Bipolar Weekly

Category: manic episodes

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

June 9, 2024 /


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.

Allan’s Mania Season

May 26, 2024 /

People seem to be aware of depression occurring during the darker months in Canada but there is a different season that those of us who have bipolar disorder have to pay attention to and for different reasons. It’s springtime. I like to refer to the spring as, “mania season,” because this is the time of year when I, and many people I have met who have bipolar disorder, are more likely to experience hypomania which can build to full-blown manic episodes. This phenomena is officially called Spring Mania (Psychiatric Times) .   

I live in Calgary, Canada and during the winter we have approximately 8 hours of daylight per day. In the springtime, that changes to 15 hours a day. My bipolar disorder can react to the increased number of daylight hours in a dramatic fashion. Most of my hypomanic and manic episodes have occurred in the spring. For me, the consequences of this happening are extreme because I have the more severe type of the illness, Bipolar 1, which means I have full blown manic episodes that can include psychosis. This has happened 3 times in my life and all of them caused irreparable harm to relationships with colleagues, some friends and family members, job loss and a struggle with maintaining enough money to meet basic needs. Since the consequences are so severe, I am hyper vigilant in keeping an eye on my mood in the spring and if something starts to go wrong, I act immediately to ensure that I don’t become acutely ill.

I have learned that the first symptom I experience when my mood is becoming elevated is irritability. I notice that when I talk to people my words have a tiny bit more of a bite to them than usual. Nobody else notices the change but I can because it’s not like my usual demeanor and the way I communicate. I also notice that I have thoughts that describe my irritation with the world. Thoughts like: Why do people in Costco always get in my way? How come everyone is driving like idiots? Why is person x taking so long to complete x?  

The other symptom I notice is that it is very difficult to calm down and rest. It feels like my blood is almost vibrating at a different frequency than the rest of my body. Regardless of how tired I feel, if I lie down, take deep breaths or close my eyes, my body will not calm down. I feel like I must keep moving but that makes the feeling worse.

When this happens, I go into my bathroom, put a towel at the bottom of the door so that it is completely dark and wait and see if anything changes. If I start to feel better, it confirms for me that my mood is becoming elevated. I sit in the dark for as long as possible and that stops my symptoms from getting worse. After I feel more settled, I close all the blinds in my house and wear sunglasses. I don’t do anything stimulating. I don’t go on my phone, watch TV or go outside. I just sit in as dark a room as possible and try to stay bored. I cancel all of my commitments including work, socializing and sports activities. If my symptoms get worse, I will call my psychiatrist and she will decide if any adjustments need to be made to my medication. Generally, when I do this my symptoms only last a few days. I have not had a manic episode since 2010 and I believe this self-awareness and my medication has made this possible.

This strategy will not work for everyone. Bipolar disorder presents differently in every single person. Unfortunately, the only way to figure out a method for yourself is to reflect on what was going on before your last and previous episodes to see if you can identify any patterns that can give you a clue that you may be becoming unwell and then working with your psychiatrist to develop interventions that will work for you specifically. For me, this process took many years and I think it is important to have some space after an episode to grieve the losses you may have experienced, heal from the shame and physically recover from the depression that follows before you start thinking about how to identify when you may be experiencing an uptick in your mood.

For family and friends who have loved ones in their lives who have bipolar disorder there is very little you can do to help in this learning process other than be supportive and compassionate just like you would for any other physical illness. It is difficult for people who don’t have bipolar disorder to understand the subtleties of the start of mania. I have heard many stories of well-meaning family members expressing concern over someone who has bipolar disorder’s mood when often the person is simply having a normal valid emotional response to a certain circumstance. Peer support provided by people who have bipolar disorder are better able to have these conversations that people can learn from. Organizations such as the DBSA, The Depression and Bipolar Support Alliance have online peer support groups for people who have bipolar disorder.

I have heard many mental health professionals say that bipolar disorder is an illness that can be managed. I think that is unfair to us. I think we can thrive and have exceptional fulfilling lives with meaningful volunteer or paid work, and healthy relationships with colleagues, friends, family, and romantic partners. We may not be able to engage in specific activities and everyone who has bipolar disorder differs in their capacity for how much activity they can do in one day. I believe with the right medication and strategies based on self-awareness it is possible for all of us to have a positive life.

Rebuilding Your Life After a Severe Episode

November 22, 2021 /

Having bipolar disorder can result in many losses that may destroy one’s belief in the possibility of returning to a positive life. Acute manic or depressive episodes can result in a lose of employment, relationships with a spouse, friends, and colleagues. Plus, it is common for people to lose all their money and assets.

For example, one could have a severe manic episode that results in an extreme amount of spending which can burn through people’s savings and assets. During this episode, one can become irritable which can lead to a loss of a job or relationships. If you experience psychosis such as hallucinations, paranoia or delusions of grandeur, people do not understand you are simply not well and may become fearful of you which can also lead to a loss of relationships. Perhaps, your spouse decides they cannot deal with the drama of your illness, and they leave. In just a couple of months, you can lose all your money, assets friendships, job, and spouse.

At the end of a manic episode a depressive episode will follow which includes symptoms like extreme exhaustion, body aches, poor concentration, suicidal ideation, and an inability to enjoy anything. It feels like you are a shell of a human being and it’s easy to become hopeless. However, it is possible to rebuild your life after this happens even though it seems impossible. I, and many other people who have bipolar disorder, have been able to claw their way back to a life they enjoy after these types of incidents.

My first depressive episode was the greatest amount of suffering I have ever experienced. I had lost everything. My career, marriage, all of my money and most of my friendships. My appetite was so poor I hardly ate anything, and I had to use two hands to brush my teeth. I spent several months lying in bed. This is common during depressive episodes because the fatigue is extreme, and the warmth of the bed helps ease the pain of the body aches.

To recover from this episode I made incremental improvements in my life on a daily basis. My first goal was to spend more time sitting up in bed rather than lying down the whole day. Eventually, I was able to spend more time out of bed. Then, I built on the tiny successes everyday. I would simply do my best to make the day a little bit better than the previous day. Eventually, this created a kind of moment that helped me start down the path of wellness.

This November I have been participating in Move for Movember, an initiative where I have to walk 60 km in one month for the 60 men who die by suicide every hour around the world. You can donate by clicking here. I was hesitant to participate in this campaign because last month I walked 0 km. But I used the same approach to completing the challenge that I have used to rebuild my life when bipolar takes so much from me. At first, I just did 2 km/day. Everyday, I managed to do a tiny bit and recently my walks have been longer. I have completed 56 km and there are still a few days left in November.

When bipolar disorder destroys your life the thought of ever having a life you enjoy again seems unfathomable, but it is possible. Methodically rebuilding your life one small piece at a time is the only way to get your life. Many people who have bipolar have done it so there is always hope that life will get better.

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