nandm

Much of the stigma of bipolar disorder is based on fear of the different. Unfortunately, people with bipolar disorder contribute to this stigma by unjustified embarrassment over their illness.

Why do people feel uncomfortable about bipolar disorder?
The very existence of bipolar disorder is a reminder to everyone else that they have their own mental and emotional problems. Chronic illnesses and injuries are not so threatening when patients have visible signs of illness such as consumption, bandages, or scars. It is easy to distance oneself from these poor wretches, but bipolar individuals are often attractive, intelligent, and successful. It can be terrifying to others to admit that they, too, could be vulnerable to illness.

What are the popular misconceptions about bipolar disorder?
Television and films usually depict persons with bipolar disorder as violent beasts with strange ideas and immoral behavior. Alternatively, bipolar individuals are sometimes characterized as mystics with special psychic powers or as special messengers from God or the devil.

How can we get rid of the stigma?
Stigma is fueled by ignorance and fear. When the population is more aware of the true nature of bipolar disease, stigma will ebb.

Does our culture value bipolar attributes?
Definitely. While many people malign those with bipolar disorder, our culture almost worships manic symptoms like boundless energy, magnetic charisma, workaholia, the ability to go without sleep, hyperverbosity, and insatiable sexual appetite. If you think about it, you will see that these attributes fit most of the heroes and heroines that appear on our film and video screens. In real life, however, this pattern of attributes is caused by bipolar illness, and it damages people's lives rather than enhancing them.

I read in a book that bipolar disorder makes you smarter and more creative. Haven't famous people been bipolar?
I think that gestalt, a viewpoint that strives to see everything at the same time, and parallel thinking, and ability to process similar thoughts at the same time, are often well developed in people with bipolar disorder. These talents can enhance problem solving and increase creativity, but the illness conspires to keep the bipolar individual from using their talents. There have long been unproven speculations that geniuses like Dostoyevsky, Van Gogh, Orson Welles, and many others suffered from bipolar disorder. Although they became prominent historical figures, their lives were often filled with tragedy.

An internet site said that world leaders like Julius Caesar, Henry VIII, and Mussolini were bipolars. How could you tell?
Try looking throughout history for charismatic, magnetic leaders with boundless energy, little need for sleep, wordiness, and an unquenchable sexual desire, who deteriorated as they aged. Were they bipolar? You can make up your own mind.

What is the cost of bipolar disorder to our society?
Bipolar disorder is among the top ten causes of disability all over the world. Millions of public dollars are spent for hospitalization and medical care that would never have been necessary if people's bipolar illness had been recognized and treated early. Homes are split, loves lost, fortunes squandered, and children made to suffer. There is no end to the toll that untreated bipolar disorder takes on all peoples of the world.

Do you think that the economy exploits people with bipolar disorder?
Absolutely. Knowingly or unknowingly, many businesses prey on bipolar individuals. For example, home shopping channels, thrive on the bipolar tendency toward impulsive spending sprees. Liquor manufacturer's advertisements stressing power, wealth, fame, and sex appeal particularly to bipolars who are at increased risk for developing alcohol problems. Casinos' mixture of grandiosity, free alcohol, and late hours prey on the manic tendency toward gambling and sexual addiction. Corrupt online casinos take advantage of bipolar obsessiveness and willingness to trust others. Pornographic internet sites take advantage of bipolars impulsitity, hypersexuality, and the need for high stimulus levels and immediate gratification. "Too-good-to-be-true" offers of free loans, weight-loss schemes, and exotic cures prey on bipolar fantasies of perfection and hopes for a quick fix. Exploitation of bipolar illness is a gravy train for marally and ethically barren businesses and schemes.

What can I do to help other people with bipolar disorder?
When their bipolar disorder is under control, many people with bipolar illness feel that they have some responsibility to help others. Join national associations that advocate for bipolar individuals in the Congress and in state legislatures. Read bipolar newsletters and magazines published by national organizations and become familiar with the medical and social issues affecting bipolar individuals. Write letters to legistators, doctors', and therapist' organizations, and pharmaceutical companies. Go to bipolar meetings and speak out in support groups. Go to Internet chat and support sites, and tell others what you have learned that works for you. Your brothers and sisters with bipolar disorder need you.

nandm

I estimate that, once optimal bipolar medications and therapy are implemented, changing lifestyle and health patterns is the best thing you can do to improve your health. I believe that lifestyle changes can reduce residual bipolar symptoms by 10 to 30 percent. Best of all, lifestyle changes are easy to make, safe, and completely, free of cost.

Overall, I have found that drinking alcohol, staying up all night, missing meals, and working too much are the most common behaviors that destabilize bipolar disorder.

Stress Drives Bipolar Disorder
Bipolar disorder is a stress-related disease. That is, the symptoms of bipolar disorder become worse as stress increases. Therefore, the most important thing that you can do is to purge the sources of stress from your life and make a commitment to keep new stressors under control. Effective stress treatment can be a godsend for bipolar sufferers: It is an effective means of helping to control bipolar illness that is both safe and free.

Unfortunately, stress reduction is often the most difficult treatment to convince patients to follow. When I tell patients to lower their stress levels they usually come up with excuses explaining why it is impossible. They say, "I couldn't possibly cut my workday by two hour," or, "I have to stay up until 3:00 am every night," or, "I have to take on this extra work. I don't have a choice." The most common thing I hear is, "Don't worry, doctor, I'll be free from stress as soon as I finish this big project." Unfortunately, as each stressful project is finnished, another one seems to take its place. It is important to remember that you can always find reasons why reducing stress seems difficult or impossible. Nevertheless, you must make your health a priority in your life in order to beat bipolar disorder.

What is stress anyway?
Stress refers to a physiological reaction of the body that overstimulates the adrenal glands, resulting in the overproduction of body stress steroid hormones such as cortisol and stress neurochemicals such as adrenaline. Among other things, these body stress biochemicals increase blood pressure and change blood flow, heart reactivity, urinary and bowel function, breathing rate, body temperature, perspiration, tremor, memory, and attention. Stress hormones are meant to be released only briefly in times of stress. However, modern life stresses are often constant. When stress steroids are present continuously in high concentrations, they produce permanent, unhealthy changes in the body and brain. Some studies have even shown that steroid hormones can kill brain cells when present at high level for a prolonged period of time.

What are some examples of stress that can affect the body?
Examples of stress include working too many hours, not getting enough sleep, going to sleep too late, working under pressure or at the last moment, having or nearly having an accident, and so forth. Stress may also come from intense, pleasant experiences such as getting married, having a birthday, taking a trip, or having a child.

How much stress do I have to cut out of my life to be healthy again?
I recommend you start by spending 25 percent less time in activities that cause you stress. For example, if work is the main source of your stress and you work seven days a week, cut back to five. If you are working fifty-five hours per week, cut back to forty. Believe me, you can do it.

What is the connection between stress, bipolar disorder, and the immune system?
The exact connection is not clear, although the immune, hormonal, and neurotransmitter systems are very closely interconnected. For example, an injection of naturally occurring immune system compounds (Called inflamatory cytokines) can trigger depression. So can the administration of stress hormones involved in the immune response.

How can I be under stress? I like working all night long with no sleep.
Stress refers to things that overstimulate our bodies. The secretion of stress steroids makes our hearts beat faster, our blood pressure rise, our hands shake, our body sweat, and our stomach acid churn. It really does not matter whether you like something or not; it can still cause damage to your body and health.

Try going to a bipolar support group or online forum and notice how much outside stressors increase other people's bipolar symptoms and severity.

If I reduce the stress in my life, will I be able to cut back on my medication?
You probably would not have to take much medication if you moved to Siberia and lived alone in a Quonset hut, eating bonbons and watching MTV all day. However, most people with bipolar disorder choose to live a more complex life with higher levels of stress. If you choose to live a life with typical amounts of stress, you will probably have to take medications and manage your life stresses to keep yourself healthy.

CatsPajamas

Judith,

This is truly great stuff. I have a nephew who has struggled with this disorder for many years, and I dated a man who was bi-polar. It's an incredibly challenging and frustrating disorder for sure, not only for the patient but for the family members as well.

Thank you for sharing this information. I'm going to print it out and save it, and I'm going to recommend the book to my brother and his son.

nandm

I am so glad that many have found this book to be as useful as I have. I have had the bipolar diagnosis for over 5 years now and the more I read this book the more I realize that I am not insane, I am just bipolar. For the longest time I felt ashamed, broken, not good enough, etc....because of my mental illness. This book has helped me realize that I am who I am and that I can live a normal life as long as I take responsibility in managing my illness. It explained so much of the things I do and why I do them. It gave me hope. I can now see it as no different than a diabetic managing their diabetes. I have certain things I must do daily to manage my illness. That is what it is an illness it does not mean I have to feel less than. It does not mean that I can not function in society, I just have to be an advocate for myself and take responsibility for my care. I am glad I made the decision to share excerpts from the book.

nandm

I suggest that you learn one or more relaxation techniques, such as muscle relaxation or meditation. You can do relaxation exercises daily to reduce your overall stress level. When you know you will have something stressful to deal with, you can practice your relaxation exercises beforehand. If all else fails and you find yourself in the middle of a stressful situation, you can excuse yourself for a moment, and do your relaxation exercise. There is no etter way to learn to cope with stress.

What are muscle relaxation techniques?
Muscle relaxation training refers to a variety of physical exercises for relaxing your body and mind. Here is one I use. Sit comfortably in a chair. Now tense all the muscles in your toes, feet, and legs. Tighten the muscles as hard as you can while breathing in slowly, then breathe out slowly and relax them. Next, tighten the muscles in your hips and abdomen as hard as you can while inhaling slowly. Hold your breath for a moment, then exhale slowly and relax those muscles. Now, tighten all the muscles in your fingers and arms while you breathe in slowly. Hold your breathe momentarily, then exhale and relax. Finally, tighten the muscles in your shoulders, neck, and face and breathe in slowly. Once again, hold your breath for a moment, then relax and exhale. Now notice your breathing. As you slowly breathe in, imagine you are gathering together all the stress in your body. Then breathe out slowly and exhale all your stress along with your breath. You should continue this breathing for at least a minute, although you can do it longer if you like. You can use this technique regularly, twice a day, or any time you have to deal with a stressful event.

What is meditation and how can I use it to manage stress?
Meditation refers to a diverse collection of mental, emotional, and physical exercises that have been devised over the last several thousand years for the purpose of changing the way we experience our lives by increasing our control over our thoughts, feelings, and physical bodies. Meditation can be useful in bipolar disorder to aid relaxation and reduce stress as well as to exercise our ability to focus and control our stream of consciousness.

What if I can't stop my wandering thoughts? My mind is racing.
If you can't keep intrusive thoughts out of your mind no matter what you do, then you are too distractible and your thoughts are too repetitive and obsessive. The next step is to talk to your doctor and make sure you are taking enough mood stabilizer(s) or other bipolar medications that can stop intrusive thoughts.

What about hypnosis? I think that would work for me if it were safe.
I do not recommend hypnosis for bipolar disorder. In bipolar illness, we are always working to improve control of thoughts and emotions, whereas hypnosis is a process of relinquishing control.

nandm

Lamotrigine is another mood-stabilizing, antiseizure medication that is an effective treatment for bipolar disorder. Lamotrigine works by blocking glutamate, an important neurotransmitter biochemical in the brain. As a mood stabilizer, Lamictal treats the core pathology of bipolar disorder and so it reduces all bipolar symptoms. In addition, it helps reduce the production of stress hormones.

Lamictal is a good general mood stabilizer that reduces the symptoms of bipolar mania and depression. However, it is not clear that lamotrigine can block a cycle of depression from starting. After bipolar depression has already started, it may be too late to reverse it completely.

Lamotrigine comes in regular and chewable tablets.

How do you decide when to prescribe lamotrigine?
I have had the best luck with lamotrigine when it is added to a major mood stabilizer. It is also useful in individuals who have failed with a major mood stabilizer or who cannot tolerate giving blood for blood tests.

What are the usual side effects of Lamotrigine?
One recent study found that the most common side effects after taking lamotrigine were headache and nausea. Those were the same symptoms commonly reported by control patients taking a placebo.

As with some other medicines, some people can get a rash with red bumps and blisters that usually do not hurt or itch. This rash is more prevelent when doses are raised rapidly. If this lamotrigine rash persists, it can become severe or even fatal. For this reason, doctors usually tell their patients to stop lamotrigine if they get a rash and either call or come for an appointment right away.

How do you dose lamotrigine?
Current licensing suggests starting at a low dose and increasing slowly every week. Ever since doctors began to raise lamotrigine doses slowly, there have been few cases of the rash.

Lamotrigine can interact with some other medications to change their levels in the blood. For this reason, doctors are advised to use a lower lamotrigine dose if they are combining lamotrigine with valproate, and to use a higher lamotrigine dose when combining with carbamazepine. Check with your doctor and see what she or he recommends.

Will lamotrigine give me energy?
My patients tell me that lamotrigine is not sedating in any way. Some of them say they have increased activation and more motivation without manic symptoms.

Does lamotrigine cause weight gain?
Unlike carbamazepine, valproate, or lithium salt, Lamotrigine does not cause weight gain in my patients. A number of my patients have even lost weight while taking lamotrigine.

nandm

Sleep disturbances is an intrinsic component of bipolar disorder. It can take the form of periodic or lifetime problems getting to sleep, staying asleep, or waking up. During inactivated periods of the illness, sleep problems are usually manifested as difficulty getting up in the morning and a desire to sleep during the day, called hypersomnia. In bipolar depression, where hypersomnia combines with symptoms of fatigue and low motivation, many patients end up feeling that the only thing wrong is that they need a good night's sleep. Ultimately, the solutions is to treat the underlying bipolar disorder that is causing the sleep problems and then the symptoms will get better.

In mania, the inability to get to sleep is often exacerbated by purposefully staying up all night, watching television, surfing the Internet, or engaging in other stimulating activities. I remember interviewing a young bipolar woman who had come to see me for insomnia. I asked her, "What is it exactly that keeps you from falling asleep?" "It is usually the headphones or a video game," she said dryly. "I make myself stay up all night."

Can insomnia trigger a bipolar episode?
One of the surest ways to trigger mania symptoms is to stay up for twenty-four hours or more. Conversely, my experience has shown that adequate, regular sleep reduces the symptoms of bipolar disorder.

My problem is that I sleep too long in the morning. I need a pill to wake me up.
When I hear this, I usually find that the problem comes from going to bed too late. If you go to bed in the early morning hours, there is nothing that can help you get up in the morning because you simply aren't getting enough sleep. Go to sleep early and after a few days, you will find it easier to get up on time. If you cannot stay asleep then lie in bed quietly with your eyes closed.

However, if you find you are sleeping ten or more hours a day, you may be suffering from bipolar depression. Sometimes, you may have to wait for the depression to ebb before excess sleepiness goes away. Discuss this with your doctor and see if your bipolar disorder can be treated more effectively to minimize this problem.

I don't have to sleep anymore, and I still have energy! I'm ecstatic! It feels like a gift from God.
Mania prompts many individuals with bipolar disorder to feel that they do not need any sleep or only a few hours of sleep a night. Nevertheless, nobody can stay healthy if they do not get an adequate night's sleep. Insufficient rest produces an excess strain on the body, interferes with performance, impairs memory, lowers the seizure threshold, and probably shortens life span. The solution is to strengthen your bipolar treatment so that the mania subsides, and your sleep will become more normal.

Six months ago, I couldn't wake up. Now I can't get to sleep. What's the deal?
This may be a sign that you are starting a manic cycle. First, check whether there are any manic triggers such as stress, drugs, or alcohol use that you can reduce by yourself. Then ask your doctor if you should have stronger bipolar medications to block a manic episode.

Attyma

for info and for citation.

nandm

Unfortunately, our culture has incorporated the notion of sleeping pills into everybody's daily lives. Many people automatically think of taking a pill if they do not get right to sleep or wake up during the night. All sleeping pills, both prescription and over-the-counter, contain sedatives that can actually disturb the natural sleep cycle of dreaming and deep sleep that is necessary for rest.

Will over-the-counter nighttime and sleeping products that I buy in the drugstore help me sleep?
I think that the sleeping pills that are available in the drugstore are worthless at best? Depending on their formulation, they may even worsen your bipolar illness. Stay away from them.

Will prescription sleeping pills help regulate my sleep cycle?
In bipolar disorder, the effects of prescription sleeping pills often diminish in a few weeks' time. Doses may have to be raised again and again, bringing about drug dependence and worsening insomnia. I have seen many people with bipolar disorder that were addicted to sleeping pills such as zolpidem (Ambien). In my opinion, sedatives do not solve problems in bipolar disorder and they may cause new problems of their own.

Will a glass of wine before bed help me feel drowsy?
Alcohol is the most common substance people take to help them sleep, but it is also the major cause of insomnia in this country. Most people can drink themselves to sleep if they try hard enough. However, alcohol upsets the dreaming sleep cycle and actually causes insomnia on subsequent days. A colleague once showed me brain wave recordings of sleeping individuals (called sleep EEGs) where evidence of alcohol's effects on sleep was visible weeks after the last drink was taken. You should also be aware that mixing sleeping pills with alcohol could be a deadly mistake.

nandm

People with bipolar disorder tend to gain and lose weight precipitously. Individuals often gain weight when they are depressed and lose weight when they are manic. Both depression and weight gain tend to increase with age if nothing is done to stop them. During manic episodes, some are pleased with their lack of appetite and ability to lose weight, but trying to become manic as a method of weight control can be deadly.

Sometimes people with bipolar disorder develop eating habits that interfere with losing weight. The most common habits I have seen in bipolar disorder are eating late at night and eating breakfast food cereals. I have known several people who were so adamant about having their midnight bowl of cereal that they could never lose weight.

How does eating affect my bipolar disorder?
It is not completely understood how food and diet affect bipolar disorder. It is apparent that missing meals and starving yourself causes bodily stress, which is probably not good for bipolar disorder. Bipolar disorder also sends your body distorted signals that may cause you to crave certain foods. Furthermore, certain foods can affect the way you feel. For example, I have heard from many people with bipolar disorder that their mood can change radically for the better after eating chocolate, carbohydrates, or even a very large meal.

There is no special diet or nutritional scheme that can effectively treat bipolar disorder. However, my impression is that a diet high in protein and low in starch will not worsen bipolar disorder and may help it. I recommend high-quality proteins like beef and lamb and low-fat protein sources such as turkey, chicken, fish, nonfat cottage cheese, yogurt, and low-fat cheeses like ricotta, farmer's cheese, and Mexican cheese. Eggs are high in proteins and easy to fix.

The most important recommendation is that you eat a healthy, nutritionally balanced diet. If you are having problems adhering to healthy eating habits, ask your doctor to recommend a qualified nutritionalist.

Why do I crave chocolate? Does it have anything to do with bipolar disorder?
Chocolate contains compounds like theobromine, caffeine, and trigonelline, which artificially stimulate the body by increasing adrenaline. Another component, called phenylethylamine, is structurally similar to addictive drugs such as amphetamines.

Does sugar worsen bipolar symptoms?
Many patients have told me that they feel hyperactive or manicky after eating "sugar," but I have never found anyone who could get a "sugar high" from eating spoonfuls of table sugar. Therefore, I suspect something else is involved when people feel hyperactive after eating. In addition to sugar, most candies contain a stimulant in the form of chocolate. Health and power bars are similar, with a lot of starch added in the form of grains. Doughnuts, cake, and pie are heavy on starch and fat in addition to sugar. If these make you feel hyper, then stay away from them.

Why do I feel so hopeless about my weight loss?
It is common in bipolar disorder to be extra concerned about your outward appearance. Many with the disorder feel that they cannot go out of the house until they lose weight or that no one will want to associate with a fat person. The burden to lose weight then inhibits those with bipolar disorder from socializing, meeting people, making friends, or applying for a better job.

You will enjoy your life better if you start going out now, before you lose all your weight.

Will going on a diet affect my bipolar disorder? What do you think about the Atkins diet and the South Beach diet?
My bipolar patients are using high-protein diets and losing weight. So far, I have not seen these diets destabilize bipolar disorder. If you have bipolar disorder, you should always discuss your personal health concerns with a doctor before you start a diet, to make sure the plan you choose is right for you.

What else can I do about my weight?
Look into national associations for bipolar disorder, professional and personal websites, and online forums. Talk about your weight issues with other persons with bipolar disorder and find out what works and what does not.

What about diet pills? I heard that if I take them, I can eat all I want and still lose weight.
Sorry. There are no magic weight-loss schemes. The notion of eating everything you want and losing weight is nothing more than a fantasy made up to sell phony diet pills. So is the advertisement that claims you will lose weight without exercise. In fact, stimulant diet pills such as phentermine (Adipex and Ionamin), benzphetamine (Didrex), and methampheatmine (Desoxyn), as well as herbal stimulants, can worsen depression and trigger mania or psychosis in persons with bipolar disorder. Many people like the energy that diet pills give them, but stimulants in the pills can also cause insomnia and put a strain on the heart. It is important that you stay away from them. To get more energy and lose weight, the healthiest and most effective options are to watch your diet and exercise regularly.

My doctor said my weight is endangering my health. Is there a safe medication I can take that can help me regain my health?
There is a prescription medication called orlistat (Xemical) that reduces the amount of fat the body absorbs from food and can be given to those who are severely overweight. My patients who have taken this medication have had success losing weight but progress is slow. Patients in research studies were still losing weight six months after beginning the medication and had not gained it back. This is an important hurdle because it is generally believed that if you can keep weight off for six months, it is much less likely to come back. Patients taking orlistat have also been able to start programs of exercise and diet that had been impossible for them before.

Some people taking orlistat will get gas, cramping, and/or diarrhea and will be unable to take the medication. Consult a doctor who is familiar with orlistat and its use.

nandm

Tomorrow "Vitamins, Herbs, and Supplements."

nandm

After years of continued reading and research, I can say conclusively that bipolar disorder and its symptoms cannot be cured with vitamins or supplements. This does not stop manufacturers and salespeople from making claims, however. It is your job to find out enough about bipolar disorder and health supplements that you can take advantage of any health benefits they might provide without being scammed. Always beware of magazines, websites, and practitioners who derive income from the sale of the products that they recommend.

What is the simplest vitamin program that you recommend?
I recommend a simple and inexpensive supplement plan to promote general health. "Once daily" type vitamins are available by brand name or as generic store brands in most drugstores and supermarkets. I recommend taking two of these "once daily" vitamins every morning for your general nutrition. This should help ensure that your body is getting plenty of vitamins without going overboard.

Are there effective herbal treatments for bipolar disorder? Are they safe?
There have been claims that evening primrose oil (EPO) may be of some help in decreasing the fatigue of bipolar depression, but none of my patients ever felt it was helpful enough to continue taking it. Many of my patients are taking omega fatty acids and fish oil supplements. These may be helpful for general cardiac health but they have never been shown to benefit bipolar disorder.

Most herbs do have side effects and potential interactions with other medications and other supplements. It depends on the situation and the dose. Check with your doctor first to see if a specific herbal product will worsen your condition or interact with the medications you take.

Are the herbs and supplements sold on the internet safe for me to buy?
Much of the information about herbal remedies on the internet and from other sources can be confusing and misleading. The best reference I have found is the Natural Medicines Comprehensive Database at http://www.naturaldatabase.com Their service is somewhat expensive but maybe you could get your doctor to sign up and let you use the service. Buying herbs or supplements on the internet can also be dangerous, as you never know exactly what is in the supplements you are buying. Talk to your doctor about which brands are reliable.

Several health professionals have offered to sell me glandular extracts for mood and energy. Do they work?
Dried preparations of cow and pig glands have been promoted for years but usually have little potency. Besides, the whole thing sounds disgusting to me.

Is there any problem if I take large amounts of vitamin A (beta-carotene)?
Taking too much vitamin A can be harmful, particularly to your liver. Major studies suggest that beta-carotene can increase your risk of getting lung cancer. And there is at least one account in the literature of a person who died from eating prodigious amounts of vitamin A. So, do not go overboard. Talk with your doctor about finding the dosage for your needs.

I have heard that Saint-John's-wort is an effective treatment for depression. Is it effective for those with bipolar depression?
Saint-John's-wort (Hypericum perforatum) has been widely used in Europe and even in the United States as a natural treatments for unipolar major depression. However, the jury is still out on its effectiveness. A large, well controlled United States study found no benefit for depression. Some of my bipolar patients have reported feeling edgy and anxious when taking the herb.

If you decide to try Saint-John's-wort, consult with your family doctor or psychiatrist first. Saint-John's-wort has numerous counter-indications and drug interactions, and it may make the skin more vulnerable to sun and thus to skin cancer.

My brother takes ginseng for energy. Is this stuff any good for bipolar?
Panax ginseng is promoted as a stimulant with many health benefits. However, its stimulant actions may be bad for bipolar disorder. I know of one report where a man took moderate doses of Panax ginseng that triggered a pschotic, manic episode so severe that he had to go to the hospital.

My sports doctor recommended high colonics to take out the poisons that cause bipolar disorder. Are there any dangers to this?
I know of no poisons that cause bipolar disorder. Historically, enemas have been promoted for a wealth of physical and mental problems, but there is no evidence for their effectiveness with bipolar disorder.

historyteach

Just my opinion, but, I think this thread should go into the research and information sticky.

Shalom!

nandm

Regular, appropriate exercise is important for heart and lung health, weight control, and combating fatigue. Patients tell me that a regular and reasonable (not excessive) amount of exercise helps with depression and anxiety.

Should I have an exercise plan?
I suggest exercising three times a week for twenty to forty-five minutes each day. If this is too much for you, then start gradually.

Can too much exercise make bipolar worse?
Too much exercise---for example, aggressive workouts lasting five hours daily, seven days a week----can help trigger a bipolar episode and/or maintain a state of mania. Excessive exercise can also cause changes in hormonal secretion, cartilage loss, musculoskeletal changes, and orthopedic problems. It is sometimes hard to tell if people are driving themselves into mania by overexercising or if they start exercising excessively when they begin to get manic. I recommend sticking to a moderate exercise program in order to guard against triggering an episode, and to beware of times when you feel the need to work out excessively, as it could be an indication that you are entering a manic phase.

Can I stop taking my medications if my exercise is making me feel better?
Exercise helps many people feel invigorated and more emotionally balanced, but exercise alone is not enough to control bipolar disorder. It is important that you continue to take your medications in addition to adopting a healthy exercise program.

What do you think about sports drinks or power drinks for bipolar?
Most of the ones I have examined look like sugar water. For the most part, I think drinking plain, clean water is the best choice. If you are in danger of being dehydrated, drink fluid and try taking salt pills or drink salted tomato juice. This will help increase the volume of fluid in your body.

Doesn't exercise cure depression? I've read that it does in several national magazines.
Exercise is good for you, but it will not "cure" bipolar depression.

Silla

This thread is so helpful and validating. Thanks so much for this.

nandm

Our culture encourages many unhealthy and potentially addicting habits, including the use of caffeine, alcohol, cigarettes, and drugs such as marijuana. Unfortunately, these substances may be especially unhealthy for persons with bipolar disorder because they can increase bipolar symptoms and even trigger bipolar episodes. It is very encouraging to see bipolar sufferers' treatment success improve after they are able to give up these unhealthy habits. Fortunately, many people with bipolar disorder lose interest in their unhealthy habits when their mood stabilizers are well adjusted.


I drink lost of coffee. Is coffee bad for you if you have bipolar disorder?
Many of my patients have noticed a distinct improvement in their stability when they stopped drinking coffee. High-dose caffeine has been reported to trigger manic and psychotic symptoms. Some people with bipolar disorder enjoy the "jazzed up" feeling that caffeine gives them, but this is not necessarily a good thing. The goal for anyone struggling with bipolar disorder should be peace, contentment, and fulfillment, and these do not require caffeine.

Caffeine is addicting, and it provokes a withdrawal syndrome when stopped. Coffee is the most serious offender involved in caffeine addiction. Iced teas can contain enough stimulant alkaloids to affect your health if you drink enough, and the caffeine content in colas can also create a problem. The tablets that are sold over-the-counter to help you stay awake contain large amounts of caffeine.

If you are addicted to caffeine and stop taking it suddenly, you may experience withdrawal. Withdrawal symptoms like fatigue and flu-like sensation may last for two days or more. However, many patients feel so much more stable after they've stopped drinking coffee that they never return to drinking it. A few days of possible discomfort are a small price to pay for a lifetime of improved health.


Is drinking alcohol bad for bipolar disorder?
Individuals with bipolar disorder often react to alcohol as if it were a stimulant, making them more mentally active, happy, charming, and sociable when they drink. Ultimately, it resembles the stimulating effects of mania. This positive experience makes drinking alcohol more pleasant, but it can also cause substance abuse problems for those with the disorder. Eighty percent of all people with bipolar disorder will suffer from an alcohol and/or drug problem during their lifetime. Alcohol in large doses is toxic to the brain and body, and ingestion of sufficient alcohol can trigger mania, depression, or even psychosis.

Nearly all medications used for bipolar disorder carry a warning against drinking alcohol. But skipping your medication when you know you will be consuming alcohol is not a good option, either. In my opinion, those with bipolar disorder should not consume more than one drink per month. Many people find that it is easier to control their drinking by stopping altogether. It is often difficult for those with bipolar disorder to give up alcohol, but consumption can be an impediment to successful bipolar treatment. I have worked with several people whose unwillingness to stop one or two daily drinks made their disease virtually untreatable. Fortunately, many people lose the desire to drink once their medication doses are well balanced.


I'm worried that if I stop drinking, I'll lose all my friends. What can I do?
It is possible to drink nonalcoholic beverages when you go out, and your friends may support your decision. However, people who try to stop drinking often find that their drinking buddies care more about getting drunk themselves than they care about people and their health. If you socialize with people who will abandon you if you stop drinking, then you need to get better friends.


I go to Alcoholics Anonymous. Does this program work in bipolar disorder?
Yes. Many of my bipolar patients have reversed their drinking problems by participating in A.A. There are usually meetings in most hospitals and elsewhere in the community. Odds are that you will not be the only person with bipolar disorder there.


I smoke marijuana every day, and it's better than any medication. Can this help my bipolar disorder?
I have heard this many times before. Marijuana apparently makes bipolar symptoms more tolerable, but it destabilizes the illness in the long run. Marijuana may contribute to depression, lung disease, and loss of memory, as well as deplete sex hormones. Moreover, using it is illegal. These reasons are enough to convince me that marijuana is not worth the risk if you have bipolar disorder.

Even in small doses, marijuana can undermine bipolar treatment. Many people with bipolar disorder are affected by one or two puffs of a joint.


What problems do cigarettes cause among people with bipolar illness?
There are instances in the literature where too much tobacco smoking has triggered bouts of mania an psychosis in persons with bipolar disorder. In addition, smoking can significantly decrease the amount of medication that reaches the bloodstream, interfering with effective treatment. Cigarettes are the proven offenders in these cases, but I suspect that the risks are similar whether you smoke cigars or pipes or chew tobacco. No one can say for sure how much tobacco someone with bipolar disorder can tolerate safely. However, we do know that tobacco shortens life and causes heart disease, lung disease, and cancer. Why should you take any chances with your health? If you do smoke, check with your doctor to see how your medications are affected by smoking and try to give up the habit.


I have tried to quit before, and it is so difficult. How can I quit for good?
If you cannot stop, then you may be rushing yourself. Many people sabotage themselves by trying to do everything at once, before they lose their nerve. However, learning not to smoke is a gradual process. You need to develop daily skills to ensure you can go without smoking for the rest of your life. Fortunately, many of my patients have stopped smoking on their own after their medications were in order. To those who are ready to get serious about kicking the habit, I have developed an effective method for giving up cigarettes.

How To Stop Smoking Painlessly
If you have tried to stop smoking cold turkey and failed, or it you just do not want to endure the bodily stress and physical discomfort usually associated with smoking cessation, follow the steps below. Most likely, you will be able to reduce or stop your smoking habit without gaining weight or suffering severe cigarette craving.

• Set a goal of quitting entirely or decide how many cigarettes you want to end up smoking
• Find an empty pack or buy a cigarette box to hold all the cigarettes you will smoke each day
• Count how many cigarettes you currently smoke per day and subtract one from that number
• For the first week, put that number of cigarettes in your pack every day
• Just smoke the cigarettes you put in your pack each day; no more no less
• The next week, subtract one from the daily number of cigarettes you smoked last week and put that amount of cigarettes in your pack each day
• Again, just smoke the cigarettes you put in your pack each day, no more, no less, for a week
• Continue smoking one less cigaretter each week until you reach your goal

For example, if you are now smoking twenty cigarettes daily, reduce to nineteen the first week, eighteen the second week, seventeen the third week, and so on. You will have broken your habit and be smoke-free in five months and your body will thank you.

Wednesday

Thank you for posting this information, it is very helpful.

1dayatatime

Thank you for this. Reading all this is helping me understand my sister and actually feeling rather guilty for my reaction towards her "episodes". I also find i have alot of the symptoms mentioned, things I thought were "habits" or I always thought I had OCD, not diagnosed by a doc, just me thinking I could get carried away in things for weeks. Then never finishing. Obsessed in new projects, over the years I have had many, spent lots of money on them, then never finishing and moving on to something else.

Looking at amazon now for this book, buying several copies for the whole family .

least

I was diagnosed bipolar, but much prefer the old term "manic depressive", as it more accurately describes how I feel. "Bipolar" makes me sound like a big magnet... to myself, anyway.

What makes me so angry is how many people (my dear mother included and especially) DON'T understand how crippling this can be. I cannot work 'regular' type jobs anymore, and dear ol' mom is always saying, brightly, "oh you're not disabled! You just need regular work! If you'd just get out there and find a job...." ad nauseum... til I'd like to slap her. My own dear teenage daughter, when told I was living on ss disability, said "you're not disabled, you just don't want to work!" Fortunately I was driving at the time so I couldn't belt her one...

But if ONE MORE PERSON, related to me or not, gives me any sh!t about their definition of "disabled" I WILL slap them.

nandm

Least,
I so completely relate to your post. I am currently fighting the system to get disability for both my PTSD and bipolar. I am on my first appeal. I have been waiting since October of last year for a response to it. Prior to that it took over a year to get the first denial letter.
What people do not understand is that it would be a lot simpler to just "go get a job" than to fight the system for disability. I believe you and I talked while you were working on your SSI claim.
Many people can not understand why a "normal" looking person like myself can not seem to work a "real job." I have had to give up a 20 year nursing career due to these diseases. If it were "all in my head" and I just need to "pull up my bootstraps" then why in the world would I have walked away from a $30/hr job?
This disease is devastating. For many years my self medicating with alcohol kept it in check, only because I spent most of that time in a manic state (I realize this in retrospect after reading this book). Once the alcohol started causing more unmanageably in my life than the bipolar I had to stop drinking. That is when the diseases hit me full bore. I have not been able to work in almost 3 years now. I have tried. I had a job for almost 3 months before I had to quit. The only reason I was able to hold that down was because the hours and days were flexible enough to allow for those days when my disease was out of control and I could not leave the house. People just don't get that part of the disease. But how many employers would understand my calling in saying "sorry I can't come in today because the anxiety from my bipolar is so out of control I can't get dressed and out my door today", that is if I was even able to pick up the phone.
I have been fighting to manage my disease with medications. I don't know how many I have tried. Right now I am better managed than I have been but I still don't sleep at night, fight with obsessions, spend too much money, fight with anxiety (meds for it only put me to sleep if they are high enough doses to manage the anxiety), have mood swings, and wind up crashing when I finally come down. I am praying that someday I will find the right combination of medications.
I have tried dietary changes and holistic options to no avail.
My partner still can not understand why I can't work, although she is patient with it. I know though that it does cause stress in our relationship. I nearly did not go to see my daughter when she had her baby, my first grandchild because of this disease. It has affected my whole life and the lives of those around me. I truly wish people could grasp how devastating this disease is and be a bit more understanding and compassionate but I don't hold my breath.
Sorry for the long post.