Tips for Bipolar Disorder Patients

Maybe you have only recently been diagnosed with Bipolar Disorder, but, you have probably travelled this road for a long time. You may have been undiagnosed or misdiagnosed for years. You may have been up and down with severe mood swings and relapses. You may feel your current treatment is not working, or you may be plagued by the side effects from medication.

Bipolar Disorder is a serious illness, and each individual’s symptoms are different. Taking an active a role in your treatment plan is the first step toward managing your disorder.

If your symptoms are not under control friends and family may feel confused by your changes in mood. Family therapy may help to promote understanding and strengthen relationships. Friends and family can be a great source of support. They can help you with compliance with your treatment plan and encourage you to avoid triggers; and learn the warning signs of an episode.

To get the most from your treatment, make sure you confide in your doctor about how you are feeling on your medication and any side effects you may be experiencing. Ask about alternate or additional treatment to help treat your symptoms.

There is no cure for Bipolar Disorder, but, there are effective treatments to help manage the symptoms. Some options may include:  therapy, group therapy, and prescription medication or a combination.

Some healthcare teams encourage patients to track their moods and discuss mood changes with a therapist. Many doctors agree that sharing this information and establishing a supportive and consistent relationship between Bipolar patients and a therapist can be an essential part of the treatment plan. In addition to having the opportunity to discuss current problems and ways to cope with symptoms; patients with Bipolar Disorder may also be able to discuss and better understand past episodes and behaviors.

Low Self Esteem and Treatment

Self-esteem is the amount of respect or self-worth that a person has for them. People are often described as having either high self-esteem, meaning they think very well of themselves and their abilities, or low self-esteem, meaning they are filled with doubts and criticisms about themselves and their abilities. People with low self-esteem may experience many problems in their lives.  Low self-esteem” is only a description of the way a person thinks or feels; it is not a diagnosis of a mental health problem. Mental health professionals do agree that healthy self-esteem is important to many aspects of a person’s life.

People with low self-esteem often think of themselves in very critical ways, such as I am a failure, or I cannot do anything right. With these thoughts there are upsetting feelings, these include: sadness, anger, anxiety, fear, and worthlessness. People with low self-esteem have difficulty making decisions, because they doubt that they will be successful. They also find it harder to make friends, because they are often shy or they do not think other people will like them. People with low self-esteem frequently stay away from situations in which they might be judged, so they avoid taking chances or trying new things.

People with higher self-esteem often have happier and more satisfying lives. They are confident about their abilities to cope with problems and take on new challenges, and more open to new people to make friends.

But despite these aptitudes, many doctors still doubtful about the benefits of helping people increase their level of self-esteem. Some researchers claim that encouraging people to raise their self-esteem does more harm than good. For people who recognize that their lives are not satisfying because of their critical, judgmental thoughts about themselves, increasing self-esteem can have many lasting benefits.

Because of the fact that low self esteem results in judgmental thoughts and troubling feelings about oneself; low self-esteem can lead to more serious problems. Research shows that it often results in problems like eating disorders and depression.

Low self-esteem can be particularly damaging during adolescence; it can be marked with aggression, antisocial behavior, and delinquency. Low-self esteem during adolescence was related to an increased likelihood of later problems in adulthood, including anxiety, depression, poor physical health, increased criminal behavior, and greater employment difficulties

Because of the possibility of low self-esteem leading to more serious problems, people who do suffer with this problem   should get help before the issue develops into a more serious disorder.

There are many reasons why people think of themselves and their abilities, including social, economic, cultural, and biological factors. Children in families who interact towards each other in positive ways often had higher levels of self-esteem. One study found that African-Americans and Latino Americans had higher self-esteem than their peers, when they were involved with their religious organizations. Also it was found that boys were more likely to have higher levels of self-esteem than girls. There are many factors that can influence a person’s self-esteem.

People with low self-esteem often think of themselves as being unworthy of happiness, unable to cope with problems, and unlikable. The combination of these thoughts and feelings causes them to avoid social events, friendships, challenges, and certain kinds of jobs, and other opportunities which all make them feel worse and judge themselves even more.

Improving a person’s self-esteem comes by attacking the self-critical thoughts that caused the problem in the first place and engaging in behaviors that have been avoided. These are the focus of cognitive behavioral therapy.

Cognitive behavioral therapy is a form of treatment that combines elements of both cognitive therapy and behavior therapy. Cognitive therapy examines the way people thinks about themselves, others, and how affects their mental health. Behavior therapy investigates the way people’s actions influence their own lives and their interactions with others. With the two, this type of therapy examines the way people can change their thoughts and behaviors in order to improve their lives.

The cognitive behavioral therapy treatment for self-esteem focuses on addressing the causes of the problem. In general, this treatment includes: conduct education; prove false the self-criticism; challenge cognitive distortions; develop compassion for self and others; omit should; learn to handle mistakes; learn to respond to criticism.

Changing one’s beliefs and improving self-esteem can be complicated and difficult. There will be successes and difficulties during the process. The key to long-term, healthy self-esteem is to continuing therapy and to seek professional help when needed.

Getting Out of the Rut

In a rut of depression or missing a High?  Wishing you was more productive and creative?  Well you are it is only a temporary feeling of missing something that is still within you.  Start a new project; read a poem; write a poem.  Delve into the arts try writing a short story; learn a new languague.  Broaden yopur horizons take photos nature soothes the thoughts that race and portraits can  introduce new people into your life.

Get into yourself for a while and get in tune with the emotions you feel and write them into a Blog.  I was going through a similar period of feeling nonproductive and a little disgusted with me for not doing what I normally enjoyed.  What did I do?  I started blogging I am now the proud owner of 2 websites and over 100 blogs all written within 6 months time.  Blogging is a great way to share what you know; learn what you do not know.

Another thing which I find very helpful is joining online support groups all the advantages of therapy with less cost and the without the time restriction of having to keep appointments.  You can login whenever you want to feel like writing at 3 am the groups are at your disposal.  Medication has also proved to be helpful with soothing my tired mind and getting rid of the negative thoughts that cloud my perspective on life. 

Get rid of the worries and disappointments by meditating at least twice a day and you will begin to see yourself as the person you are.  Anger management can be found on the internet just learning that there are people like you, who experience the same feelings can often bring you a step closer to your goals.  Make goals in life even if it to clean the baseboards in your house any goal will work to your advantage and give you something to do; keep track of you achievements and failures and you will see where you may be able to improve your life.

Don’t feel alone I found through research, which is always a constructive way to spend your time, a list of famous Bipolars.  While it is not complete and I cannot account for the accuracy you are not alone.  Millions of people have and still go through the same thing that you do.  The mood swings plague many people and have since the beginning of time.  Take thoughts off of yourself for a while and you will see improvement in your life.  And get back to a rewarding gratifying life.

Famous Bipolars ·  Abraham Lincoln (leader) ·  Adam Ant (musician) ·  Agatha Christie (writer) ·  Axl Rose (musician) ·  Buzz Aldrin (other) ·  Drew Carey (actor) ·  Carrie Fisher (actor) ·  Edgar Poe (writer) ·  Gordon Sumner (Sting) (musician) ·  Hans Christian Andersen (writer) ·  Heinz Prechter (entrepreneurs) ·  Isaac Newton (other) ·  Jane Pauley (other) ·  Jean-Claude Van Damme (actor) ·  Jim Carey (actor) ·  Jimi Hendrix (musician) ·  John Dally (sporting stars) ·  Jonathan Hay (sporting stars) ·  Kay Redfield Jamison (other, writer) ·  Kurt Cobain (musician) ·  Larry Flynt (entrepreneurs) ·  Liz Taylor (actor) ·  Ludwig Boltzmann (other) ·  Ludwig Van Beethoven (musician) ·  Marilyn Monroe (actor) ·  Mark Twain (writer) ·  Maurice Benard (actor) ·  Mel Gibson (actor) ·  Micheal Slater (sporting stars) ·  Napoleon Bonaparte (leader) ·  Ozzy Osbourne (musician) ·  Patricia Cornwell (writer) ·  Patrick Joseph Kennedy (leader) ·  Patty Duke (actor) ·  Plato (other) ·  Ralph Waldo Emerson (writer) ·  Rene Rivkin (entrepreneurs) ·  Robert Downey (actor) ·  Robin Williams (actor) ·  Sinead O'Connor (musician) ·  Sophie Anderton (other) ·  Stephen Fry (actor) ·  Ted Turner (entrepreneurs) ·  Tim Burton (writer, other) ·  Tom Waits (musician, actor) ·  Thomas Stearns Elliot (writer) ·  Vincent Van Gogh (other) ·  Virginia Woolf (writer) ·  Winston Chruchill (leader) ·  Wolfgang Armadeus Mozart (musician)

What is Your Role in Treatment

Expect everything and anything.  Be prepared to answer questions, discuss your problems, and learn about what the problem may be.  For the initial visit you should have a history of yourself, including medical problems, medications you have taken and are currently on, a family history of members who have had the same or another mental problem.  Be prepared to answer questions that at first you may be uncomfortable answering but will help the doctor to make a diagnosis.

After the diagnosis learn everything you can about your disorder; do research; question your doctor to find what the medication is and what side effects to watch for.  Learn what the medications are supposed to do and keep a journal on any out of the ordinary feelings.  Get in touch with your feelings about having mental disorder; you can be angry, sad or happy at finding that there is a treatment for it.  It is natural to have feelings of anger and a grieving process is something you feel when you learn you have an illness for which there is no cure and chronic.  Write down what you are feeling and show it to the doctor.  He can reassure you, remember he will be your main support contact, and treat him as if he is your best friend.  Some doctors encourage questions about where they went to school, how long they have been practicing, if you don’t feel comfortable with this one doctor ask to be referred to another it is your choice.  Choosing a doctor is difficult at first and finding the right doctor and therapist if needed sometimes takes time but you are in control.

Learn the treatment plan often one visit is enough for a correct diagnosis and the treatment that will help in the fastest easiest way.  Make sure your goal for treatment is the same as your treatment team.  Ask for options to what the doctor plans and if there are alternative treatments such as a different medication or your preference of a male or female therapist remember your goal is to get well.  Study your medication look it up in the various resources at the Library find all you can know about what to expect.

Once you decide which medications may work the best for our, we are all different individuals and medication works differently for every person; the expected results may not come with just one medication you may need to combine medications.  Having a mental illness takes work finding the right drug or combination of drugs takes time.  Give yourself time to heal do not stop your medication because you feel better or worse.  Contact the doctor for any unpleasant side effects there may be a way to avoid them your dosage may have to be adjusted.  Taking medication for a mental disorder is often trial and error.  Never stop a medication once you have started it without approval of the doctor relapses come with noncompliance.

Keep your appointments do not skip because you woke up on the grumpy side of the bed, besides being disruptive to the doctor’s schedule it is crucial for the doctor to know how you are responding to medication and or therapy.  Ask questions if you do not understand something that they have said sometimes the meaning is different in the medical field than to the layman.  Your doctor and therapist are there to help you on your road to recovery try not to place obstacles in the way of treatment.

Compliance is the answer to the medication regime.  Sticking to your treatment plan may seem hard at first but as it progresses you will feel more confident at handling triggers that may come your way and overall feel better at helping to help yourself.

Follow advice but keep a record of how the medication is making you feel; discuss any new symptoms; gain the knowledge to go back to living your life better than it was.  With the right treatment recovery for most people is achievable take time to heal you.

Discrimination and the Mentally Ill

 Stigma and discrimination are the principal obstacles to treatment for the mentally ill. For the most severely ill, there are other stumbling blocks to treatment, the laws that prevent treating individuals that need higher care; the IMD exclusion law is one such law.  Failure to recognize and treat these persons until they become dangerous although preserving their constitutional rights violates their right to treatment. These laws and our failure to treat individuals with schizophrenia and manic-depressive illness are the utmost discrimination against those with mental illnesses.
 

 Stigma is created by the headlines which depict the mentally ill, during times of crises, committing violent crimes and not by the statistics which show that a large number of them have been released from hospitals without the proper treatment time that it takes for stabilization of their disorders.
 

 The negative attitudes toward people with mental illnesses increased greatly after people read newspaper articles reporting violent crimes by the mentally ill according to studies that have been done.  It is futile and out of place to expect the stigma of mental illness to be changed by the news and entertainment media with pleas to help the severely mentally ill. 
  

 The government must tackle over 30 years of the disastrous deinstitutionalization policy if they hope to win the battle of mental illness stigma and solve the nation's mental illness crisis. Hundreds of thousands of defenseless Americans are living a pitiful existence on city streets, underground in subway tunnels or in jails and prisons because of the misguided efforts of civil rights advocates to keep the severely ill out of hospitals and therefore out of treatment.
  

 These grievously ill persons in our cities are grim reminders of the failure of deinstitutionalization. They are seen huddling in the cold in makeshift cardboard box dwellings, carrying on conversations with invisible companions, wearing filthy, rags for clothing, urinating and defecating on sidewalks or threatening passersby. They frequently are seen on stretchers as victims of suicide or violent crime, or in handcuffs for committing violent acts against others.
  

 All of this occurs while government officials who in blind ignorance do nothing but punish those without the insight to help themselves; without the right to long term treatment to be stabilized in a setting less harsh than the streets. The consequences of failing to treat these illnesses are devastating peoples lives until they become soothing less than human in the publics eyes.  Americans with untreated severe mental illnesses represent less than one percent of our population, and yet they commit almost 1,000 homicides in the United States each year. At least one-third of the estimated 600,000 homeless suffer from schizophrenia or manic-depressive illness, and 28 percent of them forage for some of their food in garbage cans. About 170,000 individuals are in prison and suffer from these illnesses, costing American taxpayers billions per year.
  

Delaying treatment only results in permanent damage, including increased treatment resistance, worsening severity of symptoms, increased hospitalizations and delayed remission of symptoms.  Persons suffering from severe psychiatric illnesses are frequently victimized.  Studies show that many women with untreated schizophrenia have been raped. Suicide rates for these individuals are 10 to 15 times higher than the general population.

The inadequate psychiatric hospitals and the closure of the state hospitals have only served to compound the devastation. Most state laws today prohibit treating individuals over their objection unless they pose an immediate danger to themselves. Most of the people who are untreated do not have the insight to know that they need treatment; not being aware that they have an illness causes them to refuse the treatment that could end their misery,

 It has been proven that outpatient compliance is effective in ensuring treatment compliance; the challenge remains in getting them to utilize what is their answer to their problem without the revolving-door syndrome of hospital admissions, readmissions, abandonment to the streets and incarceration that plague those not receiving treatment.

Adequate care in psychiatric hospitals for long term treatment also must be available. A large number of the 3.5 million people suffering from schizophrenia and manic-depressive illness require long-term hospitalization which means hospitalization in state psychiatric hospitals. This critical need is not being met, since we have lost most of our state psychiatric hospitals since 1955.

 It is time to reform the laws that prohibit long term hospitalization for those in need.  People with mental illnesses are not to be blamed for having a disorder; they should not be penalized for an illness that is through no fault of their own.  The discrimination and stigma against the mentally ill must be cleared from the minds of the ignorant public.  Their fellow citizens are being denied the right to a life free from shame and turmoil; that deserve a life with dignity and equality.

The Chronic Mentally Ill

Who are the chronic mentally ill; individuals who suffer from one of several diseases affecting the brain, the most essential part of human beings. The causes are still unknown, but are probably multiple. There is no cure, but, effective treatment does exist. People with serious mental illness are significantly functionally impaired by the illness for an indefinite period of time. At least 1% of the population has a serious mental illness. The problems of these persons and their families are compounded by centuries old stigma, the prejudice still persists.

Symptoms of chronic/serious mental illness:

Acute symptoms: Distorted perceptions; loss of contact with reality; delusions; hallucinations; disordered; disorganized and confused thinking; unstable and inappropriate emotions. ; Bizarre behavior; impaired judgment.

Residual or deficit symptoms, several of these usually present most of the time: vulnerability to certain kinds of stress; extreme dependency sometimes combined with hostility; difficulty with interpersonal relationships; deficient coping skills; poor transfer of learning; fear of new situations; restricted emotional response and lack of enjoyment; reduced speech and impaired abstract thinking; reduced ability to pay attention; slowness; apathy; lack of motivation; phobic avoidance of situations; sensitivity to stimulation.

 Common for anybody who learns that they have a serious, chronic, incurable illness:

General stress response with fear; grief; denial and impatience; anger; guilt and self-blame; depression; hopeless, helplessness; regression to earlier levels of functioning; preoccupation with self; immaturity.

This includes loss of normal role functioning and normal family, community functioning. Social breakdown syndrome can be a side effect of any treatment that removes the person from their usual social environment.

Coping and adaptation what is hoped for and is a possible outcome of treatment, rehabilitation, family support and self-help. Acceptance and hope; interest in the illness and its treatment active cooperation with treatment and rehabilitation; lifestyle modifications is what is attempted to achieve.

In general, patients need:

Indivilualiged treatment; Continuity of relationships with staff with a smooth transition between, and coordination among, programs and treatment components.

.Patient education and full understanding about the illness and its treatment; leading to informed consent; responsible patient role; safe and comfortable care and surroundings with adequate privacy and desired amount of contact with others; plans for crises; support and education of family and significant others.

 Compliance with care with appropriate medication by a psychiatrist and treatment team who understand the illness and its treatment; careful monitoring of beneficial effects and side effects. Elimination of unnecessary drugs; alcohol, caffeine, marijuana, etc.; symptom monitoring by patient and others.  Adequate rest and regular, planned, exercise; a balanced, nutritional diet.

:

A therapeutic teamwork with a person which involves support; varying degree of support depending on need, respect, reality orientation is the goal of therapy.

Being actively, comfortably and purposeful busy; a relaxed atmosphere; a regular daily routine; including evenings, weekends and holidays; behavioral approach using natural consequences. Minimization of the handicap. If alcohol/drug use is a problem, attention to dependencies should be integrated with other treatment; psychosocial and occupational rehabilitation. Communication and problem solving skills for patient and significant others; construction of supportive social network; prevent or reverse social breakdown syndrome;  help with daily living; money management, transportation, housing, etc.

All of these issues need to be addressed in order for the person to live a more fulfilling, rewarding life.  Chronic sever mental illness can be managed with as little stress and debilitating effects as possible.  With the cooperation of the person, doctor and treatment team long term hospitalization can be avoided.

A Step Towards A New Future

The Senate Finance Committee in September 2009 amended its version of health reform legislation to partially roll back current Medicaid policy prohibiting reimbursement to inpatient facilities known as institutes of mental disease (IMD).

The amendment, filed by Sen. Olympia Snowe, allotted $75 million for three-year demonstration projects in up to eight states that would allow federal Medicaid matching payments for emergency psychiatric treatment in psychiatric hospitals that provide services to Medicaid beneficiaries between the ages of 21 and 64.

 Currently, psychiatric hospitals are required to provide these emergency services under the Emergency Medical Treatment and Active Labor Act, but they cannot receive federal matching payments because of the rules prohibiting IMDs from receiving federal Medicaid reimbursement.

Only privately owned and operated psychiatric hospitals would be eligible to participate in the demonstration projects.  The services eligible for federal payments under the demonstration projects are limited to emergency psychiatric treatment and stabilization.

The crisis stabilization unit is in effect an emergency room for psychiatry, frequently dealing with suicidal, violent, or otherwise critical individuals. Laws in many jurisdictions providing for long term involuntary commitment require a commitment order issued by a judge within a short time, after 72 hours, the evaluation period, of the patient's entry to the unit, if the patient does not or is unable to consent

Mental hospitals, also known as psychiatric hospitals, are hospitals specializing in the treatment of serious mental disorders. Psychiatric hospitals vary widely in their goals and methods. Some hospitals may specialize only in short-term or outpatient therapy for low-risk patients. While others may specialize in the temporary or permanent care of residents who as a result of a psychological disorder, require routine long term assistance and treatment in a specialized and controlled environment.

These types of institutions vary widely in side, shape, focus, and funding. Some focus on long term care, while others are set up for criminals who have been diagnosed with a mental condition.

Every state within the United States of America has at least one publicly funded mental hospital and many states contain at least one mental hospital that is privately funded. While the funding for these hospitals may be different, both public state hospitals and private mental hospitals both use the same techniques in helping their patients.

This one step ahead toward repealing the old, outdated Medicaid law that is discriminating against mentally ill people.  With this there needs to be reform and a total abolishment of the law which prohibits Medicaid beneficiaries to receive the health care they need. 

While no one can predict the future this amendment shows the day of deinstititulization even if well intentioned people thought they were working for the benefit of the patient.  Some people need long term or permanent mental health care; it is a fact of life. 

 Whether it because of noncompliance; inability to adhere to a treatment plan; or just plain non response to medication there has to be a place for the mentally ill beside33s the streets, shelters, and jail cells.

The Government's Stand On Severe Mental Illness

 The discovery and marketing of the first, effective anti-psychotic medication Thorazine, in 1955 unleashed deinstitutionalization, the moving of patients out of psychiatric hospital settings and into the community. Deinstitutionalization increased more rapidly following the enactment of Medicaid and Medicare in 1965. While in state hospitals, patients were the financial responsibility of the states, but by discharging them, the states transfered the monetary responsibility to the federal government.

When enacting Medicaid, the federal government specifically excluded payments for patients in state psychiatric hospitals and other institutions for mental diseases, or IMDs, for 2 reasons to promote deinstitutionalization; and to put costs back to the states which were viewed by the federal government as responsible for this type of care.  The states transferred a huge number of patients from state hospitals to nursing homes and the community where Medicaid reimbursement was available.

Impoverished persons who need treatment in a hospital can count on Medicaid to pay for diseases of the heart, and most other body organs. Medicaid will not cover the individual if they are between the ages of 21 and 65 has a disease in his or her brain and needs care in a psychiatric hospital. The Federal government's Institute for Mental Disease Exclusion prohibits Medicaid from covering any treatment, even non-psychiatric, in state and private psychiatric hospitals and other IMDs.

For the most severely mentally ill, private insurance is fundamentally meaningless. Because of their illnesses, most individuals with the severest forms of brain disease are unemployed and private insurance is something that they cannot afford. While the federal government seeks equality for treatment of lesser forms of mental illness by private insurers, it continues to discriminate against those with severe mental illnesses by denying them coverage under Medicaid when they require hospitalization in a psychiatric hospital.  

The federal government reimburses states for between 50 and 80 percent of treatment under Medicaid. Because treatment in an IMD is excluded from Medicaid reimbursement, the states have a major financial incentive to limit treatment in psychiatric hospitals. This is the force behind deinstitutionalization as states force patients out of the hospitals and into Medicaid eligible services where the federal government to take up most of the cost, even though treatment may be unsatisfactory, more costly and less effective.

Approximately 500,000 individuals were inpatients in state psychiatric hospitals when the Medicaid program started, compared with fewer than 60,000 in 1999. Hospital closures have actually in recent years.  About forty state hospitals completely shut their doors between 1990 and 1997, and many more closures were planned.

As state psychiatric hospitals improved in quality, it became increasingly common to discharge patients from relatively good hospitals with active rehabilitation programs and institutionalize them in nursing homes, general hospitals with markedly inferior psychiatric care and no rehabilitation programs at all. States save state funds, but institutionalized patients pay a considerate price for the substandard care.

Costs in general hospitals are generally $200 per day more than the costs in public psychiatric hospitals. These additional costs are of little importance to the states; since federal Medicaid dollars are paying the majority of the bill; the states' costs are lower and that is the maximum of their concern. Evidence shows that general hospitals admit psychiatric patients with less severe illnesses, but turn away those who are more seriously ill. Inpatient stays for people with serious brain disorders are typically shorter in general hospitals, which puts the person's ability to stabilize on medication in jeopardy.

Medicaid's denial of coverage results in homelessness, incarceration, victimization and even death for many people; who are extremely ill and are unable to care for themselves. Of the 4 million Americans with schizophrenia and manic-depression, approximately 50 percent are not being treated on any given day. There are currently more than 250,000 mentally ill people locked up in the jails and prisons.  Another 100,000 to 200,000 mentally ill are homeless, and 28% eat from garbage cans. More than ten percent will die from suicide. Others will commit acts of violence against family, friends and even unfamiliar persons.