Hi,

Have you ever heard the expression “getting back on the horse”? People use it when talking about having failed at something and then trying it again. Sometimes, if you’ve messed up, it’s hard to get back to where you were. But sometimes it’s CRUCIAL that your loved one “gets back on the horse” when it comes to things that they mess up with their bipolar disorder.

Take, for example, their medication. It’s easy to forget to take it. If they do, that’s ok. They can just take the next dose when it’s time. But too many people will just stop taking it altogether, and that’s a HUGE mistake! Because that is almost a SURE way to go into a bipolar episode! And also because when they’re ready to go back on their medication, it’s like starting at square one again. Bipolar medication takes time to build up in the bloodstream, so if they’ve been off it for awhile, they have to start at a low dose again and build back up to the level where they were before they stopped taking it. Some people mess up seeing their doctor, psychiatrist, and/or therapist. They miss one appointment, then it gets easier to miss another, then another…Then they stop going altogether. And that is NOT the right thing to do. If your loved one misses an appointment, they have to “get back on the horse” and go to the next one.

There are so many parts that can be messed up in a treatment plan, but I’m not going to go into all the parts of a treatment plan here. But I do want to talk to you about what happens when you do start to mess up parts of your treatment plan. Let’s say your loved one has started isolating again. Isolation is one of the symptoms of bipolar disorder, and one of the top triggers to a bipolar episode. But if your loved one lets this slip, and they start to isolate again, then they are in a dangerous place, and could be jeopardizing their stability. Now they have two choices: They can either close down, shut out the world, get all depressed, climb into bed, pull the covers over their head, feel sorry for themselves, cry, and go into a bipolar depressive episode…OR… they can “get back on the horse” again. Another example is if they start to slip with their sleep patterns. Lack of sleep (or too much sleep) is another trigger to a bipolar episode. But they can fix it if they catch it soon enough. In other words, they can accept that even though they let a PART of their treatment plan get messed up, their WHOLE treatment plan is still working, and they can still fix it. First they need to identify what went wrong. Then they can fix it (“Get back on the horse.”)

It doesn’t have to be anything really dramatic, but even small parts of their treatment plan, if they get messed up, can cause them to go into an episode. For example…They could let their diet slip.

This could cause them to gain an excessive amount of weight. This could cause their self-esteem to go into the pits. Which could make them get depressed. Which could cause them to go into a bipolar depressive episode. Even if it does cause them to go into an episode, though, they can still recover from that episode and…That’s right – “get back on the horse” again. Start back doing the things they were doing before they went into that episode.

Well, I have to go!

Your Friend,

Dave