8 Steps to Rebuild Your Life after an Acute Depressive or Manic Episode.

After my first manic episode, I lost my job, my dream of becoming a Japanese interpreter, all of my money, all of my friendships and relationships with the people I had in Japan and my marriage ended in a divorce. Since then, I have had two manic episodes and a depressive episode that destroyed my life in a similar fashion.

I haven’t had an acute manic or depressive episode since 2010. Now, I can reflect on what I did to rebuild my life. I am only sharing what worked for me. I am not suggesting that this is a foolproof simple way of rebuilding your life.

1. Rest
This one is hard for people to understand. Acute manic and depressive episodes take a physical toll on the body. Just like any other illness, one requires rest to recuperate from this. How much rest do you need? Everyone who has bipolar disorder is different but I, and many people I have met, have taken a year while for others it may be months. When I ignored my bodies need for rest, it made me feel worse because I would beat myself up for not being more active. It’s not uncommon for people to need to spend many hours in bed during this time.

2. Work with your psychiatrist to the best of your ability
There is no x-ray or blood test a psychiatrist can use to diagnose how symptomatic you are. I’m not a psychiatrist and I do not know what goes into the decisions they make for treating their patients but I do know that the more information I can provide my psychiatrist the better. This may include completing mood charts, notes on side-effects, and descriptions of how much you are able to do in a day. If possible, try to get your medication in blister packs otherwise you might be frustrated with trying to remember if you took them or not.

3. Keep Moving
After my first manic episode the fatigue was so bad that every step felt like I had heavy weights shackled to my ankles. I had to brush my teeth with both hands and showering was like climbing a mountain. When you are this unwell exercising may not be possible but any movement helps. If at first, you just try to walk from your bed to the TV as much as possible that’s a win. Everyday, try to move a bit more than the previous day and eventually you will gain momentum and your activity level should grow exponentially.

Step 4 Get on the other side of the door

During an acute depressive episode, my anxiety is extremely high. The idea of leaving my home becomes horrifying. However, the longer I isolate the worse my symptoms get. My goal became just to get on the other side of the door and exit my place. I had no destination in my mind, or how long I would be gone. I just put on my runners and left.

5. Peer Support
Finding a peer support group for people who have bipolar disorder can be extremely helpful. For me, it helped give me hope to know that other people who have bipolar disorder were able to recover and the tips I learned from them were helpful. Plus, talking to people who understood what I was going through helped a lot. Many people who have bipolar disorder are kind, compassionate, fascinating, intelligent, and just cool people to spend a couple of hours with. Organizations like the Depression and Bipolar Support Alliance (DBSA) have online peer support groups for people who have bipolar disorder.

6. Grieve the Losses
A manic or depressive episode can lead to huge losses in life such as job loss, financial instability, divorce, loss of relationships with colleagues, and friends. It isn’t our fault that the episodes happen, but many people and organizations cannot separate who we are as people from the behaviour they see when we are not well. Acknowledging, the pain of these losses and addressing them through journaling, counseling and/or peer support was helpful for me.

7. Volunteer Work
When you are well enough, volunteer work can be a great way to transition back into a more active life. There is a full range of time commitments from a couple of hours a month to several hours a week. Volunteering can provide more structure into your life, create connection with people who are appreciative of your help and it can give your a sense of fulfillment.

8. Identifying Your Capacity
The last step may be the hardest. At some point, we have to reflect on patterns that have emerged after multiple episodes. Bipolar disorder can be highly reactive to stress. For some, full-time work, a busy social life, an intense workout routine and a family may be possible. For others, this level of activity could result in recurring episodes. A person who can do more than other people who are limited in the scope and how much they do are not more successful. They simply have a greater capacity to do more.

Dealing with the devastation that comes as a result of acute manic and depressive episodes is awful. It takes time, patience and support but it is possible to find a life you enjoy again.