Non Medical alternatives for Bipolar Disorder

Do you want to take medication or drugs for the rest of your life? This was my first question when I finally accepted that I had a problem and that this problem had been labelled "Bipolar Disorder" by psychiatrists.

Accepting that I had a problem was tough, probably one of the toughest things I have ever done. I was proud of my mind, or brain. It could do extraordinary things, and yet here I was told, I had a problem and that problem was a mental illness. As a doctor, I found it particularly hard to accept, because accepting that I had a mental health problem went against twenty years of medical education and meant that I publicly agreed that I was a deeply flawed human being.

Yet even though I accepted the diagnosis on the surface, underneath I was still searching for a "cure" or at the very least a way of managing bipolar disorder without medication. Especially when the psychiatric establishment was telling me I would need drugs for the rest of my life. That advice didn't seem right.

Without doubt, some people find drugs helpful. For them, medication seems to take the edge off their symptoms and enables them to lead more fulfilled and happier lives. But these are strong drugs, and an alternative approach is needed.

For me, that approach is returning myself to health in as many areas of my life and work as I can. I have developed a "non medical alternative" for bipolar

First - I see bipolar as mood instability rather than a deep flaw to my nature. Fluctuating moods are part of who I am and as long as I am sensible, they don't fluctuate too wildly

Second - Nothing gets between me and my health. I am no use to anyone if I am ill, so as long as I don't become selfish or greedy, I accept that I need to look after my health first

Thid - I need lots of friends around me, to help keep me right and I hope the relationship benefits both sides.

This is where the previous reader comes in.  Are there any groups around the world which specifically look at non medical ways to manage bipolar disorder? Not many! but sites such as the Icarus project click here
are helpful

As to face to face groups, I am not aware of  any apart from our Tuesday evening group. We accept the need for medication but we are also keen to develop our ability to manage our own condition and experiences without medication. And most of all, we like to have fun!

For those readers in the US, you can buy Mood Mapping from Amazon.com Click here and some UK sellers will export to the US   



Copyright (c) Dr. Liz Miller
www.lizmiller.info

Find out more - Buy the Book!



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www.moodmapping.com

Happy Christmas

Copyright (c) Dr. Liz Miller
www.lizmiller.info

Find out more - Buy the Book!


www.lizmiller.co.uk
www.moodmapping.com

Mood Mapping Courses 1st Saturday of the month

Learn Mood Mapping 1st hand


Places are available: up to 10 people

7th November
5th December
9th January (because of the Bank Holiday)

10.30 - 5.00pm
in Fulham

Be the Early Adopter in your neighbourhood

Email me at liz@Lizmiller.co.uk if you would like to come along

You will

Learn how to Map your own moods,
Understand what causes your moods and the 5 keys to mood
Understand what area or areas of your life cause you most trouble
To gauge other peoples' mood
To learn to influence other peoples' mood


The book is the Course manual, please bring your copy with you - with additional notes as needed,

Most of all, it will be fun!



£15 or thereabouts to cover lunch, teas and coffees











Copyright (c) Dr. Liz Miller
www.lizmiller.info

Find out more - Buy the Book!


www.lizmiller.co.uk
www.moodmapping.com

Talking points 6

Saraswati from the Yoga studio has kindly put together these points to combat stress.  Yoga of course, is a great way to counteract stress, just a few exercises for even a few minutes a day can make a difference. Saraswati's website is here www.theyogastudio.org.uk


A quick look down this list shows you lots of ways to manage your mood, which is of course the goal of mood mapping - putting you in charge of how you feel!

The next meeting of the Tuesday night group Bipolar Association is 8th September and then 22nd

 

Ways of coping with stress

 

1 Clear some clutter from life

2 Save time for things you enjoy, not just work

3 Do something creative

4 Have a warm bath if wound up

5 Have a shower if tired

6 Practice breathing to a count of 3 or 4

7 Take short periods of complete relaxation

8 Become aware of situations which cause stress for you

9 Repeat a mantra when going to sleep

10 Work out the root causes that repeatedly cause stress, do they still apply

11 Confide with close friends, talking helps release stress and lets you see things more objectively

12 Learn self massage or have or give a massage

13 Learn a mantra to repeat silently use in stressful situations

14 Realise you have a choice in how you act, speak or think, take a moment before acting in stressful situations to think about the consequences of your actions

15 Use some music to relax you

16 Do some physical activity when very wound up, work stress  out of your system

17 If possible find something absorbing to concentrate on ie a good book or film

18 Train your mind into thinking positively about yourself and your life

19 Practice yoga postures, breathing exercises, relaxation or meditation daily even 10 minutes

20 Treat yourself, look forward to your treat and remember it when you are under stress

21 Try to avoid letting too many stressful situations build up in your life over a short period of time

22 Gradually cut down on stress inducing “crutches”  ie tobacco, caffeine, alcohol

23 Slowly build up a sound nutritious daily diet; lack of proper nutrients creates stress in the body

24 Experiment with vitamin and mineral supplements, you may be lacking something

25 Do not try to change your life overnight: every change causes stress

26 If you are in a relationship / job / situation that causes great pressure and makes you miserable try to find ways to improve it. If all else fails leave!

27  Make sure you have enough sleep, you should not need an alarm to wake you up

28 Eat regularly, being hungry puts the body into a state of panic

29 Check your posture often, holding muscles tense unnecessarily causes stress

30 Avoid situations / people that make you feel stressed, be more assertive

31 Learn to appreciate yourself and believe that you can achieve fulfilment by taking life gently; peace of mind comes through relaxation not worry

 

 

UNHELPFUL THINKING

 

Below are types of unhelpful thinking that lead to worry and create an uncomfortable internal world. When noticing any of the following start three three breathing. As soon as possible put alternative kinder thoughts in your mind. It might help to ask yourself “What would a contented person think in this situation? What would I think in this situation if I were feeling really well right now?”

 

TYPES OF UNHELPFUL THINKING

 

Taking the blame

This involves taking responsibility for something when it is not yours eg “he was really angry I wonder what I can do to make it better?” – not your problem!

 

Mindreading

This involves believing that you know what other people are thinking eg “she thinks I am fat/thin/ stupid. He doesn’t like me”

 

Discounting the positive

This involves rejecting good things as if they did not count eg “She only said that to make me feel better. He was just being polite. Or anyone can do that”

 

Emotional Reasoning

This involves mistaking feelings for facts eg I know everyone can see how I am feeling inside. Or I am angry inside so it must be someone’s fault

 

Catastrophising

This involves believing one thing going wrong is a total disaster “everything is ruined” “I will never be able to show my face again”

 

Over-generalising

This involves assuming that because things went badly once they always will eg spilling a drink at a partly means you are “always clumsy”. Or failing to see a joke mean that you are always stupid or dumb

 

Predicting the future

This involves thinking things such as “I will always be on my own” “I will always be shy”

 

Labelling or name calling

This involves being mean to yourself eg thinking “I am useless/ stupid / ugly. Other people are horrible / hostile / superior”

 

Wishful Thinking

This involves supposing things would be better if they were different eg If only I were more attractive / wittier / enlightened / famous / rich / etc

 

Taking things personally

This involves supposing that some body else’s actions were directed at you personally eg When someone looks distracted while you are talking, assuming it is because of you

 

 

www.lizmiller.co.uk
www.moodmapping.com

Bipolar Disorder Article

I wrote this article on bipolar disorder almost ten years ago. It is on my website www.med4u.co.uk Med4u is an Internet Marie Celeste, floating deserted and crewless in cyberspace, long since abandoned once I realised that consulting over the Internet was too labour intensive and too individual to be commercially viable. The Internet is a place where size matters, the size of your mailing list, the size of your website and so forth. Never mind the quality, feel the Bandwidth.

Ten years later I still agree with what I wrote, Click here for the original link and because of that I have copied it here.

Bipolar disorder

Bipolar affective disorder is a mental health problem, rather than a physical illness or disease. It is a condition in which moods become difficult to regulate and may swing from one extreme to another. This causes periods of deep depression, when life no longer seems worthwhile with no energy for normal activities, and periods of elation or hypomania which are associated with excessive activity. These mood changes may become so extreme that an individual loses contact with reality. A person with manic depression becomes more vulnerable to stress, both physical stresses, like illness and lack of sleep and mental stresses, like unemployment. In addition they may suffer from severe anxiety. Most people experience times of sadness and excitement and these changes in mood are part of a healthy response to every day life. Yet for people with manic depression, sudden changes in mood make it hard to know how they will feel at a particular time. Normal mood changes do not interfere with someone's ability to get on with their life. For people with manic depression, these mood changes can be so severe that their inner world overwhelms them. In this state, it is almost impossible to carry on with normal activities. To friends and relatives, it appears that the person they know has temporarily changed. For example, it becomes difficult to communicate with them and their conversation may not make sense. This can be frightening unless they know what is happening, whether it is a period of depression or hypomania. This explains a little about bipolar disorder both for people with the condition and for their friends and relatives. It also includes sources of further information and support. ********************* As yet, bipolar disorder is a condition that can be 'managed' rather than cured. Nevertheless the goal can still be to live as fulfilling and normal as life as possible. This will not necessarily be the same life as before bipolar disorder developed as it is impossible to turn the clock back. It almost certainly means changing your lifestyle and expectations. It means accepting limitations and avoiding excessive stress, mental or physical. It involves the discipline of taking medication. It means finding out and learning about the illness, gaining self-knowledge and being prepared to take appropriate action to help prevent further episodes of illness. There is no answer to the question 'Why me?'. There is often no reason why one person responds to the environment in a different way to someone else. Nevertheless, despite these cautions, you can look forward to a life that may be different from what you had hoped, but a life that can be as rich and fulfilling in many unexpected ways. It is not easy to accept the diagnosis of bipolar affective disorder and to learn about the condition. However modern therapies and modern approaches to the illness provide opportunities that were not available, even ten years ago. About Bipolar Affective Disorder Bipolar affective disorder named after the periods of severe depression and hypomania that occur in this condition. These represent the two extremes of mood, Bi (two) polar (extremes) Affective (of emotion). It is also known as manic depression. The diagnosis depends upon a person having had at least one episode of depression and one episode of hypomania. People who have depression alone are described as having unipolar depression or simply depression. Hypomania is a state of high energy and activity in which the ability to sleep normally is lost. The person speaks rapidly, often expressing strange ideas. They may be irritable, paranoid, play loud music continously. They lose their judgement, and spend excessively. They may be sexually promiscuous. In the early stages, the individual may start many projects and appear to work productively and creatively. This breaks down as hypomania continues. Hypomania is not happiness, even if it appears exciting or comes as a relief from severe depression. Although it seems as though the person chooses to behave in this way, they are not in control and are driven relentlessly by their impulses. They lose insight and cannot understand what is wrong with their thoughts and behaviour. Depression This describes a period when life loses its meaning and seems worthless. The person has neither energy nor motivation. Sleeping is affected, either increased or decreased. Thinking is slow and their concentration poor. The person feels distanced from everything and everyone around them, and suicide is a risk. They may have feelings of severe guilt and anxiety. Psychosis At the extremes of mood, sometimes people lose contact with reality. Their thoughts become paranoid and contain many delusions. It is difficult to communicate and the person makes up elaborate explanations for their behaviour and experiences. Anxiety Many people may suffer from severe anxiety. This has many causes, and undoubtedly contributes to unstable moods. It is possible to reduce anxiety by tackling the underlying problems and learning relaxation techniques. Psychotherapy can be helpful. Rarely it may be necessary to take medication. Stable periods This is when life returns to normal after a period of illness. It is the time to build and repair relationships. It is the time to plan to make sure that further episodes of illness are less damaging - this includes financial planning, and ensuring that children will be properly cared for. It is the time to integrate the experiences of the illness. And it is the time to improve mental and physical health. Finally, it is the time to get on with life and enjoy living. Patterns of bipolar affective disorder The pattern of illness varies considerably between individuals. Some may have episodes of hypomania followed by depression, others may have periods of depression with only occasional episodes of hypomania. Some people have very few episodes, others may have many more. It is difficult to predict and only experience can show how the condition will develop. Two common patterns are known as Bipolar I - where a person has chiefly episodes of mania and Bipolar II where they suffer largely from depression, with only occasional episodes of hypomania. Rapid Cycling This is a pattern of illness where a person has four or more episodes a year. Mood changes can be very rapid and this form of illness can be difficult to control. Typically periods of rapid cycling are interspersed with more stable periods. Treatments Drug therapy forms the basis of almost all treatment of bipolar affective disorder. It can often be difficult to accept that drugs are helpful or even necessary during a stable period. Nevertheless scientific evidence shows that, as well as treating hypomania and depression, drug treatments help to prevent further episodes. In addition, psychotherapy and self-management are important for the management of bipolar affective disorder. Drug Therapy There are three main types of drug used in the treatment of bipolar affective disorder. These are mood stabilising drugs, anti-psychotic drugs used to treat hypomania and antidepressant drugs that treat depression. Other drugs include sleeping tablets and drugs for anxiety. Mood stabilisers The three most commonly prescribed mood stabilising drugs are lithium, carbamazepine and sodium valproate. If taken continously they reduce the number of episodes of illness. Each drug works differently and has different side effects. It may take time to find the most suitable drug. Newer mood stabilising drugs include gabapentin and lamotrogine. Antipsychotic drugs These drugs are used to treat hypomania. Rarely, they are used to help stabilise someone's mood over a longer period of time. They can be taken at the start of a hypomanic episode to prevent it progressing further. Examples include, haloperidol, chlorpromazine, olanzapine, risperidone and sulpiride. Antidepressants These drugs treat depression and may more rarely be prescribed long term to prevent depression. They can have side effects but often they may reduce significantly after a few weeks. Examples include; amitriptyline, dotheipin, prozac, paroxetine, sertraline amd venlaflaxine. Psychotherapy for depression Three types of psychotherapy have been shown to help depression. Cognitive therapy that helps people change their 'depressive' style of thinking, 'pleasure seeking' therapy that encourages people to undertake pleasurable activities and social skills training that helps improve communication. These therapies are challenging but are safer and more effective than drug therapy in the long term. A combination of drug therapy and psychotherapy can often be most helpful Psychoanalysis and counselling therapy may not help depression even though they can sometimes appear to be supportive. In my personal experience, I know three people whose bipolar disorder started during forms of intense psychoanalytical therapy. Psychoanalysis can be destabilising and I would not recommend it for anyone who has potentially unstable moods. Self-Management Self management of bipolar affective disorder is not an alternative to drug therapy or psychiatrists. It is an approach that gives an individual a measure of control of their illness, by learning to monitor moods, recognise episodes early and take effective action. This is similar to a person with diabetes learning to monitor their blood sugar and adjust their diet and insulin. The first episodes of hypomania or depression are often related to severe emotional or physical stress. As time passes, it seems that episodes are triggered by fewer and less severe stresses. Eventually they can seem to happen almost without any cause. Nevertheless, with experience, it is almost always possible to recognise that an episode is starting. By taking appropriate action the episode can usually be managed without too much disruption to ordinary life. The more experienced someone is at managing their condition, the less likely they are to have further severe episodes. For further information about self-management, follow this link Self-Management Causes of Bipolar Affective Disorder The cause is not known, indeed there may be several causes. Often the first episode occurs during a time of severe emotional stress. More rarely it may follow a severe physical illness, head injury or course of drugs, such as antidepressants. Bipolar affective disorder can run in families, about a fifth of people with bipolar affective disorder have a parent with the condition. Searching the family tree further may reveal more relatives who have had mental health problems. It appears that the mechanism in the brain that controls mood becomes disturbed, either because of a genetic problem or as the result of a severe stress. This disturbance in the brain almost certainly has a chemical basis and this explains why drugs can be so helpful. Nevertheless, drugs alone are not the answer. Just as there are many factors that can cause bipolar affective disorder so there are many factors that can help its management. Where now? Bipolar affective disorder is a relatively common problem, 1.2% of the population are affected. (This is similar to diabetes) Typically it develops when someone is in their late twenties or thirties, although it is occasionally diagnosed in childhood. It is important to choose a General Practitioner who knows about mental health problems and is sympathetic to how you would like to be treated. The future for mental health problems looks promising. There are many new drugs available and many more being researched. Psychotherapy and psychological approaches are coming into their own and are widely available. Friends, relatives, and bosses One of the hardest things about manic depression is talking about your illness to other people. It is not advisable to tell everyone, especially at the first meeting. Nevertheless, if you can present a positive picture and, most importantly, show that you are at ease with your illness, the overwhelming majority of people will respond in kind. Bosses, too, if you can show that you are responsible and in control, are likely to be surprisingly sympathetic and helpful. A local MDF group provides a supportive place to learn about and to talk about your condition. Voluntary Organisations www.BipolarAssociation.org Manic Depression Fellowship 020 7793 2600 The Manic Depression Fellowship produces a quarterly magazine for its membership - Pendulum. It produces information booklets about aspects of manic depression. It also runs self-management training courses and organises meetings and lectures about manic depression. Many people find it helpful to meet other people who also have manic depression. Relatives and friends may also find it helpful to other people who are involved with someone who has manic depression. The Manic Depression Fellowship has a large network of mutual support groups that meet regularly. Depression Alliance 020 7633 9929 Depression Anonymous 01482 860619 MIND Further Information Summaries of the latest medical research can be viewed on The Bipolar association web site: Bipolar Association Lithium Treatment of Manic Depressive Illness. A Practical Guide. Mogens Schou The Depression Workbook A Guide for Living with Depression and Manic Depression. Mary Copeland. New Harbinger Publications $18.95 ISBN 1-879237-32-6 Malignant Sadness The Anatomy of Depression Lewis Wolpert Faber and Faber £9.99 Mind: The Complete Guide to Psychiatric Drugs A Layman's Handbook. Ron Lacey. Vermillion London ISBN 0-7126-4778-3

www.lizmiller.co.uk
www.moodmapping.com

Tuesday evening - self management group and Mood Mapping

Many thanks to everyone in the group

We had a new member, who had written to me on a couple of occasions, but had not had a lot to do with self management of bipolar disorder before.

Because I am on the medical register - qualified if non-practising GP until my book is published (Mood Mapping - due date: 2 October 2009) he had expectations about prescriptions etc.

I don't prescribe drugs these days. Its too dangerous. Nonetheless, it was good to get someone with new experiences and a different perspective in the group. It brought home to the group exactly how radical self management is. Most people with bipolar disorder have been "medicalised". They are told to take drugs for a lifetime, most do and some people get back to work, many don't.

Self management is not about stopping drugs because there are times when medication helps. On the whole it is less damaging to take medication than to be continuously ill. But on its own medication is not enough. Medication is at best a sticking plaster, not a cure.

With bipolar disorder, a little bit of stress goes a long way. This does not necessarily mean leading a life wrapped in cotton wool, rather that those people who have a tendency to unstable moods have to learn better coping strategies.

Just as a diabetic needs to monitor their blood sugar, so a person with unstable moods needs to monitor their moods and act accordingly. Mood Mapping is the ultimate Mood monitoring tool. Moods have two components, well being and energy. There are four moods, High energy positive - Active, High energy negative - Anxiety, Low energy negative - Depression and tiredness , Low energy positive - Calm.

This was the first time our new member had seen Mood Mapping. I hope we didn't frighten him with it. Once you have seen a Miller Mood Map, you can start to understand your moods and it is impossible to go back! We always have a mood, and it is always somewhere. As long as you have energy, and as long as you have a state of mind, positive or negative, you have a mood.

Once you are aware of your moods and understand them, you can manage them and then as they come under control, so your moods become more stable and the diagnosis disappears.

It may not be easy. There are "brittle" diabetics who have, despite blood monitors and the latest insulin therapy unstable blood sugar levels. On the other hand, monitoring blood sugar does enable perhaps 95% or more of diabetics to lead normal healthy lives.

Support Meetings - The Tuesday Night Group

The Tuesday Night Group meets on the second and fourth Tuesday each month.

This is a self management group, largely for people with bipolar disorder to meet in Fulham, London to discuss non-medical ways of managing bipolar disorder.

We believe that self management, mood management and mood mapping are the principle tools you need to improve your mental health

Open to everyone! Contact me liz at liz miller dot co dot uk if you would like to come along

www.lizmiller.co.uk
www.moodmapping.com