Bipolar disorder Pendulum: stories and information Self-management Coping strategies – Mania In this short article Danny hopes to share some of the coping strategies for manic episodes and how to react to them. Often these occur with little to no realisation of what is actually going on, which can prove disastrous to those affected and those around them. Given that the afflicted party can be, as a symptom of the illness, pretty oblivious to the manic episode or their bizarre and undesirable behaviour during, it is essential to have a plan/strategy put in place to handle the situation and hopefully avoid it escalating BEFORE it has reached a critical level. Particularly as we often see the illness as progressive, so each manic episode is worse than the last and the resulting feeling of brain damage afterwards (and the shrapnel and aftermath of the episode itself) is longer and more severe. This ends up potentially having life altering consequences so early intervention is crucial. Recognise warning signs Each person is different, but for me these included an explosive temper, paranoia, spending ludicrous amounts of money, and substance abuse. So, we know to recognise these signs as an impending manic episode and to get help before they spiral out of control. If I ever find myself yelling for no real reason, I know it is time to seek medical advice. I don’t drink now but if I found myself yearning for the bottle I would know that we are going to go down a dark path without squashing the episode before it really happens. Feeling the world is in a great conspiracy to kill me and I need to “get them before they get me first” is also an extreme warning signs and means we may need to up the antipsychotics, but since taking medication this is no longer a risk for me. You will have your own signs and concerns, everyone is an individual, but the above are just mine to share and I feel in my gut that these are probably relatable to you in some way. Close support network I rely on my fiancée Alexandra to spot the above signs, because I often don’t know they’re happening. Particularly the paranoia which all seems to make perfect sense to me at the time. So a support network of people around you that know you sane and well, and can contrast this with any altered mental state. Because of the level of horrendousness of previous episodes, she watches me like a hawk. For example, I got the urge to buy a Rolex watch the other day and have successfully restrained myself from so doing – if I were to have actually bought it, she would be marching me back to my doctor again pretty swiftly. You can only realistically evaluate your mental state, as a Bipolar sufferer, by gauging the input of those around you and really trusting in your closest ones to guide and inform you if you are veering in a strange direction. Everyone is different and your warning signs will similarly be so. As a side note, if anyone wonders from reading my articles why Alexandra stays with me, I hope it’s because in between episodes and medicated I am the gentle squishy being she can rely on! And lastly, if – for some bizarre reason – things were truly are going to hell, Alexandra has my doctor’s mobile number so has a route to immediately access help if she feels at any stage one or both of us is potentially unsafe. See a doctor! I cannot be firmer or a stronger advocate on this point. I have read entreaties from people on the internet about “holistic” treatment, yoga, mindfulness, exercise, veganism, and whatever else. These are all delightful and may indeed improve health and quality of life. But the idea they are a solution to Bipolar disorder is absolute total and utter nonsense. Proponents of this theory are completely irresponsible and by espousing this rubbish are potentially condemning others to suffering and loss. It needs to be countered by a mantra in the global community that this is like telling a cancer patient to cure themselves by eating mushrooms and no chemotherapy. The only way to effectively deal with this illness is with medical oversight and treatment. So, if mania seems from the aforementioned points of observation to be impending, then it is absolutely essential to get to a doctor as soon as humanly possible. If you have not yet had something disastrous happen, then I can say that neither did I for circa 10 years – until it inevitably progresses without medical input. In my last true manic episode, I went as far in my paranoia (I was obsessed with the fact that I was the antichrist…) of actually dreaming about murdering people. Rather fortunately, this did not happen. But retrospectively I feel was a distinct possibility. If I had not seen a doctor, I would certainly be dead, or someone else would be. In my experience (and it seems, that of many) the NHS is woefully underfunded and therefore incapable of adequately handling issues of mental health and particularly Bipolar disorder, so if you have anything approaching the resources, seek private care as it can operate on your schedule and individual requirements. Remortgage your house if necessary to see a private doctor – because you will lose it if you don’t and wait 6 months to a year for an overworked NHS psychiatrist to fob you off and discharge you into the wilderness with no real care. So, if you have the warning signs approaching, get to a proper doctor. There is absolutely no other solution whatsoever and I cannot stress this point enough. I am alive and well due to the skill of mine, but if I hadn’t got the care I’d be in prison or dead. That is what is at stake. Maybe not all of you have it quite so badly, but we know it can get worse with time and surely better to head it off at the pass? Avoid stress Lastly, we know that stress is a trigger for episodes. I was under a chronic amount of stress before losing the plot entirely which certainly exacerbated the episodes and made them worse. It is imperative, so far as you are able, to subtract any superfluous stress from your life in order to live a healthy one. We simply aren’t built for it with this illness. I know I can never return to the stressful lifestyle that made me comfortably off, and will probably therefore not earn this kind of money again. But this is a small price to pay for sanity. Some stress is unavoidable and this is where again medical help can support (I am prescribed Xanax, in addition to all the mood stabilisers and others, to help with this during stressful periods). Anything to stop the brain whizzing into overactive thoughts and the mood spiralling out of control. Alexandra helps me with anything difficult and administrative that I have to face in order to stop me getting worked up, so that lightens the load on me and enables me to relax. It might seem strange to some, but it is essential for us – and a small price for her to pay in terms of effort in order to have a well and sane fiancée. It is also worth saying on the subject of stress that avoiding alcohol and drugs is vital. Alcohol (so my psychiatrist tells me) either exacerbates or indeed precipitates episodes and similarly so for illegal drugs. I am not allowed alcohol on my medication, but anyway have to avoid it for the rest of my life as the doctor says we may well swiftly end up in hospital again if I were to risk it. So - steer well clear! I highly recommend the above channels of effort in spotting the mania when it starts to bubble, and in intervening early on in the episode before something scary happens. With these firmly in place, you can live a happy and long life free of this dreadful condition. As I’ve said before, personally I have Bipolar +++ (with a skull and crossbones emoji if my computer could draw them), but I am fully and entirely in remission thanks to being taken care of so well by my doctor and my partner (and with no side effects despite all the pills). You can be too – just take it extremely seriously, and invest in treatment, and you will get there. And never stop keeping an eye on it, just in case, or it will be back to bite you. But you can be the master of it and not the other way round, if you keep a gameplan in your back pocket to put it firmly in its place if it tries anything sneaky!