Friday, May 2, 2008

If I Were a Psychiatrist

Caveat: My Bipolar Wellness Pilot Program is based on my personal opinions. It is not a medical model. Consult your doctor before making any changes to your current treatment program.

I was reading a new bipolar blog that I'm finding quite interesting, Succor Midst Sorrow, and I was struck by one of Lily's posts, My Meds Work, I Still Have Mood Swings. I think most BIPs have the misconception that if only they find the right medication, they'll be fine. In truth, whether you do or don't find the right medication, it's just one piece of the puzzle.

If I were a psychiatrist with a newly diagnosed bipolar II patient, I would give them a pamphlet about my Bipolar Wellness Pilot Program, and offer the following advice. (Bipolar depression is what I truly know about. I'm afraid I don't have similar advice for those of you who come to this illness from the manic side because I believe it's almost like having an entirely different illness. However, some of my advice is applicable to you as well.)

1. I believe you can control this illness and live a "normal" life. However, it will require your active participation in your treatment, your willingness to assume responsibility for your own healing, and your adherence to a wellness program that we will develop together.

2. You need to religiously keep mood charts (and I will provide them) in order for us to determine the patterns of your illness.

3. We need to figure out what triggered your first depressive episode and resolve it, and to determine what other triggers are causing current depressive episodes.

4. We know that exercise reduces depression and we need to figure out an exercise program for you.

5. We know that nutrition can play a key role in wellness, and I will recommend a nutritionist who can help you evaluate your diet, and suggest dietary guidelines.

6. We know that a lack of sleep fuels hypomanias and manias and I recommend that you get 8-9 hours of sleep a night.

7. We know that alcohol is a depressant and recreational drugs cause a multiplicity of problems so I need you to refrain from using both. If you have an alcohol or drug abuse problem, I will recommend recovery programs.

8. We know that there are depressive symptoms and hypomanic symptoms, and I will provide you with a list of both. I believe there are ways to stave off a depression before it takes hold, and we will discuss that. I also believe there are techniques to deal with hypomanic symptoms, and I will work with you on ways to handle them.

9. There are lots of adjunctive activities that we know work for people and I will provide a list of free classes at our Bipolar Wellness Center, including expressive writing, spirituality, yoga, music therapy, art therapy, mindfulness meditation, and Qi Gong, among others.

10. If you are currently depressed, I will recommend an antidepressant medication that will hopefully help end this episode, however, I must advise you that antidepressants can cause increased hypomanias, and over time, taking them will worsen your illness. While medication has proven effective for manias, there is no clear evidence that either mood stabilizers or antidepressant medication works for bipolar depression.

There's a wealth of other information I would provide, but most of all I would discuss my belief that bipolarity is controllable although it may require lifestyle changes and a genuine commitment to wellness!

What treatment options would you recommend?


Duane Sherry said...


I believe recovery is mind/body/spirit.

These are my thoughts -

If we are in great debt, it's best to pay the small creditors first - It's psychological - We feel early progress. We put some of the debt completely behind us....

Start with the body - as the body gets stronger, the mind and spirit are easier to work with.

A good link -


Nancie said...


I wish you are my psychiatrist :) Your advice are so good!

I had a look at your Bipolar Wellness Program and it's really very excellent. I wish we have such Bipolar Wellness Program available as that will make a great difference in the treatment of Bipolar.

I am doing some of the things you mentioned in this post on my own because I don't have much help available here. We do need more than medication to get well or stay well.

Thanks for sharing. Have a great weekends!


Paula Joy said...

Those are some great thoughts!! I haven't had my first visit with a Psychiatrist yet (still waiting) so it'll be interesting to see what she has to say on our first visit.

I really wish someone would have told me that even though I was on a mood stabilizer, that was working really well, that I would still have depressions. When I had my first one, after three months of good meds, that really threw me for a loop. Knowing ahead of time would have given me the time I was well to process that reality instead of being shot in the foot with it.

Bipolar Wellness Writer said...

Dear Paula,
My ideas are certainly not mainstream, and we'll all be interested in reading what your psychiatrist does tell you. Please know that it won't be anything like what I've described.But, yes it would be nice to have some idea what to expect!


Bipolar Wellness Writer said...

Dear Duane,
Yours is certainly another interesting "recovery" model.


Bipolar Wellness Writer said...

Dear Nanci,
My thoughts are just ideas that would have worked so much better for me than all the advice I've received for the last 15 years. But I'm glad it's helping you come up with your own ideas! Hope you have a nice weekend too!