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Learning to Manage Your Bipolar Disorder

20 June 2017 - Dr Jan Orman

Managing bipolar disorder is challenging for patients and practitioners alike. Making the diagnosis in the first place is often a challenge, but once it’s made many patients and their health care practitioners are unaware that there’s more to managing bipolar disorder than juggling the medications and doing the blood tests.

It has become quite clear in recent times that many patients with bipolar disorder benefit from lifestyle interventions and cognitive behaviour therapy as well as medications.

Lifestyle interventions include getting enough sleep, minimising recreational substances (including alcohol), eating a good nutritional diet, doing regular exercise and avoiding stress. All the things we know are good for everyone’s mental health are, of course, also helpful for people with bipolar disorder. 

CBT can teach emotional management skills and  patients (and their practitioners) also benefit enormously from understanding their illness – being able to identify early warning signs of mood change and understanding the events and circumstances that may tip them over into depression or mania.

Some patients learn to know what “dose” of stimulation they can tolerate. A patient once said to me that she had learnt that, for her, an hour on the internet on the back of a couple of cups of coffee and an exciting social event would be enough to push her into hypomania for a couple of days.  Learning how much excitement you can safely tolerate can be as important as taking your medications. 

Learning what makes you vulnerable to depression is also important. One of my patients travels overseas every couple of years and she knows that the sleep disturbance that results from changing time zones presents a real danger. She has learnt to take some extra time off work after she gets back to ward off the depression that will inevitably occur if she tries to go straight back to work.

Tegan, the patient I am discussing in this podcast, is learning to identify her warning signs and getting better at keeping her exposure to stimulating triggers within bounds.

Dr Jan Orman
Dr Jan Orman

Jan is Sydney GP, private psychological medicine practitioner in Sydney’s inner west and a GP educator for Black Dog Institute.

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