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If you’re living with bipolar disorder, a support group can help provide strength and comfort.

Are you struggling with bipolar disorder – either for yourself, or for a loved one? Connecting directly with others who are dealing with the same emotions and life experiences can be a great source of comfort and strength. For Ingrid Deetz, director of chapter relations for the national Depression and Bipolar Support Alliance (DBSA), that’s the single most important reason to join a bipolar support group. “Just knowing you’re not the only one who’s going through something can be a big help,” she says.

“There’s ‘group wisdom’ that’s just invaluable, and you can’t get it anywhere else,” agrees New Mexico-based clinical psychologist Joyce Burland, Ph.D., national director of the Education, Training, and Peer Support Center at the National Alliance on Mental Illness (NAMI). “Bipolar disorder, like other mental illnesses, can just kick you out of your own life, and you have to find a way toward it again,” says Dr. Burland, who also speaks from the perspective of having close family members with mental illness.

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Bipolar Support Group Meetings: What to Expect

Ideally, bipolar support meetings are intimate gatherings of no more than 15 people. Many groups are run by volunteers, but may also include trained facilitators who guide each meeting.

Although each person’s experience is different, you may find that a bipolar support group can help you by:

Teaching you how to stick to your treatment plan (if you have bipolar disorder). Participants in the NAMI Peer-to-Peer program, for instance, go through a nine-week program that incorporates elements of support while providing practical information about dealing with your mental illness. Participants learn specifically about how to prepare and use a relapse prevention plan. This document can alert you and others to feelings and behaviors that signal a possible impending relapse; it also details what needs to be done, and by whom, to intervene successfully.
Inspiring you. According to Deetz, group sessions aren’t “pity parties,” but rather, “places where you can get concrete ideas of how to improve your wellness.” Those who attend Peer-to-Peer see “two people with mental illness leading the class; they model how far you can come, away from demoralization. They talk about their own relapse plans, and the participants learn, ‘I can get through this, too,'” says Burland.
Creating an emotionally safe environment. “Our guidelines make it clear that it’s everyone’s job, not just the facilitator’s, to keep away from judging and criticizing,” Deetz says.
Providing information about services and resources available in the community. “Since members will likely be seeing many different health-care professionals, they have access to information from various sources,” Deetz notes.
If you’ve never attended a bipolar support group before, chances are you may not feel quite comfortable at your first meeting. Deetz advises, “Give it time and go to three or four sessions before you decide for sure whether to continue.”

Finding a Group: Options

More than 1,000 support groups are affiliated with DBSA chapters nationwide, and through its Connection program, NAMI offers weekly 90-minute groups throughout the country for people living with mental illnesses, including bipolar disorder. More information is available at the National Alliance on Mental Illness Web site (click “Find support,” then “Education, Training and Peer Support Center”) and at the Depression and Bipolar Support Alliance Web site (click “Find support”).

If you’re hesitant about attending an in-person bipolar disorder support group, or if none exists in your area, online bipolar support groups with live chats and message boards are another option. “I think it’s a little more difficult to ‘feel’ the support in an online group, but they can work well, and they offer anonymity for those who live in small towns or who, because of their professions, don’t want to be identified,” says Deetz. For those run by DBSA, go to the Depression and Bipolar Support Alliance Web site, click on Find Support, then Online Support Group or Discussion Board.

Whether in person or online, allow yourself to benefit from a supportive community, urges Burland, “because it can truly help restore your sense of hope and your sense of prospect for the future. When you develop a mental illness,” she says with compassion, “those are things that you often feel are eradicated.”

Are you tossing and turning at night, unable to get to sleep? It could be related to your bipolar disorder.

If you have bipolar disorder, keeping to a regular sleep routine is crucial to keeping moods in check. But people with this disorder often have insomnia or other sleep issues. In fact, the relationship between sleep and bipolar disorder is very complex, says Ellen Frank, PhD, distinguished professor of psychiatry and professor of psychology at the University of Pittsburgh School of Medicine’s Western Psychiatric Institute, and one of the country’s leading researchers in this area of study. “Restless sleep when you have bipolar disorder can mean two very different things,” explains Dr. Frank. “One, it can signal that an episode of mania or depression is coming. Or two, it can mean something external disturbed your usual sleep pattern. In that case, the sleep problem — even one night of missed sleep — can trigger a mania episode that might not have otherwise happened.” What’s more, says Frank, when manic symptoms occur as a result of poor sleep, you may begin to believe that you don’t need to take your medications — which will likely have serious consequences.

Bipolar Disorder and Sleep Problems: What’s the Connection?

Each body organ — from kidneys to muscles — has a gene that puts it on an internal 24-hour clock. These are called circadian genes, and the sleep-wake patterns, or rhythms, they produce are known as endogenous rhythms because they are produced within the body. However, as Frank explains, the sleep-wake cycle is also influenced by exogenous rhythms outside the body — such as the rising and setting of the sun, or mealtimes. “For instance,” Frank says, “if my plane lands in Italy at seven a.m. and my gut’s still on Pittsburgh time, where it’s the middle of the night, I won’t want to eat. But once I see sunshine, smell food cooking, and put something in my stomach, my organs will wake up: ‘Hello! Something different is going on here.'” In people with bipolar disorder, both exogenous and endogenous rhythms are much more sensitive than in people without this condition, says Frank, which makes them prone to sleep disturbances.

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Bipolar Disorder: Getting a Good Night’s Rest

So how can people with bipolar disorder get the sleep they need? Frank suggests the following:

Track your daily patterns. Filling out a daily form called a “Social Rhythm Metric” can help identify your daily sleep-wake patterns as well as other regular activities, and also track how your mood corresponds to each. “It takes two minutes a day. You record when you got up, when you first had contact with another person, when you started work or school, when you had dinner, and when you went to bed,” says Frank. By using the form over several weeks or months, you can figure out which bedtimes and wake times correspond to your best mood state.

Look out for zeitstorers! The German words “zeitgeber” (time-giver) and “zeitstorer” (time-taker) are used by researchers to describe different cues in your environment that can affect your schedule. A zeitgeber, says Frank, is an event or person that helps you maintain your routine — for example, a cat that should be let out at a given time or a spouse who must catch the same train daily. A zeitstorer, conversely, disturbs your routine, the way a business trip or overnight guests might. Figuring out how to maximize the use of zeitgebers and minimize the effect of zeitstorers will ultimately help improve your sleep and mental health.

Try IPSRT. Interpersonal and social rhythm therapy (IPSRT), developed by Frank and colleagues about 20 years ago, helps you understand the importance of regularity in your daily routines, especially how a consistent sleep/wake cycle can stabilize your mood and help to prevent new episodes of illness. “You learn to anticipate changes in routine, such as a vacation or a time when your spouse will be away, and how to maintain — as closely as possible — your usual sleep patterns in spite of these changes. You also learn how to carefully adhere to your usual medication regimen,” says Frank.

Accept the situation and work with it. “This problem isn’t going away,” says Frank. Just because your spouse can choose to go to bed at eight p.m. one night and one a.m. the next and suffer no ill effects, you can’t. You must make your sleep routine a priority of the household.

Like a Finely Tuned Watch

Frank sympathizes with how difficult it can be for people with bipolar disorder to regulate their sleep and other activity routines. “But I like to use an old TV commercial for Timex watches as an analogy,” Frank says. “A Timex was thrown off the top of the Empire State Building, and when it hit the ground, it was still ticking. Well, you wouldn’t get the same result if you threw a Piaget watch off the top of that building. It’s an exquisitely sensitive instrument. And that’s what we tell our patients: You aren’t a Timex. You’re a Piaget.”

Bipolar disorder and addiction often go together. As many as 60 percent of people with bipolar disorder will have some form of substance abuse during their lifetime, and research is underway to better understand this “dual diagnosis” — the term used for the combination of addiction and a mental disorder. Both of these disorders tend to first emerge during the teenage years, says Ken Duckworth, MD, medical director of the National Alliance on Mental Illness (NAMI), and studies have found that teens with bipolar disorder are more likely to experiment with drugs and alcohol.

Those with bipolar may turn to depressants — such as alcohol or pain pills — to try to manage their mania, or to stimulants — such as cocaine or methamphetamines — to cope with depression. In both cases, the usual result is that the substance abuse kicks the bipolar disorder into the opposite state — depression or mania — rather than fixing anything. “Short term, drugs and alcohol do change how you feel,” notes Duckworth. “But long-term it tends to be very counterproductive.”

Bipolar and Addicted: One Woman’s Story

For Jacqueline Castine, alcohol was a part of life. While growing up, everyone in her family drank. So when she became an adult, her own drinking didn’t seem that out of the ordinary in comparison.

Castine recalls drinking heavily on a daily basis for years, all while being a self-described overachiever with a high-profile career, a “perfect family,” and the “perfect marriage.”

“I was a functional alcoholic, from a family of functional alcoholics,” she says. “We didn’t realize what we were really doing was self-medicating for a mood disorder.”

Castine followed her twin sister’s lead into the world of sobriety at the age of 48. Around the same time, she also divorced and left her high-profile corporate position. That’s when “the dragon I always kept on the back porch,” as she describes it, wouldn’t stay outside any longer.

For seven years, she struggled to manage her swings between depression and mania with willpower and denial, but after a period of mania and some risky financial decisions, Castine’s life came crashing down and she lost her home, her life savings, and her grasp on reality. “I was homeless, suicidal, and psychotic,” she says. “That was the point where I realized I needed help.”

Castine was hospitalized, diagnosed with alcoholism and bipolar disorder, and began taking mood-stabilizing medication. “I was ready for treatment,” she says. “I knew that I was sick and I was willing to take the medication.”

Bipolar and Addicted: Getting Help

If you have bipolar disorder and think you may have a problem with drugs or alcohol, says Duckworth, both issues should be addressed together — in fact, he believes that anyone with substance-abuse issues should be screened for bipolar disorder or other mood disorders. Mood-stabilizing medications won’t fix the struggles with addiction, but they may reduce the drive toward it once the mania and depression are addressed.

Jacqueline Castine is living proof of this approach. Although she continues to struggle with managing the ups and down caused by her bipolar disorder, she believes it is now mostly under control. Today, at age 68, Castine has rebuilt her financial life, has written several books about her experiences (including Recovery From Rescuing and I Wish I Could Fix It, But…), and has a career she’s passionate about: She works as a community education specialist to raise awareness of mental-health issues and as a spokesperson for the Depression and Bipolar Support Alliance.

More information on bipolar disorder, including information about bipolar disorder and addiction, living with bipolar disorder, treatment options, support groups, advocacy, resources, and educational programs and events, can be found at the web sites of the Depression and Bipolar Support Alliance and the National Alliance on Mental Illness.

Weight gain is a common issue for people on bipolar medications. Learn which drugs have….

This unfortunate side effect and how you can keep your weight under control.

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.

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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.