Last Thursday, my wife and I attended a viewing of Dr. Delaney Ruston’s documentary film Unlisted followed by a panel discussion. The film and panel discussion focused primarily on schizophrenia, but individuals with bipolar disorder and their families face similar struggles.

I was very impressed by the keynote speaker, Dr. Alan Breier, MD, who passionately and compassionately described the struggles of people living with schizophrenia. He called schizophrenia the “quintessential human experience,” because it affects the two qualities most responsible for making a person feel human:

• The ability to work
• The ability to love

I always thought of recovery from bipolar disorder as a return to the BB (before bipolar) era, but as Class 10 of NAMI’s Family-to-Family course points out, recovery doesn’t necessarily mean going back to the “good old days.” It’s often healthier to look at recovery as moving forward – a process of transformation, of becoming a new you, accepting your new reality, embracing fresh dreams, and drawing up new plans. This seems to be true both for the person with bipolar disorder and his or her loved ones.

Many people who experience a serious mood episode with psychosis often have cognitive impairments that continue long after they recover from the mood episode. The actual percentages vary from study to study, but approximately 50% of those with mania and 15% of those with major depression experience mood episodes with psychotic features, so recovery from cognitive impairment is a serious concern for those with bipolar disorder.

A study published in the American Journal of Psychiatry entitled “Two-Year Syndromal and Functional Recovery in 219 Cases of First-Episode Major Affective Disorder With Psychotic Features,” found that while most patients recovered from symptoms soon after hospitalization, only about one third with psychotic affective disorders recovered functionality by 24 months.

Medication is effective in treating acute bipolar mood episodes. Medication and psychoeducation are both effective in reducing recurrences in euthymic periods (when symptoms are not present). Unfortunately, neither treatment option has much effect on restoring cognitive facilities or one’s ability to function as they did prior to the episode. But there may be hope on the horizon.

People often have a different idea of what “recovery” means in relation to bipolar disorder.

Some think of it as no longer needing to take medication or see a doctor or therapist. Others may think of it as regaining control of their lives with medication, therapy, lifestyle changes, and/or other approaches. Some people don’t view bipolar as an illness (they may even view it as a gift) and seek lifestyle changes as a way of accommodating their extreme highs and lows.

What does “recovery” mean to you?