A. Enjoy the Process

Conquering your symptoms is going to take years. In fact, it will take the rest of your life if you want to be the best person you can be. So you might as well be easy on yourself, keep your expectations low, and get a good laugh whenever you mess up. You're already a good person, or you wouldn't be reading this. You're just trying to frost the cake.

B. Use Your Positive Traits To Conquer the Negative Ones

You, a bipolar, have the potential to develop all sorts of positive traits (see Chapter 5a) to a greater extent than other people. So for heaven's sake develop some of them and use them. Find creative ways to calm yourself down when you're manic or hypomanic. Use your sense of humor, your guts, your inner strength, whatever you've got.

A positive trait I'm sure bipolars have that hasn't been researched yet is mental flexibility. We seem to be better at changing habit patterns and personality traits than most people are. 

C. You Can't Conquer A Symptom Until You Know You Have It

Q. What's the absolute best thing that can happen to you when you're sitting there wishing you could lick your symptoms, but you haven't the faintest idea where to start?

A. The absolute best thing would be if somebody came over and (accurately) insulted you, that is, if they told you that there was some specific thing wrong with your personality and then you realized that they were right.

You don't need to get an insult to conquer a symptom, of course. What you do need is to get to where you can detect the symptom, any way you can. Some people are told about their symptoms over and over and still keep denying them, because they just aren't strong enough to ditch them yet (the symptoms, I mean, not the people talking to them).

What makes you strong enough to get rid of a symptom?

1. taking meds that are effective for you steadily and for a long enough time.

2. motivation. How badly do you want to get rid of a particular symptom?

3. your environment. How badly do the people close to you want you to get rid of a particular symptom?

4. your stress level, which is part of your environment, but it's so important that I'm singling it out. You can't always help how much stress you're under, but there's one very effective way to keep stress at a minimum: go to sleep. I don't mean sleep your life away. I mean that, if you haven't gotten enough sleep lately you'll have a hard time getting rid of symptoms and bad habits.

So, when you suddenly realize, let's say, that you have a habit of talking inappropriately loud whenever you're on even a mildly interesting topic, it's silly to feel ashamed or embarrassed. (STOP that negative thought.) Rather, it's time to celebrate. Now you've detected a specific symptom, specific enough for you to conquer. The hardest part is over.

After you're on your way to licking specific symptoms, you'll discover that your general stress level and mood swings will automatically decrease somewhat. For more on tempering manic episodes, see Section F.

D. The Three Main Strategies For Conquering Symptoms

The best way to lick bipolar symptoms is the cognitive self-help way. So I recommend that you read Stephen Bernhardt's Emotional Thought Stopping before you start.  Then use these three strategies, which I've been using for years -- they work:

1. Have a goal, a dream, or at least a hobby that uses whatever kind of creativity you specialize in. One bipolar kept insisting that he had no creative abilities at all, until he discovered that he's really good at lip syncing.

2. Engage in purposeful activity. Call it exercise, call it yoga relaxation therapy, call it "I walk to the store to save gas money," call it whatever you want, but keep moving. If you're hypomanic, movement calms you. If you're dysthymic (feeling down), movement keeps depressive thoughts from stagnating in your mind.

3. Have somebody to call, email, chat with or fax to when nothing else seems to work for you. 

Stephen Bernhardt writes, "I begin by, let us say writing this article, as my mind switches to possibly the next article I am considering writing, I go with that thought, write notes on any insight or ideas I come up with, and then refocus on this present article." He's using all the strategies in perfect unison:

a. He focuses, refocuses, and keeps on refocusing on the creative goal, e.g., "I'm writing a great article." But, to follow his lead, you need to focus on your goal as a therapeutic endeavor. That is, use emotional thought stopping to prevent yourself from making your dream into something negative.

For example, you may think to yourself, "Get back on the topic, stupid!" STOP that thought! You're pretty darn smart, or you wouldn't be writing at all. Focus on the creative goal in a therapeutic, positive way.

b. He doesn't judge himself negatively when his thoughts wander. He realizes that wandering thoughts are necessary to creativity. His thoughts wander off to other useful, creative ideas. So just write them down so that you won't forget them. Then get back to your original project.

c. He has fun. Don't grit your teeth and try to force your mind back on topic. It will return when it's ready, and you'll have a rough draft of your next article to show for the additional time you spent.

E. Dealing With a Depressive or Dysthymic Episode

1. See Stephen Bernhardt's Emotional Thought Stopping, and the cognitive self-help books he recommends at the bottom of his article. 

2. If your depression is very severe and long-lasting, you might try the no-holds-barred solution that worked for Cindy in the story, Death.

F. Dealing With a Manic or Hypomanic Episode

1. Detecting It

So, rather than attempt to identify and avoid things that stress you out, try to detect how your mind and body change as you are beginning to slip into a manic episode. I'll list my signs of an impending manic episode: 

a. Initial euphoric feelings that are later replaced by a frenzied manic state. In a manic state, it can be hard to stop yourself from doing at least three things at once, even if you have no reason to hurry.

b. Irritability: You may find yourself getting more frustrated by potentially annoying things than you usually get.

c. You may get so many ideas that it's hard for you to write one down before the next one comes. Most of them will be good ideas, but not all of them will be practical. 

e. You may become even more absentminded than you normally are.

h. You may sleep only four or five hours a night without feeling tired. (But you may get headaches, watery eyes, and a crabby disposition from lack of sleep.)

i. You may become a neatnik who must have everything in its proper place.

j. Something really bad has just happened to you, you may seem to be outside yourself, feeling no emotion at all, watching yourself and wondering what I'm going to do next.

k. Something really bad has just happened to you and you feel fine.

Maybe you can add to this list. During a manic episode you may:

a. sometimes want to just sit and think, simply because thinking feels so good to you.

b. do three or four things at once, or at least try to, then make a mistake, forget important things, or have an accident.

c. not be able to stand waiting for people, waiting in lines, waiting for something to happen, waiting for anything.

d. not be a very good listener because you're too restless and impatient with whoever is speaking.

e. set unnecessary deadlines for yourself and then rush around trying to meet them.

f. be bored almost to tears by repetitious jobs.

h. be very annoyed by others' tiny mistakes, e.g. when someone calls Risperdal (aka. Risperidone) "Risperidal" or spells a word wrong.

2. Tempering It

What Stephen Bernhardt recommends works: when you are writing something, never send it out right away. Go back and look it over again in a few days, or at least a few hours. You may think you're writing something absolutely perfect but, when you come back to it later, be horrified by something or other that you wrote in that first draft. You will be relieved that you waited before sending it out.

I think this applies to all of a bipolar's life, not just what bipolars write. Before an important conversation, try to rehearse what you will say. Never make a major decision quickly.

OK, any intelligent person knows enough to "sleep on" a major decision. But bipolars need to sleep on major decisions for at least three nights. If the temptation to act right away gets too hard to resist, slow yourself down by writing down everything about the decision: costs, benefits, history, what others recommend, everything.

Also, be careful to BREATHE. It's funny how nobody teaches kids how to breathe. We go through life thinking that you take a deep breath by using your diaphragm to distend (make larger) your lungs and chest.  Then we wonder why we get hiccups all the time.

Hiccups are caused by improper breathing (which is caused by stress which, in turn, is caused by life and/or bipolar disorder). To prevent or cure hiccups, take deep breaths, but not with your diaphragm. Use your abdominal muscles to distend your abdomen, NOT your diaphragm (which distends your chest). Concentrate on getting your abdominal muscles to pull your lungs downward as far as possible, making them large enough to hold lots of air. Make your breaths as deep as you can. If you do this, you will want to breathe in a more slow and relaxed way as well, and you will swallow less air. 

But if your diaphragm wants to suck some air into your chest once in a while, that's fine. It's called sighing. If you breathe properly you will get fewer hiccups, and your singing will sound better too!

More suggestions? Email me at cassjmb@intercomm.com

G.  When Mood Swings End

There is one sure way of knowing when your manic and depressive episodes are becoming shorter and further between: your other bipolar symptoms will increase for a while.  Psychologists call it "symptom substitution."  Maybe you will start having more headaches, arthritic pain, or other physical problems. Maybe obsessive thoughts will pop into your mind more often. Maybe you will start having more trouble with annoying habits like nail biting or stuttering. Maybe you will have more panic attacks. Whatever symptom your unique mind chooses.

So, if this sort of thing happens to you, don't think you are regressing. All that's happening is that a really dangerous symptom (the mood swings) is being temporarily replaced by a less dangerous symptom. After a few months or years (I know that seems like a long time, but I have to tell you like it is!) of coping with these less dangerous symptoms, and, of course, regular medication, you will see these symptoms fade right away just as the mood swings did.

I want to quote Stephen Bernhardt one more time. "Do not concentrate on what causes your particular pain, and instead...try using the energy of mania toward a creative endeavor. "Don't spend your life obsessing on your symptoms; focus on your creative goal, and let your symptom-management program be a sideline. Use thought stopping to get off obsessive, self-pitying and self-blaming thoughts and back onto your creative goal.

It's a lot of work being bipolar, but I sincerely believe that bipolars can be very powerful, effective people.

This article was inspired by articles written by Stephen L. Bernhardt, Bipolar Disorder:  Tempering the Mania of Manic Depression.