(Part 2 Of 3) What Are The Worst Things I Could Do If I Had Bipolar Disorder?

0:00What are the worst things I could do if I were bipolar, knowing what I know as a double

0:09board certified psychiatrist?

0:12I'm going to tell you how to avoid these problems.

0:15I'm Dr. Rodriguez from Healing Sky.

0:17I'm also the medical director of the Delray Center for Healing.

0:20And today we're going to talk about what are the worst things you could do if you are bipolar,

0:26part two.

0:27We already had part one.

0:28There will be more parts in part two, but this is part two because there are a number

0:33of things that can be really bad if you do them.

0:36If you're in fact bipolar and part one, we talked about not accepting the diagnosis and

0:43then refusing treatment.

0:44Now in part two, we get into noncompliance with treatment, meaning you're accepting treatment,

0:53but you're not compliant with it.

0:54You're not reliable with it.

0:55You don't take it all the time.

0:57You don't take it reliably.

0:58You're on and off.

0:59You run out of pills.

1:01You go long on your appointments.

1:02You don't follow up properly.

1:05Noncompliance with treatment is not as bad as refusing treatment, but it's still bad

1:10and still will lead to problems.

1:14Medical treatment of bipolar disorder is essential.

1:17You can't avoid it.

1:18You can't, there's no way around it.

1:22Medical treatment of bipolar disorder is very important.

1:26It is essential.

1:27There's no way around it.

1:28It is one of those conditions in the human body, in the human brain, very much like diabetes

1:34type one right now with our current technology, diabetes type one requires insulin.

1:41There's no way around it.

1:42You need insulin or something like insulin, otherwise you're going to have problems.

1:47Bipolar disorder is very much like that in that if you don't take the medication that

1:52is required, you're going to have problems.

1:54There is no non-medical treatment option for bipolar disorder type one that can work

2:01by itself.

2:03Things like therapy will help for sure.

2:06Staying off of drugs will definitely help for sure, but by themselves, they're not enough

2:11to manage bipolar disorder type one.

2:16So not taking the medication properly leads to a lot of instability.

2:19It can lead to mania.

2:21If your mood stabilizer is not at a high enough blood level, it makes you vulnerable to a

2:27manic surge and then you get mania.

2:30The problem there, if you don't get arrested or Baker acted while manic is that the mania

2:35can burn out and turn into a bipolar post manic depression, which is very bad, very

2:41hard to treat, treatable, but hard to treat, much easier to just avoid it by avoiding mania.

2:47How do you avoid mania by taking medication consistently and reliably?

2:53I can't emphasize enough how important that is.

2:56So many people mess this one up.

2:59Probably the single most common of the worst things to do if you're bipolar is to be non-compliant

3:06with the medication, to not take them reliably.

3:09And the same way you can get depression, you can end up with mania.

3:12You can end up with a lot of cycling, which you don't want, which is when you alternate

3:16between depression and mania, that is not good.

3:19That is disruptive.

3:20It's also not good for your brain.

3:22It's hard to function if you're in one of these mood states, if you're manic or depressed

3:26when you're bipolar, you need to get yourself into euthymia and then stay there.

3:31Euthymia is the middle path.

3:33It's the middle between too high and too low.

3:37It's kind of the, the Goldilocks just right.

3:40As far as mood, you're going to have some reactivity of mood and euthymia, but it's

3:45within the normal range.

3:46It's not going to cause problems.

3:48How do you get there?

3:50How do you stay there?

3:51Being on the right medication regimen and taking it reliably and responsibly.

3:57So, so essential.

3:59So important.

4:00One of the other worst things if you're bipolar is to have a disruption of your sleep or your

4:06sleep cycle, pulling on all night or staying up all night or not being able to sleep when

4:11you're trying to sleep all of them just about equally as bad because sleep deprivation is

4:18a notorious natural trigger for mania.

4:22And there is a neurophysiologic mechanism behind this, not just in your head.

4:28This is real.

4:29This is real.

4:30It is known through studies from a long time ago that sleep deprivation has a certain type

4:36of antidepressant effect.

4:38Now, I don't recommend using sleep deprivation as an antidepressant.

4:42That's a whole separate discussion, but here talking about bipolar, the antidepressant

4:48effect of sleep deprivation is very relevant because sleep deprivation in a bipolar, you

4:56trigger the antidepressant effect in the brain.

4:59And if you're bipolar, that can then trigger hypomania or mania.

5:04And then you can get an escalation of mood where you have less of a need for sleep.

5:09So typically, if you're bipolar and you're getting manic, you'll have less sleep, which

5:14has more of an antidepressant effect at a point in time when you really don't need one

5:19or want one.

5:20And that leads to more mania, which then leads to even less sleep, which then triggers even

5:26more mania.

5:27And you get into this vicious cycle where it just escalates and it just takes off almost

5:33vertically.

5:34And then you get in trouble because then the mania is too strong.

5:38You can get arrested.

5:39You can get big corrected.

5:40You can get in trouble.

5:40You can get fired.

5:41You can get divorced.

5:43You can get shot.

5:43You can get beat up.

5:45You can get sexually assaulted.

5:47Anything can happen when somebody is manic because when they're manic, they make poor

5:51decisions.

5:52They don't mean to, but they're not thinking in their right mind and they're very impulsive

5:57and they can get into a lot of trouble.

5:59They're also very vulnerable and they can be exploited financially and sexually and

6:03otherwise.

6:04So it's a dangerous situation you want to avoid and insomnia or any kind of sleep deprivation

6:11or even a sleep disruption can trigger that.

6:13It's important to know that if you are bipolar and for whatever reason, intentional or unintentional,

6:21you have a bad night's sleep or you don't get to sleep at all, that is a sign for concern

6:27and you need immediate intervention.

6:30You need to speak to your psychiatrist because the following night you all but need to guarantee

6:36that you can go to sleep and have a good night's sleep so you can catch up.

6:40Because if you don't, if you have two nights of bad sleep in a row and you're bipolar,

6:45that can really trigger mania.

6:47By the third night, it's usually a high level of mania and it can get dangerous and you

6:52may end up in the hospital.

6:54The earlier you intervene, the easier it'll be to manage it and the less medication it'll

7:00take to get this under control.

7:02So it's so important to identify that if I'm not sleeping well, okay, I have to intervene

7:07now.

7:07Let me ask for some help.

7:09Maybe your psychiatrist gave you some emergency medication to take just in this situation,

7:13which I do recommend highly.

7:15Having a medication like olanzapine as an emergency medication can help a lot because

7:21it is easier to intervene by taking a 20 or 10 milligram dose of olanzapine and making

7:27sure you sleep and then call your psychiatrist.

7:29But if you have slept with the assistance of the olanzapine, that will buy you some

7:35time and your doctor can figure out what to do next to get the situation under control.

7:41But to have recurrent nights with poor sleep is disastrous.

7:45So again, one of the worst things is lack of sleep or any kind of sleep disruption along

7:52those lines.

7:54If you are traveling internationally across time zones, being mindful of when you sleep,

8:02when you're awake, all of that matters and try your best to not skip a whole night's

8:10sleep.

8:10If you're traveling far away to Europe or to Asia, be mindful that somewhere in there

8:15getting sleep, even if you got to take something, some medical assistance, sleep medication,

8:22or maybe olanzapine, something to help you sleep on the plane or when you get there,

8:25be mindful of your sleep cycle.

8:28You need to sleep because something as benign as foreign travel across time zones, especially

8:34across multiple time zones, can inadvertently trigger mania.

8:39So just be mindful of that.

8:41I hope you find this helpful.

8:43There are more videos of this series of the worst things to do if you're bipolar, and

8:49I will have those for you very shortly.

8:53I hope you find this helpful.

8:54If you would like to see me as a psychiatrist, you can find me at DelrayCenter.com or here

9:00on HealingSky.com.

9:02Also look for my podcast here on HealingSky.com.

9:06It's titled The Smiling Brain.

9:08Again, here on HealingSky.com.

9:10Thank you so much.