Tips for Folx with Bipolar I (From Someone Who Has Bipolar I)

Rather watch than read? Check out the video: Tips for Folx with Bipolar I (From Someone Who Has Bipolar I)

Even though I do have a master's degree in psychology, most of what I share in this post comes from my own lived experience as somebody who has bipolar I. If you want to hear more about my experience with bipolar I and depression, check out the following videos: 

• My Mental Health Story, Part 1: Living with Depression & Bipolar I Before Treatment

• My Mental Health Story, Part 2: Living with Bipolar I Now (After Treatment)

Now, here are my tips for folx who have bipolar I: 

#1. IF WE NEED MEDS, TAKE THEM! 

I’m on lithium, which is the oldest and most well-known medicine to treat bipolar I. Once I was prescribed lithium, navigating my symptoms in the long term was like night and day. For my whole life, before being diagnosed with bipolar I and being treated with lithium, I experienced depressive episodes at least once a year (if not more). Each depressive episode got longer and more difficult. I eventually had a manic episode that was super dangerous, but was precisely the occurrence that led me to finally being properly diagnosed. 

The reason why being on medication is super important with bipolar I is because this diagnosis is believed to be a result of the chemicals in our brain. Therefore, there's no real way to just talk ourselves out of having bipolar I. There's no way to talk ourselves out of a manic episode or, in my experience, a depressive episode. So, in order to navigate the chemicals that create bipolar I in our brains, we need to take medications that stabilize those chemicals in our brain.

Not only is being on medication super important with bipolar I, but staying on that medication is super important. It helps mitigate some of the really severe and dangerous symptoms like a manic episode, a depressive episode, and all the shitty consequences that come along with those episodes. And just as importantly, if we stop taking our medication when we do feel stable—whether it's sporadically or we stop taking it for good—we can actually trigger a manic episode. In order to avoid triggering a manic episode, we absolutely have to stay on our medication. We should not be skipping doses whatsoever, and we should stay on it long term. We can always talk to our psychiatrist about adjusting the dosage if we’re experiencing side effects, but we should never, ever stop taking this medication on our own. 

#2. ALLOW OURSELVES TIME TO ADJUST 

Receiving a bipolar I diagnosis can be a bit of a whirlwind, and it can take a while for us to be stabilized after being prescribed the proper medication. For example, I was diagnosed in January while in a manic episode that had begun a couple months prior to the diagnosis. The manic episode simmered down by February or March, and then I slipped right into a depressive episode. It was in June that I went into inpatient hospitalization, and that’s where I was prescribed lithium. It took me about five months after that to come out of the debilitating depression, but it took a lot longer for me to start understanding what my new baseline was now that I was treated. 

Altogether, it took almost a whole year to navigate the diagnosis and early treatment, and then it took me years after that to understand my new functioning, to relearn all sorts of things like social cues, my capacity, my comfort level in terms of communicating my diagnosis, my needs, and my boundaries. So, time and patience are crucial when navigating this kind of diagnosis, especially when we first get the diagnosis. I've been diagnosed and treated for bipolar I for six years now, but it wasn't until the last year that I've felt secure in my diagnosis and what I need to feel my best. Not until recently did I start feeling more fully myself again.

#3. EMBRACE OUR SUPPORT SYSTEMS & TREATMENT PLANS

There’s the medical side of our support team and then there’s the social and personal part of our support team. When it comes to the medical part of our support team, I think it's really important to be utilizing a variety of medical professionals to help us stay accountable around our symptoms. Folx like therapists and psychiatrists can help us observe ourselves beyond our own personal observations. I think it can be especially helpful in the early years of navigating a bipolar I diagnosis to be going to therapy regularly. Of course, it can help us in a variety of ways beyond the bare bones diagnosis. But when it comes to understanding the way our bipolar I manifests, it can be really helpful to have a practitioner observing our symptoms to make sure that we’re stable and to acknowledge when we’re not so that the right adjustments can be promptly made. Our therapist should be working with our psychiatrist in order to ensure we’re getting the right medication and the dosage that we need.

Getting clear about the roles of our medical team

A psychiatrist is the doctor that prescribes medication. Our therapist cannot prescribe medication. Our psychiatrist is not there for talk therapy—that's what the therapist is there for. So, the psychiatrist will be responsible for finding the right medication, finding the right dosage, and then observing long-term whether that medication is working. A psychiatrist is someone that we’re not going to see very often, which is another reason why I think seeing a therapist regularly (usually weekly) is super beneficial. The psychiatrist can't keep their eyes on us at all times, and it's not their job to sit and talk to us for a long period of time. Psychiatrist appointments are usually very brief, maybe about 15-20 minutes. Working with a therapist and psychiatrist together is, to me, the best medical support that we can get when navigating a new bipolar I diagnosis. 

So, that's why it's really important to be utilizing a variety of medical professionals, because we want to receive the different benefits that each type of practitioner offers. I don't think that only talk therapy can work for treating bipolar I, and I don't think that only getting medicated solves everything either. When we're navigating a bipolar I diagnosis, I think that we need all the care that we can get, and all the support that we can get, especially in the beginning of treatment. 

Being clear about our needs with our personal support system 

Our personal support system is just as important as our medical support team. It's really important that we let the people closest to us know what our diagnosis is. It’s on us to inform them about what bipolar I is, what our individual symptoms are, what our medical treatment plan is, and what our needs and boundaries are.

When I was in my last depressive episode, I think one of the most crucial elements of my treatment was utilizing my social support. I spent so much time at my best friend's house and a ton of time at another friend's house just floating around in the pool. We didn’t get up to a whole lot, but what I did do was let these people know what I needed, and let them know that I had some limitations. I was limited in terms of my ability to communicate, low energy level, and overall capacity. Giving them a heads up about what to expect (or what not to expect) from me was really important to relieve social pressure. And, letting them know my needs helped them show up for me as best as they could, so that they didn't have to wonder what they should be doing for me. It also mitigated any misunderstandings, like how some folx might avoid me because they didn't know what I needed. Long term, it's really important to continue updating our friends and family on what it is we need from them. 

Our emotional support system can truly impact our progress

When I’ve been in a depressive episode, sometimes it can be handled with a medicine adjustment. But in my personal experience, I've found that it is emotional support that carries me through and out of a depressive episode more than anything. So, what that means is making sure that I'm in therapy if I’m not already in therapy and showing up to that therapy even if I don't feel like I have anything to say. Just getting out of the house and being in contact with another person was really important for me through my last depressive episode. That’s another reason why it’s imperative that we stay in contact with the people who are closest to us; those that we can trust and feel super safe with. On days that we don’t have therapy, we can reach out to these folx to help us out of our isolation.

Awareness of our evolving needs and boundaries 

My needs and boundaries have shifted as I've gotten further into my treatment. I've also accrued new friends and a partner who were not around before or during my diagnosis and early treatment, so they can't know what a bipolar I relapse looks like unless I let them know.

I've recommended that my partner talk to my best friend about what it was like to navigate my manic episode and depressive episode, because my partner wasn't around when I was diagnosed—but my best friend was. I can tell my partner as much as I can, but just like it's important to have someone like a therapist on the outside observing us, I think our friends and family can also have important information about our experience. Just having that extra eye, perspective, and experience outside of ourselves can be really informative to people who were not there and need to know what the deal is. 

Creating personal mental health plans 

Even though our doctors are going to be the ones creating a medical treatment plan, I think that there are some DIY treatment plans that we can create for ourselves to help us feel more confident and secure in our diagnosis. One of those things is having an emergency mental health plan. I came up with this for myself, my partner, and my best friend (my emergency contacts). I felt a lot more comfortable and had a lot less fear about the “what-ifs” of bipolar I. Like, “What if I were to have another manic episode? What if my partner doesn't know what to do?” 

Having the emergency mental health plan written out and distributed to my partner and my best friend ensures that nobody has to make any decisions on my behalf. The whole plan is determined for them (by me) and all they have to do is follow the instructions. I feel more secure knowing that I was the one who consented to this plan in a stable state of mind. You can check out my video about how I developed an emergency mental health plan, but here’s the gist:  

It's recommended, if someone has a manic episode, to go to a psych hospital (not a regular medical emergency room). The reason for this is that a manic episode can be extremely dangerous, so it's partially for safety reasons. Also, when we're in a manic episode, the priority is to get stabilized again, which is a medication thing, which the hospital can provide. They also offer different programs during our time there (though, in my experience, participation is not mandatory) and they observe us to make sure that we’re safe before they discharge us. In my experience, this type of stay can last up to 72 hours, but I’m sure this can change depending on our circumstances. 

When I made my emergency mental health plan, I made sure that I wrote out the specific hospital I want to go to. I read through the whole plan with both my partner and my best friend, so that I could be sure that they felt confident about the plan and answer any questions that they had. Being that they are my emergency contacts, I also provided the document to them in a variety of ways so they could save it however they need to save it. Now, all they need to do if, I ever have another manic or depressive episode, is open the document and follow the instructions. 

*** 

Everyone who has bipolar I may have different experiences and needs, so please don’t take this as an end-all be-all guide. These suggestions come from my personal experience, and I will only ever suggest things that I’ve actually tried and have worked for me. Wherever you are in your bipolar I experience, I wish you safety, peace, and big, fat hugs!  

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