It is critical that you and your loved ones craft a safety plan when you are well to protect you when you are not.
When I am stable, my thinking is clear and the thought of creating a safety plan seems juvenile and unnecessary. However, in the depths of a depressive or manic episode, a safety plan has been crucial in maintaining my personal safety and easing the minds of those who care about me.
What is a safety plan?
I was first introduced to the idea of a safety plan when I was
hospitalized. Honestly, I was annoyed and did not even know what a safety plan
was. A safety plan is a plan of action steps I follow to maintain my personal
safety during a manic or depressive episode. I have it set out on paper step by
step what I need to do based on my mental state. On my plan, I have triggers
for depression and mania, a list of warning signs to take note that I’m
struggling, and people and places I can call or go to if I am in serious
Who needs a safety plan?
I believe anyone who struggles with bipolar disorder can benefit
from a safety plan, especially those who deal with suicidal ideation. Bipolar
disorder and depression lies to me and changes my perspective on my life.
Having a list of people I can and will call if I am struggling has helped me to
see a different perspective and have hope things will change for the better.
What needs to be on a safety plan
For me, the first thing on my safety plan is a list of warning
signs I recognize that my mood is changing. Some examples are poor sleep,
irritability, depressed mood, anxiety, impulsive behavior and decreased self
care to list a few examples.
The next thing on my safety plan is a list of people to contact
when I notice these warning signs. This list of people are my friends and close
family, as well as a list of professions who are involved in my care. My therapist
and psychiatrist are the professionals I personally have on my plan. The
important thing for me is that I actually have the confidence I will call these
people if things start to change for the worst. This list can also contain numbers
I can call if I am feeling suicidal.
Next are the action steps I can take to improve my mental state.
They include things like calling the people on the list from above, taking a
walk, taking a nap, going to an AA meeting or other support group, going to
yoga, or meeting with a friend for coffee or lunch.
After these action steps I have a list of steps I take if nothing
is working and I find myself falling deeper and deeper into my depression and
feel my personal safety is at risk. For me, this usually comes with increasing
severity and frequency of suicidal thoughts. These steps are going to my
counselor, not staying alone, and, if necessary, going to the emergency room.
Practice your safety plan
I have found that if you practice calling the people on your
safety plan when you are not in crisis, it becomes easier and like second
nature to enact these steps when you are in a crisis situation. A safety plan
is only helpful if you use it when you truly need it. I was a sceptic at first
of writing this information down on paper, but I have found it to be an
extremely useful tool when I was in desperate need of direction. My safety plan
acts as my blueprint for my actions when my brain is not functioning as it
should be. I challenge you to make your own version of a safety plan. It can be
Laura Fisher attended The University of Montana where she received her B.A. in Biology in 2004 and Doctorate of Physical Therapy in 2007. She lived and worked in Seattle for six years as a physical therapist in a variety of treatment settings. She recently moved back to her hometown of Billings, Montana and lives with her two dogs and family nearby. Laura has lived with Bipolar 1 Disorder for 18 years. She enjoys her work in physical therapy, private caregiving, and dog sitting. Laura is the Volunteer Coordinator and Leadership Team member for the Rainbow Coffee House, a safe space for high-school aged LGBT high students to gather, drink coffee, and connect with community. Laura hopes to share her own experience with bipolar disorder to provide hope for those struggling with this illness.
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