The Science of Hope: Tips for Lifting Bipolar Depression

During bipolar depression, finding hope might feel impossible at first. But the good news is that hope is a skill you can learn and strengthen with practice.

The extremes of depression and mania are powerful. But so is hope, which shines a light on the darkness, revealing that the way things feel now isn’t permanent. As a result, people with bipolar disorder can draw on strengths, coping strategies, and other people for help.

Julia, of Ohio, who was diagnosed with bipolar disorder more than a decade ago, draws hope from two things: reminding herself that a relative’s bipolar episodes always passed and from thinking back to her own good times.

“During low points, I remember that I felt better and was happy,” says Julia. “I remember laughing with my children. … When you’re deep into a depression, hope is the only thing you have.”

Feeling hope during a depressive episode may sound like a contradiction in terms, but mental health professionals — and people with firsthand experience — say there are many ways to hold onto, or build, hope.

“Some may get hope from their religion, spirituality, past experiences with success and mastery, or from the support and care of loved ones,” says Bernard Golden, PhD, a licensed clinical psychologist in Chicago and co-author of New Hope for People with Bipolar Disorder. “Others may have a personality that inclines them to be more optimistic. Whatever its source, generating hope,” he says, “pulls someone into the future of possibilities.”

The More Coping Strategies You Use, the Better

People with bipolar disorder say they feel more hopeful when they’re doing things that make them feel good about themselves and satisfied with life. That includes fulfilling work, hobbies, planning things to look forward to, and being playful.

The key is finding whatever feeds the feeling that things can change for the better. And it’s a feeling that gets stronger with practice, says Anthony Scioli, PhD.

“Hope is a skill that can be learned, expanded, and refined,” says Dr. Scioli, a professor of clinical psychology at Keene State College in New Hampshire and co-author of The Power of Hope.

In addition to faith, social support, and the other wellsprings of hope that Dr. Golden cites, Scioli’s book notes the importance of day-to-day persistence. With bipolar disorder, that means:

• Treatment with medication
• Working on emotional self-regulation
• Self-care, such as good nutrition and exercise
• “Anticipatory” coping skills that help you notice when mood swings occur
• A reaction plan to deal with episodes

Research shows that the more coping strategies you know and use, the better, says Scioli, whose own research focuses on hope and spirituality. He suggests problem-solving skills, prayer, and humor as other helpful tools.

Hope creates a spiral effect that makes these strategies even more powerful.

“Embracing hope furthers an openness for commitment to treatment, whether involving medication, psychotherapy, self-help, or simply better nutrition and maintaining a beneficial routine,” says Golden.

Finding the Motivation for Hope

In a manic state, people feel invincible — overdosed on hope, in a way. Depression plunges to the opposite extreme of hopelessness. At such times, people typically need an outside perspective to find the truth.

Julia recalls hitting a low point when she was 28. “My doctor said to me, ‘This is not reality; this is your bipolar.’ That sentence saved my life.”

Now if she gets to feeling that nothing matters to her, or about her, she pushes herself to tell a friend or her mom, and to call her doctor. Writing in a journal also helps.

Once she takes those steps, Julia says, “the hope builds and builds and builds.”

And, sometimes, an outside perspective can come from within. Golden suggests that people record themselves when they’re feeling balanced and optimistic, then use their own observations to sustain or rebuild hope.

“When their mood has shifted, they could then listen to their recording and have a clear reminder of how they could be,” he says.

Another tactical suggestion from Golden: People can urge themselves toward helpful, hopeful behaviors by setting their sights on an end goal.

“For example, they may prefer to stay home rather than socialize, even knowing that socializing will help them feel better,” he says. “I encourage them to picture, and focus on, how they will feel returning from having socialized, rather than remain focused on the energy it may take to initiate such activity. The same applies to doing any household task, or exercising.”

Sometimes, the end goal may be on a larger scale. Tanya, of New Brunswick, Canada, says discovering her talent and passion for marketing while she was a university student helped her keep moving forward.

“It gave me a goal in life,” says Tanya, who does marketing and project coordinating for a non-profit organization. “I was driven by it, and I still am.”

Her bipolar wasn’t diagnosed until two years after she got her business degree. Before that, while juggling coursework and three jobs, she would overspend during manic phases, and get tattoos and piercings while depressed.

She also drank to the point that she almost flunked out of school. She managed not to, thanks to a friend who pulled her away from daily alcohol use.

“She’d make me go to class,” Tanya says. “She believed strongly in her Christian faith and she instilled that in me.”

Clinical psychologist Chad Morris, PhD, a professor of psychiatry at the University of Colorado Anschutz Medical Campus, says that when people tell their stories of recovery, “very often, the turning point is that someone gave them a bit of hope.”

Success Builds on Itself and Promotes More Hope

Dr. Morris was the lead author in a study of people with bipolar disorder that found the more hopeful they were, the better they functioned, regardless of their symptoms of depression and mania. The study also found that the more satisfied individuals were with their mental health care, the more hopeful they were.

To that end, Tanya says that getting diagnosed and starting treatment helped her find stability, which, in turn, gave her hope that she could continue to get better.

Success builds on itself in every arena, says Morris. As director of the Behavioral Health & Wellness Program at the University of Colorado Denver, Morris devotes his energies to helping people with bipolar — and other mental health conditions — improve their physical prospects through lifestyle changes.

“When people start attending to their wellness needs, everything starts to get better,” he says.

Improving overall well-being can contribute to a more hopeful outlook, Morris explains. And when people discover they can quit smoking, lose weight, or make other changes, he says, “they realize they have the power to do anything they want to do.”

For example, Tanya aims to exercise regularly, guided periodically by a personal trainer. Setting a goal — and having a clear path to it — is one way she feeds her reservoirs of hope.

Tanya also tries to schedule something fun to look forward to, whether it’s an annual trip to visit her brother in western Canada or making the 45-minute drive to her family’s cottage.

“It gives me hope for something positive coming up in the future,” Tanya says.

Finding the fun in life also helps Carol-Anne of Florida. When she was an AmeriCorps volunteer working with children, she appreciated their ability to be playful and get excited. These days, she nurtures the child within by going down a playground slide or chasing seagulls at the beach.

“It’s very uplifting,” she says. “It makes me feel so much larger than I actually am to see the gulls scatter. And it causes me to move.”

Carol-Anne, who received her bipolar diagnosis when she was 22, feeds her spirit by photographing sunrises over the ocean, as well as other nature scenes. When her level of hope dips, listening to rap music helps clear her mind. After several hours of this music therapy, Carol-Anne says she feels energized.

Taking Charge of Your Wellness Needs

Advocating for yourself strengthens hopefulness, according to a study published in The Scientific World Journal. The study assessed those who participated in a peer-led self-management program called Wellness Recovery Action Planning (WRAP). They found that participants were more likely to speak up about their care, and doing so was linked to greater hopefulness among many people, as well as better quality of life and fewer psychiatric symptoms.

Due to WRAP’s apparent positive impact, the researchers think it should be seriously considered as a worthwhile option for improving mental health and well-being.

Chris P. Gorman, MD, a Vancouver-based psychiatrist, encourages people to be involved in their treatment planning. “A big part of hope, I think, is autonomy … feeling you have some control in your life,” he says.

Before his bipolar diagnosis five years ago, Steven S. was in despair. A married minister in Arkansas, Steven had begun to drink heavily and act promiscuously. He was sure it was only a matter of time before his seemingly uncontrollable behavior would get him kicked out of the ministry.

Once he’d been diagnosed, Steven sought out the tools he needed to get his house back in order. “Hope entered the picture when I began claiming my life again,” he recalls.

Steve is doing well, but these days, he worries about losing his job if his bipolar becomes known. He drives to a community two hours away for treatment.

At his church, he offers hope to others every Sunday. “We can lift up cancer, diabetes, pneumonia — even a loved one who’s gone astray,” he says, but society’s taboo about mental health conditions stops him from sharing his own challenges.

How Stigma Interferes With Hope and Self-Esteem

Research by Lauren K. O’Connor and Philip T. Yanos, PhD, found that stigma eats away at hope and self-esteem, which, in turn, hampers recovery. Self-stigma — internalizing negative stereotypes about mental health conditions — can be especially destructive.

Dr. Yanos, a professor of psychology at John Jay College of Criminal Justice of the City University of New York, says getting educated about bipolar disorder — in order to eliminate misconceptions — is an important first step. Some other strategies he recommends include:

• Learn skills to replace negative thoughts with more realistic ones.
• Learn to retell your life story with a more balanced perspective, emphasizing your skills, the times you’ve overcome adversity, and the opportunities you still have.
• Pursue medication and psychotherapy together, which research finds more effective than either alone.

For instance, Steve stays committed to taking his medication and continuing therapy. The other key elements to his stability are having a daily meditation and spiritual practice in place, lifting weights, and eating better.

“I couch it in the language of spiritual discipline,” says Steve. “I have to do these things to be the person God wants me to be.”

Beyond the positive feeling that comes from managing his bipolar, Steve draws hope from helping parishioners and from the church calendar, which celebrates the Easter resurrection each year. He also treasures good moments with his wife and their children.

Still, he reminds himself that his strategies are “a dam that holds back the manic waters.”

“You have to be vigilant in what you do,” he reflects. “Be aware of your body. Be aware of your mind. Be aware of your spiritual life.”

Ways to Cultivate Self-Help for Hope

Our thoughts and beliefs about hope can both indicate a mood episode and change the course of one.

After all, a pervasive sense of hopelessness is often listed among the primary symptoms of depression. Meanwhile, the grandiosity or sense of invincibility characteristic of mania can, in some respects, be thought of as an overabundance of hope.

Whether you’re grappling with an episode of bipolar depression, working to repair damage after an episode of mania, or struggling with the daily challenges of life with bipolar, hope can be the key to attaining — or maintaining — mood stability. It can also help you stay the course on hard days.

True hope is active, not passive, says Scioli. In other words, don’t wait for good things to magically happen, but work to empower yourself. He offers these approaches:

Deal with distorted thinking. Therapy sessions and self-help workbooks can help you monitor your mood and thoughts, examine whether your thinking is accurate, let go of self-blame, and learn strategies to reframe how you label things. So learn to see events in shades of gray rather than the black-and-white of “perfect” or “terrible.”

Form healing relationships. When you feel doomed, alienated, or powerless, you need friends who can help. In doing so, it’s important to actively work on building and maintaining connections with others.

Follow a spiritual practice. This could be praying, attending worship, singing or listening to hymns, walking in nature, or attending a spiritual retreat. Look for readings that are empowering, reassuring, or that address the type of hopelessness you feel.

A Treatment Plan for Turning Hopelessness Into Hope

Hope is a “central component” in recovery from mental disorders, according to a literature review published in Social Science and Medicine. In looking at previous studies, the reviewers concluded that, while no existing interventions specifically aim at increasing hope, many recovery strategies increase hope as a secondary outcome.

Among the most powerful are:

• The collaborative model of care brings together medical and mental health practitioners and the consumer.
• Treatment from family members and caregivers that empowers clients to formulate, and pursue, realistic goals of their choosing.
• Promoting positive factors, such as self-esteem, self-efficacy, spirituality and well-being, peer support, and fostering relationships.

Editorial Sources and Fact-Checking

• Morris CD et al. Care Satisfaction, Hope, and Life Functioning Among Adults With Bipolar Disorder: Data From the First 1000 Participants in the Systematic Treatment Enhancement Program [PDF]. Comprehensive Psychiatry. 2005.
• Pratt R et al. Experience of Wellness Recovery Action Planning in Self-Help and Mutual Support Groups for People with Lived Experience of Mental Health Difficulties. The Scientific World Journal. 2013.
• O’Connor LK et al. Stigma. American Psychological Association (APA) PsycInfo. 2019.
• Schrank B et al. Determinants, Self-Management Strategies, and Interventions for Hope in People With Mental Disorders: Systematic Search and Narrative Review. Social Science and Medicine. December 13, 2011.

UPDATED: Printed as “Hope Floats,” Spring 2013