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ADVANCE Perspective: Nurses

Bipolar Disorder: Seeing All Sides

Published November 25, 2011 10:51 AM by Guest Blogger
Patricia Doughty, RN, is a registered nurse and a graduate of Seton Hall University.

As a registered nurse I know that we acknowledge bipolar (manic depressive illness) to be a disorder that takes you from feelings of high mania to depths of depression. This is true. I know this because I have suffered with this disease since I was 21 years old.

However, I would like to look at it from a side view; a horizontal perspective versus the conventional vertical understanding. Although someone may not be experiencing highs and lows, they may continue to experience left to right periods of negative and positive productivity and satisfaction with interrelationships. As a consumer I can see these sides of the illness as clearly as the practitioner sees the highs and lows.

When assessing patients with bipolar disorder also evaluate their ability to move to the positive or productive side. Besides their meds, what keeps them further to the right? What keeps them away from becoming unproductive? They might not necessarily be depressed, but just not up to speed.

The treatments for staying to the right, not manic or hypomanic, but rather active and productive, are of course staying on their meds, but also doing things in some sense of order that works for them. What gives them a sense of control that keeps them productive and keeps them from sliding into the mundane? Knowing when one is sliding to the left is not necessarily becoming depressed and necessitating more medication. It is cognitive awareness that activity is slowing and acknowledgment is the start of movement back towards productivity.

If someone can identify what is stopping his productivity, what is the obstacle, he can begin to remove the obstacle or work around it. If someone identifies that a particular activity or person/persons helps her to be more productive, she knows where to go when her productivity has shifted to the left.

The cornerstone of treatment for the person with bipolar disorder is medication and psychotherapy. Meditation, self-help reading, group support, family and friends, church and other social systems are all part of a patient's recovery and staying well. Beyond all of these, the patient is an individual that can function independently in society.

I only suggest that beyond the highs and lows, there is a daily quality that we also need to consider. Keeping life productive...not just medicated. I know both sides and understand.

posted by Guest Blogger


This is a really balanced helpful article.  There is so much written on extreme mood swings and yet bi polar need not be that dramatic.  Non productive and slightly excitable is often the case and the person remains undiagnosed, treated as lazy or irresponsible which  eventually leads to a downward and often avoidable spiral.  The less extreme cases and symptoms etc should also be pointed out.thank you.

Deborah Smith, Int. Affairs - Manager, University (UPES) December 2, 2011 11:18 PM
New Delhi, India

Thank you Patricia for pointing this perspective out. For the last twenty five years this has been one of my biggest challenges.  I am on a high dose of mood stabilisers  Functioning in my role as an accountant  I have adopted a number of strategies not only to recognise my periods of high productivity and low productivity.  I have successfully learn't to do the higher brain functioning tasks when feeling productive and to leave the lower functioning tasks for when I am at a lower productivity level.  This prioritising and scheduling through awarness of what is happening has gone a long way for me surviving in full time work.

Heather, Accounting - Finance Manager, Private November 30, 2011 4:25 AM
Wellington NZ IT

I was a RN for 10 years. I agree with this perspective. Thank you for putting it in words. Between disease and meds I can no longer function as a nurse but am still productive doing what I can.

Patricia, cashier November 29, 2011 8:32 PM
Triangle VA

Thank you for this perspective. I feel this is true as well. I'm Bipolar Type 2 & have been a RN for 13 yrs.

nicole blakley, MEDSURG - RN November 28, 2011 4:17 AM

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