Harvard Mental Health Letter

In Brief: Advice about living with bipolar disorder

In a memoir about living with bipolar disorder, Dr. Kay Redfield Jamison, a professor of psychiatry at Johns Hopkins University School of Medicine, wrote: "We all build internal sea walls to keep at bay the sadnesses of life and the often overwhelming forces within our minds." Her observation highlights a common challenge faced by people with bipolar disorder: learning how to manage fluctuating symptoms throughout life.

One study provides some practical advice on how to meet this challenge. Researchers at the University of British Columbia and colleagues recruited participants with bipolar disorder through advertisements. During initial phone interviews, the researchers used standard clinical instruments to confirm the diagnosis of bipolar disorder and assess general ability to function (such as working and living independently). The investigators then conducted 60- to 90-minute structured interviews with a final sample of 32 participants classified as high functioning. The participants identified a number of core strategies they used to avoid relapse and remain well:

  • learning about bipolar disorder and educating loved ones, to combat stigma

  • getting sufficient sleep and rest

  • eating and exercising regularly

  • monitoring moods to be alert to early signs of relapse

  • adhering to medications, and increasing dose as necessary

  • practicing yoga, tai chi, or other types of relaxing and meditative practices

  • connecting with others socially

  • having a care plan in place in advance, or relying on a loved one or friend to intervene, when relapse seems imminent.

The investigators found that many participants said they kept trying different combinations of these specific strategies, and learned what helped through trial and error.

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