Managing Problems Associated with Bipolar Disorder - Working with Bipolars

Written by HealthyPlace.com Staff Writer

David: But isn't it true of many individuals who suffer from a mental illness, at least at first, that they are in a state of denial. They just don't want to believe it's true.

Dr. Bellman: Yes, and this is very similar to an intervention of an alcoholic, although done more lovingly. There are also issues that may involve family dynamics and secrets that add to the denial. Again, that is why a good history is necessary. But, especially with my teenagers who are bipolar, I find the impact on the parents and their denial almost harder than that of the young person experiencing bipolar. This is one of the most challenging parts of family therapy work.

David: I want to return to channeling your manic energies. Can you give us some specific alternatives to deal with those manic phases?

Dr. Bellman: First off, If you are a musician, artist or a writer, write down your ideas and thoughts and still take medications. Even in the more solo arts, and I include mathematics, engineering and physics in these, we need to stay connected to our colleagues, family and other significant relationships during these times so that two things happen:

One, the energy is dammed and channeled, like a great river that does not overflow it's banks because of the medications and our connections around us with other people. Secondly, we can then actually finish projects because we pace ourselves instead of hitting a manic peak and fragmenting.

David: By the way, if anyone in the audience has some tips that worked for them during manic episodes, please send them to me and I'll post them. Hopefully, that will help some others here tonight.

Here are a few audience responses to what's been said tonight:

okika: I think that when I was 'hypo' my doctors thought this was maybe the correct medication and improvement of my depression. My Diagnosis is actually Bipolar II. I have now been stable AND sober for 6 years.

Helen: I agree about relationships. Maintaining them helps me avoid withdrawal into a distorted inner world and is a good check on whether my behavior is getting inappropriate - "red flags".

derf: If you feel your head tingling or are getting goose bumps from "profound" thoughts, force yourself to sleep.

David: Here are some more questions, Dr. Bellman:

Bemused: What about complete and total trust in a relationship turning all consuming, not being able to be comfortable at all without that trusted person's physical presence?

Dr. Bellman: For adults, trust and dependency is voluntary, not involuntary. That does not mean that there are not great attachments, loves and soul mates. It just means that there are more evolved feeling states to be explored beyond the dramas of need, abandonment and betrayal. Please explore these in therapy, Bemused.

Bounder: What about the effects of caffeine during a manic episode?

Dr. Bellman: Bounder, caffeine can have a paradoxial effect during manic episodes that relax one. I would look at the heavy use of caffeine as red flags in two ways:

One, that the person is trying to preempt the beginning of a manic episode, or two, there are other stresses in a person's life that can trigger either pole of bipolar disorder.

David: What about sugar and carbohydrates? Would you put that in the category of self-medicating?

Dr. Bellman: Absolutely, as well as compulsive eating, but I am also very careful to get all my patients a good physical work up because there could be thyroid or low blood sugar or other physical conditions and disorders that can mimic bipolar disorder.

kbell: Can you give some example of family dynamics that contribute to the denial?

Dr. Bellman: Yes. If there has been any mental illness, substance abuse, or suicide, or cataclysmic events such as the holocaust, the families are reluctant to accept that the experience could happen again thus "re-opening old wounds". Plus, there may have been criminal activities, physical, sexual or emotional abuse that led to family secrets that the family hoped would die with their generation.

Judyp38: I am not bi-polar but my husband is (for two years only). How do bi-polars want to be treated? Do they take responsibility for their character or should we take into consideration that they are "bi-polar"?

Dr. Bellman: Most people want to be treated as loving human beings and not be looked at as being weird. We need to remove the stigma of mental illness, and perhaps even that phrase. I think the best way to talk about it with your husband is as an epileptic that has seizures that need to be treated with medication.

derf: On a mood scale of 1 to 10, 1 being severely depressed and 10 being out of this world manic, where would you say the most productive and creative BP people operate at?

Dr. Bellman: Five to seven is optimum; again as long as we are creative and connect with others, a little bit on the high side is OK. But keep in mind that research indicates that 0-1 is not most at risk for suicide, but 2-3 is because they have more energy.

David: I want to thank Dr. Bellman for coming tonight and sharing his knowledge and experience with us. I also want to thank everyone in the audience for participating. I hope you found it helpful. If you need to contact Dr. Bellman, you can email him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

If you haven't already, please sign up for the bipolar community mail list here and we'll keep you updated on events like this.

Again, thank you Dr. Bellman for coming tonight.

Dr. Bellman: Thank you, and everyone in the audience. Good night.

David: Good night everyone.

Disclaimer: That we are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

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