Bipolar4LifeSupport

Whenever someone commits suicide, whether they’re a celebrity, acquaintance, or even a family member, the question often asked by those left behind is why. “At least 90 percent of the time, an untreated or undertreated mood disorder is to blame,” says Ken Duckworth, MD, medical director of the National Alliance on Mental Illness (NAMI).

Those with bipolar disorder, sometimes also called manic depression, are especially at risk for suicide. Statistics are sobering: As many as 15 percent of people with bipolar disorder will die by their own hands, half will attempt to, and nearly 80 percent will contemplate doing so. Jacqueline Castine, who is bipolar herself and a spokesperson for the Depression and Bipolar Support Alliance, knows it was bipolar disorder that led her son to take his own life in October 2007. It was his fifth suicide attempt. “Nobody wants to talk about suicide,” she says. “The stigma, shame, and suffering are, for most, unspoken.” And yet, for those withbipolar disorder and their families, the threat of suicide is very real.

What Are the Signs That Someone May Be Suicidal?

People with bipolar II disorder have a particularly high risk for suicide, particularly when they are in the depressive phase of their illness. Individuals with mixed-manic episodes (states in which they exhibit intense signs of both depression and mania simultaneously) may have an even higher chance of becoming suicidal.

According to the National Institute of Mental Health, the following factors increase the risk that someone may be suicidal:

• Talking about feeling suicidal or wanting to die, discussing death or writing about it
• Feeling hopeless, trapped — that nothing will ever change or get better
• Feeling helpless — that nothing one does makes any difference
• Feeling like a burden to family and friends, that others would be “better off without me”
• Feeling a lack of purpose in one’s life
• Withdrawing from friends, family, activities
• Experiencing recent loss of a significant relationship
• Abusing alcohol or drugs
• Having a personality disorder
• Making previous suicide attempts
• Experiencing recent loss of a friend or acquaintance through suicide
• Having family members who have committed suicide
• Putting affairs in order (e.g., organizing finances or giving away possessions to prepare for one’s death)
• Writing a suicide note
• Engaging in risky behavior, putting oneself in harm’s way or in situations where there is a danger of being injured or killed
• Being incarcerated

Bipolar Disorder and Suicide: What Can You Do?

Someone who is talking about suicide should always be taken seriously and receive immediate attention, preferably from a mental-health professional or physician. If someone you know is contemplating suicide, you should:

• Call a doctor, emergency room, or 911 right away to get immediate help.
• Make sure the person’s immediate family members know how he or she is feeling.
• Make sure the suicidal person is not left alone.
• Don’t let the individual drink or use drugs.
• Make sure that access is prevented to large amounts of medication, weapons, or other items that could be used for self-harm.
• Reassure the individual that there is help available.
• Contract with the individual for safety.

If you are feeling suicidal:

• Tell someone you can trust — a family member, friend, teacher, minister, or rabbi.
• Call a doctor, emergency room, 911, or a suicide-prevention hotline.
• Stay with other people — don’t put yourself in the position of being alone.
• Stay away from drugs and alcohol.

“Suicidal feelings pass if they are not acted on, at least most of the time, for most of the people,” Duckworth says. “I would encourage anyone considering suicide to consider getting treatment for their depression first before making such a big decision.”

Where to Turn for Help

Trained counselors are available to talk with people considering suicide or friends and family members of someone considering suicide by phone, toll-free, 24 hours a day at 1-800-SUICIDE (1-800-784-2433) or at 1-800-273-TALK (1-800-273-8255).

Medications used to treat bipolar disorder are intended to help stabilize mood and ease depression, but they often come with a significant side effect: weight gain.

Drugs that are especially associated with this issue include:

• Mood stabilizers such as lithium and divalproex (Depakote)
• Antipsychotics such as risperidone (Risperdal), quetiapine (Seroquel), and olanzapine (Zyprexa)
• Antidepressants such as paroxetine (Paxil) and isocarboxazid (Marplan)

Drugs are not always solely to blame for weight gain during bipolar treatment: It’s also common for a person’s appetite to naturally increase along with his or her emotional wellness as the treatment takes effect.

Bipolar Disorder and Weight Gain: Why It Matters

Regardless of the cause, increases in your weight can have negative effects on your heart health, cholesterol levels, and blood pressure. Weight gain may also elevate your risk for diabetes, metabolic syndrome, cancer, sleep apnea, osteoarthritis, and other complications. And finally, gaining weight can contribute to low self-esteem and undermine your desire and commitment to eat healthfully and exercise regularly.

Bipolar-Related Weight Gain: How Can You Avoid It?

If you’re taking medication to treat bipolar disorder and have experienced weight gain, Everyday Health’s Emotional Health Expert, Ruth Wolever, PhD, a clinical health psychologist and the research director at the Duke Center for Integrative Medicine at Duke University School of Medicine, offers the following tips:

• Eat nutritious foods.

A balanced diet is the foundation of good health and also a key component of weight management. Go for fresh fruits and vegetables, beans and legumes, whole grains, lean meats and fish, tofu, and low-fat, low-cal dairy options. Avoid trans fats, simple carbohydrates, and processed and fatty foods whenever possible.

• Reduce your portion sizes.

Smaller servings will add up to fewer pounds. If you’re having trouble figuring out what an appropriate portion size looks like, check out the portion guidelines on

MyPyramid.gov

.

• Eat more slowly.

Taking time to chew and leisurely make your way around your plate will allow your body to catch up with your meal. It takes from 20 to 30 minutes for your brain to register that your stomach is full, so eating slowly may actually help you eat less.

• Exercise regularly.

Being active is one of the best things you can do for your body. Exercise is great for your overall health and well-being, weight management (and weight loss), and mood.

• Manage stress.

Feeling stressed can lead to emotional and binge eating, which in turn lead to weight gain. Additionally, stress can interfere with your sleeping habits, which studies show may also contribute to weight gain. Getting a handle on stress will help you gain control of your weight.

Sara Biel, LCSW, a psychotherapist in Oakland, California, also suggests the following:

• Get professional guidance.

Consult with a nutritionist to set up an individual diet plan that works for you.

• Write it down.

Keeping a food diary can help a person with bipolar disorder gain insight into eating habits by tracking caloric intake and seeing a connection between daily/monthly eating patterns and emotional states.

Talk to Your Doctor About Weight Concerns

According to Dr. Wolever, if you’re worried about your weight or if you think your medication is already causing you to pack on the pounds, it’s important to tell your doctor and/or your psychiatrist. There may be other bipolar medications that are appropriate for you that don’t cause weight gain. However, you shouldn’t discontinue your current medication or change your treatment regimen without first speaking to your doctor.

“Bipolar disorder is a chronic illness,” adds Biel, “and people need to find a medication regimen they can tolerate for the long haul.” Since every person has a unique body chemistry, Biel emphasizes that it is important for those with bipolar disorder to closely work with their own doctors to find a regimen that addresses their particular symptoms and minimizes side effects.

A varied, healthy diet is your best source of vitamins. Some researchers believe that people with bipolar disorders may metabolize certain vitamins differently, and therefore require either careful intake via food or supplementation.

If you plan to pursue vitamin therapies, purchase a basic guide to vitamins andminerals that includes information about toxicity symptoms. Some people metabolize vitamins and minerals differently, and may be more or less susceptible to potential toxic effects. Along with your doctor’s guidance, a good reference book can help you avoid problems.

Also, take vitamin company sales pitches and dosage recommendations with a grain of salt. The testimonials these companies produce are intended to sell their products, not to help you develop a treatment plan. Consult a physician or a professional nutritionist who does not sell supplements for unbiased, individualized advice.

Vitamins often cited as important in mood regulation include the B vitamins. If you are deficient in any of the Bs, depression, anxiety, and fatigue can result. The B vitamins work together, so it’s best to take a B-complex supplement that mixes them in proper proportions along with folic acid. The Bs have a generally energizing effect and help build up the immune system. Some alternative practitioners recommend vitamin B-12 shots for depressed patients. They don’t always work, but sometimes they can have surprisingly quick mood-elevating effects. Because of that energizing effect, however, they may not be a good idea for those who are hypomanic or manic. B vitamins are used up more quickly when the body or mind is stressed, so supplementing during these times could have a preventive effect. A list of B vitamins follows:

• Vitamin B-1 (Thiamin). Alone, or in addition to a regular B-complex pill, B-1 might be a good idea for bipolar patients who suffer from circulation problems, tingling in the extremities, anxiety, irritability, night terrors, and similar symptoms.
• Vitamin B-6 (Pyridoxine). In addition to a regular B-complex pill, B-6 might be indicated for bipolar patients who present with a great deal of irritability, and for those with marked premenstrual symptoms and/or motion sickness. If you start to experience tingling in your hands or feet, reduce or discontinue the B-6.
• Vitamin B-12. Helps your body turn food into energy, and without enough of it you are likely to feel listless and fatigued. Vegetarians may also be deficient in B-12, as it’s found mostly in meat.
• Vitamin E. An antioxidant that also seems to reduce the frequency of seizures in some people who have epilepsy. It’s especially important to take vitamin E if you take Depakote, Depakene, or another anticonvulsant, as these drugs deplete vitamin E. If you have high blood pressure, monitor it carefully after starting vitamin E, and reduce the dose if your blood pressure rises.

Vitamins A and D are fat-soluble, so they are stored in the body’s fat cells for later use. Having a little socked away for a rainy day is probably okay, but if you take too much, hypervitaminosis may develop.

Symptoms of hypervitaminosis A include orangeish, itchy skin; loss of appetite; increased fatigue; and hard, painful swellings on the arms, legs, or back of the head. Symptoms of hypervitaminosis D include hypercalcemia, osteoporosis, and kidney problems.

Don’t overdo it with any fat-soluble vitamin, and also be careful with fish-oil supplements (and cod liver oil), which are high in both vitamins A and D.

Folic acid can counteract the effects of Depakote, Depakene, and some other anticonvulsants if taken in large amounts. It may also cause manic mood swings.

There are many psychological, social and biological benefits of eating meals with other people.

Sharing mealtimes is good for your mental health. Whether it be through sharing experiences with family and friends, winding down with company, bonding with family members or just having someone to talk to, mealtimes provide a great opportunity for us to set aside a specific time of the day or week to give us time to socialise, relax and improve our mental health.