Self-Management Techniques for Bipolar Disorder Patients

Patients and clinicians can work together to determine appropriate and personally tailored self-management interventions.

Patients who have chronic diseases—and their health care providers—are often frustrated or confused by self-management requirements. Those needs involve various aspects of the health care system, and they can be complex. Patients who seek to manage their chronic conditions—and bipolar illness qualifies as chronic—need good tools.

An article that appears in the August 2014 issue of Current Psychiatry Reports reviews evidence-based skills that clinicians and individuals with bipolar disorder (BD) will find useful. Using a comprehensive literature search, they identified the following self-management approaches as sound:

• Psychoeducation. Patients with BD benefit from psychoeducation about their diagnosis, symptoms, and medication adherence and side effects. They also need to be educated about the dangers of substance use, and about lifestyle behaviors that may prevent relapse.
• Monitoring mood, medication, and social function. Experts advise BD patients to monitor depression and energy. The authors explain the practice of monitoring social rhythms based on core activities (rising time, first contact with another person, work/school/volunteer/family care schedules, dinner, and bedtime).
• Sleep hygiene. BP patients who have consistent sleep/wake patterns tend to be more stable. Changes in established patterns often indicate decompensation.
• Goal setting and relapse planning. Setting relationship, work, recreation, and home goals can help patients stabilize and engage in crisis or relapse planning early.
• Healthy lifestyle (physical activity, healthy eating, weight loss and management, management of medical comorbidities). Activity programs can combat some of the comorbidities BP patients develop because of sedentary lifestyles.

This review also discusses several specific types of self-management resources (workbooks, mobile technologies, and web-based activity logs; Internet interventions, such as support groups; and peer-led interventions).

The authors emphasize personally tailored interventions for each BP patient. They also remind clinicians that self-management of BD augments (as opposed to replaces) medical care, and encourage partnering with patients to promote optimal self-management for individuals with BD.