Bipolar Support Groups.com blog

Meaningful Work and Recovery

Although you will encounter roadblocks and setbacks on the road to recovery, working at something that is meaningful to you can bring you a sense of purpose that will anchor you. Meaningful activity expands your sense of self-worth by adding to your skills and helping you accomplish your personal goals and feel good about yourself. Meaningful activity, which includes school, volunteer work, part-time work and full-time employment, also enables you to meet new people and make friends.
We all need some form of meaningful activity in our lives and a means of supporting ourselves, but having a mental health condition can be an obstacle. Mental health conditions impact different people in various ways. Some people with mental health conditions may never stop working; others find that their condition interrupts their career, and still others may be able to do only limited work. As people recover from a mental health condition, they also face varied challenges in relation to work. Some people with mental health conditions find that they are able, with minor accommodations, to work in the same way they did before. Others may have to re-enter work gradually. And people on disability benefits will need to observe back-to-work rules when employed.
No matter your situation and no matter the hurdles you face, hold on to your goals for yourself and keep striving to incorporate meaningful activity into your life. In the past, people with mental illness were often discouraged from working, but today we understand that work is not only a possibility, but it can also play a vital role in recovery.
It’s true, however, that having a mental health condition can pose some practical barriers to working, such as having breaks in your career, feeling unsure of yourself, or needing to ask for an accommodation such as time for doctors’ appointments. You can figure out strategies to work around these barriers, often with the help of friends, mentors or an employment specialist. Don’t give up!
Supported Employment
Your Work Choices
Work-Related Issues

Supported Employment
Supported employment services assist you in preparing to work, finding and keeping a job and thriving in a work environment. Depending on where you live, you might be offered supported employment help through the local office of your state’s vocational rehabilitation service, through the mental health agency where you get mental health services, or through a nonprofit disability employment agency. Because of local differences, be sure to check with all of these sources. Your state’s Office of Vocational Rehabilitation should be able to help you find supported employment services.
In supported employment, a vocational counselor will help you assess your career interests, job skills, and work challenges. The counselor may suggest job categories that fit your interests, help you write a resume, coach you for interviews, and prepare you for what to expect if you haven’t worked recently. While you will get a lot of help, you will also be expected to work hard on solving problems, planning your career, and looking for jobs. Don’t expect to be handed a job or simply placed in work. The main responsibility will be yours.
The prospect of job hunting can seem daunting, and looking for work is like a job in itself. You need to put in regular hours and keep at it. Perhaps the biggest challenge is getting discouraged. In the competitive marketplace for work, expect to be turned down by many prospective employers before landing a job.
An important source of help that many job hunters in your community use is the local public employment office. These days, such offices are typically called “career one-stop centers”. They offer a wealth of self-help resources on preparing for and finding jobs, computers you can use, and trained staff. Many have a staff person trained as a disability navigator who will understand the challenges you face and guide you to sources of help. Find your state’s network of employment centers here.
Once you find a job, your next challenge is to keep it. Work is rewarding, but it also can be tiring, so be sure to get enough rest and care for yourself. Give yourself time to get used to the demands of working. Above all, it’s critical to use your support system – friends and family, your therapist or case manager and peer support group – so you can talk over your experiences at work and get help if your mental health condition is affected. Be sure to let your doctor know that you are going to work and get help in making any needed adjustments to medications as your situation changes.

Your Work Choices
What comes to mind when you think of a job? Is it working full-time, five days a week? If that prospect feels daunting to you, remember that there are other work choices to choose from. One of them might be more suited to your current abilities and stamina, and might be easier to find than full-time work.

Volunteer Work
While many people want to have a paying job, volunteer work is another form of meaningful activity for many people with mental health conditions. Some people use volunteer work as a stepping stone to paid employment; volunteering can help them re-learn skills and grow comfortable working with other people. Others decide to volunteer instead of work. Volunteering not only gives you a sense of pride, but it can make you feel good about yourself to help out in the community.
If you have a cause that you feel passionately about, you may already know where you want to volunteer. Most organizations that have a lot of volunteers will have a coordinator who can help bring you on board. To find volunteer opportunities, you can contact your city or county information line for the contact information for a coordinator. You can also look for “Volunteer Clearinghouse” or “Volunteer Center” in a phone book. The Internet can be a great tool to search for volunteer opportunities; try visiting http://www.volunteermatch.org/ or http://www.1-800-volunteer.org/.
Remember that just because you don’t receive a wage as a volunteer doesn’t mean you aren’t entitled to fair treatment and respect. You should feel safe and comfortable in your work environment, and people should treat you like a human being.

Internships
When most people think of internships, they think of college students working for free for credit. Internships aren’t actually student specific; they are a blend of education and work. An internship usually involves a close relationship with other staff at a business working on specific projects and tasks. Where a volunteer might answer phones or bring food to homeless people, an intern might help a program staff member develop strategies to bring the food to the homeless. Sometimes the line between intern and volunteer can be blurred. Some internships will offer an hourly wage or a paid stipend, although such internships can be highly competitive. If you are a full-time college student, ask your career office whether they participate in the U.S. Department of Labor’s Workforce Recruitment Program. Recruiters interview college students with disabilities early in the year for summer intern positions.
If you are interested in an internship, make sure you ask your employer at the interview about the specific tasks and projects you will work on. You should expect to spend some of your time doing administrative work like filing, but you should also get a sense of a real opportunity to learn on the job.

Temporary Employment
Temporary employment can be a good bridge to permanent work. You register with a temp agency that can then place you in short-term assignments in companies that need extra help. These assignments could last from a few days to several months and can sometimes lead to an offer of permanent work. By temping, you establish a current resume, sharpen your skills and test your own ability to return to work.

Part-Time Employment
Some people use part-time employment (working less than 35-40 hours a week) to transition to full-time employment; other people find that they prefer working part-time to working full-time permanently. Part-time employment can give you more free time to take care of yourself and your responsibilities. It may be more accommodating if you find that you need more time away from the office to handle your mental health condition. However, part-time employment usually pays less than full-time employment, and part-time work often comes without benefits.

Full-time Employment
Many people with mental health conditions are able to work full-time. Full-time employment usually includes sick leave and may include health insurance, making it easier to handle health problems. Company retirement plans for full-time employees enable you to grow your savings. You may want to look for government work, as local, state and federal employers have a good record of hiring diversity and respecting disability regulations.
Finding employment, whether full-time or part-time, usually involves preparing your own resume and job-hunting in your local employment market. Job hunting can be discouraging for anyone, especially if job openings are scarce and there is a lot of competition. If you are having a hard time finding a job, you can look for help from an employment agency, supported employment services or close family members or friends. It is important to have support while job hunting; seek it from friends, from a job-hunting club, a support group, or a peer-run drop-in center.

Self-Employment
Some people are not interested in traditional employment-working for someone else-but are able to work for themselves. You might want to start and grow your own business. Do you have a product or service that you can sell? Do you have a hobby or skill like jewelry making, baking, or playing and instrument? Can you provide a service such as lawn mowing, pet-sitting, or writing and editing?
Working for yourself enables you to set your own schedule, and avoids the problem of disclosing your condition that sometimes arises in the workplace. On the other hand, it demands self-discipline and for tax purposes, you need to track your expenses and income.
To prepare yourself, develop a simple business plan that outlines what you plan to sell, your customers, your competition, and your expenses. You can get help with starting your own business from local offices of the Small Business Administration, your county or state economic development office or craft guilds and associations. Also, be sure to contact your state’s vocational rehabilitation office for help with self-employment.
The Abilities Fund (http://www.abilitiesfund.org/index.php) is an organization that provides assistance to people with disabilities interested in self-employment and entrepreneurship.

Common Work-Related Issues

How will working affect my government benefits?
If you have a mental health condition, you may receive Social Security or other government-funded disability benefits, or private disability benefits from a previous employer. While disability benefits typically pay below a wage you would expect to get while working, they provide regular income. Additionally, if you are on disability and/or below the poverty line, you may receive health care through Medicaid or Medicare. Remember, too, that eligibility for housing programs and the rent you pay may be affected by your income.
Having a paying job or earning other types of income can affect your status in Medicaid or Medicare. This does not mean you should be afraid to work, it means it is important to understand the rules before you work. While the interaction between Medicaid and Medicare can be complicated, under either program, you can earn a certain amount of money without losing your benefits.
Because everyone’s situation is different, you should always talk to a trusted and knowledgeable person who can help you understand your work options and how your choices will affect your benefits. A good starting place is reading about Social Security Administration work incentives and reading the SSA manual called the Red Book. Contact your Social Security office, local Center for Independent Living or Office of Vocational Rehabilitation to find people with special training to help you understand how the rules apply to you. Case managers at your mental health center also may be able to help.
The Social Security Administration sponsors a program called Ticket to Work. Ticket to Work is a voluntary and free program where people with disabilities receiving social security are helped to go back to work by a local employment network. For information call 1-866-968-7842.

What are some things to watch out for?
If you haven’t worked in a while, here are some things you need to pay attention to:
Look out for advertisements that promise large sums of money for small amounts of work, such as making $2,000 a week while learning to buy and re-sell houses or making $3,000 a week sitting at home using your computer. Very few, if any, people make money doing these activities, and it may end up being harmful.
•The possibility of working from home may be very appealing to you. Be sure to look into such opportunities very carefully to be sure they are legitimate.
•When you work, your employer must withhold payroll taxes and Social Security tax. Beware of people who don’t ask you to fill out any tax forms or take taxes out of your paycheck. You can get in legal trouble if you don’t pay required taxes, and it might keep you from receiving government benefits.
•If you receive Social Security disability benefits, you must report your income regularly. Keep original pay stubs as proof of your earnings in case questions arise.

What are some other things I might need while looking for a job?
Documents – When you apply for a job, you will need certain documents to verify your identity and your right to work in the United States. A U.S. passport usually satisfies all requirements, but if you don’t have a passport, you will need other forms of ID, including a state-issued picture ID, a social security card or a birth certificate. If you don’t have a driver’s license, your state’s Department of Motor Vehicles (DMV) office can still issue you a walker’s ID.
E-mail, phone and permanent address – If you’re moving around frequently or staying with friends, you will still want an e-mail address, phone number and a permanent address that you can check regularly for your work. A cell-phone enables employers to contact you quickly. If you visit family and friends and trust them, ask if you can use their address temporarily. Otherwise, you might want to consider getting a P.O. Box from a local post office. You can get a free e-mail address from Yahoo, Google g-mail, MSN and other sources.
Transportation – You might also encounter a problem with transportation. If you do not have a car, you should always ask the places you’re interested in working for if they are accessible by public transportation.

How do I explain the gaps in my employment history?
If you have been out of work or changed jobs frequently because of your mental health condition, your resume may reflect that.
Highlight your skills first. Most people are used to a chronological resume, which shows the jobs you worked with your most recent job first. A functional resume displays your list of skills and qualifications before it shows a chronological breakdown of where and when you worked. Stress your skills, abilities and expertise first.
Be honest. One of the worst things you can do is lie in an interview or on a resume. If your employer finds out that you lied in the hiring process, he or she can usually fire you and leave you with no unemployment benefits.
Be prepared. Know what you’re going to say if or when your employer asks you why there is a gap in your employment. You do not have to disclose information about your condition during job interviews or when you are first employed.

How will my mental health condition affect my job?
If you’re already working when you are diagnosed with a mental health condition, you may be worried about the effect it will have on your employment. You may wonder how it will be possible to manage your condition and balance your work, or you may worry if you can even keep your job. Many people with mental health conditions lead very fulfilling lives, and work can be a big part of that life.
If your mental health condition affects your ability to work, you may need to ask for a reasonable accommodation under the Americans with Disabilities Act of 1990 (ADA). The Act requires that many employers make reasonable accommodations for employees with disabilities. A disability is legally defined as a physical or mental impairment that substantially limits one or more of the major life activities of a person, or a history or appearance of such impairment. You may have a disability as a result of your mental health condition.
It is illegal to discriminate against an employee in the workplace based on a disability if a reasonable accommodation can be made. However, an employer doesn’t have to make an accommodation if it would cause an undue burden-financial, administrative or otherwise-to the company. Asking your employer if you can take two small breaks instead of one large lunch break might be considered reasonable if it doesn’t interfere with your ability to help customers. Asking an employer to build you a soundproof quiet space if you work at a train station might not be considered reasonable. Some small organizations may also be exempt from ADA requirements based on their size.
Plan ahead before you bring up the subject of disability and reasonable accommodations. Make sure that you know what elements of your disability are interfering with what parts of your job and what specific steps you can take to address those concerns. Don’t assume that because the ADA is the law that your employer will be familiar with its requirements or receptive. Put your request in terms of help you need to keep doing a job for the employer, rather than a demand for an accommodation. It can be helpful to talk about your request with people who support you to get feedback and make you feel more comfortable. For free support, contact the Job Accommodation Network at 1-800-526-7234 or visit http://www.jan.wvu.edu/.

What if I’m uncomfortable in the workplace?
Despite efforts to educate the public about mental health and mental health conditions, you may still encounter prejudice from people who don’t know or understand what you are going through. If you think that your employer has illegally discriminated against you or violated your privacy rights because of your mental health condition, you should ask for help.
However, you might feel uncomfortable in your workplace even if your employer hasn’t done anything illegal. Maybe your co-workers are judgmental; maybe your work doesn’t offer enough benefits for someone with your condition. Or maybe, you are feeling self-conscious or awkward in a new situation.
Give yourself time to get accustomed to work and the people you work with. Be friendly, but use discretion in how much personal information, such as information about your condition, you share with others. Remember that the primary relationship at work is with your supervisor; listen carefully to what your boss asks of you, and ask for guidance when you need help or are unsure. Get feedback on the things disturbing you at work by talking with trusted friends or a support group outside of work.
You can suggest that your employer take steps to make your workplace more mental health friendly. Send your suggestions to your human resources department or your management team; many offices will have an anonymous suggestion box. Others might have a reward system in place for offering good suggestions.

What are the qualities of a mental health friendly employer?
A mental health friendly employer might have some or all of the qualities below:
•A Good Track Record – Employers who treat their employees with dignity and respect earn a good reputation. Ask people you know about any positive experiences they may have had with particular businesses that were especially accommodating. Ask your treatment team if they can recommend any local employers that stand out.
•Flexible Time and Scheduling – Businesses that allow employees to work outside of the typical hours of 9-5 have shown that they can balance worker and workplace needs to make employees more comfortable.
•Telecommuting and Part-Time – Employers who allow employees to telecommute and work from home on some or all days or allow people to work part time may be more accommodating.
•Time-off Benefits – You may want to consider an employer who offers a lot of sick and/or vacation leave or the ability to take “leave without pay.”
•Employee Assistance Program – An Employee Assistance Program (EAP) is a benefit that an employer provides where anyone who needs help can talk about his or her problems, confidentially by phone or in person. Some visits may be limited.
•Mental Health Benefits in a Health Plan – You can ask to see what kind of benefits an employer’s health plan includes. There may be different payment structures for mental or general health, depending on your employer’s size. You also might want to make sure that your mental health condition is covered and understand the process for mental health visits (if the plan restricts medication management or therapy).
•Short-Term and Long-Term Disability Plans – Short-term and Long-term disability can provide you 60% of your salary (including short-term disability) if a doctor decides you are too disabled to work. Some disability plans may also cover mental health conditions.

“BIPOLAR SYMPTOMS”

So much information about the symptoms of bipolar disorder (manic depressive illness) is confusing, misleading, or contradictory.
Symptoms of bipolar often get misinterpreted, leaving the real problems of bipolar disorder unaddressed.
There is still a shortage of accurate and reliable information about bipolar disorder symptoms, despite much interest.
There is no point working hard to overcome clinical depression if the REAL problem is bipolar disorder!
Traditionally bipolar disorder symptoms were framed in terms of mood swings.
However, today bipolar disorder symptoms are often framed in much broader terms.
One of the biggest difficulties is in distinguishing bipolar from major depression.
As well as confusing bipolar and severe depression, another common misdiagnosis is to mistake borderline personality disorder for bipolar disorder.
Also, bipolar symptoms are easy to confuse with other disorders such as ADHD, or physical problems such as thyroid disorder.
Discover the real symptoms of bipolar disorder. Don’t be one of the misinformed crowd who confuses bipolar with other illnesses and personality problems.
In some ways “bipolar” was easier to understand back when it was commonly known as “manic-depressive illness”.
This is because bipolar is all about mood swings. These are mood changes that are more extreme and pronounced then the usual ups and downs we all experience from day to day.

Symptoms of bipolar disorder: from National Institute of Mental Health (NIMH)

How extreme do these mood swings have to be? Psychiatrists use their professional handbook, the “Diagnostic and Statistical Manual of Mental Disorders” (DSM) in order to diagnose if mood swings are serious enough to be symptoms of bipolar disorder.

In America there is a precise, clinicalbipolar disorder definition.We will follow these official, professional definitions below:

Bipolar depression symptoms
Depression involves feelings of sadness and emptiness or a loss of pleasure or interest in things. These feelings last most of the day, on most days for at least 2 weeks. These symptoms are severe enough to impact negatively on work, relationships and everyday life.

Learn about medication for treating bipolar depression symptoms

Bipolar symptoms of depression

Bipolar depression symptoms include:
1. Feeling sadness or emptiness.
2. Losing interest or pleasure in one’s usual enjoyments.
3. Changes in appetite (up OR down), and/or substantial and unplanned loss of weigh or weight gain.
4. Insomnia.
5. Excessive tiredness or sleepiness, and/or lack of energy.
6. Restlessness and agitation.
7. Reduced sex drive.
8. Lack of motivation.
9. Feeing worthless.
10. Feeling guilty about things you are not responsible for.
11. Indecision.
12. “Fuzzy” thinking, problems concentrating, or memory loss.
13. Thoughts of self harm or suicide.
14. Hallucinations.
15. Delusions.

Bipolar symptoms of mania
The word “manic” is often thrown around quite casually, but for genuine bipolar symptoms, mania must have some very definite characteristics. Specifically, to meet a diagnosis of mania, the mood changes must last for at least a week, or be so severe that hospitalization is required. These bipolar disorder symptoms cause significant disturbance to work, relationships and daily life.
Symptoms of bipolar mania include:

Bipolar symptoms of mania
1. Exaggerated high opinion of oneself.
2. Beliefs that one has great talents or gifts that extend beyond reality.
3. Hallucinations.
4. Reduced need for sleep.
5. Talking more than usual.
6. Pressure to keep talking.
7. Skipping from one idea to the next so there is a fragmented flow of thought.
8. Racing thoughts.
9. Easily distracted but some short periods of very focused attention.
10. Feeling restless and agitated, for example finding it hard to sit still.
11. Increase in goal directed activities, related to social, work, school, or sexual pursuits.
12. Excessive engagement in pleasurable activities without thought to their distressing consequences, such as big spending sprees,gambling, sexual indiscretions,poor business investments.

Symptoms of hypomania
Hypomania is a milder form of mania, and may result in a diagnosis of Bipolar Type II or “soft” bipolar.
The symptoms of bipolar mania and hypomania are the same – what is different is the DURATION and INTENSITY of the bipolar symptoms.
In hypomania, the symptoms must last for at least 4 days and are not serious enough to require hospitalization.
See this description of major bipolar disorder symptoms from a leading bipolar research institute.
And remember, bipolar symptoms are all about mood swings – there must have been BOTH depression AND mania/hypomania.

SEXUAL ISSUES are amongst the most common, but least discussed symptoms:
“A very common symptom in maniacal conditions is erotic excitement. This varies from mere coquetry, an extended application of the command “love one another”, an undue attention to the opposite sex, up to extreme salacity, when the mind is wholly occupied by urgent sexual appetite, and all restraint abandoned.” – DANIEL HACK TUKE (1827-1895)
Sometimes we need to consider outward manifestation of bipolar as well as a sufferer’s own subjective, internal states.
Regardless of what someone may report their mental and emotional state to be, valuable insight into their symptoms can be gained if you know some basic information about Bipolar Behavior.(HINT: PLEASE do read about this and do not base your image of bipolar symptoms on what you have read about Charlie Sheen.)

Cognitive bipolar symptoms

Bipolar symptoms may include cognitive problems.

This is a tricky area because sometimes cognitive problems such as “fuzzy thinking” or memory loss are due to the side effects of bipolar medications.
Also, many people with bipolar disorder are very gifted and often believe that mania, or at least hypomania, enhances their abilities.
However, there is also evidence to suggest that with bipolar, cognitive problems can be a pretty typical symptom.
This may be anything from being easily distracted, to mental fogginess, memory problems, or becoming easily confused.
The evidence about cognitive bipolar symptoms can be conflicting. For example, one study observed poor performance in all groups of bipolar people when compared to “healthy” subjects with tasks such as verbal recall and executive functioning.
Other research has shown that once stable, folks with bipolar do not show cognitive impairment.
Also, rather than having harmful cognitive effects, some bipolar medications such as lithium have neuro-protective properties and can help the brain regenerate grey matter and protect against problems such as memory loss.

Physical effects and symptoms of bipolar
Sometimes bipolar symptoms are caused, aggravated, or exacerbated by other underlying medical conditions such as thyroid problems.
Also, people with bipolar disorder are twice as likely to die prematurely from medical conditions such as heart disease and stroke than are members of the general population.
Even scarier, they are three times more likely to develop diabetes, and some diabetes symptoms look like bipolar. Discover how to overcome these with symptoms with THE BIPOLAR DIET.

Signs of bipolar depression
Signs of bipolar depression are more varied than you may expect.
Actually one of the critical ways bipolar depression can be distinguished from unipolar depression is this variability in the symptoms of depression – bipolar depression symptoms are varied, whereas unipolar depression is more predictable.

A summary of the existing research indicates you could be looking at bipolar depression if there is:
1. Substance abuse also present.
2. Abnormally irritable or hostile (or both).
3. Psychosis of any kind.
4. More changes in mood so that the person appears more emotionally unstable.
5. Symptoms are different from episode to episode for any one particular individual, and symptoms are more varied on the whole.

On the other hand, you are more likely dealing with unipolar (“Ordinary” or “Classic”) depression if there are:
1. Physical symptoms such as unexplained pains or heightened sensitivity to pain.
2. Anorexia and/or appetite loss and/or weight loss.
3. Anxiety and agitation.
4. Insomnia.
5. Less variability in symptoms. Tends more towards the stereotypical cliche of a depressed person.

Also, there are COGNITIVE symptoms of bipolar depression that many people (including clinicians) are NOT well informed about.
By “cognitive symptoms” I mean those things that show some problems with what we usually consider normal day to day thought processes. Examples would be functions such as:

1. Concentration
2. Judgment
3. Memory
4. Comprehension, and
5. Capacity for abstract thinking.

Cognitive difficulties are increasingly recognized and researched as bipolar depression symptoms.
If the topic of cognitive problems in bipolar depression interests you, see our page on “Bipolar Memory Loss”.

Learn more about bipolar depression.

Bipolar 2 depression
Is there a difference between Bipolar 2 depression versus “classic” Bipolar 1 depression?
Traditionally we distinguish Bipolar Type 1 from Bipolar Type 2 according to the presence or absence of mania OR the intensity of any manic episodes.

Learn more about Bipolar Type 2
However, all this focus on mania may not give us the full picture of bipolar symptoms.
It seems there are differences in how depression is experienced in Bipolar Type I versus Bipolar Type II.

Bipolar depression symptoms can lead to suicide attempts.

In Bipolar Type II:
1. Sufferers are more likely to be women.
2. Episodes of depression are less severe but are more frequent and last longer.
3. In Bipolar Type II depression, the accompanying conditions are more likely to be substance abuse and/or anxiety, but Bipolar Type I is more likely to be co-morbid with psychosis and hospitalizations.
NO NOT MAKE THE MISTAKE OF THINKING THAT DEPRESSION IN BIPOLAR TYPE II IS LESS IMPORTANT OR DANGEROUS. RESEARCH SHOWS MORE SUICIDE ATTEMPTS AMONGST THOSE WITH BIPOLAR TYPE II DEPRESSION.
In summary, specific bipolar depression treatments are needed in order to successfully overcome bipolar depression symptoms. Bipolar depression differs from other causes of depression such as postnatal depression or “regular”, “unipolar”, or “classic” depression. In particular bipolar depression does not exist in isolation from other bipolar symptoms such as switches into bipolar mania.
(Anyone who wants to learn more about bipolar depression symptoms should read Manic-Depressive Illness: Bipolar Disorder and Recurrent Depression, 2nd edition, by Goodwin and Jamison – the most authoritative text book on bipolar and depression and the main source of the information reported here.)

So is it depression or bipolar?
The wrong diagnosis may lead to disaster. Is it depression or bipolar?
The short answer is that the difference between the two lies in the presence or absence of mania.
For the person who is suffering, their subjective experience will feel a lot the same. And it will suck!
A “regular” depression and a bipolar depression may feel the same on the inside:

It is dangerous to confuse bipolar depression symtoms with

1. Feelings of hopelessness or worthlessness
2. Lethargy or outright exhaustion
3. No interest in the people, activities and things that once mattered most
4. Changes in appetite, sleep and concentration
5. Zero interest in sex and/or no confidence in one’s own sexual appeal
6. Social withdrawal
7. Sometimes feeling weepy or outright crying jags
8. Sometimes decline in personal grooming or hygiene
9. In extreme cases, an inability to keep getting up and going to work or school, or even get out of bed.

Is mania present or not? With mania = bipolar! Without mania = depression!
Bipolar disorder is characterized by the presence of major depression, AS WELL AS episodes of mania that last for at least one week.
So what is mania anyway? The tricky part is that mania can take different forms.
Sometimes it can be feeling euphoric or expansive. A manic episode may lead a person to feel highly energized, on top of the world, or like they can do anything (feelings of grandiosity).

A manic person may:
1. Need little or no sleep
2. Become very talkative
3. Become very uninhibited
4. Have racing thoughts
5. Engage in reckless or impulsive behavior like excessive spending where they waste cash or run up credit cards, or be very sexually active (in contrast with usual attitudes and behaviors about sex).

To satisfy the clinical criteria, the manic episode must negatively effect the person’s life.
However, some manic episodes go undiagnosed because the signs overlap with certain symptoms of depression or other conditions, and do not fit into the old time stereotype of the manic-depressive.

For example, instead of seeming euphoric or energized, the manic person may be extremely irritable, disorganized or anxious.

Bipolar or depressed? Discover commonly overlooked clues.
Differentiating depression from bipolar depression symptoms matters a lot because of the difference in treatment options.
You can check for unipolar depression using a reputable online depression test. For example, the Beck Depression Inventory Test.

Some of the most effective treatments for depression are medications such as SSRIs like Lexapro, Prozac and Zoloft.
The issues are complex and still being debated, but it seems that at least sometimes, these medications can trigger mania in a person with bipolar depression symptoms and make their condition much worse.
The most effective treatments for bipolar are different to the more commonly prescribed SSRIs and include mood stabilizers such as lithium

Am I bipolar? Am I showing bipolar symptoms?
There are many reasons for asking this question. Some common ones include:

1. You may have taken a bipolar test.
2. You may have learned about major bipolar symptoms such as pronounced mood swings and identified with the picture, thinking “this is me”.
3. You may have read some information on bipolar disorder and be worried about your seemingly “bipolar” behavior.
4. You may have done a bipolar self test, for example an online bipolar test, and “tested positive” for bipolar symptoms or signs of bipolar disorder.
5. You may have been labeled “bipolar” by someone else.
6. You may identify with one or more of the many famous people with bipolar disorder, again thinking “this is me” or “this explains everything”.
7. You may have been diagnosed with bipolar disorder by a psychiatrist, your family doctor, or some other expert.
8. You may have received some other diagnosis, for example depression, ADHD or borderline personality disorder and be finding that your medication and other treatment is not helping.

Don’t get over-invested in the diagnosis and don’t fall into the trap of “am I bipolar” as the current great existential question.
Am I bipolar is not a matter of existential angst, or a fashion choice. It is a health issue and the best thing you can do is:
1. Educate yourself with objective and high quality information on bipolar disorder and symptoms.

2. See a psychiatrist who is board certified in the area and who has considerable expertise in the diagnosis of bipolar symptoms and the treatment of mood disorders.
3. Educate yourself on the differences between unipolar depression and Bipolar Depression.
Make sure you rely on information from trusted sources such as this U.S. National Library of Medicine overview of bipolar disorder.

Bipolar disorder self test

Anyone asking “am I bipolar” can easily do a Bipolar Disorder Quiz to check their bipolar symptoms.
Any preconceived notions you have about bipolar symptoms and your diagnosis will distort the results. This is why the checklist approach, in combination with self-reporting, can never yield a result that does not require further confirmation.
There is no physical bipolar test, such as a blood test for bipolar. Also, there is no genetic testing.In other words, You cannot take a definitive, objective bipolar test.

Moving beyond the bipolar test
Please do not think I am dismissing bipolar tests, especially the well established tests compiled by reputable experts and confirmed through rigorous empirical scientific method.
I actually have several of these on this Bipolar Lives website, and encourage anyone who has ever asked “Am I bipolar?”, or who suspects a mood disorder in someone close to them, to take at least one, and probably two or three.
However, at the end of the day these are still just checklists based on self-reporting. They are guidelines, not definitive info on bipolar disorder in you or anyone else.

Bipolar Disorder or Bipolar Syndrome

Anyone who scores positive on such a test needs to consult with an expert immediately. Preferably this would be a board certified expert psychiatrist with extensive experience in bipolar and other mood disorders.
One reason for this is to get treatment, such as a prescription for a mood stabilizing medication.
However, getting medication is a secondary reason.
The main reason is to CONFIRM THE DIAGNOSIS!
A skilled clinician will do much more than administer a paper and pencil checklist. As well as tests just like the bipolar tests we have just looked at, there needs to be a conversation.
Only an expert has have enough experiential info on bipolar to recognize genuine bipolar symptoms.
This will involve various techniques and elements, depending on the doctor. All of them will probably ask about family history and your family members as bipolar disorder has a strong genetic component. EVERY expert should ask you about POSSIBLE, as well as diagnosed, bipolar family members.

Many professionals may ask you to bring along a trusted third person who knows you very well and over a long period of time. This helps to confirm certain bipolar symptoms, to fill in blanks, help you remember important info on bipolar from your Dr, and to help you by providing further perspective.
Another important technique in diagnosisng Bipolar is the Life Chart. Having the trusted third person present can be most useful in creating the Life Chart. This chart is a diagram that starts at birth and records significant life events alongside a mood scale. In this way it is possible to get an overall picture of both mood episodes and other bipolar symptoms, and possible triggers for episodes of depression and mania.

Also, certain physical tests are required. Lab work and other tests will be needed to rule out diseases such as thyroid conditions, diabetes, Lyme disease, and quite a few others.
My own bipolar diagnosis happened through pure chance. My psychiatrist and I both believed I had major depression and also acute anxiety. In passing I mentioned some shopping I had done on the weekend. When my shrink discovered that I had spend over $5,000 (I was a full time grad student at the time and should have been living frugally) on exquisite European furniture for my crappy one bedroom student housing, there was a diagnostic breakthrough.
This kind of irrational spending spree is a classic symptom of mania. It didn’t take long to uncover many other manic episodes and my diagnosis was finally accurate and helpful. I have never looked back!

Bipolar behavior

There are many dimensions to “being bipolar” and pop culture does not convey enough accurate info on bipolar for us to understand genuine bipolar symptoms.
(The correct or PC term is actually “a person living with bipolar disorder, or the more traditional “a person living with manic depressive illness”.)
First and foremost there are bipolar feelings and moods – and of course mood swings.
There are also what we could call “bipolar thoughts”.
And as those of us who have lived with bipolar for a while know, there is that pesky (sometimes ruinous) bipolar behavior.
A reliable diagnosis requires a very careful balance of examining all three of feelings, thoughts, and bipolar behavior.
Although there is an inner experience of mood that is possibly the ultimate arbiter of “Am I Bipolar?”, focusing to some extent on potential bipolar behavior is inevitable because this is what is measurable and observable to other people – and what will create serious and destructive real world consequences if not addressed.
The main danger of misdiagnosis arises because bipolar behavior can closely resemble other mental health conditions, for example the ADHD and Bipolar connection.

3. Borderline Personality Disorder.
Researchers at Rhode Island discovered that many patients diagnosed as bipolar actually had borderline personality disorder instead. In fact, it appears to be becoming one of the most common misdiagnosis traps.
How to tell? Bipolar disorder is episodic, whereas borderline personality is a more pervasive and constant state.
After beginning treatment, Am I Bipolar? will answer itself in that if mood stabilizers make you “better”, (remove bipolar symptoms) then it is probably the underlying condition.
However, consider that if the traditional bipolar disorder treatment of mood stabilizers does not help, then maybe the answer to Am I Bipolar? is a possible “no”.
Also don’t lose sight of the fact that there are two aspects of bipolar disorder signs and symptoms – the INTERNAL mood states you experience as your bipolar symptoms and the observable SIGNS of bipolar – the external behavior that is displayed by your actions.
You need to track both with a mood chart and discuss BOTH with a medical expert to properly answer “Am I bipolar?”

Bipolar disorder quiz
You cannot answer “AM I BIPOLAR” if you do not have a basic knowledge bipolar disorder and what it involves.

http://www.bipolar4lifesupport.co

SUPPORT FROM OTHERS:

Your friend gets your joke. Your co-worker offers congrats. Your spouse hugs you hello. They are all helping you bust stress and boost well-being. In fact, Mental Health America found that 71 percent of people surveyed turned to friends or family in times of stress.
Humans are social animals: We crave feeling supported, valued and connected.
Research points to the benefits of social connection:
• Increased happiness. In one compelling study, a key difference between very happy people and less-happy people was good relationships.
•Better health. Loneliness was associated with a higher risk of high blood pressure in a recent study of older people.
•A longer life. People with strong social and community ties were two to three times less likely to die during a 9-year study.
Sometimes connection is a heart-to-heart, spill-it-all-out talk. But sometimes it’s just a laugh-out-loud e-mail.

Creating Connections
Connection happens when you get:
•concrete help, such as having a friend pick your kids up from school
•emotional support, like hearing someone say, “I’m really sorry you’re having such a tough time”
•perspective, like being reminded that even the moodiest teenagers grow up
•advice, such as a suggestion to plan a weekly date with your wife
•validation, like learning that other folks love reading train schedules too

Do You Have Enough Support?
One author called her support network her “pit crew,” the people she could rely on to rev her up. Ask yourself if you have at least a few friends or family members who:
•feel comfortable to be with
•give you a sense you could tell them anything
•can help you solve problems
•make you feel valued
•take your concerns seriously

Making Friends
If you feel your current connections don’t provide enough support, you can take steps to form new ones. Consider these suggestions:
•Enroll in a class that intrigues you. You’ll know your classmates already share a common interest (and if you don’t meet anyone, at least you’ll have boosted your brain).
•Join a book group, hiking club or other group. If you want to make your entry smoother, consider contacting the group’s leader in advance.
•Volunteer. Working together builds bonds, and helping others has its own rewards.
•Reach out—a lot. Especially if you’re in a completely new situation, like starting college, you may need to meet lots of people before finding some that suit you.
If extreme shyness or anxiety prevents you from making friends, working with a therapist might help.

Strengthening Your Relationships
If you want to get more out of the relationships you have, consider these steps:
•Make a list of the people you want to contact regularly. If necessary, add a reminder to your calendar.
•Commit to a certain amount of time together each day or week—without pagers, iPods or other distracting contraptions.
•Listen really well. Repeat what you heard to make sure you understood.
•Ask for specific kinds of help. Even the best of friends can’t read your mind.
•Show how much you respect, support and appreciate your friends and family. You may think positive thoughts, but sharing them works wonders.
•Move out of relationships that make you feel unsafe, lower your self-esteem or draw you into unhealthy habits, like abusing drugs.
If you’re in a troubled relationship, it pays to work on it. Experts say a bad relationship can hurt you even more than a good one can help you. If your relationship is rocky, here are some suggestions:
•Take responsibility for your part in the problem
•Stay constructive and propose solutions
•Consider how you might feel if you were the other person
•Try to focus on what you value about the other person
If disagreements get intense, remember to fight fair. Researcher John Gottman, PhD, who has predicted with amazing accuracy which couples will divorce, says your fighting style really matters. Consider two great ways to reduce the heat:
•Avoid over-generalizing. Beware of statements like, “You never pay attention to me.” Instead, make specific requests like, “Could we spend an hour together soon?”
•Avoid finger-pointing. Instead of blaming the other person, focus on how you feel with an “I” statement such as, “I feel upset when you come home and just read the newspaper.”
When appropriate, try to forgive—for your own sake. Research shows that forgiving reduces tension, depression and anxiety. Of course, letting go can be tough. Try to:
•think about what stresses might have contributed to the other person’s behavior
•contemplate what’s good about that person
•ask for an apology if that would help
•remember that forgiving doesn’t mean you’re saying the behavior was acceptable
If you’re having trouble expressing your needs or getting them met, consider individual or couples Therapy.

Getting Support from a Group
If you’re facing a particular stress, like a serious illness, you may want to get additional support beyond what your friends and family can offer. Support groups can provide:
•concrete suggestions and information about the issue
•people who can empathize with how you are feeling
•a reminder that you’re not alone
•inspiration from seeing others coping well
You’ll likely benefit most from attending a group in person since hearing someone’s voice and seeing the look on a person’s face can really deepen connection, but if there’s no group in your area, consider online support or discussion groups.

perfect place to connect with others http://www.bipolar4lifesupport.co

EXERCISE HELPS:

How Exercise Helps:

The dusty tennis shoes. The gym membership that mostly exercises your wallet. The jump rope coiled at the back of the closet. Lots of us have proof that it can be tough to stick with exercising. Pump up your resolve by considering that exercise can:
•prevent heart disease and high blood pressure
•lower your risk for stroke, osteoporosis, colon cancer and diabetes
• improve your sleep
•increase your energy
•decrease some kinds of pain
•boost your immune system
•help with weight management
Exercise matters for your mood too. Millions of people have found it:
•decreases stress, anger and tension
•reduces anxiety and depression
•offers a greater sense of well-being
It’s not clear exactly how exercise boosts mood, but experts say it:
•relieves pent-up muscle tension
•stimulates feel-good hormones
•burns off stress hormones
•increases blood flow to the brain

Sweating: The Details
Sure, lots of us would rather serve cookies than tennis balls and would rather channel-surf than surf. But some tips can make exercising easier. For one, you don’t have to join a glitzy gym: Lots of city recreation departments, senior centers and YMCAs have great equipment and fun classes (salsa dancing, anyone?) at reasonable rates. Also find out if you can hit the track at your local high school.
Here’s some more helpful information to strengthen your ability to exercise:

How Much Exercise Do You Need?
For your overall health, the American Heart Association recommends
•at least 30 minutes of moderate aerobic activity (think walking or a leisurely bike ride) five days a week PLUS strength training twice a week.

OR
•at least 20 minutes of vigorous aerobic activity (like jogging or a challenging bike ride) three days a week PLUS strength training twice a week.
The Centers for Disease Control offers more detailed guidelines.
A little twist on the rules: Though 20- or 30-minute sessions may be ideal for health and mood, experts say that you can get plenty of benefit from exercising in just 10-minute spurts too.
For your mood, aim for 30 to 60 minutes of aerobic exercise or a combination of aerobic exercise and muscle-strengthening three to five days a week. Some research shows that even lower levels of activity may offer mental health benefits, according to the U.S. Department of Health and Human Services.

Exercise Essentials
•Before starting to exercise, it might be a good idea to check with your doctor if you haven’t been active in awhile. Also, you’ll likely need to build up slowly. The first week you might try walking on two days for 15 minutes each. Then you can gradually increase the number of days and minutes per session over a few weeks.
•Ready, set, don’t go until you gently warm up your body. Starting slowly gives your muscles and joints a chance to loosen, which prevents injuries. Around five or 10 minutes of warm-up usually is enough.
•Go, but as you work out, remember moderation. Don’t push yourself to the point of pain, dizziness or shortness of breath.
•Cool down by moving more slowly for around five or 10 minutes to bring your heart rate and body temperature back to normal.
•Stretch to relax the muscles you’ve taxed. Don’t force past the point of tension and don’t bounce. Check out some model stretches.
•Drink water before, during and after a workout. If you wait until you’re thirsty, you’re already getting dehydrated.

Squeezing in Some Exercise
No time for a major workout? Just break your exercise into 10-minute chunks-and break up some blah parts of your day too. Try
•really running errands: Walk a bit faster or further in the parking lot when you stop at the store.
•playing: Race the kids. Shoot some hoops. Remember, you don’t have to be good to get fit.
•scrubbing: Instead of a few wipes here and there, clean energetically for 10 minutes
•dancing: Pull down the shades and let loose; if it’s fun, you’re more likely to do it
•watching TV: Yes, watching TV–while walking in place, doing leg lifts or punching the air

Staying Strong When Your Resolve Sags
There probably are more obstacles to working out than calories in a Boston cream pie. The trick is to keep going anyway. Try these tips:

•Keep a record. Write down why you want to exercise, some realistic goals and your achievements. Seeing on paper what you hope for and what you’ve accomplished can boost motivation. You can print a weekly tracker.
•Put it in your calendar. Schedule physical activity as you would any important appointment-and keep it.
•Make it fun. You’re much more likely to stick with something you enjoy. If you’re finding your routine a drag, try something new.
•Find a friend. Working out with a partner can banish boredom. Plus, it’s sometimes harder to break a commitment to someone else than to ourselves.
•Figure it out. Think about what’s really stopping you and then find alternatives that address those problems. Maybe you’re too tired at the end of the day: Try working out in the morning instead. Maybe you’re intimidated by the beefy set at the gym: Consider working out at home. (Lots of exercise routines are available online, including some free workouts.)
•If you drop the ball, pick it up. It would be a shame to give up entirely just because you missed a few days–or even a few weeks. Remember to acknowledge yourself for any steps forward, no matter how small.
•Reward yourself. Yes, sticking to your goals is its own reward, but a little gift is pretty good too.

How Healthy Eating Helps

Mom was right: You’ve got to eat well to function well. Just in case you didn’t gobble up Mom’s wisdom, here are some useful tidbits.
Among other benefits, good food can:
•boost your energy
•lower the risk of developing certain diseases
•provide fuel to your brain
• counteract the impact of stress on your body
•affect mood-related body chemicals
In an unhappy twist, good nutrition can help at times of stress, but that’s exactly when lots of us tend to eat less well. According to a recent survey nearly half of Americans overeat or eat unhealthy food to cope with stress. In fact, it’s not just that we’re seeking creamy comfort—our stress hormones actually give us the munchies.
Still, if you follow some reasonable guidelines you may be able to reduce your stress and promote your overall health and well-being.

The Basic Ingredients
No one knows exactly which foods promote maximum mental health. But following some basic suggestions can boost your energy, mood and overall wellness. We can’t cover all the elements of nutrition here, so we’re offering a few morsels:
•Consider Uncle Sam’s recipe. The U.S. Department of Agriculture, which builds the food pyramid, says a healthy diet •emphasizes fruits, vegetables, whole grains and fat-free or low-fat dairy products
•includes lean meats, poultry, fish, beans, eggs and nuts
•is low in saturated fats, trans fats, cholesterol, salt and added sugars

For additional nutritional information, see mypyramid.gov. You’ll find a food tracker, menu planner and other tools.

•Don’t skip meals. Eating consistently throughout the day provides your brain and body with a steady supply of fuel. It also prevents your blood sugar from dropping, which can cause nervousness, irritability and other problems.
•Snack well. Sustain your energy—and your ability to resist the vending machine—by packing healthy snacks. Try to keep some nuts, whole or dried fruit or other portable food in your bag or backpack.
•Work on your balance. Maybe you know that your body needs a varied diet. But have you thought about your brain? Your brain needs a healthy supply of carbohydrates, fats and proteins, or it can’t perform functions that affect your mood and thinking.
•Don’t over-diet. Eat to be healthy and fit—not to fit into a certain pair of jeans. Strict food rules usually backfire, and excessive dieting can be dangerous. If you or someone you know seems at risk of an eating disorder, professional couseling may help.

Food Warnings
Some foods just pack on pounds and bring no nutrition to the table. Others can deflate your mood or wreck your sleep. Still, you probably don’t have to give up all your goodies. Take a look at a few cautions:
•Be carb smart. Carbohydrates can boost the body chemical serotonin, creating a relaxed feeling. But sweets and other refined carbs can cause your blood sugar to rise and drop, ultimately resulting in a loss of energy. To stay steady, pick carbs that enter your blood slowly and evenly, like whole-grain breads, fruits and veggies.
•Reduce saturated fat and cholesterol. Your brain needs a strong blood supply to function well. Saturated fats and cholesterol can narrow your blood vessels, so watch out for too much red meat, egg yolks, butter and whole milk. Look for healthy fats like the ones found in fish, avocados, olive oil and nuts.
•Limit alcohol. If you’re stressed out, alcohol may seem to offer relief. However, it actually adds stress to your body and cause problems like disturbed sleep and poor judgment.
•Cut back on caffeine. Caffeine is a stimulant, so it can make you nervous and restless. A cup of coffee can also wreck your sleep—even if you drink it hours before bed. Caffeine also may worsen depression. If you’ve been imbibing a lot, cut back slowly or you’ll risk withdrawal.

Diet and Depression
Some evidence links depression and nutrition, though some of the research is still under debate. Nutrients that may play a role in combating depression include:
•Vitamin B-12 and folate. Good sources of B-12 are fish like salmon and trout and fortified breakfast cereals. Folate is found in dark leafy vegetables, almonds, dairy and fortified whole-grain breakfast cereals.
•Omega-3 fatty acids. The best sources of omega-3 fatty acids are fatty fish like salmon, catfish and trout. Other sources include ground flaxseeds, walnuts and omega-3 fortified eggs.
If you’re feeling depressed, diet alone is likely not the answer. Consider contacting a mental health professional.