3 Key Coping Strategies for Bipolar Mania

coping strategies bipolar mania healthyplaceCoping strategies for bipolar mania are critical in order to minimize the negative effects this mood can have on a person’s life. These coping skills are specifically for those with bipolar disorder type I as they experience mania; whereas, those with bipolar disorder type II experience a less severe mood known as hypomania. However, these bipolar disorder coping strategies may be effective in cases of hypomania as well.

While bipolar manias do vary from person to person, these three key bipolar mania coping strategies are helpful for most.

#1 Key Coping Strategy for Bipolar Mania – Understanding and Avoiding Triggers

There are often events, known as triggers, that precede a bipolar mania. Each person has a unique set of bipolar triggers but some common ones include:

  • High degrees of stress
  • Very enjoyable events
  • Relationship troubles

No matter what your triggers are, it’s an important bipolar disorder coping strategy to minimize or avoid them when possible and watch for signs of mania if they do occur.

#2 Key Coping Strategy for Bipolar Mania – Seeing It Coming

Bipolar manias are best dealt with as soon as they begin. Some people are more able to see manias coming than others, but most people can learn to recognize prodromal symptoms – the signs that someone is headed into mania.

Prodromal symptoms for bipolar mania include:

  • Hostility
  • Ideas of grandiosity
  • Distractibility
  • Being uncooperative
  • Ideas of persecution
  • Increased religiosity
  • Making decisions easily
  • Reddening of eyes
  • Being abusive
  • Listening to loud music
  • Recalling past events and ideas of reference

It’s worth noting that while learning about prodromal bipolar mania symptoms is a coping skill that those with bipolar can learn, it’s often the case that those around the person, such as family members, can actually see these prodromal signs more easily.

#3 Key Coping Strategy for Bipolar Mania – Reaching Out

When bipolar mania hits, it’s a critical coping strategy for bipolar disorder to reach out to others like your mental health team and loved ones.

Your healthcare team needs to know so they can help you take action to quell the bipolar mania. This may include a medication change or even an inpatient stay in a hospital, depending on the severity of the mania. No matter what your healthcare team decides, though, it’s important to remember that it’s for your own good. It’s understandable that reaching out to professionals is particularly hard to do in the midst of a mania, but if at all possible, trust that your healthcare team has your best interest at heart.

Your loved ones can help you through a bipolar mania, too. They can help look after your pets if you’re in the hospital, for example; they can help pick up new medications and more. Additionally, when people are in a bipolar mania, they often feel compelled to spend more money than they can afford. Loved ones can help with this by purchasing what is truly needed and temporarily taking away a person’s credit cards.

Bipolar Disorder Coping Strategies

In addition to bipolar disorder mania coping strategies, there are many coping skills for bipolar depression as well.

APA Reference
Tracy, N. (2021, December 28). 3 Key Coping Strategies for Bipolar Mania, HealthyPlace. Retrieved on 2025, April 30 from https://www.healthyplace.com/self-help/bipolar-disorder/3-key-coping-strategies-for-bipolar-mania

Last Updated: January 7, 2022

Pilled Out: Why I Keep Quitting Medication for Bipolar Disorder

When it comes to medication for bipolar disorder, there are many reasons why people quit taking their bipolar medications.

When it comes to medication for bipolar disorder, there are many reasons why people quit taking their bipolar medications.

I got a letter from a drug store which I only used once informing me that I needed to continue my bipolar medication, even if I feel good, and that I had not refilled my prescriptions. Their mask of concern irritated me. I hear the same words from nearly everyone I meet in treatment. Now it's being used as a marketing gimmick.

The fact is that I started getting my meds for bipolar disorder through a different drug program and my doctor had to write new scripts. The ones at the drug store are currently irrelevant.

It reminds me of the words I hear so often when a person who is schizophrenic makes the evening news in some way or another (rarely positive, I might add). Why can't they just take their medicine? "They" includes anyone with a mental illness. Don't forget intake at the hospital. What are you supposed to be taking? Why did you stop? I say I didn't stop and they give me a look that clearly says I don't believe you. At one point my mother asked me nearly every day. Then I pointed out to her that the answer would always be the same. If I quit, I would just lie about it. I always did before.

Why don't they just take their medicine? Maybe it has serious side effects. Maybe it's not effective. Maybe it cost too much. Maybe working with community health centers is a maze of paperwork and procedure. Maybe they just can't remember which to take when, pill bottle after pill bottle, complex schedules. Maybe they're depressed and it just doesn't matter anymore. Why bother?

But nearly every healthcare profession and even that drugstore mail out assume that the reason patients don't comply is because they feel so good they think they don't need it anymore.

I'm sure that happens. I don't dispute it. But it makes me mad when someone stops there, ignoring all of the other factors involved.

Once I asked a doctor to change my medication because it was too expensive and I couldn't afford it. He told me it was my problem. When I told him at my next appointment that I had dropped some, he was furious.

Once I quit taking the only medicine that had really been effective because it wasn't on my insurance company's formulary. Paying out of pocket would have taken half my take-home pay and, since I was insured, I didn't qualify for drug company programs or indigent drug programs. It definitely had a negative effect on my mood.

Once I quit taking one of my meds because it made me feel jerky, like I couldn't sit still. It was either quit the drug or quit the job. Not a difficult choice.

And then I quit taking my meds when I got so depressed it was a struggle to open the pill bottle or even to remember to open the pill bottle.

Compliance is a complex issue. Doctors, counselors, psychiatric nurses and even families should be on alert for these blockades to using medications effectively, especially as medication regimes are becoming more complicated with drugs that are expensive and the practice of polypharmacy.

And yet, not a single doctor has asked me if I could afford a prescription.

My mother started taking a tricyclic for chronic headaches. She was appalled at the side effects and quit promptly. For the same side effects from one drug or another, I have been told not to quit. I don't have the same option.

I gained about sixty pounds in less than seven months. I complained about the rapid weight gain every time I went in for a med check. Nothing was changed until I went to an internist for edema. Based on her opinion the medication was changed.

I found myself all too often settling for effectiveness regardless of side effects, of the effect it had on my life. Once my bipolar meds made me so sleepy I was falling asleep on the job. I was reprimanded for it. The nurse suggested I drink caffeine or go on disability. I refused to give up a job I enjoyed. One morning I drove through one of the busiest intersections in the city asleep. I woke up on the other side. Luckily, I had caught a green light. I continued to take my meds as prescribed, continued to work. Call that compliance. I call it stupidity.

There's another reason why people stop taking their bipolar medications, it called complacency.

About the author: Melissa has been diagnosed with bipolar disorder and shared her experiences for the benefit of others. Please remember, do NOT take any action based on what you have read here. Please discuss any questions or concerns with your healthcare professional.

APA Reference
Staff, H. (2021, December 28). Pilled Out: Why I Keep Quitting Medication for Bipolar Disorder, HealthyPlace. Retrieved on 2025, April 30 from https://www.healthyplace.com/bipolar-disorder/medication-noncompliance/quitting-medication-for-bipolar-disorder

Last Updated: January 7, 2022

How to Cope with Bipolar Disorder: Bipolar Coping Skills

how cope bipolar healthyplace

Learning how to cope with bipolar disorder can be a lifelong process; after all, bipolar disorder is a lifelong illness and it can change over time. That said, coping skills for bipolar disorder can be learned, be effective, and help anyone’s quality of life. In fact, some might say that managing bipolar disorder without developing solid coping skills is a recipe for disaster.

What Are Bipolar Coping Mechanisms?

Coping mechanism, or coping skills, are generally thought of as methods a person uses to deal with stressful situations. In the case of those with bipolar disorder, they have a special set of coping skills that may help with stress, yes, but are designed to specifically help with bipolar disorder.

Some general coping skills that anyone can use to improve their mental health include:

  • Meditation and relaxation techniques – great for dealing with excessive energy in bipolar disorder and anxiety
  • Social relationships – having people available to reach out to when things get bad is really important, and having people to have fun with when times are good is important, too.
  • Spirituality – some people find religion or other forms of spirituality give them the strength to face the challenges of life and bipolar.
  • Pets – You can distract from stressful thoughts and difficult situations by taking care of a pet. Studies show that pets are a calming influence on people's lives.

There are many other general coping skills and bipolar-specific coping skills available, too.

Practicing Bipolar Disorder Coping Skills

Bipolar coping mechanisms aren’t something you can just easily learn and forget about. Just like coping with bipolar disorder is a daily event, practicing your bipolar coping skills is a frequent event, too.

For example, maybe one of your coping skills is to try to see the positive while in bipolar depression. This isn’t necessarily easy and doesn’t necessarily come naturally in that mood. It may take conscious work to see the positive when all your brain wants to perceive is the negative. The first time you try, you may not even be able to do it. The second time you try, it might take a long time to find something positive to focus on. But over time, it will get easier. It is true with bipolar coping skills that practice makes perfect.

What Good Are Coping Skills for Bipolar Disorder?

Coping skills for bipolar disorder compliment other bipolar treatments such as medication and therapy. They allow you to handle the stresses of bipolar disorder more successfully so that they impact your life less. And while the bipolar disorder symptoms you experience over time may not improve, coping skills can make them easier to deal with.

See Also:

APA Reference
Tracy, N. (2021, December 28). How to Cope with Bipolar Disorder: Bipolar Coping Skills, HealthyPlace. Retrieved on 2025, April 30 from https://www.healthyplace.com/self-help/bipolar-disorder/how-to-cope-with-bipolar-disorder-bipolar-coping-skills

Last Updated: January 7, 2022

Treating Depression Without Medication: Is Self-Help Enough?

Treating depression without medication is a big decision. Self-help strategies can be effective but are they enough? Find out on HealthyPlace

Whether or not to take medication for depression can be a big decision, and many people wonder if treating depression without medication is possible. Self-help strategies can be incredibly effective in beating depression; however, is self-help for depression enough?

The answer to whether or not depression treatment without medication is possible is a resounding maybe. Every individual is unique, and depression is experienced differently by different people. For some, self-help is enough, so treating depression without medication is possible. For others, medication is needed. What follows is a look at medication, self-help, and their abilities and limitations.

Medication for Depression and What it Can and Cannot Do

Depression medication has a purposeful function. It restores the biochemical balance within the brain by affecting, among other things, the neurotransmitters that can play a role in depression: serotonin, dopamine, and norepinephrine (Luciani, 2007).

When severe, treating depression without medication usually isn’t effective or even recommended. Medications soothe the brain so therapy or self-help techniques, or both, can be more successful.

Medication works on the brain and can restore balance. Medication can’t, however, directly improve the way people think and feel and act. Medication alone usually can’t completely treat depression.

Self-Help for Depression and What it Can and Cannot Do

Self-help isn’t just one single thing that someone does but rather is a host of things done to decrease depression symptoms and increase the quality of life. Depression self-help is about actions taken to improve someone’s life. Self-help also involves paying attention to thoughts and perspectives in order to make them more realistically positive. Self-help techniques are about lifestyle changes and can encompass every area of someone’s life (5 Best Books on Depression You Must Read).

Taking depression medication might make self-help techniques easier, but medication doesn’t do the true healing work for someone. Therefore, when depression is mild, or sometimes even moderate, treating depression without medication is possible.

That said, there are times when self-help isn’t enough and medication is needed to restore the biochemical balance discussed above. Preston (2004), describes times when treating depression with medication is necessary. When:

  • Despair is deep and debilitating
  • Depression interrupts life by making it impossible to work and interfering in relationships
  • Someone experiences sleep problems (even if other symptoms of depression are mild, sometimes a doctor might prescribe sleep medication)
  • Someone is very apathetic and lethargic
  • Someone is experiencing suicidal thoughts

Please note: If you are having suicidal thoughts, go to an emergency room (or have someone take you) or call/chat online with the Suicide Prevention Lifeline (1-800-273-TALK [8255]).

Strategies for Treating Depression without Medication

Whether or not to take medication for depression is an individual decision that is best made with a doctor or mental health professional. With or without medication, self-help can be valuable in treating depression. In Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You (2010), Richard O’Connor provides some self-help techniques that are practical and in reach of anyone:

  • Take care of yourself (Depression Self-Care for When You’re Really Depressed).
  • Make priorities; what would you most like to improve? Determine how you’ll get there, and take small steps every day.
  • Pay attention to your thoughts in order to notice negative thinking and change it.
  • Practice mindfulness by being fully present in the moments of your life; pay attention to what you are doing and let negative thoughts go.
  • Look for heroes, people to admire and emulate to help you answer the question, "How do I want to be?"
  • Cultivate connections and intimacy by reaching out to others even when it’s hard.
  • Keep practicing; overcoming depression is a process, sometimes a long one. The more you practice the things that work for you, the smaller your depression will become (10 Things to Help with Depression).
  • Get help when you need it. Reaching out for support from friends, family, professionals is part of self-help because you’re doing what you need to do to feel better. And that includes taking medication.

Treating depression without medication can be possible. The best way to know if it’s right for you is to consult with a mental health professional. He or she can help determine the severity of your depression and whether or not medication can be useful.

Depression medication can be used to augment your self-help strategies. Or, self-help strategies might be enough in treating your depression. With or without medication, seek and use self-help strategies that work for you, and you’ll eventually rise above depression.

article references

APA Reference
Peterson, T. (2021, December 28). Treating Depression Without Medication: Is Self-Help Enough?, HealthyPlace. Retrieved on 2025, April 30 from https://www.healthyplace.com/self-help/depression/treating-depression-without-medication-is-self-help-enough

Last Updated: March 29, 2022

Childhood Bipolar Disorder: Growing Up A Bipolar Child

What’s it like living with childhood bipolar disorder and growing up a bipolar child? Bipolar author, Natalie Jeanne Champagne, shares her personal story.

I am twenty-eight years old as I write these words. I was diagnosed with childhood bipolar disorder at the age of twelve. Sixteen years has passed since the diagnosis yet it still feels recent−particularly when I am asked what life was like living with a serious mental illness at such a young age.

When I am asked what childhood bipolar symptoms I exhibited and experienced that led to the diagnosis, I have to stop and think. I have to remember that time in my life−that frightening time−in order to paint a picture of what bipolar disorder looked and felt like, and the impact it had on my family life. Sometimes, it's easy to forget that mental illness, in all of its shapes and forms, is a family disease and each member suffers in his or her own way.

I have been blessed with a wonderful family and my mother−the strongest woman I have ever met−asked if she could contribute her experience to this article. She wanted the opportunity to speak from a parent's perspective and what it was like being a parent of a bipolar child. As is the case with all of life's stories, I must start at the beginning; I must take myself back to that scary time in my life.

Childhood Bipolar Disorder Affected Everyone

My Parents Knew Something Was Wrong

My mother tells me that she knew I was different before she even laid eyes on me. I did somersaults in her womb, kicking hard, unlike my two siblings. I came into this world screaming, and I never stopped. The doctor told my parents I was colic—a simple term describing a newborn that is otherwise healthy, even thriving, but screams for no reason, expresses symptoms of distress.

Five years later, able to walk and talk, I would not sleep—I could not sleep. I lay in my tiny bed and kicked the walls. I screamed and I cried and my parents knew something was wrong. Something, my mother tells me, was not right. My siblings were younger than me, one two years younger and one five, and my behavior affected the family dynamic immensely. We could not enjoy dinner together because I could not sit still. Although I was young, I remember a feeling of extreme agitation, an angry energy I could not rid myself of. A distinct feeling that I was different than my siblings.

By the age of seven, my behavior had become more destructive. I am ashamed to admit that I was abusive to both my siblings and our pets. My mind was like an engine that pushed my young body. I felt completely out of control. I was completely out of control. My parents tried to integrate me into my peer group; they enrolled me in baseball and soccer and figure skating. When I was manic, I would decide I wanted to join these teams and my parents, elated, would pay for it. I was never able to attend more than a few of the events, my anxiety was so high that I had trouble breathing and talking to people.

Family History of Bipolar Disorder

My family tree is populated with people who have been diagnosed with bipolar disorder, severe depression, anxiety disorders and, sadly, more than a few suicides. Mental illness runs rampant in both my mother and father's side. Armed with this knowledge, my parents took me to the first psychiatrist at the age of ten. Diagnosing childhood bipolar disorder (aka juvenile bipolar disorder) was rare at the time, and though the psychiatrist listened to my mother and father speak, describing my childhood bipolar symptoms, he simply told them they were bad parents. He was adamant that they were not disciplining me properly. In other words: I was not mentally ill, it was their fault. This experience is shared by many parents who have tried to help their children. Nobody wants to believe a child, innocent and still new to the world, can have a serious mental illness.

Being Told You're A Bad Parent

I asked my mother what it was like, that first meeting, being told that it was their fault and she told me in no uncertain terms, that she and my father felt it was there fault. They believed this professional, believed in the various medical degrees hanging on his wall, and took his advice: They sent me to my room and told me I had to sit quietly for ten minutes. They had tried this before. I ran up and down the stairs with energy that could not be explained and so "sitting" and being "quiet" were not things that were possible for me. As soon as the door shut, I would lie on my back and start kicking it. I would kick until the wood splintered and cracked, the handle falling to the floor, and then scream that I was going to jump out the window.

I tore all of my clothes off the hangers; I threw things out my third story window, ripped off the wall paper with my hands and tore up my favorite books. I was like an animal, only I was caged in my mind and my parents could not reach me. It became clear that my actions were not a result of "bad parenting" as both my siblings were stable and thriving−as much as they could be amongst my madness. I was admitted to a children's psychiatric hospital at the age of twelve. I remember being terrified and wondering what was wrong with me. I wanted to be like my brother and sister; I wanted to go to school and make friends and smile! Being a child with a serious mental illness is frightening, disruptive, and above all else, it can feel hopeless. I am blessed that my parents never gave up on me but they did, as the years went on, lose faith in those who refused to believe I had a mental Illness.

We saw our fair share of mental health professionals−during this time I was in and out of hospital −before we found one who listened to my parents and who listened to me describe how utterly scared I was. After many meetings discussing what was going on, she sat our family down one day and told us she had come to a diagnosis. She had a lovely office painted in pinks and in blues, the walls lined with books and large windows, it's strange the things we remember. But I will always remember the look on her face, both serene and matter of fact---a look that tells you that you will soon receive good news or bad news. In our case, a bit of both.

Natalie Has Bipolar Disorder

She stated: "Natalie has bipolar disorder." My mother remembers this being first immensely sad but also relieved. At last someone believed them! And maybe, they hoped, I could become well now. I cannot imagine how difficult this was for them, but I do recall my being confused. I had heard the words before − "bipolar disorder", but I wasn't really sure what they meant. I wondered: "Will I die?" "Will I get better?" and simple things, things that indicated I was just a child, I wondered if I could go to school like my siblings.

Above all else, I wanted to be normal. I wasn't sure what that meant, but I knew it was something I was not. Being diagnosed with a mental illness at a young age affects the way you view yourself and the world. You are not sure who you are. You wonder: Am I just an illness or am I really me? The diagnosis of mental illness is confusing at any age, but even more so when you are a child who just wants to be like other children.

Having received the childhood bipolar diagnosis just before my thirteenth birthday was both a blessing and a curse. I spent half of the year in the children's hospital trying out new medications like they were new shoes. Some of them worked but most of them did not. The side-effects were often terrible and before the medication had a chance to work, I would refuse to take it. At the age of fifteen, when I had nearly given up and I felt too tired to fight anymore, I felt the life draining out of me. With each month that passed in the hospital, I started to get better.

Waiting for Bipolar Recovery

My recovery from childhood bipolar disorder was not easy, and it was certainly not easy for my family. Although I was in hospital during this time so they could monitor any serious side-effects, all of us were waiting. We were waiting for the medications to stop working like they had in the past; we were waiting for me to become unwell. When you live with a mental illness the word "waiting" takes on new form. It is the purple elephant in the room. It is a terrifying word, a state of being, but hopeful as well. At this point, after over a decade of illness, any reprieve would be a blessing.

The months passed slowly, soon I was sixteen, and had started to believe that perhaps I was getting better! It was the simple things that people take for granted: I was able to get out of bed in the morning or fall asleep at night. I could maintain eye contact and my level of anger, rage, and confusion had lessened. Becoming well was difficult, after all, I had never been well and I had no idea what it felt like. I wondered: "Is this what being normal feels like?" It was a lonely time for me. I spent much of my time thinking about how other kids were in school, going to Halloween dances, and I was still staring at the bleak hospital walls or the light blue wallpaper in my bedroom at home.

My mother tells me the family was equally frightened. I had had very brief periods of stability in the past and had become ill quickly after. The nature of bipolar disorder is particularly cruel. But, she tells me now, this time was different. She could see it in my eyes; in the way my body moved, neither too quickly or slow. For the first time, my family thought I might make it.

A few more months passed and the bipolar medications I was taking---mood stabilizers and an antidepressant---continued to work. I continued to get better. When I think of this time I connect it to images and to colors: it was both bright and dark. I see myself crying, my knees to my chest on my bed, wondering if it would stay this way. If I would stay this way. I picture myself smiling the first time I found out I would be going to college after working hard to catch up on the education I had missed. But life was not suddenly easy. I felt alone in my struggle; never had I met another child with bipolar disorder, not even in the hospital. It's different now—the prevalence of children with mental illness is more recognized and more (though certainly not enough) support is available to families in need.

Bipolar Disorder Very Isolating for Everyone

My mother remembers this time in a way I do not: She was afraid, as I was, but for the first time she felt she was able to get to know me. My other family members felt the same. I was no longer defined by the cycle of bipolar disorder, the damage it caused, but was able to relate to people. I was suddenly a sister, a daughter, a student, and above all, a young woman trying to figure life out. The years following my stability were a time of healing in my family. Though I struggled with guilt; with the memories of the abuse I caused when sick, but slowly, as the years have passed, I have been to accept the illness.

Later in life, in my early twenties, I struggled with addiction. I believe it was a way for me to escape the memories of being a child and being so sick. The addiction was as hard on my family as the onset of mental illness was. Addiction is dark and frightening but, somehow, I found my way home to them.

My life now is a balancing act; my medication works well, but I still falter in the winter months. I am sober and am doing what I love: Writing and running and being part of the world. Part of my family. I suppose that's the most important part---children with mental illness can and do recover and, in the process, we find out who we really are. And I believe I have.

The Third Sunrise: A Memoir of Madness

About the author: Natalie Jeanne Champagne is the author of The Third Sunrise: A Memoir of Madness. She is also an author of the Recovering From Mental Illness Blog on HealthyPlace.com.

APA Reference
(2021, December 28). Childhood Bipolar Disorder: Growing Up A Bipolar Child, HealthyPlace. Retrieved on 2025, April 30 from https://www.healthyplace.com/bipolar-disorder/bipolar-children/childhood-bipolar-disorder-growing-up-a-bipolar-child

Last Updated: January 7, 2022

What Is Bipolar Disorder Self-Help and Is It Really Helpful?

Bipolar self-help is something that can help anyone with bipolar disorder. Read examples of self-help for bipolar and the benefits on HealthyPlace.Bipolar disorder self-help can be a very important part of achieving and maintaining wellness for those with bipolar disorder. While medication and therapy may be the most important formal treatments, self-help for bipolar can add to the improvements they make. Additionally, by employing self-help techniques for bipolar, you can feel more in control of bipolar disorder and your life.

What Is Bipolar Disorder Self-Help?

Self-help for bipolar disorder is anything that can be done on your own that may improve your bipolar disorder or your mental health in general. Self-help might be things that are solely personal, include interpersonal relationships or be information you supply to your doctors and other professionals to improve treatment. No matter what kind of self-help for bipolar you choose, it can help improve your condition and your quality of life.

What Are Examples of Self-Help for Bipolar Disorder?

Self-help for any mental illness runs the gamut from bipolar routines to types of communication skills. Not all self-help techniques are right for every person and it’s typically impossible to focus on all types of self-help at once. The best thing to do is to pick the self-help techniques that you think will help you the most and focus on them one at a time. Once the first one is becoming easy, then you can work on another.

Examples of self-help for bipolar disorder include:

  • Learning how to spot and deal with bipolar triggers
  • Learning about effective communication techniques for interpersonal or medical relationships
  • Increased self-involvement in treatment
  • Employing a healthy routine
  • Improving sleep
  • Learning how to track moods and using this information to improve treatment
  • Various psychological and physical coping skills for bipolar disorder

There are many more self-help techniques available as well.

What Are the Benefits of Bipolar Disorder Self-Help?

One of the main benefits of using bipolar disorder self-help methods is that you will stop feeling so powerless in your treatment. When you’re always relying on doctors and therapists for help, it can seem like they have the power over you and your recovery, but this isn’t true. People with bipolar disorder typically do need the services of medical treatment and psychotherapy but personal coping skills are important, too.

Other benefits to bipolar disorder self-help include:

  • Minimization of mood fluctuation
  • Minimization of mood impact on the quality of life
  • Improved relationships
  • Improved treatment

How Can You Find Out More About Self-Help for Bipolar?

Here at HealthyPlace, we have a whole section on self-help for bipolar disorder. It includes topics like:

However, if this section doesn’t give you everything you need to practice self-help skills or if you are looking for more, the best place to get more information is from your therapist or doctor. 

APA Reference
Tracy, N. (2021, December 28). What Is Bipolar Disorder Self-Help and Is It Really Helpful?, HealthyPlace. Retrieved on 2025, April 30 from https://www.healthyplace.com/self-help/bipolar-disorder/what-is-bipolar-disorder-self-help-and-is-it-really-helpful

Last Updated: January 7, 2022

Not Taking Medications for Bipolar Disorder: Alternatives for Non-Compliance

Is someone you know not taking their medications for bipolar disorder? Read about alternatives for medication non-compliance.

Is someone you know not taking their medications for bipolar disorder? Read about alternatives for medication non-compliance.

Q. I am a mental health clinician who is looking for alternatives to the challenges of non-compliance not only with medication but also psychosocial strategies. Currently, there are legislative options that enforce treatment but I would like some other less intrusive options especially with the chronic disorders. Do you know of any?

Dr. Ronald Pies' response: The problem of non-compliance (or, less paternalistically, non-adherence) is a major barrier to effective treatment of psychiatric patients. As Gaebel notes [Int Clin Psychopharmacol. 1997 Feb;12 Suppl 1:S37-42], "Patient non-compliance is as high as 50% under outpatient conditions; potential reasons may be either illness-related (e.g. lack of insight or idiosyncratic concepts of the illness or its treatment), drug-related (e.g. intolerable side-effects) or related to inadequate treatment management (e.g. insufficient information or lack of environmental support)."

Thus, the approach to non-compliance first hinges on a thorough assessment of the underlying reasons for the behavior. For example, a patient with bipolar disorder who refuses to take lithium because "there's nothing really wrong with me" will require a different approach than a schizophrenic patient who believes that the medication will "take away my manhood"--though, in fact, sexual side effects are quite common with psychotropic medications.

In my own experience, the therapeutic alliance is a critical factor in promoting compliance with both medication and psychosocial interventions. This means not only mutual trust, but also a willingness to negotiate, within reasonable bounds. I remember bargaining with some of my schizophrenic patients over a few milligrams of medication! That I was even willing to do this often allowed them to feel empowered, and more likely to take the medication appropriately.

A number of novel approaches to non-compliance have been described; e.g., the self-management of psychiatric medications (Dubyna & Quinn, J Psychiatr Ment Health Nurs. 1996 Oct;3(5):297-302) and intensive "case management" services. In a study by Azrin & Teichner (Behav Res Ther. 1998 Sep;36(9):849-61), patients were matched and randomly assigned to receive in a single session either (1) information regarding medication and its benefits, (2) guidelines for assuring adherence which encompassed all phases related to pill-taking including filling prescriptions, use of a pill container, transportation, self-reminders, doctor's appointments, etc.; or (3) the same guidelines as (2) above but given in the presence of a family member who was enlisted for support. Adherence increased to about 94% after the guidelines were given for both the individual and family guideline procedure, whereas adherence remained unchanged at 73% after the medication information procedure.

In my own experience, involving the patient's family can make a big difference in compliance. Of course, there are innumerable psychodynamic reasons (resistances) why patients do not accept treatment recommendations. For more details on such treatment-resistant patients, you may be interested in the book edited by my colleague, Mantosh Dewan MD, and myself, entitled, "The Difficult-to-Treat Psychiatric Patient."

Good luck with your cases!

About the author: Dr. Ronald Pies is clinical professor of psychiatry at the Tufts University School of Medicine and a lecturer on psychiatry at Harvard Medical School and co-editor of The Difficult-to-Treat Psychiatric Patient.

APA Reference
Staff, H. (2021, December 28). Not Taking Medications for Bipolar Disorder: Alternatives for Non-Compliance, HealthyPlace. Retrieved on 2025, April 30 from https://www.healthyplace.com/bipolar-disorder/medication-noncompliance/not-taking-medications-for-bipolar-disorder-alternatives-for-non-compliance

Last Updated: January 7, 2022

More Ideas on Managing Your Bipolar Medication

People who have bipolar disorder take a lot of pills every day. Here are ways to keep track of medications.

Often people who have bipolar disorder take a lot of pills every day. Here are ways to make sure you take the right pill at the right time and learn what you should know about your medications.

Here's How:

  1. Always read the package inserts on new medications. If you find a drug interaction with something else you are already taking listed, call your doctor right away.
  2. Save the inserts or know where you can look up the possible effects and side effects of all your meds.
  3. When you start a new drug or have a dosage change on a med, pay attention to how you feel and behave for a few days to a week in case of adverse reactions.
  4. Consider keeping a medication journal where you record your prescriptions and dosages and keep track of changes and how you responded to them.
  5. Consider making a daily list and checking off the pills as you take them.
  6. Purchase a pill case or "med minder" that has compartments for days and/or time of day, depending on your own needs.
  7. Choose a day of the week or a time of day to put the proper pills in the proper compartments of your pill case.
  8. Set alarms to go off when it is time to take the next pill(s). Use clocks, watch, computer programs, electronic organizers - whatever works for you.
  9. If you always take certain pills with meals, put them in a little bowl by your place setting before the meal starts.
  10. For something attractive at home, think about using a spice rack to hold your pills. Re-label the bottles appropriately. These bottles are large enough to hold vitamins, too.

Tips:

  1. When you travel, always put your medications in your carry-on luggage so you will have them if your checked baggage goes astray. If you might run out, get refills early.
  2. Check your prescriptions at the pharmacy, if possible, to make sure the proper medication has been dispensed.
  3. Consult your doctor before mixing prescriptions with over-the-counter drugs or herbal supplements. Check package inserts for food interactions, too.

APA Reference
Tracy, N. (2021, December 28). More Ideas on Managing Your Bipolar Medication, HealthyPlace. Retrieved on 2025, April 30 from https://www.healthyplace.com/bipolar-disorder/medication-noncompliance/more-ideas-on-managing-your-bipolar-medication

Last Updated: January 7, 2022

Bipolar Disorder Symptoms: How to Tell If You Have Bipolar

The symptoms of bipolar disorder aren’t always easy to spot. While some people experience dramatic highs and lows, for others the signs are much subtler. There is also a lot of misinformation about bipolar disorder, making it easy to misdiagnose or leave untreated, as well as different forms it can take. So how do you know whether you have bipolar or you're just experiencing normal mood changes? Here are some tell-tale symptoms of bipolar disorder.

What are the Symptoms of Bipolar Disorder?

The symptoms of bipolar disorder vary according to the form the illness takes. A person with bipolar I disorder has typically experienced at least one manic episode, characterized by abnormally high energy, elevated ideas, disruptive or destructive behavior and grandiose ideas. Most people with bipolar I also experience bouts of depression.

Bipolar II is similar to bipolar I, but the “up” moods never meet the criteria for full mania. These episodes are referred to as hypomania. Most people with bipolar II disorder experience more depressive episodes than hypomanic ones.

The third form of bipolar disorder is called cyclothymia. Cyclothymia is characterized by rapid mood cycles between depression and hypomania that don’t fit the criteria for mania or major depression. Many people consider cyclothymia to be the “less severe” form of bipolar disorder, but it can still lead to erratic and unhealthy behavior and disrupt your quality of life. What's more, people with bipolar II or cyclothymia have a heightened risk of developing bipolar type I. All forms of bipolar disorder can have potentially dangerous consequences if left untreated.

Bipolar Disorder Signs and Symptoms List

According to the fifth and most recent edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5), which is prepared by the American Psychiatric Association and contains the formal requirements for diagnosing mental illnesses, there are certain diagnostic criteria for bipolar episodes.

According to the DSM-5, tell-tale signs of bipolar disorder symptoms include:

Manic episodes

  • Extremely high self-esteem or grandiosity
  • Reduced need for sleep
  • Talking more than usual, often loudly and quickly
  • Becoming distracted easily
  • Doing too many activities at once
  • Risky behavior, such as spending sprees, substance abuse, hypersexuality and reckless driving
  • Racing thoughts

Hypomanic episodes

According to the DSM-5 bipolar disorder symptoms list, a hypomanic episode is similar to a manic episode except the symptoms are milder, usually lasting a maximum of four days in a row. Most people in hypomania are still able to function perfectly well and do not require hospitalization.

Major depressive episodes

Major depressive episodes are periods of two weeks or more in which a person has at least five of the following symptoms, including one of the first two:

  • Intense sadness or despair, including feeling helpless and hopeless
  • Loss of interest and pleasure in usual activities
  • Feelings of guilt and worthlessness
  • Sleep problems, such as sleeping too little or too much
  • Feeling restless or agitated
  • Slowed movements
  • Changes in appetite
  • Extreme fatigue
  • Difficulty concentrating and making decisions
  • Recurring thoughts of death or suicide

Cyclothymia

To be diagnosed with cyclothymia (cyclothymic disorder), the symptoms of hypomania and depression must be present for two years or more, without becoming full bipolar disorder. During this period, the symptoms will have lasted for half the time and never stopped for more than two months.

Bipolar Disorder Symptoms: How To Know If You Have Bipolar

While educating yourself about bipolar disorder symptoms can be helpful, the only way to tell if you have bipolar is to receive a diagnosis from a medical professional. If you experience symptoms of bipolar disorder, you should see your doctor, even if you don’t have all of them. Your doctor will most likely refer you to a mental health specialist who will assess whether you fit the DSM-5 bipolar disorder symptoms criteria.

article references

APA Reference
Smith, E. (2021, December 28). Bipolar Disorder Symptoms: How to Tell If You Have Bipolar, HealthyPlace. Retrieved on 2025, April 30 from https://www.healthyplace.com/bipolar-disorder/bipolar-symptoms/bipolar-disorder-symptoms-how-to-tell-if-you-have-bipolar

Last Updated: January 7, 2022

How to Manage Your Bipolar Medications

People with bipolar disorder must take medication to stabilize moods and keep the illness from worsening. Read how to manage your bipolar medications.

Reasons why people stop taking their bipolar medications and what you can do to help ensure they don't.

As we've mentioned many times throughout this area of our site, bipolar disorder is not a character flaw or a sign of weakness. It is a biochemical condition that can be made worse by stress.1 Just as those with diabetes take medication to stabilize blood sugar, people with bipolar disorder must take medication to stabilize moods and keep the illness from worsening.1 Because bipolar disorder affects the biochemistry of the brain (like diabetes affects the biochemistry of the pancreas), staying on medication is critical.

However, any concern about medication should be addressed by the patient with his or her doctor.

Do not be discouraged if results aren't seen immediately.

Medications for bipolar disorder generally do not make people feel better right away. They often take time to work completely. Sometimes a medication must be started at a lower dose and increased over time to be effective. Slowly increasing the dosage until it is effective is a tried and true way to help the body adjust to a  new medication.

Bipolar medications can sometimes cause side effects. For some people, they are bothersome but can be ignored for the most part. For others, the side effects outweigh the benefits. In that case, the doctor may either reduce the dose or prescribe another medication. Many side effects are known to go away once the body has adjusted to the medication. Some side effects may be present as long as the medication is being taken but are not enough of a problem to interfere with treatment.

If you don't see any improvement, or if your loved one is experiencing side effects, let the doctor know immediately. This may be a sign to reduce or change this particular treatment.

This chart identifies some common reasons why some people with bipolar disorder stop taking their medication and what you can do to help.

Reasons commonly given for stopping bipolar medications Reasons to keep taking bipolar medications How to help your loved one  
I don't like the idea of taking medicine for the rest of my life. Bipolar disorder can produce symptoms that last, change, or even worsen over a lifetime.1 Only with the appropriate treatment can bipolar disorder be managed effectively

Have the patient talk to a support group or others who are successfully managing a chronic illness using long-term medication

Let them know that taking medication is not a sign of weakness

I feel better. There's nothing wrong with me anymore.

Bipolar disorder affects judgment and the patient could be experiencing symptoms of a mood episode

Feeling better could just mean that the medication is working

Going off medication or adjusting it without consulting a doctor can cause symptoms to return and get worse1

Make sure they explain these feelings to their doctor. It may be necessary to adjust the medication.1 Over the course of treatment, sometimes medication is increased or reduced

Having your loved one listen to the experiences of their support group could make them feel better about being on medication

Let them know that they should not judge taking medication as weak or shameful

I'm getting side effects that make me feel physically or emotionally uncomfortable. I'm gaining weight. I feel sleepy.

The symptoms being experienced may be temporary1

Going off medication or adjusting it without consulting a doctor can cause symptoms to return and get worse1

Manageable side effects must be weighed against the benefits of mood stability

Make sure they call the doctor right away and describe the symptoms. It may be necessary for the doctor to adjust the dose of the medication or change the medication

Tell the patient to let his or her family and support group know what is going on with the side effects

Tell the patient it is not acceptable to go off the medication without a doctor's advice

I don't agree with my treatment. I don't want to take this particular medicine. Going off medication or adjusting it without consulting a doctor can cause symptoms to return and get worse1

Tell them to speak to the doctor about other treatment options1

Let them know it's okay to get a second opinion

Have them talk to others in their support group who have had similar experiences

Tell them that it is not acceptable to go off the medication without a doctor's advice

Reference: 1. Kahn DA, Ross R, Printz DJ, Sachs GS. Treatment of bipolar disorder: a guide for patients and families. Postgrad Med Special Report. 2000(April):97-104.

APA Reference
Tracy, N. (2021, December 28). How to Manage Your Bipolar Medications, HealthyPlace. Retrieved on 2025, April 30 from https://www.healthyplace.com/bipolar-disorder/medication-noncompliance/how-to-manage-your-bipolar-medications

Last Updated: January 7, 2022