Onika L. Dainty

How to Start Managing Bipolar I Disorder: A Comprehensive Guide

Living with Bipolar disorder is a unique journey that comes with its own set of challenges and lessons. I’ve been navigating Bipolar I disorder for over 20 years, and during that time, I’ve learned a lot about how to manage this condition effectively. As a 42-year-old woman, born in Georgetown, Guyana, and now living in Durham Region, Ontario, my journey has been shaped by both personal experience and professional growth. Today, I’m a Peer Support Specialist, a daughter, sister, granddaughter, aunt, cousin, and friend, using my lived experiences to help others.

In this guide, I’ll share my insights on how to manage Bipolar I disorder, including my personal experiences with Hypomania, Mania, psychosis, delusions, hallucinations, and suicidal ideations. I’ll also touch on Bipolar II disorder and Cyclothymic disorder, although I’m not an expert on those. Through self-advocacy, a structured routine, medication management, and the support of a strong team, it’s possible to build a more stable life.

Understanding Bipolar I Disorder

Bipolar disorder is a mental health condition characterized by extreme mood swings that include emotional highs (Mania or Hypomania) and lows (Depression). Bipolar I disorder, which I live with, involves episodes of Mania lasting anywhere from 6 days to 8 weeks. Hypomania can last for months before progressing into full Mania, which often leads to hospitalization. During these manic phases, I’ve experienced delusions, hallucinations, and psychosis, often accompanied by suicidal ideations.

Bipolar II disorder, on the other hand, involves Hypomanic episodes followed by severe Depressive episodes, while Cyclothymic disorder is characterized by numerous periods of Hypomanic and Depressive symptoms lasting at least two years, though less severe.

For a long time, I kept a copy of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) on my nightstand—my reference to understanding the medical definitions and criteria for Bipolar and other mental health disorders. If you haven’t familiarized yourself with the DSM-5 yet, it’s a helpful tool for understanding the nuances of these conditions.

My Experience with Triggers

I’ve learned the importance of identifying triggers that can lead to mood swings. For me, triggers include lack of sleep, seasonal changes, traveling, and even daily changes in routine. Substance use has also played a role in triggering episodes. I don’t have a history of alcohol abuse, but marijuana was my drug-of-choice and a gateway into my first manic episode at 21-years-old. I later struggled with cocaine use, which became a significant trigger for Mania. Today I am proudly sober, however self-medicating with substances is often a slippery slope that leads to serious and life-altering episodes. Recognizing these patterns and avoiding triggers is critical for managing my Bipolar disorder.

Medication Management

When it comes to medication management, it’s essential to build a relationship with your doctors and communicate clearly when medications aren’t working or when side effects are unbearable. I’ve experienced side effects ranging from weight gain, insomnia, a zombie-like state, tremors, and even suicidal thoughts. Currently, I’m on a cocktail of mood stabilizers and antipsychotics to balance my brain chemistry, but it took time and advocacy to find what worked for me. Self-medicating, especially with marijuana or other substances, can be the downfall of managing the condition, as it was for me.

My Support Team

Your support team doesn’t have to be large—it can consist of 2-3 people with different roles. In my case, my substitute decision-maker is someone I met during my third manic episode in 2009. She handles my home, medications, and doctor communication when I’m hospitalized. I also have a wellness support friend who pushes me towards positivity, and my cousin provides spiritual counseling, helping me recenter on my faith.

In addition to my main support team, I have a few others who provide intellectual stimulation, motivation, and caretaking. For mental health professionals, I work with psychiatrists, therapists, and counselors, though it’s important to note that there can be long wait times and high costs. Alternatives like counselors, caseworkers, and social workers are available through outpatient services.

Hospitalization Experiences

I’ve had 13 manic or psychotic episodes that required hospitalization, and they are often deeply isolating experiences. Hospital stays can last anywhere from 2 to 3 months, and I’ve been restrained, sedated, and placed in isolation during these periods. These experiences are difficult, and they underscore the need for a crisis plan that outlines your preferences for which hospitals to go to and which to avoid. It’s also important to have a plan for who will manage your bills and speak on your behalf during these times.

Structure, Routine, and Habits

Maintaining structure and routine is a crucial aspect of managing Bipolar I disorder. Personally, after major episodes, I’ve found that going back to school provided the structure I needed to regain stability. It’s through this cycle that I found my passion—helping others through peer support. I’ve since become a Peer Support Specialist through Peer Support Canada, and it’s a designation I’m incredibly proud of. Building a routine centered around spiritual practices like daily prayer and meditation, self-care activities, medication management, nutrition and exercise, psychoeducation, self-reflection and counseling I continue to build good habits that help me thrive in my Bipolar I disorder.   

Crisis Planning

A comprehensive crisis plan includes regularly updating it with your doctors and counselors and ensuring that the important people in your life know how to act during a crisis. For example, in Ontario, we can use outpatient services to work on crisis plans, and in Durham Region specifically, I rely on Durham Mental Health Services (DMHS). Familiarizing yourself with local resources can be life-saving. You should also share your crisis plan with those close to you, including information on wellness checks and preferences for hospital care.

Emergency Resources

It’s vital to be aware of what emergency resources are available in your community. In Durham Region, Ontario, I rely on Durham Mental Health Services (DMHS). They provide support for individuals experiencing mental health crises and connect people with the resources they need. These services have been a cornerstone in my crisis planning and overall management of Bipolar I disorder.

Final Thoughts

Managing Bipolar I disorder is a complex journey that requires self-awareness, a strong support system, and effective strategies for coping. By understanding the condition, identifying triggers, and advocating for yourself in medication management, you can work towards a more balanced life. My experiences have taught me the importance of connection, both with others and with myself. As I continue on my journey, I hope that sharing my story and insights will help others navigate their own paths with Bipolar I disorder. Remember, you are not alone, and there is a community of support available to help you through.