Bipolar Resources

Along my journey with bipolar disorder I have had many questions. Several books have helped me immensely. My all time favorite, most used book is The Bipolar Survival Guide , by David J. Wolfowitz. I have included a thorough summary of this book.

David J. Miklowitz
The Bipolar Disorder Survival Guide
(New York: Guilford, 2002), 322 pages.

One problem with self-help books is that few people actually do what the books prescribe. To put all this advice into practice would be a full-time job! Most readers settle for a few snacks rather than the entire meal. This tendency is exaggerated with those who exhibit symptoms of bipolar disorder because they aren’t persuaded that they even have a problem. They are not inclined to invest in the process of change when they do not see that change is needed. They think that the real problem is the other people who have low tolerance for the more energetic and creative moments of their bipolar flights. And they certainly do not see the need for hospitalization.

The basic premise of the book is this: “knowledge is power.” The more you understand about the problem, the more you will be able to accept it and manage it. It reviews the symptoms, possible causes, traditional treatments, and self-management strategies.

The book begins with vignettes from the lives of people who have experienced the highs and lows of bipolar. For readers who have rarely, if ever, witnessed bipolar, such stories create an opportunity to accumulate vicarious experience.

From there, Miklowitz presents a few chapters on the traditional psychiatric perspective regarding bipolar disorder: this is a biological problem—an illness—and only a combination of medication and counseling will help.

Bipolar people do have unique disabilities. They rarely believe that they have a problem, and that alone can make them insufferable to family and friends. The traditional view emphasizes medication, in part, because it seems to inject clarity and protection into an otherwise destructive .

Miklowitz’s explanation of bipolar is that a genetic predisposition can be latent until provoked by difficult life circumstances and/or by unhelpful interpretations the person makes. Therefore, the pillars of this treatment plan include (1) medication, (2) changing the environment, and (3) changing how one thinks.

His thoughts on medication are predictable: medication is essential, and a bipolar person will probably take it for life. He suggests that medication can extend the length of time between recurrences. If there are recurrences, medication limits the extremes of the highs and lows.

Regarding changes in environment and lifestyle, he includes the following suggestions:

  • Avoid all drugs and alcohol.
  • Deal quickly with conflicts.
  • Stick to a wise schedule. Opt for as much sameness and predictability in life as possible. For example, go to bed and rise at the same times and avoid allnighters. There is some reason to think that significant and rapid changes to the routines of life can trigger those vulnerable to bipolar highs and lows.

His psychotherapeutic component focuses on present problems more than past history and addresses these questions:

  • How does bipolar affect your work and relationships?
  • Have you identified early warning signs?
  • Do you know how to grow in your relationships?
  • How have you handled the possibility of future bipolar fluctuations in your life?

The author gives practical suggestions for identifying early warning signs and assembling a team of persons who can help. He advises that whenever the bipolar person notices connections between early behavioral changes and later bipolar highs, he (or the counselor) should write these down, then date the paper and sign it. If, during more stable periods, the bipolar person acknowledges that certain steps would be wise to follow during the highs, he or the counselor should write these down as well. These steps could include taking away (or giving up) car keys and credit cards as a means to limit the damage done by impulsive decisions.

By Ed Welsh

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