Is it possible to live with bipolar disorder? How to Deal with Bipolar Affective Disorder

On the initiative of public organizations uniting scientists, doctors and activists, every year on March 30 the Day of People with bipolar disorder- . The date chosen was the birthday of Vincent van Gogh, an artist who, according to researchers, was the embodiment of a “bipolar genius.”

With bipolar disorder, a person lives either in a state of strong emotional upsurge and excitement (mania), or in depression. According to the world, bipolar disorder in different forms about 2% of people are affected. This means that there are at least three million bipolar people in Russia - this is approximately half of St. Petersburg.

In most cases, this disease gets better with the help of medications. But, unfortunately, many do not seek help or do not know how to find it. Without treatment, the disease progresses and ultimately leads to sad consequences: loss of family, job, ability to work in general, and in almost every seventh case - to.

These consequences can be avoided. The peculiarity of bipolar disorder is that the onset of remission depends not only on the doctor and medications, but also on. Very often, bipolar people provoke attacks with their own hands. The mood of people with bipolar disorder (bipolar affective disorder. - Note ed.) is very unstable, balance is fragile, and mania or depression can be “triggered” in dozens of ways: the psyche is easily undermined by psychoactive substances, alcohol, lack of sleep, too intense work, travel, and even falling in love. So later a short time after the next course of treatment powerful drugs the person ends up in the hospital again. And everyone new attack reduces the chances of long-term remission, affects social status, and even more painful - in terms of self-esteem.

Experience of people with mental disorders around the world: you are much more likely to overcome difficulties when you are supported by people who understand your problems and condition, but do not look at you as a patient. As practice shows, such a person can be not only a partner or a close relative. Can help you get through the darkest times old friend, and even a person you have never met in person. Masha Pushkina spoke specifically for Afisha Daily with several bipolar people about those in whom they found their support. The result is a story not about illness, but about friendship and trust, which can overcome even madness.

Yana, 31 years old

Housewife, collects books and enjoys confectionery

I didn’t purposefully learn about ways of support anywhere; everything happened quite naturally. I have been sick for 15 years. The first person who looked after me was best friend, and now it’s my husband.

When my hypomania ( mild degree mania, which is characterized by a constantly elevated mood. - Note ed.) accelerated into full-fledged mania (this condition is also characterized by a one-sided attraction to some topic, sometimes accompanied by delusions. - Note ed.), it became clear that I needed to be kept an eye on. A friend began to pay attention to recurring patterns of behavior in one phase or another, and we decided together to find out what helps in such cases. I think my friend was scared to take responsibility for my condition, but she turned out to be generous and selfless. When I got married, a friend passed on this knowledge to her husband, and he already supplemented it, relying on own experience. The husband initially knew with whom he connected his life. He says it didn't scare him.

During manic episodes I have. My husband doesn’t argue with me at this time, but he doesn’t feed them either, trying to redirect my violent energy in another direction. It is impossible to argue, because the result will be the opposite: I will be completely stuck on the idea, I will believe that I have to prove it at all costs, even if the whole world is against me, and there are enemies and conspiracies around me. If this does not help, the husband agrees to discuss all these things, but at the same time tries to slow down their implementation, offering to draw up a specific and detailed plan. Sometimes it takes me a long time.

For example, I always want to move somewhere. Right now, and why aren’t we packing our things yet? My husband is trying to get me to sit down and explain what the pros and cons of different cities are, and what attracts us to them. As a result, I spend hours on various forums, making lists, thinking about how we will arrange our life, calculating the budget for different countries peace. There is also a manic passion for travel, but after preparation we usually implement these plans. And many years ago, in a fit of mania, I bought an apartment - with a mortgage, with hellish payments. Then it took a long time to resolve this situation, but fortunately everything worked out well.

The husband initially knew with whom he connected his life. He says it didn't scare him

Anna and Valeria, 21 years old

Female students

Anna: After a major depressive episode four years ago that almost resulted in a suicide attempt, I began looking for information on the topic [of support]. Managed to find on English manual for relatives and friends on how to behave with such a person. I sent this list to all my friends so that they would have an idea of ​​what was happening to me. For the last few years, Lera has been supervising my daily emotional condition, and if, in her opinion, it is outside the norm, she tells me about it. Lera simply asks every day how I’m doing, and if she sees that I’m reacting strangely, she asks if something has happened. At first it was very difficult, because in principle I did not like to regularly share my personal experiences. But, regularly receiving feedback, I can imagine the dynamics: do the pills help, how long do the side effects last, does the depressive phase become moderate to severe, do I lose critical thinking during hypomania.

Valeria: We have gradually established very trusting relationship. Anya studied the topic of BAR inside and out, and I read the articles that she sent me. The diagnosis did not change anything for me, because it remained the same. Afterwards we already discussed some formalities (for example, who to call in case of an emergency).

Anna: I asked Lera to monitor hypomanic manifestations, in which I lose an adequate assessment of my actions: impulsive night walks and alcohol begin.

Valeria: My friend is a very responsible and conscious girl who takes care of herself, her health and her wallet. Before buying something expensive, she asks my advice - and then we figure out the situation. We can trust each other with the bills and not worry. I also know where and to whom to run in cases of exacerbation.

Anna: I react poorly to prohibitions and reminders of my illness. Yes, I periodically have to turn to loved ones for help, change treatment or take long breaks, but I expect mutual respect so that I am not looked at through the prism of my illness.
When the mood is unstable, harsh phrases like “the illness is speaking in you”, “these are not your real emotions” cause persistent rejection, even when they are true. The line between accepting a loved one’s illness and identifying it with a diagnosis for healthy people is extremely thin. Therefore, those who were able to find it deserve great respect.

Anna: IN Last year I go to appointments with the doctor with my parents. When the doctor notices that I may not be able to cope alone, she duplicates the instructions and advice for them. I, in turn, tell my friend. The doctor emphasized more than once that from the outside the change in episodes is more noticeable.

Valeria: We don’t have any kind of hierarchy in our relationships, so there’s no pressure when one makes decisions for the other. This is not eating each other's emotional resources, but complementing and supporting.

Anna: The main danger in a relationship with a person with serious illness- is to fall into. This format is equally bad for both the “controller” and the “subordinate”. Unfortunately, I have been in such relationships before. It is worth maintaining mutual respect and treating each other as equals. Illness should not dominate a relationship. In severe episodes, it temporarily comes to the fore, but you should always remember that you are not a disease.

Anna: I have memory problems: I don't remember some of the episodes. In such cases, I can ask Lera for help. If you remember last weeks, then these are regular reminders to call the doctor. In mixed episodes it becomes acute problem, because I might suddenly change my mind or forget. Against the backdrop of a severe episode, I may develop psychosis, and this is the most dangerous thing in the disease. Thanks to our format, I almost always manage to avoid such aggravations.

Maria Gantman

Psychiatrist, candidate medical sciences, Mental Health Center clinic

The advantages of observation by a loved one are early response and the fact that he knows the patient’s usual behavior very well and can notice even small changes. The main disadvantage is that normal friendly communication risks turning into constant monitoring of symptoms. Not everyone is mentally healthy man able to remain within the bounds of reason.

To choose a person you can rely on in a critical situation, take a closer look at your surroundings. First of all, it is necessary high level trust. Your assistant should be open to non-judgmental and open dialogue and at the same time emotionally stable and resistant to stress.

Anna Ushkalova

Psychiatrist

Support is extremely important for every person - very often we, as mental health professionals, need it. And with bipolar disorder, this problem arises especially acutely. On initial stages those closest to you often ignore the presence of the disease, and friends advise you to either “pull yourself together” or, conversely, “relax”, sometimes with the help of alcohol. When it becomes obvious to everyone that the “condition” will not go away on its own, urgent hospitalization is required. A safe patient receives “stigma.”

Psychiatrists then assign the responsibility to the uninitiated next of kin (parent or spouse) to monitor any changes in the patient, and they do try to do so. At the level of “laughed loudly - hypomania began, got upset - depression.” As a result, psychiatrists begin to treat quite normal cases based on complaints from relatives. human emotions... and the circle closes.

For the situation to change, main role mental health literacy must play a role. To be able to help, relatives need to have a good understanding of what is happening to their loved one. In many, including public clinics, groups for training relatives either already exist or are being created.

Support from loved ones is especially important when emergency situations. IN deep depression or in mania, a person is not able to independently control his behavior; this decision is made by relatives, sometimes without his consent. In the case of bipolar disorder, this should be a last resort option when all others have been exhausted.

Bipolar affective disorder (BD, bipolar disorder, manic-depressive psychosis, manic depression) is mental illness, which appears in the form sudden changes mood and other mental health disorders. A person suffering from bipolar disorder experiences very rapid mood swings and good mood (manic phase) is replaced bad mood(depressive phase). Bipolar disorder cannot be completely cured, but its symptoms become less severe when a person receives the treatment he needs and the support of others. Early diagnosis manic depression and properly selected treatment help reduce the symptoms of the disorder and significantly improve a person’s quality of life.

Steps

Recognize that you need help

1. Recognize the symptoms of the manic phase of bipolar disorder. To seek help for bipolar disorder, you must first recognize the symptoms of the condition and acknowledge that you have the disorder. First, you need to know what symptoms people with bipolar disorder experience in Everyday life. During the manic phase, a person feels overwhelmed with energy and a thirst for activity, becomes irritable, quickly switches from one thing to another, and tends to commit rash and risky actions. In some cases, a person experiences delusions and hallucinations, as well as paranoid thoughts and pathological suspicion.

   • Write down your symptoms and pay attention Special attention how your mood changes from one phase to another and back again throughout the day or week. These records will be useful to you when you seek help from a psychiatrist - with their help, the doctor will be able to choose the optimal treatment plan.
   • Keep in mind that some forms of bipolar disorder can be quite difficult to diagnose because the symptoms in the manic stages are much milder. In this case, it is customary to talk about the hypomanic stage, which is not easy to identify: its symptoms manifest themselves in the form of a tendency to thoughtlessly spend large sums of money and make impulsive purchases. In addition, the hypomanic stage is often accompanied by insomnia and compulsive overeating.

2. Pay attention to the symptoms of the depressive stage of bipolar disorder. Characteristic symptoms this phase include lack of appetite, insomnia (or vice versa, constant desire sleep), fatigue, feeling of loss of strength and inability to concentrate. The person feels worthless and useless, he is tormented by guilt and overcome by thoughts of death and suicide.

   • In bipolar affective disorder, the manic phase is replaced by a depressive phase. At certain times you experience predominantly manic symptoms, while at other times you experience predominantly depressive symptoms. However, keep in mind that it is enough long periods time you may be in in good condition, especially if you get adequate treatment. Rapid cycling of phases in bipolar disorder is quite rare. However, if you notice that your mood easily switches from elated to depressed and back again, and each period lasts from several days to several weeks, you should consult a doctor. A specialist will be able to determine whether you have bipolar disorder and discuss with you possible options treatment.

3. Admit that you need help. If you notice symptoms of bipolar disorder, try to accept this fact and realize that you need help and adequate treatment for your condition. Be honest with yourself and your loved ones. Recognize that you have bipolar disorder and accept that you need professional help to feel better. Remember: you should not feel guilty or ashamed about your condition. A person is not to blame for his illness and is not responsible for it.

   • For example, you might tell your loved ones, “I understand that I have bipolar disorder and that I need help,” or “I think I have manic depression and would like to see a doctor.”
   • Keep in mind that it is not always possible for a person to notice the symptoms of mental illness on their own. Listen if friends or relatives tell you about this. If they offer to help you get necessary treatment, agree to their proposal.

4. Contact a specialist for help mental health. Take the initiative to get necessary help. Psychiatrists diagnose and treat bipolar affective disorder. Depending on where you live, how severe your symptoms are, and your financial situation, you can choose where you want to make an appointment. If you live at your place of permanent registration, you can contact a local psychiatrist who sees you at a psychoneurological clinic or clinic. Appointments with a psychiatrist are free and are carried out on a first-come, first-served basis. Please note that in order to attend your appointment you will need to bring your passport and your medical card. If you do not have the opportunity or desire to contact a local psychiatrist, you can make an appointment with a state or private clinic, where among the specialists there is a psychiatrist. Many clinics provide the opportunity to contact a doctor anonymously, without giving your name or place of residence. In addition, you can look for contacts of psychiatrists who practice private practice and contact such a specialist. The psychiatrist will conduct necessary diagnostics and create a treatment plan that will help you improve your quality of life.

   Seek medical help

   1. Make an appointment with a therapist. First, go see a therapist: some somatic diseases can cause sudden changes moods that are similar to symptoms of bipolar disorder. The therapist will prescribe for you necessary tests and studies to confirm or exclude the presence of these diseases. If necessary, the therapist will advise you to contact an appropriate specialist, including a psychiatrist. Your therapist will likely ask you to describe your symptoms in detail and review your medical record.

      • There are two main types of bipolar affective disorder: bipolar disorder of the first type (affective states manifest themselves clearly and significantly affect a person’s life) and bipolar disorder of the second type, when the manic phase is absent in the picture of the disease and only the depressive phase appears. Depending on your symptoms, a psychiatrist will diagnose your type of disorder.

   2. Discuss with your mental health professional what treatment would be best for your condition. Used to treat symptoms of bipolar disorder various groups drugs. Most likely, the psychiatrist will suggest several treatment regimens to determine which medications will be effective in your case. In most cases, treatment includes a combination of drugs from three groups: mood stabilizers (mood stabilizers), atypical antipsychotics and antidepressants.

      • Be sure to ask your psychiatrist about contraindications and side effects of the medications prescribed to you. If you experience any side effects while taking medications, please notify your doctor immediately. The psychiatrist will help solve the problem by changing the dosage of the medications, or prescribe you a different medication.
      • Never stop taking medications without consulting a psychiatrist. If you stop treatment, your bipolar disorder symptoms may return, and in some cases they may even get worse. Additionally, if you stop taking your medications, it may cause withdrawal symptoms.

   3. Consider a course of cognitive behavioral therapy. Psychotherapeutic treatment provides positive effect for bipolar disorders. Most likely, your psychiatrist will recommend that you undergo cognitive behavioral therapy. Working with a therapist can help you understand the impact your thoughts have on your emotional state. Cognitive behavioral therapy gives you the opportunity to change negative patterns of thinking and behavior. It will also help you better manage the symptoms of the disorder and avoid flare-ups.

      • In CBT, you will need to attend regular therapy sessions where a therapist will help you manage the symptoms of the disorder.

   4. Learn about intrapersonal and social rhythmic psychotherapy. Intrapersonal therapy can help you reduce the stress caused by bipolar disorder. Stress is the main trigger for people suffering from this disease.

      • In many cases, specialists practice intrasocial psychotherapy in combination with social rhythm therapy, which is aimed at stabilizing the patient’s social rhythms, such as eating, sleeping and physical activity. Making your life more stable can in many cases help smooth out mood swings.

   5. Symptoms of bipolar disorder are often Negative influence on family relationships, so consider a special course of family therapy.

      • Through therapy, your family and friends will learn about bipolar disorder and learn how to help you stick to your treatment plan. Family therapy can be especially helpful if your family members do not understand the specifics of bipolar disorder and have difficulty interacting with you as you try to cope with your illness.

   6. Therapy sessions can be conducted for the entire family at the same time or for each family member individually. Ask your psychiatrist to tell you about other treatment options.

      • In some cases, psychiatrists recommend electroconvulsive therapy (ECT) for patients with this type of disorder. This type of treatment (formerly known as electroconvulsive therapy) works well for people with severe bipolar disorder, especially when other treatments have not been effective. Short-term side effects of ECT include confusion, disorientation, and memory loss.
      • A psychiatrist may also recommend medications to help you sleep. Insomnia and trouble sleeping are common symptoms of bipolar disorder, so sleep medications can help you manage this problem. Please note that if you have bipolar disorder, you should avoid using methods alternative therapy

   7. , including avoiding dietary supplements and herbal preparations. Record aspects of your state in a mood table. A mood chart is an important part of your treatment plan because it gives you the opportunity to regularly record your symptoms and sleep-related information. In addition, you can enter treatment-related information into the table, and the events of your life. These records will help your doctor evaluate the effectiveness of your treatment and adjust it if necessary.

      • The mood table can be kept in the form of a diary or filled out on the computer. Try to record information about your mood and symptoms in as much detail as possible to track your progress.
   • For example, you might tell your family and friends, “I am currently undergoing treatment for bipolar disorder. I really appreciate your help and support and hope that you will support me now as I try to cope with my problems.”

5. Join the group psychological support for people with bipolar disorder. Try to find psychological support groups in your city that are organized to help people with bipolar disorder. It's best to ask your psychiatrist about this, as specialists usually know about such groups. In addition, quite often such groups work closely with psychoneurological dispensaries and clinics. If you start attending a support group, try to attend meetings regularly. With people who know about manic depression first-hand, you can talk about your experiences with symptoms and listen to others share their stories of coping with the disorder. In many cases, talking to people who understand what is happening to you can help you stick to your treatment plan and make positive changes.

   • Ask your psychiatrist or psychotherapist if there is a mental health support group for people with bipolar disorder in your city. Most often, the leaders of such groups are psychotherapists or medical psychologists, so your doctor will likely know where you need to go. Also, try to find online groups and forums where people with bipolar disorder communicate.

6. See your mental health care provider regularly. To make sure your treatment is progressing as expected, set a schedule for yourself. regular visits psychiatrist. Discuss with your doctor how often this should be done. When you begin treatment, you may need to meet with a mental health professional once a week or twice a month to make sure your treatment plan is having a positive effect on your condition.

   • If you have any problems with your treatment plan or medications, tell your doctor. Only by working closely with your mental health professional can you create a treatment plan that works for you.

7. If you feel an affective state coming on, seek help as soon as possible. If you notice symptoms of mania and depression, contact your doctor as soon as possible. Describe your symptoms and say you need help. If you are unable to reach your healthcare provider, call a crisis helpline or contact an emergency mental health service.

   • If you have an established treatment plan, it will likely include a course of action in the event of a mood disorder. Be sure to tell your friends and family what to do if you have a manic or depressive episode. This information will enable them to notice symptoms early and help you get the treatment you need.

Talking openly about illnesses in Russia has always been considered something almost indecent, at least for young people.

But Instagram and Youtube have changed everything: in the last couple of years, people with the most various diseases talk openly about their lives. This trend has reached Russia: some people decide to start a blog in which they openly talk about their illness.

The Mail.Ru Health project spoke with video blogger Sania Galimova, a 23-year-old entrepreneur from St. Petersburg who recently learned that she has bipolar affective disorder (BAD) - when episodes of mania (increased mental excitement) alternate with episodes of depression.

- Sania, tell us about your illness. When did you realize that you were different from others?

I always considered myself normal - just a cheerful person who often gets into difficult situations. life situations and experiences them hard. To be honest, I considered myself even cooler than others - my illness provides such an opportunity.

During “light periods” I have more energy than ordinary person, more determination, more ability to work, more capacity for happiness. I used to look at the sunset and cry. Or I left for a strange city without a penny of money, jumping into the last carriage of the train like a hare, confident that I would figure it out on the spot - and I figured it out. Light episodes are called mania: in it, emotions are bright, like on “acid,” and performance is like on amphetamines.

When the “dark” episode began, there was little strength, and in the area solar plexus It became so painful that it was difficult to breathe. I always found external reasons of my depression: little money, lonely, my boyfriend left me, I need to rest. In fact, I experienced depressive episodes: during them you suffer without strength, and it seems as if you are dying, and you still cannot die.

I remember my most severe depression: For two weeks I got to the toilet holding on to the wall, I didn’t have the strength to speak loudly, I could barely mutter.

I was tormented, and when I managed to fall asleep for three hours once every couple of days, I regretted falling asleep - I hoped that without sleep my body would completely weaken and let me go. During this episode I stopped believing in God.

At the peak of my mania, I had hallucinations. But they let me go, and I “forgot” about them, I’m “normal”.

When the psychiatrist finally diagnosed me with bipolar disorder, everything came together: I remembered mania, depression, delusions, hallucinations, suicide attempts - everything was just like in the textbook.

When did you realize that everything you talk about could be a manifestation mental illness, and not just a “quarrelsome character”, and consulted a doctor?

I was lucky to become a frog who, desperately floundering in milk, turned it into butter and climbed out. Since I was 13, it has often been difficult, I literally felt as if my sternum was scratched inside and hurt. But I believed that there were external reasons that made it so difficult and painful for me, and that when I eliminated them, I would finally begin to live happily.

I always kept a list in my head of what didn’t suit me, and tried, point by point, to remove from my life what made me unhappy. So I gave birth to a child, moved to St. Petersburg, started my own business, then closed it and got a job interesting work with a good salary, I moved my mother to live with me.

By the age of 23, I had almost completed my “must list.” And then I again felt the familiar heaviness throughout my body, I “broke”: I slept 16 hours a day and couldn’t get enough sleep, couldn’t concentrate, couldn’t do what I loved, didn’t want to make love with a loved one.

The melancholy and pain returned, I often wanted to die. I could no longer figure out what else I needed to let go. Then I turned to a psychotherapist, she gave me borderline disorder personality and said that long-term treatment is needed.

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- Have you tried to find information on the Internet about what is happening to you? Did you succeed?

Yes. When I was diagnosed with borderline disorder, I started reading about it. And I realized that I hardly have borderline disorder: it is based on a person’s lack of understanding of who he is, emptiness instead of self-identification. And I always knew who I was and what I wanted.

At the same time, I read about other mental disorders and, of course, about bipolar disorder. And the more I read, the more it seemed to me that this was about me: “bipolars” are impulsive people who can burst with energy and then fall into powerlessness.

- How did you decide to start your own video blog?

I've been keeping diaries online since my first depressive episode. In them I tried to describe my feelings and figure out why I felt bad. At first it was a blog on LiveJournal, then it was reincarnated as a channel on Telegram, then I wanted to try myself in the Youtube format.

In Russia, the topic of mental illness is taboo - because of this, patients do not understand what is happening to them, they do not know that they can get help and that it is effective.

Meanwhile, the mortality rate from bipolar disorder is gigantic: 20% of patients commit suicide. And this number does not include those who die from risky behavior in mania.

On the English-language Internet there is not only Stephen Fry, but also simple people, who tell their story of struggle and show how they cope with the disease.

There are no media personalities in RuNet who are strong, attractive and successful enough to talk openly about how they live with the disease in Russia and how treatment helps them. So I decided to try filming my life. And I chose Youtube because it allows me to be at a minimum distance with the viewer.

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- Why are you blogging?

I would like to remove the taboo from the disease. There are many people with mental disorders, including bipolar disorder, and they live in pain - while many can be raised with pills and psychotherapy, but because of the taboo, they do not know this or do not seek help.

I believe that in the future everyone will know about this - just as everyone knows about allergies and antihistamines.

Knowledge not only gives opportunities, it makes us tolerant - when we at least approximately imagine what a loved one with an illness feels, we begin to understand him and stop judging him. I believe that in the future there will be more love instead of judgment. I hope that by being open about my diagnosis, I will bring this moment closer.

- What topics are most important to you?

All aspects of the life of a “bipolar” person: can I work and earn money; Are they afraid at work of a person registered with a psychiatrist; how I managed to give birth to a child; what I cook and where I live; what stopped me when I tried to hang myself, get off the roof, jump in front of a train; how I continue to laugh after all this; how did you do business? what kind of hallucinations did I see? what mascara do I buy, and how much do the pills help me?

Do you actively communicate with commentators and viewers of your blog? What is their reaction to the blog, are they asking you to talk about anything specific?

Yes. I read all comments, respond to some, and almost always respond to PMs. Mostly people perceive the blog positively, which is very nice.

They are asked to talk mainly about acute or frightening questions: what does the psychiatrist do with the patient? Should I take antipsychotics? Have they turned me into a vegetable? The day before yesterday I made a video about how women carry babies, taking into account that with bipolar disorder you need to regularly take toxic drugs.

- Do you consider yourself an educator?

I hope to become one. It would be great if the blog turned out to be a non-boring movie about how we were born to be happy and will be - even if for the sake of this we have to choose to live when it is a hundred times easier to quit.

Together with like-minded people from the Bipolar Association, we published the first book in Russia about people with. In it, 12 heroes share their knowledge of how to be stronger than the disease. The book also includes the necessary minimum information about bipolar disorder: advice from a psychiatrist, useful resources, contacts of psychological assistance services.

More than two million people - according to world statistics, there are so many people in Russia with bipolar affective disorder. At the same time, it is known about it in countries former USSR very little: there are no self-help manuals popular in the West, no support groups in every city, no celebrities who talk about their struggle with the disease in popular programs.

“Bipolar people” do not understand what is happening to them for years, and instead of getting treatment, they blame themselves for their failures. "If only I had known about this earlier!" – I heard this phrase from many.

I tried to fill this gap and published a book that shows that living with a mental illness can be prosperous and productive. But to do this, you need to take responsibility for it: take medications regularly, healthy image life and follow many rules that other people are not even aware of.

The characters in the book are ordinary people who have faced an extraordinary ordeal. They tell very personal stories: how they realized that they were sick, how they were able to accept this knowledge and move on with their lives. Let's give them the floor.

About depression

“Depression is insidious in that it changes the coordinate system. Your consciousness changes, and if you did not realize in time that you are sick, then you take everything that your sick brain gives out at face value. You are insignificant, your world is insignificant, everything loses its meaning, and you gradually come to the idea of ​​suicide,” artist Asya echoes her.

But depression can be overcome - with the help of medications, support from loved ones, and awareness.

"The first depressions burned everything inside me and I had to look for at least some meaning again. Now I know that as soon as depression will pass, I will be interested in exactly the same thing that was interesting before her - I love my work, I love beauty, I love drawing, making jewelry, sewing, I like inventing something and bringing it to life,” Asya concludes.

About mania

“Now I understand that during the period of mania I did a huge amount of stupid things. Being in a kind of “flight”, I began a large number of projects and "businesses" using the services different people. As it turned out later, most of these “colleagues” were swindlers and sucked a huge amount of money out of me. As a result, I owed about four million rubles,” IT architect Mikhail shares his sad experience.

“You can’t come to an agreement with the devil. You can’t be a maniac for a while, create a masterpiece and stop of your own free will. Mania is borrowing power, and then there’s nothing to give back; you have to pay with depression,” admits programmer Vladimir.

About treatment and personal responsibility

"The medications changed my entire personality, I became different from myself - calm, cheerless, like a different person. My mood really leveled out. But this means that it became limited. The usual range of emotions has narrowed, I can no longer be very sad, I’m not very happy, I just have so few emotions that I often have to play them in order to communicate normally,” says Mikhail.

But most people simply don’t realize that pills can help. Meanwhile, at severe course illnesses, only medicines make it possible to live normal life. Each of the characters in the book came to this conclusion, but the path to this knowledge was long and painful.

“That’s how my wife and I first heard the diagnosis of “bipolar affective disorder” and received a prescription for mood stabilizers. After that, the scandals, showdowns, power struggles and sharing of space somehow stopped by themselves,” Evgeniy shares his experience.

Mikhail: “Finally, I realized that no one could save me except myself, and I took treatment into my own hands. I came to the conclusion that in order to be healthy, you need to read, think and search a lot yourself. I eventually found a good psychiatrist , which brought me out of depression in five months (and that’s very quickly!).”

About stigma

“It didn’t occur to me to go to the doctor. It seemed to me that they wouldn’t help, but would criticize and shame, saying that I was pretending to be so young and healthy, but pretending to be weak and unhappy,” recalls Denis.

“You never know what to expect from people. It’s such a social taboo. Probably like prison, prostitution, violence or suicide. It may be on TV, with some distant acquaintances, but never with yourself or best friend", says Asya.

I really want to believe that thanks to enlightenment, the attitude towards diseases of the soul will become as calm and everyday as towards diseases of the body - for example, diabetes or asthma.

About love

“This is why dating during manias is dangerous, especially romantic ones. You meet Gray, who sails to you on scarlet sails, and then... Then the sails are torn off by a cold wind. You understand that all these sails, romance, gushing passion are not the norm, but you get hooked on them like a drug,” Nastya recalls the beginning of her novel.

About mutual assistance

The characters in the book create support groups and communities for people with mental disorders, engage in education and charity work.

“In Russia, people don’t understand well what mental illness is. Neither in my family nor in my entire social circle, no one could understand and support me. American websites became the main source of information. There I once saw contacts of support groups. I started looking for something... something similar in Russia, but I didn’t find one, and in the spring of 2016 I decided to organize a support group myself,” says accountant Anya.

Psychologist Svetlana came to the conclusion that helping others is also a way to find your own balance:

"I began to work with people with mental disabilities, with those who are often rejected by society, with those who have a difficult, painful, difficult life. I know that they also need to be believed in them. Believed in the way someone once believed in me. My illness helps me in my work, helps me to subtly feel and feel the value of everyone. small step on the way to a big goal. I also think that my activity saves me from madness and despair, from the invisible clutches of depression that are ready to grab me as soon as I forget about the meaning, about why I wake up every morning, about the fact that someone needs me , that today I can make this world a little better."

If someone close to you is dealing with bipolar disorder, your love and support will play a big role in treatment and recovery. You have the power to help by learning about the disease, offering hope and encouragement, monitoring symptoms, and becoming a partner in treatment. But caring for someone with bipolar disorder will take its toll if you neglect your own needs, so it's important to find a balance between supporting your loved one and caring for yourself.

How to help someone with bipolar disorder?

Dealing with the ups and downs of bipolar disorder is difficult—and not just for the person with the condition. The moods and actions of a person with bipolar disorder affect those around them, especially family members and close friends. During manic episodes, you are forced to cope with reckless behavior, outrageous demands, explosive outbursts, and irresponsible decisions. And when the whirlwind of mania passes, the person often “falls on you” to share the consequences. During an episode of depression, you are forced to reckon with the depressed state of your loved one, who does not have the energy to take responsibility for home and work.

The good news is that most people with bipolar disorder are able to stabilize their mood with help. suitable treatment, medications and support - and you can play a significant role in his recovery. Often a simple conversation plays a big role in motivating your loved one and their outlook on life. Here are more tips on how you can help:

• Learn everything about bipolar disorder. Find out everything you can about symptoms and treatment options. The more you know about bipolar disorder, the better prepared you are to help your loved one and understand what to expect.
• Encourage the person to ask for help. The sooner bipolar disorder is treated, the better the prognosis, so encourage your loved one to seek professional help now. Don't expect the person to get better without treatment.
• Provide understanding. Let a friend or family member know that you are there for them if they need empathy, encouragement, or help with treatment. People with bipolar disorder are often reluctant to seek help because they don't want others to see them as a burden or burden, so remind the person that you care and that you will do whatever it takes to help.
• Please be patient. It will take time for the condition to improve, even if the person adheres to treatment. Don't expect quick recovery or permanent healing. Be patient with the pace of recovery and prepare for setbacks and difficulties. Managing bipolar disorder is a lifelong process.

The Importance of Support for Recovery in Bipolar Disorder

People with bipolar disorder feel better when they have the support of family and friends. Those whose loved ones are involved and supportive tend to recover faster, experience fewer episodes of mania and depression, and experience milder variations of symptoms.

Bipolar disorder and family

Living with someone suffering from bipolar disorder causes stress and strain on the family. During the most acute manifestations symptoms and their consequences, family members often struggle with feelings of guilt, anger and helplessness. Ultimately, tension causes serious problems in a relationship. But families can successfully cope with bipolar disorder if they learn to accept the illness and its difficulties. When you feel guilty or frustrated, it is important to remember that bipolar disorder is not anyone else's fault or fault.

Accepting bipolar disorder involves accepting that life may never be “normal.” Treatment will have a huge impact on your loved one, but it will not always eliminate all symptoms or problems. To avoid disappointment and resentment, it is important to set realistic expectations. Expecting too much from a family member is a recipe for failure. On the other hand, expecting too little will also slow down recovery, so try to find a balance between encouraging independence and providing support.

Tips for coping with bipolar disorder in the family

• Accept your loved one's limitations. People with bipolar disorder are unable to control their mood. They simply "slide" into depression or "pull themselves out" during episodes of mania. Neither depression nor mania can be overcome through self-control, willpower, or rational thought. Telling a person to “stop acting crazy” or “look on the bright side” does not help.
• Accept your own limitations. You cannot save a person with bipolar disorder, nor can you force them to take responsibility for their own condition. You can offer support, but ultimately recovery is in the hands of the person with the illness.
• Reduce stress. Stress makes bipolar disorder worse, so try to find ways to reduce stress in your loved one's life. Ask how you can help and also take on some of the person's responsibilities yourself if necessary. Establishing and enforcing a daily routine—wake up at the same time, eat at the same time, and go to bed at the same time—also reduces stress in the family.
• Communicate openly. Open and honest communication is essential to coping with bipolar disorder in the family. Share your concerns in a loving manner, ask the person how they are feeling, and make an effort to truly listen, even if you disagree with your loved one or don't care about what is being said.

Supporting someone with bipolar disorder

What can you say that will help:

• You are not alone. I'm near.
• I understand what you have real illness and that it is she who causes these thoughts and feelings in you.
• You may find it hard to believe now, but how you feel will change.
• You are important to me. Your life is important to me.

Source: based on materials The Depression and Bipolar Support Alliance

How to convince someone with bipolar disorder to see a doctor

In addition to offering emotional support, The best way help a person with bipolar disorder - encourage and support treatment. However, people with bipolar disorder usually have little understanding of their condition, so getting them to see a doctor is not always easy. When a person is in the stage of mania, he feels great and is not aware of his problems. When he is depressed, he knows something is wrong, but he doesn't have the energy to ask for help.

If your loved one doesn't acknowledge the possibility of bipolar disorder, don't argue about it. The very thought can frighten a person, so be sensitive. Suggest a planned medical checkup instead of this. Or visit a doctor in connection with specific symptoms: insomnia, irritability or fatigue (it is better to inform the doctor in advance by phone about your suspicion of bipolar disorder).

What can you say that will help?

• Bipolar disorder is a real disease, like diabetes, for example. It requires medical treatment.
• Don't blame yourself for having bipolar disorder. You are not the reason for it. It's not your fault.
• You will feel better. There are many types of treatments that help.
• If left untreated, bipolar disorder usually gets worse.

How to support during treatment

Once a friend or family member has agreed to see a doctor, you can help by becoming a treatment partner. Your support will play a big role in the success of treatment, so offer your participation in any way that the person with bipolar disorder agrees to. Here's what you can do to support the treatment of a person with bipolar disorder:

• Find a qualified doctor or psychotherapist
• Arrange meetings and accompany the person to them
• Tell your doctor about your observations
• Track your loved one's moods
• Find out all about the medications prescribed for your loved one
• Track your treatment progress
• Watch for signs of relapse
• Tell your doctor about problems

Encourage the person to take medication for bipolar disorder

Medication is the cornerstone of treatment for bipolar disorder, and most people need mood regulation to avoid relapses. Despite the need for medication, many people with bipolar disorder stop taking it. Some do it because they start to feel better, others because of the side effects, and others because they enjoy the symptoms of mania. People who don't think they have a problem, especially with high probability stop taking medications.

You can help a person with bipolar disorder by emphasizing the importance of medications and making sure that all doctor's orders are followed. Also encourage the person to tell the doctor about any bothersome side effects. Side effects sometimes extremely unpleasant if the dosage of medications is too low or too high, but changing the pills or dosage can solve the problem. Remind the person that suddenly stopping medication is dangerous.

Monitoring warning signs of relapse

Even if a person with bipolar disorder adheres to treatment, there will be times when symptoms worsen. Take immediate action if you notice problematic symptoms or changes in mood. Point out any symptoms of bipolar disorder to your loved one and tell your doctor. With prompt intervention, you may be able to prevent a full-blown episode of mania or depression.

Warning signs and symptoms of mania

• Less need for sleep
• A good mood
• Restlessness
• Fast speech
• Increasing your activity level
• Irritability and aggressiveness

Warning signs and symptoms of depression

• Fatigue and lethargy
• Great need for sleep
• Trouble concentrating
• Decreased interest in activities
• Alienation from others
• Change in appetite

If a relapse is not prevented, there are steps you can take to cope with what happens during an episode of mania or depression.

• Don't take bipolar disorder symptoms personally. When in the middle of bipolar disorder, people often say or do things that hurt or embarrass them. In the case of mania, the person becomes restless, cruel, critical and aggressive. During depression, he becomes rejecting, irritating, hostile and sullen. It's hard not to take this behavior personally, but try to remember that these are symptoms psychological illness, and not the result of selfishness or immaturity.
• Be prepared for disruptive behavior. During mania or depression, people with bipolar disorder behave disruptively or irritably. Planning ahead to deal with this behavior will help. When your loved one is in good health, enter into a treatment agreement that gives you the patient's consent to protect them when symptoms flare up. Agree on specific steps, such as handing over all credit cards and car keys, sharing doctor's appointments, or transferring responsibility for finances.
• Know what to do during a crisis. It's important to plan ahead during a crisis so you can act quickly and effectively when it happens. Having a crisis plan will help. Make sure it includes a list of emergency contacts for doctors, therapists, and other people who help your loved one. Also include addresses and telephone numbers of hospitals where you can take the person if necessary.
• Call the emergency services at emergency . If a person with bipolar disorder is suicidal or violent, do not try to resolve the situation on your own. If you are concerned that a loved one may hurt you, create a safe environment for yourself and call the police. If a person is suicidal, do not leave them alone. Call an ambulance and stay with the person until it arrives.

Helping a person during mania

• Spend time with the person. People with mania often feel isolated from other people. Spending even a short time together will help. If the person has a lot of energy, take a walk together - this will allow the person to keep moving, but in your company.
• Answer questions honestly. However, do not argue or engage in debates with a manic person. Avoid heated conversations.
• Don't take any comments personally. During periods of excess energy, a person often says or does things that he would not normally say or do, including focusing on negative aspects other people. If necessary, distance yourself from the person and avoid arguments.
• Prepare food and drinks that are easy to consume(for example, peanut butter and sandwiches, apples, cheese crackers and juice), since it is difficult for a person in a state of mania to sit in one place, even just to eat.
• Avoid human stimulation. It is best if the environment is as quiet as possible.
• Let the person sleep whenever possible. During periods of high energy, it is difficult to sleep, which is why you need to take naps during the day. Sometimes a person feels rested after only 2-3 hours of sleep.