Bipolar disorder manifests as episodes of extreme high and low moods. Mania can lead to seriously risky behavior, inflated self-esteem, racing thoughts, and irritability. Periods of depression are marked by feelings of hopelessness and worthlessness, problems sleeping and eating, loss of interest and thoughts, and potential thoughts and actions on suicide. Managing bipolar disorder is difficult. While medication is the first-line treatment, it doesn’t always work. People with the disorder often have to rely on themselves to find ways to manage it. A new study looks at the benefits and limitations of self-management in bipolar disorder.

Self-management of bipolar disorder involves patients monitoring their own signs and symptoms and responding to them. Ways people self-manage their bipolar disorder include:

  • Becoming educated on bipolar disorder
  • Medication adherence
  • Monitoring moods and symptoms
  • Maintaining lifestyle and sleep routines
  • Exercise
  • Healthy diet
  • Stress management
  • Noting and monitoring signs of relapse

The new study, led by Emma Morton of Swinburne University of Technology, Melbourne, Australia, surveyed 43 individuals on their feelings toward and reactions to the effectiveness of self-management for bipolar disorder. Participants were provided with access to a website that focused on self-management, a quality of life self-monitoring tool, webinars, videos, online support, and in-person group workshops.

After three to four weeks of participating in self-management, the participants were interviewed on three sets of questions. The first set included questions regarding their engagement with resources regarding self-management. The second set asked about the implementation of self-management strategies and the third set asked about their quality of life.

The researchers found four themes described by the participants.

1 Self-management for bipolar disorder is empowering
Participants described appreciating the autonomy that self-management provided. It gave them a sense of independence rather than simply following set rules laid down by a psychiatrist or therapist. Several participants remarked on how they enjoyed not having to rely solely on medication for treatment.

2 Individual responsibility for self-managing
Participants described having a sense of ownership and personal responsibility. People recognized that they were in control over their actions as far as self-management strategies like eating right and getting enough regular sleep. Some described situations involving noticing symptoms or signs and taking actions to help themselves.

3 Self-management strategies lack the power to control bipolar disorder
A small group of people told interviewers that they did not find self-management effective in staving off episodes of bipolar disorder. They felt a lack of control over the disorder despite taking steps to manage it. They felt that, at the end of the day, they were not able to prevent relapse no matter what actions they took.

4 The relationship of self-management to the healthcare system
Some people considered self-management as being integrated with the healthcare system. They considered themselves a key part of their management team alongside doctors and therapists. However, most people saw self-management as completely separate from their medical management. They gave examples of healthcare workers never mentioning self-management or disregarding it completely.

Most participants in the study found self-management to be effective and empowering, however, even with self-management, it is still important to maintain contact with a treatment team. Medications may need to be adjusted if an episode is being detected or present and therapy still remains effective in treating bipolar disorder.

 

 

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Image credit: Prairie Kittin