How is everyone doing? Especially with the holiday weekend coming up in the US.

Therapy Directories

• Open Path Collective (affordable therapy, $40-$70)
• Psychology Today
• Therapy Den
• Mental Health Match
• Good Therapy
• Therapy Tribe
• ZenCare
• Therapist.com
• Inclusive Therapists
• Therapy for Queer POC
• Therapy for Black Girls
• Therapy for Black Men
• National Queer & Trans Therapists of Color Network
• Asian Mental Health Collective
• Canadian Directories
• British Directories
• Australian Directories
• New Zealand Directories

There are many kinds of therapy out there. The four mentioned below have been shown to be effective for bipolar, although it’s not an exhaustive list – it’s just to get you started on your exploration.

When you are looking for a therapist, make sure you seek a bipolar specialist. You can filter by “bipolar” in the directories above. Make sure to interview a potential therapist to confirm their competence and make sure they are a good fit for you.

Therapy for Bipolar

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) for bipolar is all about identifying negative thinking patterns and challenging them. For example, instead of thinking “Everyone is judging me all the time,” start looking for evidence that disputes this thought. Ask yourself, why are you thinking this? Has anyone said anything to you? Is there an alternative explanation here? How can you reframe this thought?

Your CBT therapist will guide you as you learn different techniques for combating unhelpful thinking. They will also teach you practical skills for climbing out of depression. Cognitive behavioral therapy is considered highly effective for depressive phases of bipolar, and it can keep you from acting out on impulse during manic phases.

Interpersonal and Social Rhythm Therapy

Interpersonal and Social Rhythm Therapy (IPSRT) is a mouthful, but this therapy is considered quite effective for bipolar disorder. IPSRT works by improving the person’s biological and social rhythms. Research shows that disruptions in routine can cause mood episodes in people with bipolar, thus IPSRT encourages keeping a schedule to maintain a stable circadian rhythm.

IPSRT usually starts with therapist and client choosing an area where the client could improve in terms of social functioning and biological routine. Therapist then uses tracking, teaches skills, and instills confidence about client’s ability to handle disruptions in routine. IPSRT is usually used as a complementary treatment for another kind of therapy and is designed to be short-term.

Dialectical Behavioral Therapy

Dialectical Behavioral Therapy (DBT) is all about mindfulness, tolerating distress, emotional regulation, and improving relationship skills. Mindfulness skills will help you be more aware of your emotions, thoughts, and behaviors. Distress tolerance skills will teach you about healthier ways to cope with your emotions such as distraction, exercising, journaling, etc.

Emotional regulation will help you manage your emotions when you are going through a depressive or manic episode. Finally, you will learn how to repair relationships damaged as a result of bipolar symptoms and how to prevent those mistakes from happening again. DBT is often done in groups, but it can also be taught in individual therapy where it is often combined with other approaches.

Family-Focused Therapy

While you may be thinking you are the only one struggling with manic or depressive episodes, your family is struggling with you. Family-focused therapy for bipolar disorder has been around since the 80s. Early sessions are all about education on your symptoms, recognizing the warning signs, and how to manage them as a team. Later sessions are about communication and problem-solving skills, especially about family issues.

Did you have a particularly good or bad experience with therapy? Please share in the comments!

Information in this post is NOT medical advice; it’s provided for educational purposes only. Please consult with a doctor and/or a mental health professional for any medication changes.

Need to look up your specific medication's full information? USE THIS SITE.

Antidepressants

• Bupropion (Wellbutrin, Zyban)
• Citalopram (Celexa, Cipramil)
• Desvenlafaxine (Pristiq)
• Fluoxetine (Prozac)
• Gabapentin (Neurontin)
• Mirtazapine (Remeron, Avanza, Zispin)
• Nortriptyline (Aventyl HCl, Pamelor)
• Paroxetine (Aropax, Paxil, Seroxat)
• Sertraline (Zoloft)
• Trazodone (Desyrel, Oleptro, Beneficat, Deprax)
• Venlafaxine (Effexor)

Antipsychotics

• Fluphenazine (Prolixin)
• Haloperidol (Haldol)
• Perphenazine (trilafon)
• Risperidone (Risperidol)

Atypical Antipsychotics

• Aripiprazole (Abilify)
• Lurasidone (Latuda)
• Olanzapine (Zyprexa, Zalasta, Zolafren, Olzapin, Oferta, Zypadhera)
• Paliperidone (Invega)
• Quetiapine (Seroquel)
• Asenapine (Saphris)
• Cariprazine (Vraylar)
• Ziprasidone (Geodon)

Benzodiazepines

• Alprazolam (Xanax)
• Clonazepam (Klonopin)
• Lorazepam (Ativan)

Beta Blockers

• Propranolol (Deralin)

Mood Stabilizers

• Carbamazepine (Tegretol)
• Lamotrigine (Lamictal)
• Lithium
• Oxcarbazepine (Trileptal)
• Topiramate (Topamax)
• Valproic acid (Depakote, Epival)

Stimulants

• Adderall
• Armodafinil (Nuvigil)
• Dexedrine (Dextroamphetamine)
• Lisdexamphetamine (Vyvanse)
• Methylphenidate (Ritalin, Concerta, Metadate, Methylin)

Information in this guide is NOT medical advice; it’s provided for educational purposes only. Please consult with a doctor and/or a mental health professional before implementing anything you read here.

This guide is meant to be communal – please message me if you think something should be added or removed. Thank you for making this community great!

General Info

Now that you have your diagnosis, try your best to learn as much as you can about bipolar. This free online book by the International Bipolar Foundation is a great start. Another fantastic resource is The Bipolar Disorder Survival Guide by David Miklowitz

Bipolar is a psychiatric disorder in which people experience extreme swings in mood, energy, and activity levels. The “highs” are referred to as mania or hypomania, and the “lows,” depression. It is a lifelong diagnosis, and there is no cure.

Symptoms described below are from the American diagnostic criteria (DSM-5). To discourage self-diagnosis, we are not mentioning the specifics, just a general outline of symptoms.

Mania

Mania is a temporary state where the person has an extremely elevated (grandiose) or irritable mood and drastically increased levels of energy and activity. Other symptoms include:

• Distractibility
• Insomnia
• Flight of ideas (a lot of different ideas going through the - mind at a lightning speed)
• Starting a lot of activities and projects
• Talking a lot and very fast (Pressured speech)
• Impulsivity

All of these symptoms are so severe that they cause a significantly negative impact on the person’s life. It is also possible to have psychotic symptoms during mania.

If you or your loved ones experience mania, here is a free mania contract you can fill out together.

Hypomania

Hypomania symptoms are the same as for mania – the difference is in severity. A person in hypomania may actually be quite productive and successful in accomplishing tasks and projects, unlike a manic person, who may be too energetic and scattered to follow through.

Please note that if you have psychotic symptoms (described below) or if you are hospitalized during hypomania, it automatically gets upgraded to mania.

Depression

A person must have depressed mood and/or a loss of interest in almost all activities to have depression.

Other symptoms include:

• Significant weight loss or gain without dieting or significant decreases or increases in appetite.
• Sleeping too much or too little nearly every day.
• Moving too much or too little nearly every day in a way that’s noticeable to other people.
• Feeling fatigued and devoid of energy nearly every day.
• Feeling worthless or inappropriately guilty nearly every day.
• Having brain fog and indecisiveness.
• And, finally, having thoughts of suicide.

It’s possible to have psychosis during depression in bipolar type 2.

Psychosis

Psychosis includes symptoms like delusions and hallucinations. It can also include disorganized speech and behavior, like talking loudly to yourself in public. Delusions of grandeur or paranoia are common with bipolar.

Psychotic episodes can be devastating to one’s life because you lose touch with reality. It’s easy to lose jobs, friends, housing, etc. when psychosis occurs frequently.

Types of Bipolar

Type 1

All you need to be diagnosed with type 1 is one episode of mania. While depression is not necessary for type 1, it is still common for people with this type to have depressive episodes.

Type 2

For type 2, you need to have periods of hypomania – but never mania – and depression. Type 2 is characterized by longer and more chronic periods of depression than type 1.

Cyclothymia

Cyclothymia involves periods of mild hypomania and depression that last at least 2 years and happen at least half of the time with a break of no more than two months between episodes.

Grief

It’s important to grieve after receiving your diagnosis. You are grieving the loss of the healthy self, and it’s perfectly normal. You can expect crying spells and feelings of sadness and resentment different from depression. You may also feel guilt because you see your diagnosis as “letting others down.”

Remember that your life will be different now that you have your diagnosis. And you can still make it amazing. Both are true.

Professional Help

Ideally, you want your medical team to contain these three people: a psychiatrist (or psychiatric nurse, which is usually cheaper), a general practitioner, and a psychotherapist.

A psychiatrist is a medical doctor who specializes in psychiatric conditions. Compared to general practitioners, psychiatrists have vastly more knowledge and experience in the field of psychiatry. They can provide the best care and should be consulted on diagnosis and prescriptions.

A general practitioner is your regular doctor, and you should get routine checkups including checking your thyroid levels (low levels can be tied to depression). If you cannot afford or find a psychiatrist, your doctor will be the one diagnosing you and prescribing medication.

A psychotherapist is someone who provides therapy. Therapy for bipolar can look very different depending on the provider. It can be direct and goal-oriented (like coaching) or it can be more about listening and expressing empathy. A fully licensed therapist should be able to provide a diagnosis but cannot prescribe medication. Check out this post if you are looking for therapy.

Safety

If you ever get suicidal, you may want to complete a safety plan and confide in a close friend if you have not already. Suicide may seem like the right solution in the depths of despair, but it only creates more pain and suffering. Please stay.

Check out a free safety plan here.

Tracking

It’s important to start tracking your mood. You can start seeing trends, which will help with identifying your triggers and warning signs. You want to start catching episodes before they become full-blown, so you can get ready and implement some coping strategies.

There are many apps out there, like Daylio, Bearable, Emoods, Moodfit, etc. Play around to see what fits you best. You can also track with pen and paper. Get creative – draw emojis on a calendar or get colorful with your bullet journal. Check out this printable tracker from the DBSA.

Triggers

You should be aware of things, people, and situations that can trigger episodes for you. You may know some of these off the top of you head, and you will identify the rest with time.

Some common triggers include stress from both negative and positive events, substance use, lack of sleep, and change of seasons.

If you know your triggers, you can prepare yourself when you know you will come into contact with one of them.

Warning Signs

Warning signs are big and little things that tell you an episode is underway or coming soon. For example, not everyone gets hypersexual during hypomania, but if you do, then an increase in sex drive could you one of your warning signs.

When identifying warning signs, try to be as specific as possible. For example, instead of saying “I shop online more”, you might say “I start spending more time browsing Amazon and opening emails with discount offers.”

Medication

Many people with bipolar have to take medications for the rest of their lives, and there are also many who choose not to take medication. Either approach can yield great results as long as you work with a competent medical professional and develop additional coping skills.

You will likely be prescribed medication, and it is likely to be in one of these three groups: mood stabilizers, antidepressants, or antipsychotics. If you have anxiety or any other conditions, like ADHD, you may be prescribed other medications as well. People with bipolar on average take at least 3 psychotropic medications.

It is worth mentioning that prescribing antidepressants for bipolar is somewhat controversial. Please note that you should never go off medication suddenly or without consulting your medical professionals.

You can find a list of commonly prescribed medications here.

Diet

We are starting to learn that a ketogenic diet might be good for mood stabilization; however, research is in its infancy. Read more:

Can a ketogenic diet successfully treat bipolar disorder?

New Study: Serious Mental Illness Improves on Ketogenic Diet

A comprehensive website about bipolar and keto

Next Step

Check out this free 1-hour video course, Living Successfully with a Mood Disorder, from the Depression and Bipolar Support Alliance.

Your contribution is what makes it thrive, so please share your thoughts.

This is a safe place to discuss, vent, and share information about bipolar disorder. It is also a place for peer support and comfort.

Please use empathy and common sense when posting and commenting. We are all in this together, let’s stay kind and civil.

The rules for posting and commenting, besides the rules defined here for lemmy.world, are as follows:

Rules

• If you are having thoughts of suicide, please call a friend, family member, 988 in the US, or find transportation to your closest emergency room (call 911 in the US).

• Please be sensitive when discussing suicide and self-harm. Posts threatening suicide are subject to immediate removal.

• Posts containing medical advice or diagnosing others are not allowed. If you are posting about traditional or alternative treatment methods, please keep the post focused on your personal experience.

• We do not allow promotion, solicitation, or affiliate links. For interviews, surveys, and studies, please contact the moderators.

• Harassment of any kind is not tolerated. Do not harass any user for any reason including treatment plan/medication adherence, race, religion, gender, sexuality, disability, etc.

• You may post bipolar memes and jokes as well as serious content. This rule may change later at the community’s discretion.

Community Moderation

For inquiry on becoming a moderator of this community, please send a message to the current moderators.