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					Mood Disorders Association
                        of
                 Manitoba
                 Presents
RECOVERY AND
EMPOWERMENT for people with bipolar illness

 What is bipolar disorder
 Symptoms of Highs
 Symptoms of Lows
 Causes of Bipolar Disorder
 How can you help someone with Bipolar
  Disorder?
 What is Recovery?
 What are 13 things that Empower a person
 Your Action Plan
             BIPOLAR DISORDER
Or Manic Depression (as it used to be known)
is a treatable illness marked by extreme changes
   in mood, thought, energy, and behaviour.

   A person’s mood can alternate between the
    "poles" mania (highs) and depression (lows).
    This change in mood or "mood swing" can last
    for hours, days weeks or months.

   These swings can be severe, ranging from
    extreme energy to deep despair.
        Symptoms of BIPOLAR
            DISORDER
   Bipolar disorder differs significantly from
    clinical depression, although the symptoms
    for the depressive phase of the illness are
    similar.

   The severity of the mood swings and the way
    they disrupt normal life activities distinguish
    bipolar mood episodes from ordinary mood
    changes.
 LIVING WITH BIPOLAR
DISORDER AND BEYOND

You may have bipolar illness if
    you have some or all of
  the following symptoms of
     depression and mania
        Symptoms of mania –
   the “HIGHS" of bipolar disorder
 Increased physical and mental
 activity and energy

 Heightenedmood, exaggerated
 optimism and self-confidence

 Excessive   irritability, aggressive
 behaviour
        Symptoms of mania –
   the “HIGHS" of bipolar disorder
 Decreased need for sleep without
 experiencing fatigue

 Grandiose delusions, inflated sense of
 self-importance

 Racing   speech, racing thoughts, flight of
 ideas
            Symptoms of mania –
       the “HIGHS" of bipolar disorder

 Impulsiveness,    poor judgment,
  distractibility

 Reckless   behaviour

 Inthe most severe cases, delusions and
  hallucinations
     Symptoms of depression - the
      “LOWS" of bipolar disorder
 Prolonged  sadness or unexplained
  crying spells

 Significantchanges in appetite and
  sleep patterns

 Irritability,   anger, worry, agitation,
  anxiety
      Symptoms of depression - the
       “LOWS" of bipolar disorder

   Pessimism, indifference

   Loss of energy, persistent lethargy

   Feelings of guilt, worthlessness

   Inability to concentrate, indecisiveness
      Symptoms of depression - the
       “LOWS" of bipolar disorder

   Inability to take pleasure in former
    interests, social withdrawal

   Unexplained aches and pains

   Recurring thoughts of death or suicide
    BIPOLAR DISORDER
NO TREATMENT CAN CURE BIPOLAR
              DISORDER,
                 BUT
      RECOVERY IS POSSIBLE
 LIVING A FULL AND COMPLETE LIFE
             IS POSSIBLE


     IT IS UP TO YOU
    BIPOLAR DISORDER

1 in 4 Canadians will be affected by a Mood
             Disorder this year

      The Canadian economy loses
 52 Billion dollars per year
          Due to Mood Disorders


90% of people who have a mood disorder
         never seek treatment
  What causes Bipolar Disorder?

Bipolar Disorder affects approximately 1.5% of all
                      people.

 In Canada, more than 450,000 people have, or
             will have this disorder.

Although not a single cause has been identified, it
       is known that many factors, including
   biochemical, genetics, and environment play a
                 part in this illness.
  What causes Bipolar Disorder?
 Research  suggests that an improper
 balance of neurotransmitters in the brain is
 related to the symptoms and episodes of
 depression and mania.

 The biochemical imbalance may represent a
 genetic vulnerability set into motion by
 prolonged stress, trauma, physical illness, or
 some other environmental factor.
    What causes Bipolar Disorder?

 Medications    work for most people by
    correcting the chemical imbalance.

    There is growing evidence that heredity is
    involved, especially in the more recurrent
    forms of the disorder. The exact mechanism
    by which Bipolar Disorder is transmitted
    from one generation to the next is not
    known.
CHEMICAL IMBALANCE
BIPOLAR DISORDER
 Fortunately, very effective
 treatments are available to
stabilize your mood and help
 you regain and maintain a
satisfying and productive life.
          BIPOLAR DISORDER
   You cannot diagnose yourself. Only a properly
    trained health professional can determine if you
    have bipolar disorder.

   Many people do not seek medical attention during
    periods of mania because they feel manic
    symptoms (increased energy, heightened mood,
    increased sexual drive, etc.) have a positive
    impact on them.

   However, left unchecked, these behaviours can
    have harmful results.
Types of BIPOLAR DISORDER

   Patterns and severity of
  symptoms, or episodes, of
  highs and lows, determine
   different types of bipolar
           disorder.
                 BIPOLAR I
   Bipolar 1 is characterized by one or more manic
    episodes or mixed episodes,

   symptoms of both a mania and a depression
    occurring nearly every day for at least 1 week,

   and one or more major depressive episodes.

   Bipolar I disorder is the most severe form of the
    illness marked by extreme manic episodes.
            BIPOLAR 2
 Bipolar 2 is characterized by one or more
  depressive episodes accompanied by at
  least one Hypomanic episode.
 Hypomanic episodes have symptoms similar
  to manic episodes but are less severe, but
  must be clearly different from a person’s non-
  depressed mood.
 For some, Hypomanic episodes are not
  severe enough to cause notable problems in
  social activities or work. However, for others,
  they can be troublesome.
              BIPOLAR 2
   Bipolar 2 disorder may be misdiagnosed
    as depression if you and your doctor
    don’t notice the signs of hypomania.

   In a recent DBSA survey, nearly seven
    out of ten people with bipolar disorder
    had been misdiagnosed at least once.

   Sixty percent of those people had been
    diagnosed with depression.
         BIPOLAR DISORDER
   Because bipolar disorder is complex and can be
    difficult to diagnose, you should share ALL of
    your symptoms with your health care provider.

   Keep a daily log of how you feel and show it to
    your Doctor. It will help him decide what and
    how much of a medication you need.
     Mood Disorders
Many people with Bipolar disorder try to
             self-medicate
     with alcohol and illicit drugs

        “Drown their sorrows”
 By using alcohol or other substances
to reduce the pain or induce euphoria.

 This only worsens the mood disorder.
When Manic Or Depressive Episodes
             Occur

   Family life is often stressful. Symptoms of
    both phases are distressing in different ways.

   If mood swings are mild, the family may be
    able to handle them without too much
    difficulty. When the episodes are severe,
    coping may be extremely difficult.
    What To Expect When Mania Appears

   Depending on the severity of the manic episode,
    reactions can range from frustration and annoyance
    to anger and hatred. Family members are dismayed
    as they see their loved one turning into a stranger.

   Spending sprees, promiscuity, criminal acts or other
    forms of erratic and risky behaviours may occur. The
    manic person is sure there is nothing wrong with
    these actions and often takes no responsibility for the
    consequences. Family members are often faced
    with having to “pick up the pieces” or “bail out” their
    relative (both literally and figuratively).
    What To Expect When Mania Appears
   At the first signs of over-activity and after the first night’s
    loss of sleep, express your concern and take action if
    necessary.
   Don’t tell (or expect) the person to “snap out of it.”
   Use a firm but consistent approach. Avoid sounding strict or
    bossy. Don’t make demands. Don’t argue with the person.
    The severity of the manic episode will affect how firm or
    forceful you need to be.
   Recognize that people with bipolar disorder are often unable
    to control their thoughts. Their behaviour is the result of the
    illness.
   Try to maintain your usual routine, for example, serve meals
    at the regular times.
   Try to keep your home as quiet and restful as possible, for
    example, keep lights low, play soothing music.
WHAT TO DO WHEN A DEPRESSIVE EPISODE
              OCCURS
   Limit stimulation.
   Make your expectations clear.
   Be supportive and understanding. A depressed person needs
    to talk with someone who will not be critical.
   Encourage self-care, especially with respect to eating, bathing
    and personal hygiene. For example, prepare balanced meals
    that can be easily reheated; keep nutritious snacks available;
    suggest a relaxing bath.
   Try to enhance self-esteem and self-confidence by
    emphasizing the positive and talking about the person’s past
    and current achievements.
   Promote “not getting depressed” over “being depressed.”
    Provide reassurance that the depression will pass.
        WHAT TO DO WHEN A DEPRESSIVE
               EPISODE OCCURS

   Monitor all medications carefully. It is common for a depressed
    person to forget or become confused about medications.
   Watch for evidence of hoarding medications. It is often a sign that
    suicide is planned.
   Determine whether there are thoughts of or any plans for suicide.
    Take action if necessary.
   Ask the depressed person if you are doing anything that may be
    contributing to their condition. Be prepared to do some problem
    solving.
   Don’t tell (or expect) a depressed person to “snap out of it.” This
    leaves the impression that they are responsible for, or have
    control over, their condition when they do not.
   Above all, get professional help.
                 HOW TO HELP?
   “One of the things I found useful when I was
    depressed was to ask people around me to
    write a list of my positive qualities. At the time I
    couldn’t have thought up one on my own. It
    sure helped. And anytime I need to, I can see
    that someone cares. It’s right there on paper.”

    Ask yourself, “How would I like to be treated in
    this situation?” and act accordingly.
    Suggestions are:
                         HOW TO HELP?
   TREAT THE PERSON WITH THE ILLNESS AS AN ADULT.

   EMPHASIZE THE POSITIVE. Focus on accomplishments.

   ACKNOWLEDGE EFFORT. Recognize attempts.

   USE HUMOUR. Laughing together can help to relieve tension, put things in a better
    perspective and demonstrate warmth, caring and mutual understanding.

   SET CLEAR EXPECTATIONS.

   DEAL WITH PROBLEMS SOONER RATHER THAT LATER.

   OFFER HELP JUDICOUSLY.

   RECOGNIZE THAT STIGMA EXISTS.
              HOW TO HELP?

   Don’t lose hope.

Living with bipolar disorder can be discouraging,
         particularly when relapses occur
              or in times of distress.
         But there is hope for recovery.
      People who live with bipolar disorder
    can have satisfying and productive lives.
 Many say they value the insight and sensitivity
     they have gained from their experience.
                 Things to consider:

 “No one is to blame and you cannot cure a mental disorder
    for a family member.”

    Despite medication compliance, episodes may occur. It may
    take some time to find the right medications and dosages.

     Additionally, the symptoms of the disorder may change over
    time requiring medication adjustments.

   Despite your efforts, the symptoms may get worse.

    Separate the person from the disorder. Love the person, hate
    the disorder, and separate the medication side effects from the
    disorder/person.
                  Things to consider:
    It is NOT okay for you to neglect your needs. Take care of
    yourself, ensuring you have a rich and fulfilling life. Do not
    shoulder the whole responsibility for your family member.
    You may have to assess your emotional commitment.

   There is nothing to be ashamed of if someone in your family
    has a neurological chemical brain disorder.

   It is natural to experience many strong emotions such as
    denial, grief, guilt, fear, anger, sadness, hurt, and confusion.
    Healing occurs with acceptance and understanding.

   Allow your affected family member and other family
    members to go through their grieving processes at their own
    pace. This is also true for you.
RECOVERY IS:

 CHOOSING
    TO
TAKE ACTION
Recovery is a journey
  without an end!

There are always new thing to learn
 and do for ourselves
             RECOVERY IS:

Having an improved quality of life

Psychological well-being

Accomplishment of life goals

     living a satisfying life
  with meaning and purpose.
        RECOVERY IS:
Having what we feel are meaningful,
        purposeful activities.

 Being part of our community in a
         meaningful way.
           RECOVERY IS:

    Success is not simply an absence of
     symptoms or a reduction in inpatient
           admissions to hospital.

Success is also measured by how well we are
      able to pursue the things that give
     our lives purpose and meaning.
 TO RECOVER :
We must choose to:
Believe that it is possible to have a better life.

Hope again.

Believe that we are more than our illness

Believe that we have the skills, talents and ability
 to change
TO RECOVER:
We must choose to:
Believe that we, the individual, deserves dignity,
 love and happiness
Believe that we have the ability to address the
 dissatisfaction we have with our present disabling
 and disempowering circumstance
Believe that we are responsible for our own life.
Believe that we have the ability to change the
 thoughts and behaviours that are barriers to our
 recovery.
EMPOWERMENT IS:
1.Having decision making power

   We need to be able to make our own
decisions about the treatment that is best for
                     us.

 We also must be allowed to make our own
 decisions about our own lives if we wish to
       gain a sense of independence.
EMPOWERMENT IS:
2.Having Access to Information

  We need to educate ourselves about our
   illness and how it is affecting our body,

   Only then can we empower ourselves
       to make the best choices for
            our OWN recovery.
EMPOWERMENT IS:
3. Having a Range of Options from
 Which to Make Choices.


     We, as people with lived
  experience need to be aware of
         what choices are
         available to us.
EMPOWERMENT IS:

4.Assertiveness


 Those with lived experiences
 need to know how to request
   what we want and need
           correctly.
EMPOWERMENT IS:
5. A Feeling that the Individual can make a
 Difference.


    We must be hopeful and believe that
            recovery is possible
and that with effort on our part there will be a
       change to our current position.
EMPOWERMENT IS:
6. Allowing us to reclaim “OUR OWN
 STORY.”

   We are often made to feel that we are a case
    history and not a real person with real life
                  experiences.

    We need to tell our story and have people
                  listened to it.
    This is where self-help groups can play an
           important part in the process.
 EMPOWERMENT IS:
7. Not Feeling Alone, Feeling Part of a
  Group


      Empowerment best occurs when an
         individual does not feel alone
          but feels a part of a group,
       a connection with other people.
EMPOWERMENT IS:
8. Understanding that People have
  Rights

   We with lived experience need to believe
      that we are entitled to the same
     basic human rights that any other
         individuals are entitled to.
EMPOWERMENT IS:
9. Affecting change in one’s life and
 one’s community

         When we feel empowered
 we not only feel a change in our own life,
          but can work toward
      changing the lives of others
                around us.
EMPOWERMENT IS:
10. Learning skills that the individual
 defines as important.

       The emphasis needs to be on what
   the individual deems is important to them.

        We will feel empowered only
     when we have been given the ability
                 to CHOOSE
          what is important to us.
EMPOWERMENT IS:
11. Changing others perceptions of
 one’s competency and capacity to
 act.

    When individuals with lived experience feel
                   competent
     around the so called “normal” people
                  in our life,
           we become empowered.
 EMPOWERMENT IS:
12. Increasing one’s positive self image
 and overcoming stigma.

When we are truly empowered, we are confident
 enough to let people know we have an illness.

This will help lessen the stigma and we will begin
 to feel more confident and capable
EMPOWERMENT IS:


13. Growth and change that is never
 ending and self-initiated.
     Attitude
…Life is only 10% what
    happens to me
          and
 90% how I react to it
   WHAT CAN I DO TO HELP
         MYSELF?
Being diagnosed with a mental illness is like
 having any other serious medical condition.

It means being more careful in how you live
                  your life.
         You need to live a more
           STRUCTURED LIFE
        And put together your own
              ACTION PLAN
            ACTION PLAN
1)Tell someone how you feel.

          Ask them to just listen to you.

      No interruptions, advice, criticism, or
              judgments just listen.

          This will help you feel better.
                  ACTION PLAN
2) Take a rest from your responsibilities.

 Don’t leave all your duties completely, just simplify.

         Avoid making any major decisions.

  Ask if employer will make allowances for you at
                        work.

       DON’T ISOLATE YOURSELF.
                ACTION PLAN
3.MEDICATION COMPLIANCE:

 Medications taken to improve our functioning sometimes
    make us feel physically worse than the illness itself.
     There are many different types of medications.
  You don’t have to live with unacceptable side effects.

 Too many people stop taking medications for this reason;
  Medications need to be taken for a long
       period of time to be effective.
             ACTION PLAN
4) Limit Alcohol and Drug use:

         Continued abuse of alcohol
                   and or
         dependence on street drugs
  --even marijuana-- could alter the course of
                  the illness.
          DON’T SELF MEDICATE
                   ACTION PLAN
5) Monitor sleep:
 Normal sleep occurs with fatigue and reduced stimulation.


In bipolar disorder, loss of sleep can precipitate or exacerbate
                        an episode of mania.

   Even losing one night of sleep may trigger an episode.
      You need at least 6 to 8 hours of sleep a night.

     Too much sleep can start an episode of depression.
                ACTION PLAN

6) Positive thinking:

Your attitude is perhaps the most important thing you can do
                   towards your own recovery.

        You are the only one who has full control of


               YOUR ATTITUDE
            ACTION PLAN
7) Sleeping.

 Go to bed and get up at a regular time.

       Establish a bedtime ritual.

   Do something calming before bed.

   Not sleeping is serious with bipolar
                  illness.
             ACTION PLAN
8) Get some exercise.

              Any movement will help.

            Don’t do too much at once.

 Climb the stairs, take a walk, sweep the floor, etc.

       Don’t rush from one thing to another.

                Live in the moment.
                 ACTION PLAN
9) Spend time outdoors
             At least a half-hour per day.

                Again, don’t overdo it.

Walk or just sit outdoors. Even if it is cloudy or rainy.

          Roll up the shades, let the sun in.

                  Turn on the lights.
                  ACTION PLAN
10) Eat healthy foods
.
    Avoid sugar, caffeine, alcohol, and heavily salted foods.

      If you can’t cook for yourself, ask a friend or family
                      member to cook for you.

             Buy healthy frozen or canned foods.

    Make sure you eat 3 to 6 small meals a day, don’t skip
                             meals.
              ACTION PLAN
11) Obsessing and Negative thoughts.
 Obsessing can make those issues larger than they
                   really are.

               Divert your attention.

 Do something you really enjoy such as gardening,
       crafts, playing with your pet, reading.

  Try turning negative thoughts around to positive
     thoughts. Train yourself and make it a habit.
               ACTION PLAN
12) Relax.
                  Sit in a comfortable chair.

                  Loosen any tight clothing.

          Take deep breaths (BELLY BREATHING)

     Relax every part of your body. Start with your toes.

                 Notice how your body feels.

                 Focus on a favorite scene.

             Do this for at least 10 minutes a day.
             ACTION PLAN
13) Nutrition:

Balanced intake of food is needed to provide
 vitamins and nutrients that are essential for a
            healthy body and mind.

   Nutrients are not stored so they must be
          replenished at regular times.
             ACTION PLAN
14) Build a strong Support system:

 Surround yourself with people you trust and
                   respect.

  You must be willing to accept their support
                and judgment,
   especially at times when your judgment
   regarding mental health may be impaired.
             ACTION PLAN
15) Build a therapeutic Partnership with
               your Doctor

           Shared common insights:
            Empathy and Honesty
                     Trust
                Confidentiality
 Persistence-commitment to working at getting
                     better
         Unconditional Positive Regard
                   ACTION PLAN

Build a therapeutic Partnership with
 your Doctor continued

 Positive therapeutic relationship is more important than the
                          therapy used.

You can’t do this alone, yet you are the only one that can help
                             yourself.

  Inform yourself about your condition or you will forever be
                     subject to it’s whims.
            ACTION PLAN
16) Financial Management:

 Prepare a budget – learn to live within your
                   means.

  Make financial decisions before episodes
                    occur.

 Put limits on your spending by decreasing
      your credit and withdrawal limits.
                    ACTION PLAN
17) Add structure to your life

  It is important to have regular times for sleeping, meals,
            medication, exercise and social activities.

                 Don’t overbook activities.

Focus your energies, if you get sick you accomplish nothing

              First rule Self-help.
              ACTION PLAN
18) Educate yourself about your illness

To be an effective advocate for yourself and the
 type of treatment you receive, you will need
 to know what you are talking about.

            Knowledge is power
              ACTION PLAN

19) Join a support group

Getting together with people who also have an
 illness such as those in support groups helps.
     Check the times for groups at the Mood
       Disorders Association of Manitoba
             ACTION PLAN
20) Write a plan to keep yourself well

Making time for paying bills, buying groceries,
           or cleaning your home.

Watching for early warning signs of the illness.

         Signs of getting much worse.

  Watch for signs that you are cycling higher.
       ACTION PLAN

Everyone develops a different
        recovery plan,
      and the right one
          is the one
     that works for you!
        REMEMBER
Recovery is a journey filled with hope:

             Take control.

            Take charge.

         Look after yourself.

No one else can do it as well as you
               can!!!!
The Mood Disorders Association of Manitoba
                              4 Fort Street
                             Winnipeg, MB
                                  R3C 1C4
                             PH: 786-0987
             TOLL FREE: 1-800-263-1460
          E-mail: mdam@depression.mb.ca

				
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