Strengths Based Biopsychosocial Approach to Recovery from Bipolar
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs
Continuing Education (CE) credits can be earned for this presentation at https://allceus.com/member/cart/index/product/id/509/c/
Objectives
– What is bipolar
– What causes bipolar disorder (and how to mitigate it)
– Emotionally (Stress reduction, Anger Mangement, Happiness)
– Mentally (Cognitive Errors and Negativity, Self-Esteem)
– Physically (Exercise, Nutrition, Sleep, Medication)
– Environmentally
– Co-Occurring Conditions (and interventions)
Why I Care/How It Impacts Recovery
– Uncontrolled bipolar disorder puts people at risk for
– Suicide
– Addictions and Addiction Relapse
– Extreme risk taking behavior
– Poorly controlled bipolar disorder can leave people feeling hopeless and helpless
– Well controlled bipolar, like well controlled addictions helps a person feel happy, optimistic, motivated and energized.
What is Bipolar Disorder
– It is a brain a disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.
– Many very successful people have managed their bipolar disorder including
– Mel Gibson
– Demi Lovato
– Axl Rose
– Britney Spears
– Jean-Claude Van Damme
– Mark Vonnegut
– Amy Winehaus
– Lee Thompson Young & Robin Williams were both quite successful and revered in their fields, despite losing the battle with bipolar
What Causes Bipolar Disorder
– What causes bipolar disorder
– Imbalances in neurochemicals, especially dopamine, serotonin and norepinephrine
– Imbalances can be genetic, triggered by sex-hormone changes or stress-hormone changes
– Prevalence
– More than 1 in 50 adults are classified as having bipolar disorder in any 12-month period (2.6% of the adult population)
Understanding Your Bipolar
– Understanding your bipolar
– Symptoms
– Depression
– Feel very sad, down, empty, or hopeless
– Have very little energy
– Have decreased activity levels
– Sleeping changes
– Feel worried and empty
– Have trouble concentrating
– Forget things a lot
– Eat too much or too little
– Feel tired or “slowed down”
Understanding Your Bipolar
– Understanding your bipolar
– Symptoms
– Mania
– Feel very “up,” “high,” or elated
– Have a lot of energy and increased activity levels
– Feel “jumpy” or “wired”
– Have trouble sleeping
– Talk really fast about a lot of different things
– Be agitated, irritable, or “touchy”
– Feel like their thoughts are going very fast
– Think they can do a lot of things at once
– Engage in risky and/or reckless behavior
Understanding Your Bipolar
– Understanding your bipolar
– Symptoms
– Mixed
– Includes symptoms of both manic and depressive symptoms
– Feeling very sad, empty, or hopeless AND
– Feeling extremely energized.
Keeping a Life Chart
– Ideally for 3-6 months
– Chart
– Sleep
– Dietary Habits
– Exercise
– Life stressors
– Hormones (women)
– Bipolar symptoms
Understanding Your Bipolar
– Understanding your bipolar
– Depression
Understanding Your Bipolar
– Understanding your bipolar
– Mania
Understanding Your Bipolar
– Understanding your bipolar
– Warning Signs: Depression
Understanding Your Bipolar
– Understanding your bipolar
– Warning Signs: Mania
Motivation & Treatment Compliance
– Mania
– Benefits of eliminating manic episodes (If I were no longer manic…)
– Emotional
– Mental
– Physical
– Social (Family and Friends)
– Drawbacks to eliminating manic episodes (If I were no longer depressed…)
– Emotional
– Mental
– Physical
– Social (Family and Friends)
Motivation & Treatment Compliance
– Depression
– Benefits of eliminating depression (If I were no longer depressed…)
– Emotional
– Mental
– Physical
– Social (Family and Friends)
– Drawbacks to eliminating depression (If I were no longer depressed…)
– Emotional
– Mental
– Physical
– Social (Family and Friends)
General Techniques for Addressing Bipolar
– How do you deal with it-
– What are you willing to do-
– Remember
– Anything that causes your mind to perceive a threat will result in the fight/anger or flight/anxiety reaction
– Initially CAUSES feelings of anger or fear and secretion of excitatory/stress hormones
– Eventually results in neurochemical imbalances and a feeling of helplessness
– Poor nutrition and inadequate sleep prohibit your body from effectively balancing neurotransmitters and other hormones –> mood issues
General Techniques for Addressing Bipolar
– Emotionally
– Mindfulness
– Prevents episodes from “sneaking up”
– Encourages behaviors to prevent vulnerabilities
– Stress reduction
– Identify and eliminate or mitigate stressors
– Time Management
– Cognitive Processing Therapy
General Techniques…
– Emotionally
– Anger Management
– Identify and understand anger triggers
– Develop a plan for de-escalation
– Begin addressing anger triggers to maintain control of your own energy
– Happiness
– What makes you happy….do more of it
– Schedule a belly laugh every day
– Keep a Good Things/Silver Lining/Gratitude Journal
General Techniques cont…
– Mentally (reduce threats)
– Cognitive Errors
– All or nothing thinking
– Focusing on only the positive or negative
– Using feelings as facts
– Focusing only on a small piece
– Self-Esteem
– View failures as lessons
– Applaud courage and creativity
– Nurture your inner child
General Techniques…
– Physically (Help the body balance itself)
– Exercise
– Increases serotonin
– Reduces stress
– Helps balance hormones and neurochemicals
– May help combat some medication side effects
– Nutrition
– Provides the building blocks for the neurochemicals (quality protein, 3 colors on a salad plate)
– Stay hydrated to keep medication levels stable
– Avoid mindless or comfort eating
General Techniques…
– Physically
– Sleep
– Helps the body repair and rebalance
– Sleep deprivation is known to trigger episodes
– Too much sleep, or sleeping at the wrong times can mess up circadian rhythms
– Keep daytime naps to less than 45 minutes 1x/day
– Medication
– Adjust dosage times to fit your schedule
– Discuss negative side effects with your doctor
– Don’t expect a pill to do everything
General Techniques…
– Interpersonally (reduce isolation, worry, increase feelings of support)
– Support groups
– Chat rooms
– In-the-know family and friends
– Self-awareness of the Jekyl-Hyde syndrome
General Techniques…
– Environmentally
– Essential oil aromatherapy
– Energizing: Peppermint (any of the mints actually), Rosemary, Lemon
– Calming: Lavender, Chamomile, Valerian, Catnip, Bergamot, Rose (Rose-Geranium is less expensive), Frankincense
– Memory Triggering: Ginger, Clove, Cinnamon, Orange, Jasmine
– Visit a store selling essential oils and sniff them to see which ones work for you.
General Techniques…
– Environmentally
– Organization
– Eliminate or manage impulse items
– Car keys
– Credit Cards
– Porn Sites
– Video Games
– Alcohol
– During the day keep it light and bright
Co-Occurring Conditions
– Depression
– Suicidality
– Addictive Behaviors/self-medication
– Mania (Excessive and Impulsive)
– Explosive Anger
– Heightened Libido
– Risk taking
– Legal
– Physical
Summary
– Bipolar is caused by neurochemical imbalances, especially among serotonin, dopamine and norepinephrine
– The symptoms and presentation vary widely
– It is more important to:
– Address each symptom
– Identify warning signs
– Eliminate or mitigate triggers and vulnerabilities
– Treatment compliance is a huge issue because mood stabilizers tend to flatten the highs
Summary
– The most dangerous times for suicidal ideation in people with bipolar disorder are:
– Coming out of a depressive episode
– During a mixed episode
– Ensure people with bipolar disorder have:
– A crisis plan
– People who interact with them daily who are aware of their warning signs and symptoms
– People with co-occurring addictions also need to be aware that a bipolar episode (relapse) can trigger an addiction relapse and vice versa