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Learning to Live with Bipolar: What My Clients Have Taught Me

Bipolar disorder is for many referred to as a major mental illness which has far reaching implications for the lives of those who live with this disorder. In my 25+ years of being a therapist, I continue to be amazed by the inner strength and determination my clients have demonstrated in trying to live beyond this illness.

A consistent theme occurs when I first meet my clients who have been diagnosed with this significant illness. Often, clients living with this condition carry such profound fear of a relapse with this illness. Relapse for many clients historically means hospitalization at a psychiatrist unit. My clients have often shared with me, and generally with tears in their eyes and an overwhelming negative emotion, “Will I end up in the hospital again?”

I find myself spending several initial sessions supporting my client with this disorder with first building safety and connection. Reassurance that each and every one of my clients with this illness are supported and not standing alone with this disorder. The first step to stabilization is the therapeutic relationship. The therapeutic relationship is the beginning of “hope” for those living and suffering with this disorder.

There are two types of Bipolar known as Type 1 and Type 2. According to stats Canada, they report:

  1. One percent (1%) of Canadians aged 15 years and over reported symptoms that met the criteria for a bipolar disorder in the previous 12 months

  2. About 1 in 50 adults aged 25-44 years or 45-64 years reported symptoms consistent with bipolar disorder at some point in their lifetime

  3. The proportion of men and women who met the lifetime criteria for bipolar disorder decreased slightly with age. (2002 Mental Health and Wellbeing Survey, Statistics Canada)

  4. Nearly 9 out of 10 Canadians who reported symptoms that met the 12-month criteria for bipolar disorder (86. 9%) reported that the condition interfered with their lives. (2002 Mental Health and Wellbeing Survey, Statistics Canada)

  5. While most people with bipolar disorder (or depression) will not commit suicide, the risk of suicide among those with bipolar disorder is higher than in the general population

The “bi” in bipolar suggests the duality of mood swings experienced such as, extreme happiness to sadness or even for many, despair. Other features of this illness for clients who experience the mania within Type 1 Bipolar include super human abilities, even being invincible or beliefs that they are a famous person with powerful knowledge.

The euphoria of mania is addictive and can be very destructive, leading individuals towards unwise and even at risk behaviour. These at risk behaviours include severe spending sprees, excessive and intense addictive behaviour including alcohol, drugs and sex when individuals are in the manic stage of this illness.

This disorder can induce severe human suffering within the individual. Getting a proper psychiatric assessment is critical to beginning the stabilization process. Therapy begins with stabilizing stress levels.

This includes managing sleep by reviewing sleep hygiene strategies, activation levels and addressing daily stressors that are contributing to the relapse. I personally have found mindfulness based approaches to be helpful. CBT therapy is also an evidence based approach that can be valuable in addressing irrational thoughts distortions.

The good news is that when my clients learn to understand their illness, their triggers to relapse and stress levels, they can live meaningful lives. The key to managing this illness is managing stress levels. Pharmacological treatments and therapies all play a role in the journey towards recovery and effective management of this illness, which does need to be life debilitating but managed.

Kindest regards Ian

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