During my seventh hospitalization for bipolar disorder - 18 years after I first cracked-up as a graduate student in psychology - I finally wrote a plan to keep myself out of the nuthouse. Here are some steps that you can use to write your own plan to Stop a Downward Bipolar Spiral.
1. Identify your pattern of thoughts, feelings, and behaviors that ends in a bipolar episode.
We all have our own patterns. Mine starts with a frustrating event that I interpret as a problem and then exaggerate to be more serious than it is. The pattern ends with me telling myself that I am a complete failure, becoming depressed, feeling hopeless, and responding to the hopelessness with rage. When you recognize the pattern starting, you can stop it. But first, you need to know what the pattern is.
2. Write down your pattern.
This will give you a more clear and specific idea of your pattern and will help you recognize it as soon as it begins.
3. Make note of the times when you have been able to avoid or stop the pattern.
Recognizing that you have avoided potential bipolar episodes in the past (probably many times) will help you to avoid them in the future. It is a skill that you most likely have already used without even knowing it. You may have bipolar disorder, but there are many times when your mood, thoughts, and behavior are quite normal. And, sometimes, you do respond to stress quite well. What did you do at those times that enabled you to successfully avoid a bipolar meltdown?
4. Remember that you do have some control over the pattern.
The chemical imbalance of bipolar can powerfully affect our moods, but we can still make conscious, deliberate choices about our thoughts and behaviors. You can literally force yourself to think new thoughts and change your focus. Once when I was thinking obsessively and unproductively about something that may (or may not) have been a problem, a friend suggested that I do a crossword puzzle. I was desperate, so, in spite of my serious doubts, I gave it a try. It worked. I stopped obsessing - at least while I was doing the puzzle.
5. Make a list of thoughts and behaviors you can use to replace your bipolar pattern thoughts, feelings, and behaviors.
When I recognize that my pattern might be starting, I have a number of alternative thoughts and behaviors that I can use to interrupt, contradict, and stop the pattern. They include: recalling my past successes, exercise, positive self-talk, taking a walk, removing myself from stressful situations, praising God in spite of my circumstances, calling my counselor, and declaring the promises of scripture. (I roar out loud with a fist in the air, "Yes! The Creator-King of the universe is my Dad and He is right now at work for my absolute best!"Romans 8:28)
It's wise to write the list down. Once your bipolar pattern thinking/feeling/acting begins it can be hard to recall the good ideas you had when you were a little more sane. Keep the list handy and pull it out as soon as the pattern begins.
6. Give a copy of your plan to your family and/or counselor.
In the midst of a bipolar episode, these people can pull out their copy and remind you of your own good advice. Nothing short of seroquel stops distorted thinking quite like being confronted with your own words.
Your plan doesn't have to be anything at all like mine. But make a plan! Don't leave yourself exposed to the next potential downward spiral. You can stop it! Make a plan.
