The extreme mood swings of bipolar disorder have long been treated by medication management. Though the cause of the disorder is not known, scientists now believe that it is the combined result of many factors. There are many environmental influences that impact the progression of the disease. Understanding these influences empowers the patient as well as the medical provider to make choices that maximize positive treatment results.
Seasonal Affective Disorder
Bipolar patients have heightened sensitivity to climate changes and light availability, a fact confirmed by two separate university studies. In 2005, Dr.Karen Shin at the University of Toronto indicated that her study of two separate groups of bipolar patients had markedly greater seasonal mood fluctuations than three other non-bipolar control groups. Two years later, Dr. Jose Goikolea from the University of Barcelona presented his 10-year follow up with 325 bipolar patients to the International Review of Bipolar Disorders meeting in Rome, Italy. Goikolea noted that bipolar patients who faced even slight changes in light availability were more likely to experience depressive episodes that lasted for longer periods of time. Mania, depression, and even suicide attempts by bipolar patients have been tracked to follow seasonal changes. Light therapy and adjusting medication management to anticipate the symptom changes that correspond with the changing seasons may shorten or even prevent the episodes of mania or depression, and promote healthy sleep patterns.
Healthy Habits
The change of mood often brings a change in diet. Depression leads to simple carbohydrate cravings, as do many of the medications used to treat bipolar disorder. Mania may offer temptation to drink excessive alcohol or abuse other substances, which serve to further darken the mood. Cigarette smoking is popular among bipolar patients. Smoking increases bipolar psychosis, according to research involving 92 bipolar smokers studied at the Department of Psychiatry, Trinity Centre for Health Sciences, St James's Hospital, and published in the "British Journal of Psychiatry" in 2001.
In her book "The Bipolar Diet," author Sarah Freeman lists sugary cereals, candy, white breads, and caffeinated drinks as part of the "dirty dozen" to be avoided. Instead, eating cold water fish, egg whites, lean poultry, leafy green vegetables, olive oil, and berries will improve the physical and mental health of bipolar patients. Omega-3 fatty acids and folic acid are recommended dietary supplements.
Attention to healthy eating habits as well as support offered to address substance abuse and cigarette smoking will enhance both the patient's and the provider's efforts in reducing dysfunctional symptoms associated with bipolar disorder.
Stress Management
Approximately four out of 10 bipolar patients have post-traumatic stress disorder, according to author M.P. Freeman from the University of Cincinnati, College of Medicine and Biological Psychiatry. Between the shifting mood polarities and trauma-related anxiety, the patient's adrenal glands are working overtime, and their body is under continual stress.
Kay Redfield Jamison, a Johns Hopkins University professor of psychiatry, author, and bipolar patient, states that providers must screen carefully for anxiety disorders after a patient is diagnosed with a mood disorder. It is critical to treat both disorders separately. In addition to medication management, supportive relationships are an important asset to the bipolar patient, whose relationships are often strained by the effects of the disorder---incessant talking, erratic spending and substance use. In those relationships, individual and family counseling helps to address the pressure on all parties, thereby making it possible for the bipolar patient to maintain a healthy support system. Yoga is another effective tool for stabilized bipolar patients to combat tension.
