By Lily Johns
As someone living with bipolar II, I often find myself getting caught up in the details of my bipolar; tracking daily symptoms, sleep patterns, or how I am doing with taking my medications. However, it is important to consider that managing my bipolar disorder isn’t only about reducing my symptoms and keeping up with my treatment plan, it’s also about living my life doing the things that I enjoy. In other words, ‘living well’ with bipolar disorder often means more than lessening your symptoms. This winter, I attended an event that made me reflect on this by highlighting the importance of centering conversations around wellness in the research and treatment of bipolar disorder.
The event, a webinar titled “Living Well with Bipolar Disorder”, was held this February by the Prechter Bipolar Research Program at the University of Michigan. In the first half of the webinar, Dr. Sarah Sperry of the Prechter Program led a conversation on this idea of wellness for folks living with bipolar disorder. To introduce the topic, Dr. Sperry discussed how living well with bipolar disorder is commonly conceptualized as an absence of symptoms (i.e., depression, anxiety, mania, hypomania). However, for people living with bipolar, this isn’t always representative of how they view their own health and wellness. A study by Morton et al. (2022) found that only 17% of people in the study reported that reducing their symptoms of bipolar was an important part of their wellness. Alternatively, most people highlighted other, more holistic, aspects of their life and sense of self as contributing to their wellness, including the ability to be independent or act according to their own will (86%); purpose in life (74%); getting through the day (81%); self-acceptance (73%); having a calm and relaxed presence (63%); following through on ideas and intentions (63%); having a sense of influence over the events in my life (75%); having positive relations with other (71%); and achieving personal growth (68%). However, 76% of people in the study reported that the healthcare they received for their bipolar disorder was mainly focused on minimizing symptoms. This shows how to many folks with bipolar disorder, living well and managing their bipolar means much more than a reduction of symptoms. And, because most healthcare settings consider symptom relief as the primary way to measure health and wellbeing, we are largely unable to capture these additional complexities of wellness in the existing framework.
Working to address this, Dr. Sperry highlighted ongoing research that she and other folks at the Prechter Program are leading that is working to develop a measure of wellness for bipolar disorder. This measure of wellness was developed alongside those with lived experience and centers their voices in what wellness means to them. The goal is for the measure to be implemented in both research and clinical settings and to be used to further the conversation around wellness and bipolar disorder.
Wanting to know more about these concepts, I met with Dr. Sperry to have a conversation about living well with bipolar disorder. According to Dr. Sperry, incorporating measures of wellness in bipolar treatment is complementary to existing approaches: reducing symptoms and symptom severity is an important part of treatment for bipolar and centering wellness can be an effective aspect of an individual’s treatment plan. Having conversations about wellness and bipolar disorder can also create a more individualized approach to research and treatment of bipolar because everyone has their own unique path to living well with bipolar that incorporates their own needs, strengths, and personal goals.
Speaking from my own experience, I know that how I’m feeling in my day-to-day life does not necessarily translate into how my symptoms look ‘on paper’ following an appointment with my healthcare provider. Often, my depressive symptoms are relatively consistent, but the distinguishing factor is how much I am engaging in activities I enjoy. Working with my health care provider to understand this aspect of my bipolar disorder can be beneficial to both me and my provider as it provides additional information about how my bipolar affects my life, helping us work to better my health and wellbeing. To me, it can also be empowering to define your symptoms as something other than lack of mania, depressive symptoms, anxiety, etc. Therefore, it is essential to shift the framework of how we treat and think about bipolar disorder to one that incorporates wellness in addition to clinical indicators. Going forward, Dr. Sperry emphasized that it is key to incorporate discussions of the importance of wellness into research and advocacy as well as the training of the next generation of clinicians.
As described by the Depression and Bipolar Support Alliance, “[a] relief of symptoms is only the first step in treating depression or bipolar disorder. Wellness is a return to a life that you care about.” I am very hopeful that the work that Dr. Sperry and folks from the Prechter Program are doing to develop a measure of wellness will encourage future work on the importance of wellness to bipolar disorder and mental health as a whole.
For further reading on wellness and bipolar disorder, see the recording of the “Living Well with Bipolar Disorder” webinar as well as resources from the Depression and Bipolar Support Alliance, including the Wellness Wheel.
Lily lives in Ypsilanti and works for the University of Michigan as a Research Coordinator for a study on suicide prevention. She is passionate about mental health promotion from an individual and public health perspective. In her free time, she enjoys listening to music and (occasionally) reading.