Self-help without medication
Bipolar disorder, like many psychiatric illnesses, can be seen as similar to diabetes . In severe diabetes, no amount of good living, careful eating, regular exercise etc. will reverse the illness, unless the diabetic takes a reasonable amount of insulin. The combination of insulin and proper diet and exercise is far better than taking insulin alone and ignoring these other aspects.
Similarly, bipolar illness or disorder usually requires a combination of medication and attention to lifestyle factors. A small number of people with mild bipolar illness believe they can minimize their illness without any need for medication, by being very careful about their lifestyle and the stresses in their lives. Understandably, many people are reluctant to take long-term medication when they feel well, regardless of warnings from doctors that the underlying chemical problem is almost certainly going to flare up from time to time.
DEALING WITH STRESS
We all have pressures in life, and how we deal with them determines how much pressure is actually allowed to attack our underlying chemistry . This is the case in all psychiatric illnesses, ranging from depression to bipolar disorder. An important, and indeed perhaps the most important factor in dealing with stress, is talking to somebody close to you about the issue or issues . While talking to somebody else does not necessarily change what is happening, it helps you to put words to your emotions and thoughts, and your own brain can generate a whole list of possible solutions. Sometimes, this is called problem-solving therapy, even if the therapy is being carried out accidentally by you and your friend talking about how to solve the issues! And for human beings, talking with a friend, partner, family member or therapist about the stresses we experience, reminds us that we are not alone emotionally . Knowing you are not alone when you are trying to solve stresses in your life is very helpful and reduces the impact of the stresses on your chemistry.
In bipolar illness in particular, it does seem that disturbed sleep is not only an indicator of the illness returning, but in many people it is a major stress damaging your chemistry . All the usual advice about how to sleep well applies here, such as not drinking a lot of alcohol or coffee or cola before bed, not exercising before bed, and trying to sleep in comfortable, dark and quiet surroundings. It is very useful to take some over-the-counter medications from pharmacies or health food shops to help you sleep occasionally. Typically these are anti-histamine tablets which can be bought without a prescription from your chemist. Some natural herbal tablets, such as Valerian , help some people to sleep. Indeed, occasional use of prescription sleeping tablets is very useful for isolated periods of time when you are having trouble sleeping, in an attempt to keep your chemistry as stable as possible. Learning relaxation techniques to practise at night can also be very useful.
DEALING WITH ANXIETY
Staying calm when dealing with the normal events of life, and avoiding getting upset over trivial details, and avoiding being a "control freak", all help to keep your anxiety from becoming a problem . Relaxation tapes, Yoga, meditation etc. are all very useful. Telling yourself to stay calm and deal with issues, rather than getting agitated about them, is also very useful. We are all very good at giving advice to friends, so giving this same sensible advice to yourself can be quite enlightening!
EARLY RECOGNITION OF PROBLEMS
It is very useful if you, or ideally somebody you live with can recognize early warning signs that your bipolar illness is trying to flare up again. The depression may manifest itself by you feeling very tired, having trouble keeping your mind on what you are reading or what you are seeing on TV or feeling everything is becoming much more of an effort than it used to be. Highs are often recognized by suddenly feeling you have much more energy than usual and much less need for sleep than usual. When you recognize you have the early symptoms, or when someone close to you can tell you the symptoms are creeping up on you again without you recognizing them, it may be possible to prevent them intensifying by avoiding pressures in your life as much as possible, and resting and avoiding socializing as much as possible, if you find interaction with other people a problem. However, just like diabetes, if your own interventions and precautions do not prevent your illness from attacking you, a lot can be achieved by seeing your doctor early, and sometimes even a simple medication like Valium may be enough in early cases, or in mild cases, to stop the illness in its track.
Psychologists and counsellors can help you deal with pressures and stresses, and these therapists do not prescribe medication.