By team Mental’s Alice Lamb and Kim Power:
These are tips that have helped Kim maintain wellness in recovery, but experiencing bipolar and the process of managing it is different for everyone. Also, during one individual’s recovery process, the kind of therapies and medication that are effective may change. The meaning of recovery is unique to everyone, some people see recovery as maintaining ways to manage further relapses better, some see recovery as not having another relapse again. Recovery is about finding your individual pathway to empowerment and taking back control in anyway that works for you.
1 Accepting the condition.
Some people find it useful to have a diagnosis because it means they can separate themselves from the illness, and are reassured in knowing they aren’t alone in what they are experiencing. Whereas others, feel that being labelled with a mental illness engulfs their identity, because of the stigma still attached to having a mental illness. Whichever way people chose to see what they experience, bipolar doesn’t define who you are. The Mighty has some excellent articles about people’s journeys to accepting bipolar.
2. Sharing Experiences.
It takes great courage to address and share experiences of bipolar, but by doing so Kim has realised how many of the people around her struggle with their mental health, diagnosed or undiagnosed, ‘breaking down the attachment to stigma and labels have been a great topic of conversation within my peer groups, allowing me to feel less isolated with my conditioning.’ She feels that sharing her experience with others and volunteering with mental health charities, is helping her maintain perspective and is using a negative experience to have a positive outcome.
By opening up to loved ones, it allows them have a better understanding which help will enable them support you in the best way. ‘My friend who has remained consistent throughout my years of UN health and wellbeing has been hosting a sacred community fire at my house. She creates a very relaxed and open shared space for all in the community to share their stories their concerns their fears and their aspirations for the future. I find this valuable as it offers a gentle approach to allow me to open up my home environment with others, enabling more communication and more confidence to be comfortable with myself in the company of others.’
Buddying systems and peer support groups provide reciprocal support, whether, social, emotional or practical, the focus of these groups are to focus on an individual’s strengths and working towards wellness and recovery. There are different kinds of peer support available, such as informal contact between people that experience bipolar or peer support workers employed by an organisation to provide a service.
3. Maintaining a good support network.
Self- managing your wellness does not mean going at it alone. There are many different kinds of support networks available, for example; peer, social and medical support. All are important but it’s up to the individual on what kind of support they find most useful. Some research and personal experiences points to improved outcomes for those who don’t engage with formal mental health services. But for others, including Kim, being supported by a network of mental health professionals that collaborate with her has been helpful. ‘Coming face to face with what is beyond my control has urged me to maintain more self awareness, I am managing this with the help of psychotherapy, the help of second step lived experience peer support worker and the ongoing support of my wellbeing navigator all part of the NHS mental health support network.’
The Buddy app, created by South London and Maudsley NHS trust, is an alternative to mood diaries and is a simple way for clients to share daily thoughts with their clinicians between appointments.
4. Have your say in how you are treated.
Being involved in your care and making decisions for yourself is a good way to help you gain control of your recovery. In order to find the best treatment for you, there has to be a two way dialogue between you and your support team. Staying informed in decisions, making informative choices about treatment and having a range of therapies open to you is useful in maintaining wellness.
5. Have a plan put in place.
An increase in stress can be a trigger for having an episode. Kim is currently focusing on her WRAP plan (Wellness recovery action plan) with her peer support worker. The WRAP plan was developed so people could discover their own wellness tools, identify upsetting events, create a list of things to do everyday to help them stay well, make a crisis and post-crisis plan. Kim’s peer support worker is able to offer competent advice and support because of her own lived experience.
6. Learning to recognise triggers.
Being able to work with your support workers in order to notice and avoid triggers is a long process but can be incredibly useful. ‘Maintaining mindful awareness is a key factor of maintaining wellness because I am not always in control of my thoughts.’ Kim has stopped listening to the news on the TV and Radio because she has identified this as a trigger. Loved ones can often recognise unusual behaviour triggers before the person being triggered.
7. Finding out more about bipolar.
Becoming an expert on how your mind works can help you to feel more in control. There are many different therapies such as psychoeducation, which involves working with your health worker to map the history of your mood experiences. Cognitive Behavioral Therapy (CBT) is the process of changing negative thought patterns into positive ones, therefore changing the way we feel and behave in situations. Family therapy is offered to improve understanding for everyone the illness affects, and to help maintain positive relationships under difficult circumstances. Beatingbipolar.org is a fantastic online programme to help people better understand the condition. Researching bipolar can help you to realise that you have an illness which is by no means your fault. ‘Watching ‘The Mental Show’ taught me, how I can present to the world, this has been a kick up the ass because I know I am so much more than my labelled condition.’
8. Finding the best medication for you.
There are different schools of thought about the use of medication to treat mental illness. Research in ongoing and recent breakthroughs are changing the way psychiatrists approach diagnosis and treatment. Lecturer and psychiatrist Joanna Moncrieff, argues that we need to have a greater understanding of the alterations drugs incur on the mind and body. ‘The psychoactive properties of some drugs may be useful in some situations, but they can also be unpleasant and disabling, and this is not recognised widely enough.’
Medication for bipolar can be put into three categories; mood stabilizers, antidepressants and major tranquilisers (neuroleptics). Mood stabilizers are used to increase the period of recovery, but if you suddenly stop using them you can increase the risk of a having a manic episode. It’s important that you are aware of the side-effects when starting any medication, so it is recommended that you do a pro’s and con’s list with your health professional before starting any medication. ‘It is important that I work effectively with the medication, but because I struggle with the side effects I try and manage my anxiety levels through peer support and task setting, volunteering and creating space for others who are also experiencing difficulties.’ Finding the right medication is a long ongoing process and needs to be reviewed regularly. In recovery, it is the choice of the individual as to whether they take medication.
9. Small Steps.
Maintaining recovery can sometimes feel overwhelming. ‘Some days are very negative and despondency takes over and sometimes I just have to let life happen. Taking small steps is better than taking no steps at all, I am encouraged not to try too hard and not to take on too many tasks at once, especially when I am feeling very well, bipolar has shown there is a very fine line and being gentle with myself and giving gratis on good days instead of just beating myself up for my failings on the bad days are also important.’
10. Self-forgiveness and self-care.
Learning to be compassionate about yourself and doing what you enjoy can be a vital part of recovery. ‘Writing poetry and journals, listening to healing frequencies, and selected musical vibes, alongside supported activities, qigong, ping pong, walking my dog, art therapy, three support workers spread over a monthly time scale, empathic friendships, a supportive landlord, all help me to override the dark thoughts. Beginning with self forgiveness through this self reflection is scary but I’m curious for a future without a relapsed section and I am making this my goal.’ There are many online resources to help with self-forgiveness, Kim finds NPA (Non Personal Awareness and EFT (Emotional Freedom Techniques) online courses helpful.