Managing moods and impulsive urges requires more “brain energy” among people with bipolar disorder. No wonder you’re so tired at the end of the day!
Bipolar disorder is more than manias, hypomanias, and depressions; sometimes one blends into another. Often a topsy-turvy day needs a solid dose of personal time in personal space just to get things together.
Why do my emotions bounce around so much?
Individuals with bipolar disorder are more reactive: exciting events often result in an overly enthusiastic response, and sad situations may drive an overwhelmingly depressed response. The perception of an impulsive and over-dramatizing personal temperament can be very frustrating to the individual and those around them.
Several clinical studies have reported patterns of behaviors among people with bipolar that are in fact consistent with heightened impulsivity compared to those without. Managing impulsive urges requires more “brain energy” among people with bipolar compared to unaffected controls. Electrical activity of the brain is significantly higher when the instruction is to not respond to an appealing stimulus. At the personal level, a lot of energy often goes into managing the day’s trials and tribulations: the morning start at home, the traffic, work with its successes and challenges, the everyday ups and downs. Many people with bipolar often find themselves exhausted at the end of the day.
There are fundamental elements of biology that show the reactivity of bipolar disorder. Labs at the University of Michigan and at the Salk Institute (in La Jolla, CA) have demonstrated that nerve cells made from individuals with bipolar disorder are significantly more reactive compared to those made from healthy controls. While we cannot say exactly why bipolar nerve cells are hyper-reactive, the ability to measure the reactivity in the lab represents the beginning of a biological model by which we can assess the efficacy of new medications.
How can I manage the stress of my ups and downs?
Effective management of bipolar disorder requires a lifetime commitment to one’s health and well-being, in the same way that the care of diabetes requires lifelong attention to many features of daily life beyond taking insulin.
Medication is a mainstay for most people; be sure to get as much information as possible. If you are not on a mood stabilizer, ask your health-care provider for an explanation. Establishing a regular routine is crucial. Recognize the risks of over-reacting to powerful social situations; talk to your health-care provider about examples of reactivity in your history, and look for learning points. Avoid making “on the spot” decisions; a good idea today will still be a good idea tomorrow (if, in fact, it is a good idea). Finally, engage your confidants and look for ways to improve your ability to recognize situations wherein you may be at risk.
In addition, there is a recent surge of interest in meditation, yoga, and other self-awareness programs. One element these practices have in common is self-reflection: asking oneself how one is doing and why a situation is causing the reaction at hand. Another component is self-direction: calming oneself down by thinking a specific thought, repeating a soothing mantra, and/or practicing a relaxation technique or breathing exercise. Such techniques can help “take the edge off” the stress of suffering fast-changing and intense emotional extremes.
What can my family and friends do to help me?
Loved ones can help you by learning as much about the illness as possible, reading informative books, attending support groups such as those offered by NAMI or DBSA, and/or attending a therapy session with you. Consider family therapy for as many of the immediate family as will attend. Provide your loved ones with guidance by using statements like “When I am depressed, it’s helpful for me if you …”
Probably the most important advice I give my patients’ families on a regular basis is: “Be informed. Be supportive. Simply put: be there for your loved one.”
Printed as “Ask the doctor: Up and down and all around,” Fall 2018
Mood symptoms such as overspending, hypersexuality, anger attacks, and self-isolation hurt those around us. A simple apology is just the starting point of making things right. When Our Actions during Bipolar Mood Episodes Harm Others Olivia S. of Colorado got up one morning to unexpectedly find two of her four grown children in her living...
Enhanced primary care helps reduce ER visits October 1, 2020, CHAPEL HILL, NC—Integrating primary care services and behavioral health services appears to reduce emergency room visits among people with severe psychiatric conditions such as bipolar disorder, a new study suggests. American researchers, using the customary term “serious mental illness,” noted that individuals with such conditions...
With bipolar disorder, we’re more likely to become overdependent on our digital devices. Here’s how personal tech can affect our moods—plus tips for self-protection. Are we too attached to our digital devices? That question has been debated for almost as long as the iPhone has been around, giving rise to the first National Day of...
Tips for tweaking how you plan, shop for, and prepare meals to have a diet that nurtures stability and health without blowing your grocery bill. No doubt you’ve heard it before: Fast food, junk food, and highly processed products are linked to greater risk of depressive moods—not to mention so-called “lifestyle diseases” such as diabetes...