Ask the Doctor: Self-Management & Mood Stability

Understanding the importance of self-management is vital for managing bipolar symptoms and episodes to attain better mood stability. Here’s how to get started.

I’m in treatment for bipolar symptoms, so why do I need self-management?

The treatment team that includes you is the most powerful team! Self-management has a proven track record of effectiveness for people living with chronic conditions such as diabetes and asthma, and is being shown to be remarkably important for depressions and bipolar disorders.

However, the term self-management can be confusing and misleading. It does not and should never mean that anyone is alone in the fight against depression. Nor does it ever imply that anyone with depression should decide to “tough it out” without seeking help.

Approaches that integrate psychotherapy and medications with exercise, stress reduction, healthy sleep, avoiding substance misuse, spirituality, and other aspects of self-management are amazingly effective in addressing depressions. To be most successful, every depression-fighting strategy requires the active participation of one critical person: the person seeking wellness.

Educating yourself about managing your health condition—and becoming an expert in knowing where and when to turn for answers—is a vital step toward feeling and staying better. (And please remember, not everything on the Internet is good advice.)

In addition to working with you on therapeutic interventions, your clinician can be a valuable ally in learning about the best ways to attain and maintain wellness by mobilizing your own skills. That includes improved awareness of your personal risk factors, measuring and monitoring symptoms, incorporating evidence-based strategies on everything from treatment adherence to exercise, and weighing the use of over-the-counter herbals and supplements.

So how do I self-manage, anyway?

#1 Keep track of how you are doing.

You can create a chart or graph on paper to monitor your daily moods, but many smartphone apps now make this task easier. Some also keep track of exercise, weight, alcohol intake, and other variables. Pick out the ones that list elements that are most important to you. Consider sharing the information you collect confidentially with your clinicians so they, in turn, can monitor whether your treatments need to be adapted.

#2 Join a support group.

Peer support groups allow individuals and families to learn from others in their situation how to best monitor and manage symptoms. Advice coming from “teammates” with lived experience is sometimes easier to absorb. But such encouragement should be evidence-based, so checking in with clinicians should be routine.

#3 Exercise.

Exercise is an important part of a healthy lifestyle. Beneficial changes occur in the brain following regular exercise. Exercise improves neurotrophins, a family of proteins that promote brain functioning. (Neurotrophins are among the most exciting new developments being explored by neuroscientists.) If you are not physically active, talk with your healthcare provider about beginning an exercise program. Ideally, arrange regular exercise sessions with other friends or support group members, use one of those exercise apps to monitor your progress, and celebrate milestones.

#4 Sleep.

Maintaining good habits for restful sleep—sometimes called good sleep hygiene—is crucial for managing your mental health.

#5 Eat well.

Even small changes to improve your diet can improve the way you feel. Both high-fat and high-sugar foods can have a negative effect on mood, so limit junk food and fast food. Limit or eliminate stimulants like caffeine, and remember those “power drinks” don’t really provide the power we need for wellness. Evidence-based advice from your clinicians, a nutritionist or dietitian, or another reputable source provides the roadmap for doing what works best for you.

#6 Develop positive self-talk patterns.

Thoughts influence moods. Recognize the role that your negative thoughts play in causing you stress and the settings in which that tends to occur. Then “cut those thoughts off at the pass” as soon as they start to form. Divert your attention, pick up a new task, exercise, intentionally smile, or make phone calls to your favorite people—whatever works for you.

Knowledge is power. Knowledge heals. And self-knowledge plus action introduces one of the most effective players—you—in your recovery.

Printed as “Ask the Doctor: Self-Important,” esperanza Fall 2014