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原文：
LEARNING TO COPE WITH BIPOLAR DISORDER
Another important part of treatment is education. The more you
and your family and loved ones learn about bipolar disorder and its
treatment, the better you will be able to cope with it.
Is there anything I can do to help my treatment?
Absolutely, yes. First, you should become an expert on your
illness. Since bipolar disorder is a lifetime condition, it is essential
that you and your family or others close to you learn all about it
and its treatment. Read books, attend lectures, talk to your doctor
or therapist, and consider joining a chapter of the National Depres-sive
and Manic-Depressive Association (NDMDA) or the National
Alliance for the Mentally Ill (NAMI) near you to stay up to date on
medical and other developments, as well as to learn from others
about managing the illness. Being an informed patient is the surest
path to success.
You can often help reduce the minor mood swings and stresses
that sometimes lead to more severe episodes by paying attention to
the following:
● Maintain a stable sleep pattern. Go to bed around the same
time each night and get up about the same time each morning.
Disrupted sleep patterns appear to cause chemical changes in
your body that can trigger mood episodes. If you have to take a
trip where you will change time zones and might have jet lag, get
advice from your doctor.
● Maintain a regular pattern of activity. Don’t be frenetic or drive
yourself impossibly hard.
● Do not use alcohol or illicit drugs. Drugs and alcohol can
trigger mood episodes and interfere with the effectiveness of
psychiatric medications. You may sometimes find it tempting to
use alcohol or illicit drugs to “treat” your own mood or sleep
problems—but this almost always makes matters worse. If you
have a problem with substances, ask your doctor for help and
consider self-help groups such as Alcoholics Anonymous. Be very
careful about “everyday” use of small amounts of alcohol, caf-feine,
and some over-the-counter medications for colds, allergies,
or pain. Even small amounts of these substances can interfere
with sleep, mood, or your medicine. It may not seem fair that
you have to deprive yourself of a cocktail before dinner or a
morning cup of coffee, but for many people this can be the
“straw that breaks the camel’s back.”
● Enlist the support of family and friends. However, remember
that it is not always easy to live with someone who has mood
swings. If all of you learn as much as possible about bipolar dis-order,
you will be better able to help reduce the inevitable stress
on relationships that the disorder can cause. Even the “calmest”
family will sometimes need outside help dealing with the stress
of a loved one who has continued symptoms. Ask your doctor or
therapist to help educate both you and your family about bipolar
disorder. Family therapy or joining a support group can also be
very helpful.
● Try to reduce stress at work. Of course, you want to do your
very best at work. However, keep in mind that avoiding relapses
is more important and will, in the long run, increase your overall
productivity. Try to keep predictable hours that allow you to get
to sleep at a reasonable time. If mood symptoms interfere with
your ability to work, discuss with your doctor whether to “tough
it out” or take time off. How much to discuss openly with em-ployers
and coworkers is ultimately up to you. If you are unable
to work, you might have a family member tell your employer
that you are not feeling well and that you are under a doctor’s
care and will return to work as soon as possible.
● Learn to recognize the “early warning signs” of a new mood
episode. Early signs of a mood episode differ from person to
person and are different for mood elevations and depressions.
The better you are at spotting your own early warning signs, the
faster you can get help. Slight changes in mood, sleep, energy,
self-esteem, sexual interest, concentration, willingness to take on
new projects, thoughts of death (or sudden optimism), and even
changes in dress and grooming may be early warnings of an
impending high or low. Pay special attention to a change in your
sleep pattern, because this is a common clue that trouble is
brewing. Since loss of insight may be an early sign of an im-pending
mood episode, don’t hesitate to ask your family to
watch for early warnings that you may be missing.
● Consider entering a clinical study.
What if you feel like quitting treatment?
It is normal to have occasional doubts and discomfort with
treatment. If you feel a treatment is not working or is causing
unpleasant side effects, tell your doctor—don’t stop or adjust your
medication on your own. Symptoms that come back after stopping
medication are sometimes much harder to treat. Don’t be shy
about asking your doctor to arrange for a second opinion if things
are not going well. Consultations can be a great help.
How often should I talk with my doctor?
During acute mania or depression, most people talk with their
doctor at least once a week, or even every day, to monitor symp-toms,
medication doses, and side effects. As you recover, contact
becomes less frequent; once you are well, you might see your
doctor for a quick review every few months.
Regardless of scheduled appointments or blood tests, call your
doctor if you have:
● Suicidal or violent feelings
● Changes in mood, sleep, or energy
● Changes in medication side effects
● A need to use over-the-counter medications such as cold medi-cine
or pain medicine
● Acute general medical illnesses or a need for surgery, extensive
dental care, or changes in other medicines you take |
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发表于 04-7-8 22:02:21
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