Managing the ups and downs of bipolar disorder

One in five American adults live with some form of mental illness, and 1 in every 25 live with more serious conditions such as schizophrenia, bipolar disorder and major depression. While effective treatments are available, less than half of adults with mental health issues receive help.

Often there are long delays — sometimes decades — between the first appearance of symptoms and when people get treatment. And many are unaware that their symptoms could be connected to mental health issues.

Sharp Grossmont Hospital Behavioral Health Center patient Richard Law understands this all too well.

One man’s mental health journey
At age 15, Law began having psychological challenges. By his later teen years, he was experiencing extreme highs and lows not connected to events, as well as mania — a heightened mood state that causes increased energy and activity, irritability, restlessness, an inability to sleep, and reckless behavior. Without knowing the cause of his symptoms or how to relieve them, he continued to struggle with his mental health.

Law remained undiagnosed until his late 20s, when he learned he has bipolar disorder. Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels and the ability to carry out day-to-day tasks.

People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and unusual behaviors. These distinct periods are called “mood episodes.” Mood episodes are drastically different from the moods and behaviors that are typical for the person. Extreme changes in energy, activity and sleep go along with mood episodes.

In the years following his diagnosis, Law received inconsistent care. He saw numerous psychiatrists and psychologists and even underwent inpatient treatment. None of these provided lasting relief from his symptoms, and he continued to deal with the extreme ups and downs of mania and depression. It wasn’t until he enrolled in the mood program at Sharp Grossmont Hospital’s Behavioral Health Center that he felt like he finally found the help he desperately needed for so many years.

Addressing mood disorders with cognitive behavioral therapy
The mood program is a group-based, outpatient treatment that addresses the mental health needs of people struggling with depression, anxiety disorders and bipolar disorders. In the program, a multidisciplinary team of therapists, psychiatrists and nurses helps individuals contend with their mental health issues as well as life stressors and losses.

Using a three-pronged approach — medication management, a supportive group therapy process and mindfulness-based cognitive behavioral therapy (CBT) — clients are empowered to achieve their wellness goals.

With mindfulness-based CBT, patients develop an understanding of the interplay among thoughts, emotions, physical sensations and behaviors. They learn to identify and change thought patterns and unhealthy behaviors that feed into negative emotional states, and how to respond more effectively to events that may lead to emotional upset. Mindfulness increases self-awareness and helps with disengaging from painful thoughts and feelings.

Lori Alford, LCSW, is one of the therapists who leads the mood program. According to Lori, the program’s group-based structure is a big reason for its success.

“There are tremendous benefits to group therapy,” she says. “First and foremost, it promotes insight and personal growth through mutual support and shared experience. It also shows people that they are not alone and helps them put their own problems into perspective. It is a powerful and impactful process in that patients can relate to and learn from each other.”

The length of treatment varies for each person based on their needs. Patients learn to self-rate their symptoms and, with the expanded ability for self-observation, learn the signs and symptoms of when they are not doing well and when they are functioning more optimally.

Feeling better with therapy
Since enrolling in the mood program three years ago, Law has noticed a significant improvement in his ability to manage the symptoms of bipolar disorder. He has better relationships with his family and others. He is grateful that he has been prescribed medication that works well for him. In addition to taking the medication, he applies coping tools to manage his mood swings.

A key ingredient to success, Law says, is being actively involved in treatment and continuously applying what he learned in therapy. The mood program has provided him with so many helpful tools that he decided to compile his learnings into a booklet. When he is going through a tough time, he can refer to the booklet and apply the tools and techniques to help manage his condition.

“What we are trying to achieve with each person in the program is meaningful behavior change,” explains Alford. “The team teaches self-counseling skills as well as strategies to implement those skills and work toward their goals. We also talk about values, usually long-term beliefs about what is truly important to each individual. From there, each client can set a workable goal or specific behavioral action that is reflective of his or her value.”

There are more than 50 concepts, tools and acronyms listed in Law’s booklet. One of his favorite techniques is thought reframing. He is able to recognize when he is catastrophizing an event, challenge his thinking about it and then change his thinking to be more balanced and helpful. This, in turn, leads to a more positive outcome in both his behavioral choices and his emotional response.

As Law explains, “It’s hard not to think about something, and this technique has taught me to think of things in a different way, and to cope better with how things are.”

Alford and the behavioral health team enjoy seeing patients’ growth and watching many of them help others in the group. “It is wonderful to witness patients’ progression as they move through the program, and to see them not only get better, but flourish,” she says.

“As a team, we strive to foster self-compassion and hopefulness for each individual in the program, presenting coping skills and encouraging active involvement in using those skills for long-term wellness,” she says. “We hope each patient graduates from our mood program with the ability to use self-counseling skills so that they can reach their goals and their optimal mental health.”

For the news media: To talk with Lori Alford about Sharp Grossmont’s mood program for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.