between lifestyle factors and clinical symptoms of bipolar disorder patients in a Chinese population. Psychiatry research. . Published August 2018.
  7. Frangou S, Lewis M, McCrone P. Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: Randomised double-blind placebo-controlled study | The British Journal of Psychiatry. Cambridge Core. . Published January 2, 2018.
  8. Sylvia LG, Peters AT, Deckersbach T, Nierenberg AA. Nutrient-Based Therapies for Bipolar Disorder: A Systematic Review. Psychotherapy and Psychosomatics. . Published November 6, 2012.

View Comments



  • Hi last yr I started getting really chronic headaches dr's and neurologist couldn't find or give me a diognosis. A close friend of mine has bipolar and said my symptoms sound like bipolar. I feel as though I have a week or so of normal behaviour then all of a sudden i get angry adjutated and its taking a massive toll on my relationship. I feel i want to be on my own, I have all these things going round in my head but cant focus on one thing, I feel tired a lot and have no willingness to go out or do anything. I feel when someone is talking to me there are a thousand voices all at once n i just want to scream! Could this be bipolar ?

  • As I sit here at the computer at 12:30 am reading all these comments, it gives me hope. Hope because I realize that there are so many other people who are going through exactly the same thing as me, and it sucks! I have tried medication, meditation and natural remedies and still I can't find anything that helps. I have a very loving man in my life and I will lose him if I can't get this under control and I don't know what to do. There are so many days when I just want to crawl under the dirt and not ever get up. My search for something, anything that will help me will continue and I pray that someone, somewhere will have some information they will post that will help. You are all in my prayers.

  • I have been reading the comments and realize chances that I have bipolar diorder are high. I get angry at minor things, my mind is always racing between thought, can't focus and then get mentally tired that I don't want to do anything else. I have been working out a lot and it helps but I avoid talking and socialising as I get irritable so easily. It has really taken a huge toll on me, I can't maintain a stable relationship of late.

  • hi there have read all the reports on you site? my daughter as biopolar she will not take her medication what i would like to say is we are all one hundered % in charge of our own lives we are all very special ! we need to feed our selves good food good thoughts and really love our selves happiness comes from inside yourself not outside of your self life in always leadinding you never missleding take a deeper look love always Ann love love love

  • I would like to try some of these herbal remedies with my Husband. He refuses to take his bipolar meds. If I tell him what these herbal things are for he will refuse them as well. He was diagnosed as a teen and the military tested him as well. The military diagnosis was sever bipolar. More mania than the depression side. He wakes nice, then instantly starts screaming and throwing things as well as calling me names. They found he has ADD and PTSD as well. I can tell him these will help him sleep or improve his memory and he would take them. Some days are good and some are bad. It's hard to handle sometimes and leaves me beside myself at times. His Mother is also bipolar but more depressed. Any suggestions?

  • Won't list the website where this is located because nobody wants another website on their site but...
    I have to tell people about this miracle cure for Bipolar.

    Four supplements:
    Morning: about 5 mg of nascent iodine (in glycerine)
    and 3 Vitamin A & D capsules (cod oil)
    Never take synthetic vitamins.
    A person is also supposed to eat a little liver every day.
    But I bought desiccated liver.
    Evening: 20 mg lithium orotate.
    That broke her mania attack in about 20 hours.
    All of these are well below the safety level.

    Take the iodine in the morning because it can prevent sleep.
    Iodine and the lithium orotate should not be taken together.
    They do not like each other.
    Iodine in the morning and lithium orotate in the evening.

    I got this from a German doctor that said this would cure 97% of all illnesses. Well....I believe it after the change in my daughter.
    The two times she did not take this combination,
    she had a bipolar attack.

    Her problems started at about 14 or 15 years old.
    It progressed. Did not realize it was bipolar.
    At age 18, she went into a psych ward.
    For one year, it was in and out, over and over.
    Prescription lithium gave her Parkinson-like tremors.
    She began to be dizzy and would fall on the floor.

    Psych doctor took her off all med to clear the body.
    Ended up in the psych ward again.
    When she came out, she was still nuts.
    Started the German doctor's protocol.
    In 20 hours, she was a normal person.
    Not perfect, but acceptable, normal behavior.
    Over time, she improved.
    Began to smile, was able to leave the house, etc.

    This is our third month.
    This is the winning remedy for her.
    I took the same supplements so I would have a control reference.
    I had some itchy skin for awhile, but over time it stopped.
    We are still taking those four supplements and doing great.
    I liked this remedy because there is nothing that is dangerous.

    • You might check her for anemia. A multi w iron has really helped me and I do take meds my mania is insane Im too scared to go off

    • Hello Fred,

      My name is Caterina and just finished reading what you posted and quite frankly THRILLED your daughter is doing better.!!! I hope your daughter has regained some happiness and some stability in her precious life.
      Listen my brother also was diagnosed with Bi-polar along with other possible disorders. This cure I would love my brother to try it for he is doing really BAD!! I am afraid a little, could you provide the Dr's name so I or we can consult with him? I hope this email reaches you, for our entire family are in dire need of help for the psychotropic drugs are not helping!
      May God bless you and your family and continued heath most of all.

      SINCERELY CATERINA,

  • Love the article! Herbs have really helped my wife get her life back. I found it was hard to get good quality of herbs each time. I found a good company botanical products that really carry all the herbs you mention in your article and the quality is amazing. So many people don't even think of natural only meds:( Keep up the good work!

  • Hello you all ,
    I have/ suffer from bip.disorder after accidently being prescribed Prozac and after becoming rapid cycling ,and becoming suicidal ,then a psychiatrist prescribed Effexor ,i then became hypomanic , after a cardiac arrest , i stopped this medication , and became depressed (slowly like a bucket with a hole in it, running empty ) , now ,after everything i think i know what happens when taking those ¨¨"medicines¨¨", it reduces bloodsugar , after 2 weeks or so (depending on the person, and age ) , it is reduced below ¨"optimum bloodsugar levell ¨¨ , and adrenalin kicks in (together with cortisol } , you become ¨¨very lively / or aggresive ,irritated , this is mistaken by your surroundings as being healed ,not depressed anymore......, and you become fatter and fatter , get sexual problems , and so on , now i am ¨¨ disregulated ¨¨ (mentally and physically ) , and have a disabillity pension , and will never take ¨¨regular medication ¨"again .
    When mentioning , to my cardiologist , that i had been on antidepressants for 2 years , i saw him being startled , and excammening my MRI scans , he said : thank god your heart valves are ok ....., so they know .......
    Now i ¨¨ doctor myself ¨¨ with herbals and am doing reasonably well , but will never recover completely .....

  • ps,
    After reading the part concerning the "German doctor ¨¨ , i must say he is right , the cause of almost all disease is an imbalance of the automic nerve centre ( what the Chinese call Yin and Yang ) , between sympatic function ¨¨action being awake ¨¨ , and parasympatic function ¨¨ resting /restoring / sleeping , this system is in sympatic overdrive in the whole western world , and is caused by excessive stress , and mallnutrition : ¨¨refined ¨" foods ,like vegatable oil ( an example flaxseed is good for you the oil is not , has no choline in it , this being water soluble , so is present in the whole food , not the oil ) and sugar etc. , this is why flaxseedoil can cause prostate cancer . and the whole seed can cure it...,also never eat foods from packages ,coming from factories , like ¨¨ heart healthy ¨¨margarines ,and oils etc ( see doctor Esselstyn, no oil ! ) it is only healthy for the people who make the profit......
    This choline together with acethyl (see acete as vinegar ) forms acethylcholine ,this is the activator of the parasympatic nerve centre , so choline is essential for good health , the richest choline foods being liver and eggs , foods that are being dodged because of ¨¨ dangerous cholesterol ¨¨.......,
    Lately they ¨ discovered ¨¨ that cholesterol is not that unhealthy ..., even essential to good health , it is the same as saying nails are a hazard because someone died afrer a car crash caused by ... a nail .!
    My last comment : i think bipolar disorder is the mental expression of an imbalance of the automic nerve centre ,as almost all disease and should bee seen and treated as such .
    From Utrecht the Netherlands : good health to you all!!

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Published by
Patrick Moser, FNP-BC, RN

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