Bipolar Disorder.

Bipolar Disorder for Dummies.By Kristofor G. Learmonth BSc (Hons).

What is bipolar affective disorder?

Bipolar affective disorder is an abnormality of mood which ranges from severe depression at one extreme, to severe mania at the other. In bipolar disorder (also known as manic depressivedisorder) people suffer from bouts of both depression and mania.

Hypomania is a mild form of mania and dysthymia is a mild form of depression.

While everybody suffers from transient mood changes such as depression, the qualitative differences in bipolar disorder are when the symptoms become pervasive and interfere with normal everyday functions.

Depressive aspects of the disorder are characterized by disturbances of mood, speech, energy, and ideas. In physical terms marked headaches and fatigue are the two most common

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symptoms of the depressive phase. Bipolars may describe the world as grey, lacking an interest in life and find life devoid of pleasure.

The manic aspect of bipolar disorder are a marked elevation in mood often characterized by euphoria, over activity and disinhibition.

Hypomania is a milder form of mania and lasts for a shorter period of time with none of the psychotic features of mania. Hypomania can be distinguished from normal happiness by its persistence, non - reactivity to normal emotional stress and have a social disability.

Mania almost always occurs as part of bipolar affective disorder. Mania can lead to overspending, reckless or disinhibited behavior leading to debt, marriage breakdowns and excessive drinking or drug use.

In bipolar disorder people can suffer from a rapid cycling illness with frequent swings from one mood state to the other.

How I got bipolar affective disorder

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I was diagnosed with dipolar disorder in 2007 after incurring huge debts and drinking an excess of alcohol. My spending and drink problemdeveloped after I had a car accident in 2006. I was working as a health care professional at thetime, my work involving minor surgery.

I had graduated from Queen Margaret’s UniversityCollege as a state registered Podiatrist in 2005and started working as a Senior II Podiatrist two weeks after graduating.

After working in my profession for only two years I was informed I had a mental illness by my G.P. Then diagnosed with bipolar affective disorder by a psychiatrist.

This changed my whole life.....

How to deal with Bipolar affective disorder?

I have found exercise to be the most effective tool in the battle against mental illness to de-stress and for relapse prevention.

Once you have started to exercise the trick is

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to keep your passion alive the most compelling reason to exercise is to enjoy yourself.

If you jog, focus on the feeling of the outdoorsand what it feels like for your body to move. These positive experiences can then be reproduced on a daily basis.

If you lift weights you can envisage yourself strong, if you will feel a little stronger and alittle happier then the exercise not only makes you fitter, it improves your mental health as well.

Always choose an exercise medium which you enjoydoing (I chose running and body building).

Getting exercise, results in better sleep patterns which improves your quality of life andexercise performance.

Some medication encourages weight gain which canlead to self-embracement and a loss of confidence. The benefits of regular exercise arestill underestimated.

What motivates you?

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You can use music as a tool of motivation for exercise, any kind of music, and any time of theday.

Entering into events is good way to stimulate the growth of an interest and performance which is great for boosting self-confidence and belief.

I always try to remember how good it feels to finish a run. Hindsight is a powerful thing.

Use the measuring tape, scales, camera and mirror and enjoy the feelings of accomplishing small goals and use that feeling to form greaterpersonal achievements.

If you run, lace up to get in shape, de-stress and to chase your personal bests.

What to remember?

After exercise relax please remember muscle soreness is normal and can take a day or two forthe stiffness and aches to set in (this is

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called delayed onset muscle soreness or DOMS), it sometimes requires another day or three to reach full recovery.

You should always minimize the pain by introducing a balanced type of workout, cross training is the answer to this and allows you tohave a larger volume of exercise than you could normally achieve when using a single type of exercise.

I recommend doing a cardiovascular exercise along with resistance based anaerobic exercise (i.e. running and weight training).

Your aim should be to use all your muscle groupsso your core is strengthened as well as the larger muscle groups, while also receiving the cardio vascular benefits of exercise. After a run, always allow some time for a cool down and stretch to prevent tightness from developing.

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You should aim to sleep more than seven hours. Any less can lead to chronic sleep deprivation. A lack of sleep affects the body's ability to control stress, convert glucose to energy and repair sore muscle. Research has shown sleep deprivation reduces time to exercise exhaustion considerably.

How to get started?

Get ready for your next challenge by investing in a good pair of trainers (I suggest ASICS as aquality reliable make), jogging bottoms (any type) and a good T-shirt (rugby shirts are the best value for money).

Cast iron weights are great for exercising at home. The standard weight plates are ideal when space is an issue. This is an investment which will last your whole life.

Weightlifting gloves and a strong leather belt

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are also a great investment if you are planning to improve your quality of health, life and mental health.

York cast iron weights, gloves and belt.

The total cost of equipment should be no more than two hundred pounds. You get really do get what you pay for.

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I advise you purchase weights equipment as you progress and get physically stronger. Trainers, joggers and t-shirt are a first, if you run it will cost you nothing and buying your own weights is more cost effective than joining a gym.

How long does it take to get the benefits from regular exercise?

The psychological benefits of exercise start immediately. It gives a greater sense of wellbeing, self-worth and a rise to confidence. The physical health benefits are more gradual including reduced blood pressure, cholesterol, heart rate and improved lung function and volume. Skeletal muscle becomes more efficient, enlarged and improves in tone and shape.

After twelve weeks muscle hypertrophy and shape become visibly improved, muscle strength and efficiency will also show noticeable improvement.

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The benefits of consistent exercise by far outweigh the equipment costs and effort involvedin the participation of physical exercise.

Energy and persistence conquer all things including mental illness. Running around the county side is wonderful and physically running will totally change your body shape. It will give you a huge sense of freedom and will transform your life.

Once you start exercising you are headed for major lifestyle changes.

The big picture

A combination of exercise and diet is amazing ifyou need to give yourself a psychological lift.

If you eat meat just keep it lean. Meat provides

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iron which helps maintain energy levels and amino acids that repair microscopic muscle tearsthat occur during training.

Running and weight training will boost your metabolism allowing you to consume a much largeramount of calories than a sedentary individual.

If you are exercising just don’t be a glutton and everything will fall into place, don’t just target weight loss. Your body has a unique response to exercise and so does your mind.

Reclaim your mind

Dig in. You will become a fitter leaner person. Just dust off your trainers and celebrate your body. If you are bipolar you will learn to love a healthy, self-disciplined lifestyle. Select your own disciplined goal, then make your own exercise and lifestyle choices.

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You can concentrate on cardiovascular exercise or resistance work. Remember mixing them together will allow you to have a more versatileand productive workout routine.

With bipolar affective disorder the trick is knowing what is affecting your mind and how to take control of it. Exercise allows you to take an active approach in dealing with a psychological condition.

Know your type

People with Bipolar affective disorder most commonly have a mixture of what are termed highsand lows, cycling between varying degrees of hypomania or low levels of dysthymia.

Everyone is different. Exercise prescription should be bespoke to your own individual needs, personality and level of psychiatric illness.

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I find anaerobic exercise best for me when I have a suffered from varying degrees of dysthymia, as they say "just do it". Making myself lift weights improves my concentration, reaction speed and lifts the dull, numb heady sensations associated with dysthymia. My unhappyemotions are always swept away after a good resistance - based anaerobic exercise workout.

On the other extreme, in my case elevated mood, or hypomania (I have never had mania), a good cardiovascular workout is like meditating. It rewinds, relaxes, soothes and slowly blows all the cobwebs away. Anger, anxiety and frustrationgive way to a calm, rational and mellow pleasureas endorphins are slowly released and the body transitions repetitively through the unthought motions of automatic efficiency. It makes you relax.

Analysis.

The key is to listen to your own instinctive

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feelings and act appropriately when choosing an exercise routine for yourself. Running, swimming, cycling, jogging, powerlifting, bodybuilding and gymnastics are all great choices when it comes to exercise if you are a bipolar affective disorder sufferer.

The benefit of cross training by this I mean selecting an aerobic exercise such as running, swimming etc. and an anaerobic exercise such as powerlifting and bodybuilding, or you can however switch to an exercise type which consists of both, like gymnastics, sprinting etc.

Keep a reflective personal diary of your own feelings and moods after, before and during a workout.

You should always enjoy what you are doing and be confident, happy and self - assured.

Your mind is the most powerful weapon in your 14

arsenal when it comes to consistent effective exercise. No matter how severe your mental illness is, learn how to use your brain to overcome physical and psychological problems. Nothing is impossible. Stay positive.

Train to become established at an exercise, through persistence and you can train indefinitely, eradicate negative thoughts and your psychological problems may resolve themselves spontaneously.

A little knowledge goes a long way. Adapt to life like you have to exercise and your problemsmay become self-resolving, confusion is usual only to the uneducated eye.

Be smarter, calmer, extend your life and controlyour illness

Mental illness is nothing to fear and can be accepted as part of everyday life. The trick is

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to limiting its negative effects and the potential niggles which come along with bipolar affective disorder.

Through exercise you will lower your blood pressure, have better sex, higher fertility, boost your mood, sharpen your mind, burn body fat, protect your joints and build lean muscle.

My daily routine consists of the following:

Standing (alternate) dumbbell shoulder press, 3 x Max, 30kg

Side Laterals (alternate), 3 x Max, 10kg

Concentration Curls (alternate), 3 x Max, 10kg

Push-ups, 3 x Max

Reverse Crunches, 3 x Max

Crunches, 3 x Max

Running (outdoors), 30 Minutes, Moderate pace.

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Getting Serious

Run to victory. Start setting some serious goalsfor yourself. No one will judge you on how hard you push yourself. Keep it real, you should be able to hold a conversation after a workout and during a run. You can exercise everyday if you pace yourself. These are all just guide lines, however a structured training plan is essential to achieve your training goals. Aim high to kickstart your motivation. If you run find a race and set a date for a 5k road race, then build upto a 10k, a half marathon and finally a full length marathon. Rookie to ready.

Survival

People who suffer from bipolar affective disorder are at real suicide risk, delusions of guilt and persecution are common with the illness. Do anything you can to prevent this. Combining medication and exercise helps relieve

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the negative mental pressures of the bipolar illness. Learn to always put yourself first and use commonsense. If you feel bad just put your body under extreme stress, you won't worry as much that way. A workout could save your life.

Bright ideas.

Fast food makes you slower, mentally and physically (fact).All you need to do is eat clean healthy food. Thousands of people die every year from obesity, they get diabetes, infections, die from myocardial infarction, stroke, transient ischaemic attack, atherosclerosis acceleration and if they survive, amputation is common place.

The new cocktail.

I advise you consume a kilo of meat at least once a week, do not fry, use the oven and slap some honey on it. You don't need to take

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anabolic steroids build muscle and strength. Buya camera and take photographs every twelve weeks(or higher a photographer), you will start loving yourself, gain more pleasure from life and get lucky more often. Challenge yourself.

Stay motivated use films, music and the oppositesex. Learn to love what you do. Exercise must become habitual. To get good results from a workout. Reshape your future.

Make lasting lifestyle changes for the sake of your own health. With mental illness exercise isharder to do. In comparison to a normal healthy adult. If you exercise and suffer from bipolar disorder I would advise you break it down into small, manageable, bite size chunks.

The problem.

What everyone really should aim to do is reduce body fat (especially visceral fat) and to clear

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their mind of frustration and anger. Your weaponof choice is your brain. Choose exercises you enjoy doing, listen to music you enjoy, have a look in the mirror (it’s not vain to save your own life).

With exercise the trick is to be consistent. Even if you don’t train hard, you will get a good baseline of fitness (promise). Make your own program maintainable, as this is the real key to getting psychological and physiological health benefits from exercise. The solution is to be honest with yourself. If in doubt variety can revive your mojo.

Your first three easy steps

Exercise will completely change your life. Firstly get some gym kit and a decent pair of trainers.

Secondly, find a gym near to where you live (you

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could jog to the gym in the mornings), ask a fitness instructor to help around the gym. You can ask for a tailor made program designed to suit your own needs and goals.

Finally once you have your gym kit, and access to a gym (I prefer to train at home so... make your own choice). Find the best times to access the gym. This should reflect your mood, how busythe gym is and the cost of participation (mornings are sometimes at a lower rate). Do it yourself.

Become a healthier, happier, and slimmer versionof yourself. Get fit for life. Through exercise everything in your life will start to make more sense.

Smell success

As well as being a Senior II Podiatrist, I also worked as a fitness instructor for 4 years. The

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experience has helped me reach my own health based goals. However I'm actually a smoker. Cigarettes are addictive, harmful, and cause a substantial increase in cardiovascular and peripheral vascular disease, lung cancer and chronic obstructive pulmonary disease.

If you smoke, (as is common strangely enough with people who suffer from psychiatric illness), you can get nicotine replacement therapy, in the form of gums, self-adhesive patches, tablets and inhalers.

I would recommend giving at least one form of nicotine therapy a go in conjunction with counselling.

Before undergoing any exercise routine, always get the all clear from your general practitionerfirst, otherwise you could end up doing something. Which might harm you. Ironic or what.

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Be persistent, consistent and determined and youwill reap the rewards for your hard work. Make realistic goals, be patient, progressive and consistent. Make exercise a habit you can perform on a daily basis. Most of all learn to love what you are doing and strive to improve all the time. Be all you can be.

Bipolar affective disorder is controlled throughmedication and counselling, but exercise has a

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feel - good factor which will improve your quality of life, psychologically as well as physically.

Don't be a quitter. Make an informed choice and stick to your guns. Guts and hard work always pave the way to great results.

What's your medication?

Medication has a huge impact on the mind and sometimes has a detrimental effect on the body. Lithium is the most commonly used type of medication used initially with bipolar affectivedisorder. The medication is a mood-stabilizing drug that prevents mania rather than depression.It reduces frequency and severity of relapse, however its mode of action is actually unknown but acts on the serotoninergic system. Blood serum levels are checked every 3 months.

Sodium valproate is often used in conjunction

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with lithium and is used in prophylaxis and manic states. I found both drugs in my case to cause an increase in body weight and found them also to cause water retention, as well as producing a distorted and dream - like thought process.

Due to suffering from hypomania my medication was changed to an anti-psychotic drug which is injected intra-muscularly. This does not cause weight gain, but does cause lethargy, disorientation and can cause fainting during thefirst 24 hours of injection.

The injected drug takes up to 3 days to metabolize, making you feel listless, disorientated, and “doped up" and sick. The drughas a more physical effect than the tablets. I have found that I need to force myself into exercise rather than just doing it for pleasure.

"Where there's a will, there's a way" mental strength is required to push yourself into

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exercise. When taking anti-psychotic medication,cope with the side effects. It can be very demanding physically and psychologically. My advice is go slow, if you jog, just concentrate on putting one foot in front of the other, gradually increasing the cadence of your gait, until a moderate, coasting speed is achieved during your run.

With anti-psychotic medication you have to use your brain to be aware of how your body is goingto react after the initial injection of the medication. After 24 hour from injection, I always feel much better although the groggy and disorientated state lasts for nearly 3 days. After this I feel absolutely fine and can participate in any activity I want to and with pleasure.

Whatever medication you are given, from my own experience it can take up to 3 months to become accustomed to the side effects. Be strong and single minded about what you want to do and persist.

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Whatever the severity of your illness or type ofmedication you are taking, when suffering from bipolar affective disorder, exercise can help you improve your quality of life, both on a social and a personal level. At worst you'll only get tendinitis as a result of over activityand it's a great way to cleanse the mind.

The stigma attached to mental illness

With mental illness there is a stigma attached. Education is normally needed to change perspective, but so can the participation of sport, athletics and any other form of exercise.Open your mind.

Physically you can achieve the same results as anormal able minded individual. However you do have to try much, much harder because of the implications bipolar illness has on the mind. You have to teach yourself to focus, concentrateand how to feel what is normally done

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intuitively, if you want exercise to work for you. It's not only the illness that causes problems: medication, as previously mentioned, causes major hurdles. Persistence really is the only answer to your problems. Don't back down...think about what you want to do, then do it.

Anatomy and Physiology.

Essential knowledge. A basic knowledge of structure and function is critical to get the best results from any exercise routine. You needto know, that structure is an expression of function. The relationship between the two is integral to any improvement you want to see in your body. It allows your body to perform specific everyday functions such as walking and breathing. It maintains what is known as homeostasis that is the maintenance of all internal and external mechanisms of the human body, by keeping the body's cells with in an optimum environment (homeostasis) that is necessary for basic survival. This is what is

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responsible for the changes we see in the human body in response to increased physical exercise.This knowledge will enhance your own appreciation for your own body. It's a fantastic, highly adaptable, efficient machine.

Homeostasis is the body's adaptive response to environment. It's just the adaptive maintence ofcells in response to changes in the internal andexternal environmental. The body must always maintain a relatively constant environment for optimal function (homeostasis). Muscle growth isa form of homeostasis. Changes occur due to the pressures placed on the body from an external source and the body adapts, hence structure becomes an expression of function. It's all doneautomatically by the body in order to maintain the body's homeostasis (optimum environment). Inshort, the body's mechanisms just adapt to pressure.

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This photograph shows my body's adaption to exercise after 39 weeks of running and resistance - based exercise. It's all done to maintain homeostasis.

Decide what you want to do, then stimulate yourbodies’ adaptive response through persistent exposure to exercise.

Your body of evidence

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Get naked. Walk without shoes and roll on the balls of your feet and tap your feet to the sound of loud music. Get out of your discomfort zone, quit fidgeting and embrace the world. Shodoff. The mirror can help you manage your condition, have a good physical examination. Maintain a good lean weight.

With minimal effort increase your fitness, speedup your metabolism. If you felt sluggish, had a slow metabolism and a low sex drive then exercise is a dark horse. Take sugar instead of artificial sweeteners, become a competitive person with a pre-empitive strike on boredom andself - loathing.

If you couldn't hold onto your car, then get a bike. Sculpt.

Become lean, ripped and strong. Be strategic, bend your body to your minds desire. Preform to failure.

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Conclusion.

Whether you are in the hospital or the community, this book is for reference, and is tobe used in the practical management of bipolar affective disorder. It's an easy to read, indispensable guide to the psychiatric illness. Always obtain permission from your G.P when undertaking any exercise program. Medical knowledge is constantly changing, however I havetaken care to ensure all information I have given is accurate and up to date.

It's the self-determination of the patients thatdetermines the life sustaining effect of physical activity as treatment for bipolar illness. It also shows a respect for human dignity. Use humor and laughter.

I have tried to provide positive information in the form of a small book so as not to cause a headache. It should help you to make sense of

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your illness and is some hope, tempered with realism.

Me bipolar weighing 95.3Kg.

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