Transcript bipolar disorder

Mood Disorders Association
of
Manitoba
Presents
RECOVERY AND
EMPOWERMENT for people with bipolar illness
What is bipolar disorder
 Symptoms of Highs
 Symptoms of Lows
 Causes of Bipolar Disorder
 How can you help someone with Bipolar
Disorder?
 What is Recovery?
 What are 13 things that Empower a person
 Your Action Plan

BIPOLAR DISORDER
Or Manic Depression (as it used to be known)
is a treatable illness marked by extreme changes
in mood, thought, energy, and behaviour.

A person’s mood can alternate between the
"poles" mania (highs) and depression (lows).
This change in mood or "mood swing" can last
for hours, days weeks or months.

These swings can be severe, ranging from
extreme energy to deep despair.
Symptoms of BIPOLAR
DISORDER

Bipolar disorder differs significantly from
clinical depression, although the symptoms
for the depressive phase of the illness are
similar.

The severity of the mood swings and the way
they disrupt normal life activities distinguish
bipolar mood episodes from ordinary mood
changes.
LIVING WITH BIPOLAR
DISORDER AND BEYOND
You may have bipolar illness if
you have some or all of
the following symptoms of
depression and mania
Symptoms of mania –
the “HIGHS" of bipolar disorder
 Increased
physical and mental
activity and energy
 Heightened
mood, exaggerated
optimism and self-confidence
 Excessive
behaviour
irritability, aggressive
Symptoms of mania –
the “HIGHS" of bipolar disorder
 Decreased
need for sleep without
experiencing fatigue
 Grandiose
delusions, inflated sense of
self-importance
 Racing
ideas
speech, racing thoughts, flight of
Symptoms of mania –
the “HIGHS" of bipolar disorder
 Impulsiveness,
poor judgment,
distractibility
 Reckless
 In
behaviour
the most severe cases, delusions and
hallucinations
Symptoms of depression - the
“LOWS" of bipolar disorder
 Prolonged
sadness or unexplained
crying spells
 Significant
changes in appetite and
sleep patterns
 Irritability,
anxiety
anger, worry, agitation,
Symptoms of depression - the
“LOWS" of bipolar disorder

Pessimism, indifference

Loss of energy, persistent lethargy


Feelings of guilt, worthlessness
Inability to concentrate, indecisiveness
Symptoms of depression - the
“LOWS" of bipolar disorder

Inability to take pleasure in former
interests, social withdrawal

Unexplained aches and pains

Recurring thoughts of death or suicide
BIPOLAR DISORDER
NO TREATMENT CAN CURE BIPOLAR
DISORDER,
BUT
 RECOVERY IS POSSIBLE
 LIVING A FULL AND COMPLETE LIFE
IS POSSIBLE
IT IS UP TO YOU
BIPOLAR DISORDER
1 in 4 Canadians will be affected by a Mood
Disorder this year
The Canadian economy loses
52 Billion dollars per year
Due to Mood Disorders
90% of people who have a mood disorder
never seek treatment
What causes Bipolar Disorder?
Bipolar Disorder affects approximately 1.5% of all
people.
In Canada, more than 450,000 people have, or
will have this disorder.
Although not a single cause has been identified, it
is known that many factors, including
biochemical, genetics, and environment play a
part in this illness.
What causes Bipolar Disorder?
 Research
suggests that an improper
balance of neurotransmitters in the brain is
related to the symptoms and episodes of
depression and mania.
 The
biochemical imbalance may represent a
genetic vulnerability set into motion by
prolonged stress, trauma, physical illness, or
some other environmental factor.
What causes Bipolar Disorder?
 Medications
work for most people by
correcting the chemical imbalance.

There is growing evidence that heredity is
involved, especially in the more recurrent
forms of the disorder. The exact mechanism
by which Bipolar Disorder is transmitted
from one generation to the next is not
known.
CHEMICAL IMBALANCE
BIPOLAR DISORDER
Fortunately, very effective
treatments are available to
stabilize your mood and help
you regain and maintain a
satisfying and productive life.
BIPOLAR DISORDER

You cannot diagnose yourself. Only a properly
trained health professional can determine if you
have bipolar disorder.

Many people do not seek medical attention during
periods of mania because they feel manic
symptoms (increased energy, heightened mood,
increased sexual drive, etc.) have a positive
impact on them.

However, left unchecked, these behaviours can
have harmful results.
Types of BIPOLAR DISORDER
Patterns and severity of
symptoms, or episodes, of
highs and lows, determine
different types of bipolar
disorder.
BIPOLAR I

Bipolar 1 is characterized by one or more manic
episodes or mixed episodes,

symptoms of both a mania and a depression
occurring nearly every day for at least 1 week,

and one or more major depressive episodes.

Bipolar I disorder is the most severe form of the
illness marked by extreme manic episodes.
BIPOLAR 2
Bipolar 2 is characterized by one or more
depressive episodes accompanied by at
least one Hypomanic episode.
 Hypomanic episodes have symptoms similar
to manic episodes but are less severe, but
must be clearly different from a person’s nondepressed mood.
 For some, Hypomanic episodes are not
severe enough to cause notable problems in
social activities or work. However, for others,
they can be troublesome.

BIPOLAR 2

Bipolar 2 disorder may be misdiagnosed
as depression if you and your doctor
don’t notice the signs of hypomania.

In a recent DBSA survey, nearly seven
out of ten people with bipolar disorder
had been misdiagnosed at least once.

Sixty percent of those people had been
diagnosed with depression.
BIPOLAR DISORDER

Because bipolar disorder is complex and can be
difficult to diagnose, you should share ALL of
your symptoms with your health care provider.

Keep a daily log of how you feel and show it to
your Doctor. It will help him decide what and
how much of a medication you need.
Mood Disorders
Many people with Bipolar disorder try to
self-medicate
with alcohol and illicit drugs
“Drown their sorrows”
By using alcohol or other substances
to reduce the pain or induce euphoria.
This only worsens the mood disorder.
When Manic Or Depressive Episodes
Occur

Family life is often stressful. Symptoms of
both phases are distressing in different ways.

If mood swings are mild, the family may be
able to handle them without too much
difficulty. When the episodes are severe,
coping may be extremely difficult.
What To Expect When Mania Appears

Depending on the severity of the manic episode,
reactions can range from frustration and annoyance
to anger and hatred. Family members are dismayed
as they see their loved one turning into a stranger.

Spending sprees, promiscuity, criminal acts or other
forms of erratic and risky behaviours may occur. The
manic person is sure there is nothing wrong with
these actions and often takes no responsibility for the
consequences. Family members are often faced
with having to “pick up the pieces” or “bail out” their
relative (both literally and figuratively).
What To Expect When Mania Appears






At the first signs of over-activity and after the first night’s
loss of sleep, express your concern and take action if
necessary.
Don’t tell (or expect) the person to “snap out of it.”
Use a firm but consistent approach. Avoid sounding strict or
bossy. Don’t make demands. Don’t argue with the person.
The severity of the manic episode will affect how firm or
forceful you need to be.
Recognize that people with bipolar disorder are often unable
to control their thoughts. Their behaviour is the result of the
illness.
Try to maintain your usual routine, for example, serve meals
at the regular times.
Try to keep your home as quiet and restful as possible, for
example, keep lights low, play soothing music.
WHAT TO DO WHEN A DEPRESSIVE EPISODE
OCCURS


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

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Limit stimulation.
Make your expectations clear.
Be supportive and understanding. A depressed person needs
to talk with someone who will not be critical.
Encourage self-care, especially with respect to eating, bathing
and personal hygiene. For example, prepare balanced meals
that can be easily reheated; keep nutritious snacks available;
suggest a relaxing bath.
Try to enhance self-esteem and self-confidence by
emphasizing the positive and talking about the person’s past
and current achievements.
Promote “not getting depressed” over “being depressed.”
Provide reassurance that the depression will pass.
WHAT TO DO WHEN A DEPRESSIVE
EPISODE OCCURS






Monitor all medications carefully. It is common for a depressed
person to forget or become confused about medications.
Watch for evidence of hoarding medications. It is often a sign that
suicide is planned.
Determine whether there are thoughts of or any plans for suicide.
Take action if necessary.
Ask the depressed person if you are doing anything that may be
contributing to their condition. Be prepared to do some problem
solving.
Don’t tell (or expect) a depressed person to “snap out of it.” This
leaves the impression that they are responsible for, or have
control over, their condition when they do not.
Above all, get professional help.
HOW TO HELP?

“One of the things I found useful when I was
depressed was to ask people around me to
write a list of my positive qualities. At the time I
couldn’t have thought up one on my own. It
sure helped. And anytime I need to, I can see
that someone cares. It’s right there on paper.”

Ask yourself, “How would I like to be treated in
this situation?” and act accordingly.
Suggestions are:
HOW TO HELP?

TREAT THE PERSON WITH THE ILLNESS AS AN ADULT.

EMPHASIZE THE POSITIVE. Focus on accomplishments.

ACKNOWLEDGE EFFORT. Recognize attempts.

USE HUMOUR. Laughing together can help to relieve tension, put things in a better
perspective and demonstrate warmth, caring and mutual understanding.

SET CLEAR EXPECTATIONS.

DEAL WITH PROBLEMS SOONER RATHER THAT LATER.

OFFER HELP JUDICOUSLY.

RECOGNIZE THAT STIGMA EXISTS.
HOW TO HELP?

Don’t lose hope.
Living with bipolar disorder can be discouraging,
particularly when relapses occur
or in times of distress.
But there is hope for recovery.
People who live with bipolar disorder
can have satisfying and productive lives.
Many say they value the insight and sensitivity
they have gained from their experience.
Things to consider:
 “No one is to blame and you cannot cure a mental disorder
for a family member.”

Despite medication compliance, episodes may occur. It may
take some time to find the right medications and dosages.

Additionally, the symptoms of the disorder may change over
time requiring medication adjustments.


Despite your efforts, the symptoms may get worse.
Separate the person from the disorder. Love the person, hate
the disorder, and separate the medication side effects from the
disorder/person.
Things to consider:

It is NOT okay for you to neglect your needs. Take care of
yourself, ensuring you have a rich and fulfilling life. Do not
shoulder the whole responsibility for your family member.
You may have to assess your emotional commitment.

There is nothing to be ashamed of if someone in your family
has a neurological chemical brain disorder.

It is natural to experience many strong emotions such as
denial, grief, guilt, fear, anger, sadness, hurt, and confusion.
Healing occurs with acceptance and understanding.

Allow your affected family member and other family
members to go through their grieving processes at their own
pace. This is also true for you.
RECOVERY IS:
CHOOSING
TO
TAKE ACTION
Recovery is a journey
without an end!
There are always new thing to learn
and do for ourselves
RECOVERY IS:
Having an improved quality of life
Psychological well-being
Accomplishment of life goals
living a satisfying life
with meaning and purpose.
RECOVERY IS:
Having what we feel are meaningful,
purposeful activities.
Being part of our community in a
meaningful way.
RECOVERY IS:
Success is not simply an absence of
symptoms or a reduction in inpatient
admissions to hospital.
Success is also measured by how well we are
able to pursue the things that give
our lives purpose and meaning.
TO RECOVER :
We must choose to:
Believe that it is possible to have a better life.
Hope again.
Believe that we are more than our illness
Believe that we have the skills, talents and ability
to change
TO RECOVER:
We must choose to:
Believe that we, the individual, deserves dignity,
love and happiness
Believe that we have the ability to address the
dissatisfaction we have with our present disabling
and disempowering circumstance
Believe that we are responsible for our own life.
Believe that we have the ability to change the
thoughts and behaviours that are barriers to our
recovery.
EMPOWERMENT IS:
1.Having decision making power
We need to be able to make our own
decisions about the treatment that is best for
us.
We also must be allowed to make our own
decisions about our own lives if we wish to
gain a sense of independence.
EMPOWERMENT IS:
2.Having Access to Information
We need to educate ourselves about our
illness and how it is affecting our body,
Only then can we empower ourselves
to make the best choices for
our OWN recovery.
EMPOWERMENT IS:
3. Having a Range of Options from
Which to Make Choices.
We, as people with lived
experience need to be aware of
what choices are
available to us.
EMPOWERMENT IS:
4.Assertiveness
Those with lived experiences
need to know how to request
what we want and need
correctly.
EMPOWERMENT IS:
5. A Feeling that the Individual can make a
Difference.
We must be hopeful and believe that
recovery is possible
and that with effort on our part there will be a
change to our current position.
EMPOWERMENT IS:
6. Allowing us to reclaim “OUR OWN
STORY.”
We are often made to feel that we are a case
history and not a real person with real life
experiences.
We need to tell our story and have people
listened to it.
This is where self-help groups can play an
important part in the process.
EMPOWERMENT IS:
7. Not Feeling Alone, Feeling Part of a
Group
Empowerment best occurs when an
individual does not feel alone
but feels a part of a group,
a connection with other people.
EMPOWERMENT IS:
8. Understanding that People have
Rights
We with lived experience need to believe
that we are entitled to the same
basic human rights that any other
individuals are entitled to.
EMPOWERMENT IS:
9. Affecting change in one’s life and
one’s community
When we feel empowered
we not only feel a change in our own life,
but can work toward
changing the lives of others
around us.
EMPOWERMENT IS:
10. Learning skills that the individual
defines as important.
The emphasis needs to be on what
the individual deems is important to them.
We will feel empowered only
when we have been given the ability
to CHOOSE
what is important to us.
EMPOWERMENT IS:
11. Changing others perceptions of
one’s competency and capacity to
act.
When individuals with lived experience feel
competent
around the so called “normal” people
in our life,
we become empowered.
EMPOWERMENT IS:
12. Increasing one’s positive self image
and overcoming stigma.
When we are truly empowered, we are confident
enough to let people know we have an illness.
This will help lessen the stigma and we will begin
to feel more confident and capable
EMPOWERMENT IS:
13. Growth and change that is never
ending and self-initiated.
Attitude
…Life is only 10% what
happens to me
and
90% how I react to it
WHAT CAN I DO TO HELP
MYSELF?
Being diagnosed with a mental illness is like
having any other serious medical condition.
It means being more careful in how you live
your life.
You need to live a more
STRUCTURED LIFE
And put together your own
ACTION PLAN
ACTION PLAN
1)Tell someone how you feel.
Ask them to just listen to you.
No interruptions, advice, criticism, or
judgments just listen.
This will help you feel better.
ACTION PLAN
2) Take a rest from your responsibilities.
Don’t leave all your duties completely, just simplify.
Avoid making any major decisions.
Ask if employer will make allowances for you at
work.
DON’T ISOLATE YOURSELF.
ACTION PLAN
3.MEDICATION COMPLIANCE:
Medications taken to improve our functioning sometimes
make us feel physically worse than the illness itself.
There are many different types of medications.
You don’t have to live with unacceptable side effects.
Too many people stop taking medications for this reason;
Medications need to be taken for a long
period of time to be effective.
ACTION PLAN
4) Limit Alcohol and Drug use:
Continued abuse of alcohol
and or
dependence on street drugs
--even marijuana-- could alter the course of
the illness.
DON’T SELF MEDICATE
ACTION PLAN
5) Monitor sleep:
Normal sleep occurs with fatigue and reduced stimulation.
In bipolar disorder, loss of sleep can precipitate or exacerbate
an episode of mania.
Even losing one night of sleep may trigger an episode.
You need at least 6 to 8 hours of sleep a night.
Too much sleep can start an episode of depression.
ACTION PLAN
6) Positive thinking:
Your attitude is perhaps the most important thing you can do
towards your own recovery.
You are the only one who has full control of
YOUR ATTITUDE
ACTION PLAN
7) Sleeping.
Go to bed and get up at a regular time.
Establish a bedtime ritual.
Do something calming before bed.
Not sleeping is serious with bipolar
illness.
ACTION PLAN
8) Get some exercise.
Any movement will help.
Don’t do too much at once.
Climb the stairs, take a walk, sweep the floor, etc.
Don’t rush from one thing to another.
Live in the moment.
ACTION PLAN
9) Spend time outdoors
At least a half-hour per day.
Again, don’t overdo it.
Walk or just sit outdoors. Even if it is cloudy or rainy.
Roll up the shades, let the sun in.
Turn on the lights.
ACTION PLAN
10) Eat healthy foods
.
Avoid sugar, caffeine, alcohol, and heavily salted foods.
If you can’t cook for yourself, ask a friend or family
member to cook for you.
Buy healthy frozen or canned foods.
Make sure you eat 3 to 6 small meals a day, don’t skip
meals.
ACTION PLAN
11) Obsessing and Negative thoughts.
Obsessing can make those issues larger than they
really are.
Divert your attention.
Do something you really enjoy such as gardening,
crafts, playing with your pet, reading.
Try turning negative thoughts around to positive
thoughts. Train yourself and make it a habit.
ACTION PLAN
12) Relax.
Sit in a comfortable chair.
Loosen any tight clothing.
Take deep breaths (BELLY BREATHING)
Relax every part of your body. Start with your toes.
Notice how your body feels.
Focus on a favorite scene.
Do this for at least 10 minutes a day.
ACTION PLAN
13) Nutrition:
Balanced intake of food is needed to provide
vitamins and nutrients that are essential for a
healthy body and mind.
Nutrients are not stored so they must be
replenished at regular times.
ACTION PLAN
14) Build a strong Support system:
Surround yourself with people you trust and
respect.
You must be willing to accept their support
and judgment,
especially at times when your judgment
regarding mental health may be impaired.
ACTION PLAN
15) Build a therapeutic Partnership with
your Doctor
Shared common insights:
Empathy and Honesty
Trust
Confidentiality
Persistence-commitment to working at getting
better
Unconditional Positive Regard
ACTION PLAN
Build a therapeutic Partnership with
your Doctor continued
Positive therapeutic relationship is more important than the
therapy used.
You can’t do this alone, yet you are the only one that can help
yourself.
Inform yourself about your condition or you will forever be
subject to it’s whims.
ACTION PLAN
16) Financial Management:
Prepare a budget – learn to live within your
means.
Make financial decisions before episodes
occur.
Put limits on your spending by decreasing
your credit and withdrawal limits.
ACTION PLAN
17) Add structure to your life
It is important to have regular times for sleeping, meals,
medication, exercise and social activities.
Don’t overbook activities.
Focus your energies, if you get sick you accomplish nothing
First rule Self-help.
ACTION PLAN
18) Educate yourself about your illness
To be an effective advocate for yourself and the
type of treatment you receive, you will need
to know what you are talking about.
Knowledge is power
ACTION PLAN
19) Join a support group
Getting together with people who also have an
illness such as those in support groups helps.
Check the times for groups at the Mood
Disorders Association of Manitoba
ACTION PLAN
20) Write a plan to keep yourself well
Making time for paying bills, buying groceries,
or cleaning your home.
Watching for early warning signs of the illness.
Signs of getting much worse.
Watch for signs that you are cycling higher.
ACTION PLAN
Everyone develops a different
recovery plan,
and the right one
is the one
that works for you!
REMEMBER
Recovery is a journey filled with hope:
Take control.
Take charge.
Look after yourself.
No one else can do it as well as you
can!!!!
The Mood Disorders Association of Manitoba
4 Fort Street
Winnipeg, MB
R3C 1C4
PH: 786-0987
TOLL FREE: 1-800-263-1460
E-mail: [email protected]