How To Be Bipolar and High-Functioning
People with mental illness have various levels of functioning. Sometimes a good day is when you talk in your group therapy session at the psych ward. Sometimes a good day is getting out of bed. Sometimes a good day is going to the doctor. And sometimes a good day is giving successful presentation to a bunch of executives.
It varies from person to person.
And while anyone can tell you to “take your meds,” that doesn’t really tell you how to get from non-functional to functional. It’s true no one has the exact answer, 33 high-functioning people with bipolar disorder identified six things that keep them moving forward.
As I’ve said before, high-functioning bipolar disorder is a bit of a funny term. High-functioning to one person isn’t the same as it is for another. That’s OK. The idea is to do the best you can with your illness in this moment. You don’t have to reach a magical “functioning” number on a magical “functioning” scale.
What Helps Functioning
According to Murray et al. from Melbourne, there are six categories of strategies that help people with bipolar disorder function:
- Sleep, diet, rest and exercise
- Ongoing monitoring
- Reflective and meditative practices
- Understand bipolar disorder and educating others
- Connecting with others
- Enacting a plan
Why Do These Things Matter?
These sound like pretty good ideas to me. Here’s my take.
- I consider sleep the #1 predictor/cause of mood by a long shot. Rest is up there too. If you don’t have good sleep hygiene now, I have no idea what you’re waiting for.
- Checking in with professionals is critical. You need a touchstone to keep you on your treatment plan and hold you accountable. Plus, it forces you to think about how you are and what you’ve been doing, which makes you more aware.
- I’m so reflective I see my face in a stone, but that’s me. I’m a touch obsessive about such things. But you don’t have to be. Take five minutes a day and be mindful and reflective. Use those five minutes to write in a mood journal. Use those minutes to see how you did on your treatment plan today and what you are going to do tomorrow.
- Psychoeducation has been shown as a critical factor is recovering from mental illness. I know psychoeducation seems like a big word, and it’s a big idea, but learning about bipolar disorder will give you tools to spot its symptoms and handle them better. (Therapists can help you with this.)
- No man, or bipolar, is an island. Even if you really don’t feel like it, spending time with others is essential. Make yourself do it. It will help in the long run.
- A plan has also been shown to be critical in preventing mood relapse. How can this be? Well, you see, after you’ve psychoeducated yourself and know what to look for, you can then see the early warning signs while reflecting and reach out to others as needed. You can hopefully stop a mood dead in its tracks before it gets all dramatic-like. Plans are also great for what to do if you feel unsafe for any reason. Who you gonna call? Your plan should tell you.
Not everyone is going to do all of these things every day. That would take a long time. But what anyone can do is take one part of one of these things and work on it today. How are you going to build a sleep routine? Can you go for a walk? Do you have groceries in your fridge? Have you taken a moment for yourself?
And so on, and so forth. You’re not perfect, and you’re not going to be doing all those things perfectly all the time. But it does pay to remember that there are things you can do every day to help attain, or maintain, your recovery.
Just don’t go overboard with it because you’ll note that perfectionism and obsession were not on the list.
Murray G, Suto M, Hole R, Hale S, Amari E, Michalak EE. Self-management strategies used by 'high functioning' individuals with bipolar disorder: from research to clinical practice. Clinical Psychology and Psychotherapy. Mar-Apr 2011.
Tracy, N. (2011, June 6). How To Be Bipolar and High-Functioning, HealthyPlace. Retrieved on 2020, February 26 from https://www.healthyplace.com/blogs/breakingbipolar/2011/06/how-to-be-bipolar-and-high-functioning
Author: Natasha Tracy
I understand your lovely pool analogy, it can feel like the harder is increasing, I feel that in and off and it’s hard to have enough stamina to stay the course. That’s when I try to eliminate something that I don’t have to do at least not for now. Take it off the list with full permission and make self care a priority. An essential priority. Whatever that means to you. An hour more of sleep, naps, afternoon matinees by yourself, chocolate.
I am trying to honor how challenging it is so challenging.
I am trying to do the same thing. I don’t even want to describe it to anyone who isn’t BP
I was moved my what you wrote
You have lots on yours side
Your intelligence your insights
Thanks for the excellent blog(s).
I veer (sometimes sharply some times slowly) between feeling everything deeply and feeling absolutely nothing at all.
I have a good job, stable relationship and I socialise. These things have been very difficult to maintain and I have made many many mistakes.
The longer I am either void or nova (forgive the prose) the worse it is.
It feels like your swimming a full length of a pool and you've just got enough air and energy left to get to the end, only the pool keeps incresing in size.
I've been feeling nothing for 8 months now (2nd longest spell) - people are noticing and commenting
I know I'm not contributing to this discussion (not even sure why I'm writing this) but I am pleased that so many people here (and hopefully everywhere) clearly care and are finding ways to cope and thrive.
Good luck x
hi i am tired all the time but i sleep all the time. i get upset for no reson. i tryed to talk to my doctor about bipolar but she said she dont think i have it but i think i do so what should i do?
I know a lot of people find sleep to be crucial, but I've actually found it to be less crucial to me than food, which didn't make your list. (Maybe because I also have ADHD and take stimulants for it, so I get a bit of leeway.) Yes, if I only get 4h of sleep it's going to be a problem, but I've never had sleep issues on my own (except when medications have given me sleep problems) and can easily get between 8-10h a night. As long as I get more than 6, I'll probably be ok on that front.
However, food's a different story.
It's so easy to skip meals with a busy life. It's so easy to not eat meals that have enough protein or starches or vegetables/fruits/those kinds of nutrients. (Not every meal, for me, needs to be balanced in and of itself, but I try to eat at least a full meal's worth of each of those every day.) I have to eat a lowfat diet due to my gallstones, but I also have to be careful to eat enough fats. But I can have serious mood swings (to depression and/or anxiety) that are (most likely... I've never formally tested it) related to my blood sugar. Eating doesn't always fix things, but if I'm mood crashy, I'll sit down and see if it might be because I'm hungry... and sometimes it is. Every time that happens, it feels ridiculous to think that something as simple as food can fix it... and then I eat something... and then I start to feel better... and then I feel stupid for not remembering on a gut level that, no really, proper nutrition makes a difference. And I feel stupid for having something so basic affect me so much, but as you say, it's not our fault and it's not like it's something we chose.
(P.S. Totally adore your blog. Yours is the first mental illness blog that I've ever found that REALLY feels like it expresses my actual experiences. At one point, I found myself reading "Being Overwhelmed by a Bipolar Life" and I found myself pointing at the screen, yelling "YES!" over and over again, and then breaking down and crying because YOU ACTUALLY *GET* IT. Someone else actually completely and totally GETS it. I really am NOT alone, so thank you so much for writing your honest and unabashed experiences.
And for one more data point, that breaking things down into teeny weeny little tasks was how I found myself a mental health practice this last time I decided to look for help again. And that way of doing it TOTALLY worked. So yay!)
Truely appreciate the more wholistic approach you advocate. For myself having personal responsiblity and self-advocacy,education and supports are needed, paramount however to all these ingredients of recovery is HOPE. I also subscribe to a 'person first' discussion of recovery.
There is great information about the process of recovering revealed in this article. Those who are living with mental illness are continually 'pigeon-holed' with a mythical discription of skill sets ie, "high functioning". Recovery is not a destination but a journey, so I experience more of life's bleesings and my own as time and skill sets improve.
Please consider the effects such practices have on the target market of your information. Person First, Symptoms vs. diagnosis, Inclusion versus exclusion.
I'm sorry you're having a hard time right now. We've all been there. Sometimes episodes come out of no where.
There are many people who can still help even if your MD is out of town.
1. If you think you may hurt yourself or someone else get to an ER right now. They have psychiatric staff who can help you.
2. Reach out using one of these helplines: http://www.healthyplace.com/other-info/resources/mental-health-hotline-numbers-and-referr…
People on the helplines will be able to direct you to more local help and offer support.
You are not alone in this. You did the right thing by reaching out here; now you need to take the next step. One of the above can help you. You don't have to handle this on your own.
can't stop crying, can't stop feeling angry,don't know why??? i'm in the middle of something. yes itake and have taken my meds. i've been feeling something coming on and here it is!!! m.d's out town, i tried.
trying over here.
I know what a difficult position you must be in. It's very difficult, and sometimes it feels impossible, to watch someone go through this types of illness. I haven't written extensively, but please see these articles:
This article is more generic for those worried about loved ones with a mental illness: http://www.healthyplace.com/blogs/breakingbipolar/2010/09/how-do-i-convince-my-friend-to-…
If there is a specific topic you would like to see, please let me know and I'll see if I can work it in.
I hope that helps.
Could you write some advice for the parents and partners of bipolar people? Or have you? I am the parent of a rapid cycling bipolar son who has been on and off meds for ten years. He's currently off, and extremely isolated, cynical and angry about just about everything
It definitely is helpful to be able to see these things in ourselves.
I hope you and your doctor come up with a plan that helps
You're welcome. I'm glad I could help.
Thanks for the link. After reading it I realized another sign...a short fuse. I've been easily angered lately and didn't realize why. I see my doctor on Monday and hopefully we can stop this before it gets out of hand. Thanks for all you do.
Yup, that sure is a clear sign. Good on you for being aware, recognizing it and trying to stop it early. You're doing exactly what we all need to do.
I wrote this article you might want to take a look at: http://www.healthyplace.com/blogs/breakingbipolar/2010/08/5-signs-youe28099re-heading-int…
"Reflecting helps keeping us from beating ourselfs up with stuff we do not have control over."
I think the point you make about doing things in spurts is important - no one can do this stuff all the time. It doesn't mean it doesn't work or that we don't do it, it just means we have other stuff going on too.
I feel like sleep is critical to not only regulating but detecting oncoming mood changes. Lately I've been sleeping 16 hours plus a day. This is a sure sign that depression is setting in again. What to do about it is another story...any ideas in that department?
I sure am with you with plenty of sleep and creating good sleep patterns.. I also believe in the introspection or reflective stuff ( I likie that word stuff ) Reflecting helps keeping us from beating ourselfs up with stuff we do not have control over.. I don't have a complete plan but in doing the work I do, usualy in spurts, I get new info. and insight. Recently I found info on a med I take and am thinking of switching up...Awesome work as always. Keep up the short vids.
Great post, as always. Love your blog but first time posting! I too agree that sleep is critical. I know that for me, lack of sleep = unstable mood. Every single time.