DBT for Bipolar~Read this guys :)

Hey gang,

So, I am still very unstable on meds. Haven't changed meds. Might get a new psychiatrist. His specialty is bipolar in women. I hope it works out because things aren't working with the one I have had for the last 12 years. I will know more this week.

In the fall I started seeing a psychologist for psychotherapy. Someone at work recommended him as being one of the best and he so is! Working in mental health, I have been seeing what DBT can do for people with mental illness. I bought a great self help book for DBT for Bipolar for the psychotherapy sessions and the Dr. bought his own copy so we have been working on it since. I go every 3-4 weeks; have to pay for the sessions here in Canada.

Anyway, it's been a challenge to say the least. Those of you who know me on here from all these years, know that I am the biggest believer in therapy. DBT has been a challenge not only because its freaking HARD, but because I am also very CBT trained from years ago and the two are a bit different. Now that I have started DBT I am able to tell you all that yes, CBT is so helpful but I think DBT is a real hero to Bipolar Disorder. It is mind blowing you guys! And I haven't even begun to master any of it because it's so tough! But I am not going to give up.

Here are the main points:

Mindfulness (this is not my friend yet but it will be someday!)
Distress Tolerance (Stress is the killer!)
Emotion Regulation (ugh HELLO! Emotions totally trigger us!)
Interpersonal Effectiveness (YES!)

The skills are so geared to bp!! It's amazing. Like I said, it is a real challenge and I've gotten stuck A LOT! But I know once I get through this book and learn these skills, they will stay with me just like CBT did, and they will become my every day skills I use to cope with this illness.

I am so unstable and unwell guys, and yet I am trying to do this. I am only on Chapter 3, we are working slowly. So if I can do it, you guys can too! Remember, Meds are only a part of this every day battle, we neeeeeeeed the skills!

There are some DBT self help web sites also. The book I purchased was The Dialecitcal Behavioral Therapy Skills Workbook for Bipolar Disorder by Sheri Van Dijk.

And a bonus...DBT skills are helpful just all around to live a better life!

Hugs to you all, hope you are well today,
Mogs

hi mogli.

did them all DBT skills training when i was dx with borderline personality disorder in 2004. this was a live in psycho-social rehabilitation program. i practice mindfulness daily. i still have my workbook as well. CBT i do not like, i find it dated. many practioners are using DBT for bi-polar in my country. (australia)

in kind friendship,
jamie

it is hard work, but well worth it mogli. with healing compassion, jamie

DBT was the single most helpful thing I found aside from when the meds actually help (currently on cymbalta and trileptal)... It is amazing! Everyone from 6th grade on needs these skills.

Hi there,

My therapy benefits maxed out in 6 sessions last fall and it made me realize DBT cannot be learned in 6 sessions.

Just today my psychiatrist got back to be about a DBT group where I work but I am concerned about coworkers etc and confidentiality. Also because I work in mental health my level of understanding is a bit higher than others but I am considering it. I think it is a 46 week program. When I start I am also put on a wait list for individual DBT. But at this point the wait for a DBT therapist is at least 6 months.

I have been drifting in and out of crisis for a year now. I am fighting tears writing this. My psychiatrist has not been there for me as much as I have needed him to be.

I think also I am going to start Latuda. Don't know what else to do at this point.

I still believe DBT is my best option. I have wanted to pick up my book again but rapid cycling moods have interfered and DBT is just not something that I believe you can self-guide through. Happy to hear you have started this journey and wish you the best.

A very important thing to tell you about Zyprexa. I gained 60 lbs that I have only lost in the past two years. It ruined my life being that overwieght for years. Do yourself a favour and google "class action law suit zyprexa."

Hugs,
Mogs

Hey Mogli,

We used to run a DBT group here. Maybe we could think about starting one up again... it really helps develop skills and put them in practice. I did my DBT course 4 years ago and it has been amazing for me. I use it each and every day... wouldn't be here if I didn't! Keep going, it is well worth the effort. Anything worth having is worth changing for :)

Cheers,

Jade x

Yes, I have the diary but I chose to get the bipolar workbook instead of the borderline one. I used to get in so much trouble when I did DBT because I had the dx of BPD instead of BAD. They kept insisting I could change my states and I just couldn't. I sent myself into exhaustion with DBT but refused to throw the baby out with the bath water - just because of that mix up. It has been invaluable for me to surviving bipolar without medication (because I have liver issues and meds cause me paralysis and seizures). So as you can imagine I have to rely heavily on psychological techniques to get through. DBT is wonderful for resilience building. It is the best. Keep going Flo... it is well worth pushing yourself beyond your comfort zone and learning new behaviours. It is a brave, courageous journey... well done x

You are spot on with the acronyms Flo. Bipolar is for life and the sooner we accept that and resign ourselves to managing it the best we can, the better we will fare. Acceptance is a very important technique to learn. I like you, fought everything my entire life, and have found peace with accepting that which I can't change. I still do everything to manage that I can't change the best I can though. Another therapy that is similar to DBT is ACT - acceptance and commitment therapy, but ACT is not as sophisticated when it comes to the management of trauma. There are people who are predisposed to bipolar but have not had the trauma that usually sets it off. Most bipolar people experience trauma due to their symptoms regardless of what activated the bipolar lying dormant up to that time. It is really important to not expect psychological techniques to remove bipolar symptoms. Bipolar is very much a physical illness and no amount of psychology can fix it. Psychology can only help us manage our physical symptoms. Healthy lifestyle is also important in managing our symptoms. Medication works the most effectively on the physical side of the the illness and does need to be taken where it can - and finding the correct meds in the correct dosage is essential in the treatment of bipolar, to enable the real person underneath the illness live the best quality of life possible. It's not an easy journey, I know, but I feel I have come far enough on my journey to provide comfort to even the worst, most hopeless feelings that bipolar can bring. What I can't help though is what is referred to as "wilfulness" when people are more fused with their habits and symptoms and problems than they are the solutions. You seem ahead of the game because you seem so proactive and prepared to do whatever it takes to make bipolar your slave, not your master. You inspire me, with your faith and your courage as you take leap into the unknown. Very brave and strong!

Flo, I have severe complex PTSD and have what I refer to cheekily as a "smorgasbord of triggers". In turn, the PTSD is a major trigger of the bipolar. I have to retreat a lot from the world just to lessen the amount of triggers I come in contact with. I have accepted that this is how I need to be sometimes in order to keep a more enduring equilibrium. I do let my walls down occasionally and in short bursts to try to experience as full and as meaningful life as I can though. It is about balance. I have found my new home a source of stability and enjoyment. It is the first time I am safe and not being dictated to. I am making my own decisions in my life and having my home reflect the person I am. My surroundings are reflecting who I am inside and this is helping me to develop a better sense of self. I also have a strong affinity with animals. The three animals I have mean the world to me and bring me an enormous sense of joy into every day. Mindfulness used to be very difficult for me because I couldn't cope with the intensity of the trauma without distraction. It took me a year or two to persevere with the panic that mindfulness brings in people who have major trauma. The DBT therapists we had in our DBT group didn't quite understand how the intensity of that trauma resurfaces during mindfulness. It is not a reason not to do it. It is the best reason we have to persevere with it. But I do think we do need to be validated with just how hard it is initially to sit in that sense overwhelming panic, terror fear and pain. Healing can create crises and it takes a lot of grit to endure those times and to continue to more integrated places. Mental health is not static. It ebbs and flows. With bipolar there will be times that our health will fail us even when we do everything "right" and there is nothing that we can do that merely survive the experience while it is there and then get on with enjoying the good times that inevitably follow every single episode of deep despair. Is that kinda what you wanted to know about my journey? I can really fire up (angry) and I can get very hypersensitive. The more I live a healthy lifestyle, it is like I starve the intensity of those emotions. I find taking valium early also helps me circumvent acting out and creating negative outcomes. I am not recommending valium for psychological issues. I use it only for that purely physical, intense brain chemistry solely due to bipolar that cannot be any further moderated by psychological techniques. Even when we do everything "right" psychologically, I think we have to have very effective strategies in place to minimise the harm done during the times when the bipolar takes over, despite our very best attempts. Bear in mind that I am treatment resistant. Someone who is taking the right medication at the right dose will notice a great reduction in symptoms and will not have to rely on PRN to the same degree. What are your experiences regarding all that? We may have the same cluster of symptoms but the way the illness plays out in each of our lives is so unique.

Sorry you are doing it tough Mogli. Sounds like you are doing a great job. Well done on the exercise.

Post Edited (Living Well) : 8/27/2013 8:37:29 PM (GMT-6)

Thanks for your compassion, both of you. I am doing better than I was Monday. I worked out Monday night, sat with the mood lamp like I said I was going to do. It helped. Went on a movie double date Tuesday night, worked out last night (set a record for myself, 40 mins on the bike).

I gained 60lbs from Zyprexa years ago and 2 years ago I started my journey to lose 80lbs. So far I have lost 64lbs, but have been stuck at that point for the past several months. Seems the last 15 lbs are taunting me. Have had a lot of setbacks, hand injuries, depressive episodes, bronchitis in the winter...But even though it's been a slow process, I am proud of myself and I really hope that I can lose this last bit somehow.

Flo, sounds like you are working hard which is amazing! Poor you with the bedbug inspection. I cannot imagine. I am a clean freak so that would major stress me out. Glad to hear it's almost over. I do need to get back into DBT, so thank you for the encouragement. Knowing someone is using the skills and it's working is really hopeful for me. I will definitely have to work on activities that I enjoy. It's been so long since I've taken time for myself for things like that. For the longest time now, I literally go to work, try to work out when I get home, prepare/eat dinner, watch TV and go to bed. I know I need to fit some things in somehow. At the same time, I can't beat myself up because I know holding a full time job and working out is such effort and accomplishment considering I've been in and out of crisis for the past year. It just gets so exhausting because it's so much effort and depressing because I feel like I'm going through the motions in a sense.

Anyway, some help is on the horizon and I have to remember that.

Hugs to you both,
Mogs

Hi Mogli,
It's good that you are keeping in touch :). I've got some food for thought for you that you can see how it fits for you and reject if it just isn't applicable. Given that you have lost more than your Zyprexa weight, isn't that something to celebrate in itself. Given that you've only lost 4lbs of the additional 20lbs you want to lose - and are leading a very active life, I would like to pose the question as to whether is it possible that you are at a good weight now? We need to make realistic goals and sometimes our biggest wishes are not realistic. Is not working full time not enough for you to be absolutely amazed with the level of functioning you achieve with an illness like bipolar? Isn't the consistency of your workouts with all the various challenges you've had something to be applauded? I know only too well that the way an outsider might see things can be very different to how it feels for us and how it resonates with our priorities. In DBT there is similar concept as the 12 step programs of change, acceptance and the ability to discern what is required. Possibly spend some time in your body, meditating to get the unique answer that is just right for you. Go with your gut feeling, your intuition, not you conscious mind. Do up a list of pros and cons of further weightloss and that might help you decide whether you are taunting yourself with something unnecessary, or whether it is a priority and you are merely going through a plateau and it is a worthwhile goal to continue to pursue. I know I've just picked one thing out of your entire post. I did read it all. I merely am highlighting one aspect of your life that you may like to trial a range of dbt skills in relation to. The year program in DBT is merely for you to tailor make your personal DBT program and collection of skills because it is such a unique personal program, and we have to find which skills work the best for us. Only we can know that - and DBT - especially mindfulness - gets us more in touch with ourselves so we do know what beliefs, actions are helpful and what are harmful. DBT is empowerment, self awareness and resilience packed into one powerful package. Don't lose sight of just how highly functioning you are. It stands you in very good stead for applying DBT skills and principles. You've got determination, discipline and grit... Like many of us, learning how to play can be terrifying, opening our hearts again can be terrifying. Being undistracted and vulnerable is when our demons can creep up and it is a challenge to be able to sit with uncomfortable feelings and let them ebb and flow. The process, I find has tapped me more into my core self and grounded me quite a lot. Hope I've given your some ideas, inspiration or food for thought. We never can know what thoughts and feelings our words can be a calalyst for in another. At the bottom of everything, I am wishing you all the best for your journey.
Jade x

Hi, just saw this thread after I googled bipolar and BPD. I was hoping someone can answer something for me.

It sounds like most of the people who have bipolar and done DBT also happen to have BPD. Is there anyone here who has done DBT and has bipolar but doesn't have BPD at all?