Making Healthy Decisions When You Have Bipolar Disorder

“When you have bipolar disorder, it can often feel like you’re at the mercy of your emotional states — like you’re the passenger in the car, just along for the ride,” writes Sheri Van Dijk, MSW, in The Dialectical Behavior TherapySkills Workbook for Bipolar Disorder. But “this doesn’t have to be the case.”

In the book, Van Dijk shares how individuals with bipolar disorder can learn to act — rather than react and make smart decisions. (I personally think these insights and advice are valuable for all readers, regardless of whether you struggle with bipolar disorder.)

 

Finding the Balance Between Emotions & Logic

According to Van Dijk, in order to make healthy choices, we need to find a balance between our emotions (emotion mind) and our logic (reasoning mind). This balance is called “wise mind,” a concept from dialectical behavior therapy (DBT).

Wise mind means that you’re able to feel your emotions while still being able to think straight, she writes.  It’s possible to make smart decisions based both on your feelings and your thoughts about a situation.

Everyone has a wise mind. According to Van Dijk, you’ve used this wise mind whenever you’ve gotten out of bed even though you felt depressed, or gone to work even though you felt anxious or taken a walk even though you wanted to watch TV and be alone.

Telling the Difference Between Wise Mind & Emotion Mind

It can be tough to tell if you’re making a decision based on your wise mind or your emotion mind, because, as Van Dijk writes, both include emotions.

She suggests assessing the strength of your emotion. If your emotion is intense or overwhelming, you’re likely in emotion mind. If it’s not overpowering, you’re likely in wise mind.

Also, making a decision from your wise mind means sitting with it. If you find yourself vacillating, you’re probably letting emotion mind take over. That just means that you need to give yourself more time.

An Exercise to Be More Effective

A wise mind will help you be more effective in life, according to Dijk. In other words, this involves “doing what it takes in a situation to get your needs met.”

Think about it this way: How many times have you acted in a way that felt great in the short term but not so great in the long term?

Dijk uses the example of stopping your medication. Let’s say you’re experiencing unpleasant side effects. Instead of telling your psychiatrist that the side effects are bothering you, you just stop abruptly. The side effects do go away in the short term. But you end up in the hospital because of a manic episode.

Dijk says that several things can interfere with acting effectively and making good decisions: your thoughts, or how you wish a situation was; not knowing what you want out of a situation; and thinking short-term needs vs. long term.

For instance, as Dijk explains, “While you might get some satisfaction out of yelling at an employer whom you feel didn’t treat you with respect, in the long run, you must remember that you need that person to say good things about you to help you get to the next job.”

Also, consider the earlier example about stopping medication abruptly. There, you were letting your emotions make your decision. If you were to consult your “reasoning mind,” you’d realize that not taking your medication can lead to a relapse and other risks.

When you think with both your emotions and reasoning, you’re able to identify your goals (making sure that they’re not at the expense of others). As Dijk writes, you might say: “I’m frustrated with the side effects and have decided that [they’re] not acceptable. I need to book an appointment with my psychiatrist to inform her of this request that she prescribe a different mood stabilizer.”

Dijk suggests readers practice by thinking of a situation that requires a decision. She suggests asking yourself the following questions (and recording your responses):

• Describe the situation
• What are the emotions you are experiencing about this situation?
• What is your urge in this situation? (What is emotion mind telling you to do?)
• What is your long-term goal in this situation?
• What would be a helpful action for you to take in this situation? (In other words, what can you do that would make it most likely for you to meet your long-term goal?)

Other Ways to Be Less Reactive

According to Dijk, there are other things you can do to be less reactive, so you don’t let emotions rule your decisions. These include: improving your sleep habits (key for bipolar disorder — shaky sleep can trigger manic or hypomanic episodes); avoiding drugs and alcohol; practicing good self-care; reducing your caffeine intake; not skipping meals; getting nutrients from your diet; and participating in physical activities you enjoy.