More on Bipolar 2 and Self Care

Calling Bipolar 2 the softer version of Bipolar 1 is not quite accurate. It might be easier to hide and avoid hospitalization. And aside from actual suicide attempts, you are less likely to land in the emergency room. But Bipolar 2 actually has a higher suicide risk than both Bipolar 1 and Major Depression. Of the three, over a lifetime you spend the longest time depressed. Sprinkled throughout are higher energy times when you might actually have the willpower to kill yourself.

You don’t exactly swing between happy and sad states.  To describe from my own experience, which seems fairly close to textbook Bipolar 2, it is more accurate to say you swing between low and high energy states, with the vast majority spent in low. Note that low doesn’t necessarily mean sad, nor does high mean happy. Low states might be lethargy and way too much sleep, it might even feel comfortable in a weird way.  High energy states can bring happy and productive hypomania, but this is woefully infrequent. More likely they arrive with high strung anxiety, irritability, and explosive anger. 

At first glance the more serious depressive episodes might look indistinguishable from major depression but apparently the latter is more likely to suffer from sleep disturbance and insomnia. Also bipolar depression tends to have a much earlier onset in life. In my case the first major episode was at age 13.

Unfortunately most available information on Bipolar paint a simplified picture. Describing it as a fairly well defined chemical imbalance of the brain that must be controlled lifelong with mood stabilizers. For some these might be life saving, but they are probably a subset of the diagnosed. We don’t try all the other less invasive and about as effective methods available. Sometimes societal pressure and stress don’t give us a choice. It also doesn’t help that there’s no money to be made in these lifestyle tweaks.

The following are my own self care strategies (aside from therapy and/or medication) that seem to help.

Regular routine (sleep, meals, work, social activities…)
Exercise
Sunlight
Someone to talk to
Low stress (not living up to my “potential”)
Writing, music
No alcohol
Dark therapy

Interestingly this is pretty close to what people with bipolar self report worked according to a 23andme survey. (https://blog.23andme.com/23andme-research/what-patients-say-works-for-bipolar-disorder/)

Bipolar is not only a problem with mood regulation. There are also executive functioning deficits. Once you are out of the thickets there is still much work to do.  Personally, I still need to put in a lot of effort in decision making, focus, goal setting, and social contact.

All these do not require any money or prescription and they carry no risks. But they do require changing your habits and you just may not have the energy to do so. I was only able to get to the point of self care deterring further episodes after years of therapy and constant support from my spouse. But as mentioned before, I still struggled with mild mood problems, low energy, brain fog, and occasional explosions, among others. The final key, the point of this whole blog, was diet.

There is increasing evidence that mental disorders are connected to inflammation, particularly of the gut. The source of this inflammation may differ from person to person, but in my case undiagnosed allergies and sensitivities seem to have played a key role. That the brain and gut and immune system all influence each other may have at one point been dismissed as wild speculation but in recent years there was a game changing discovery of a direct physical connection between the brain and immune system. (http://www.nature.com/articles/nature14432.epdf) Toppling the notion thus far that the brain was immune privileged.

Now I am at a point that I didn’t know I’d ever get to. I am on an even keel, almost saintly sometimes. I seem to have many times more energy and clarity. At most I might have mildly low mood for a day or two after tiny accidental ingestion of some problem foods.

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