Bipolar 1 support group

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

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Last Updated: 08/30/2022

8 Best Bipolar Support Groups of 2022

  • Best for all-encompassing support:
  • Best for face-to-face support: The Depression and Bipolar Support Alliance (DBSA)
  • Best for a variety of chat rooms: HealthfulChat
  • Best for education and advocacy: The National Alliance On Mental Illness (NAMI)
  • Best for online chatting: 7 Cups
  • Best for quick pairings: My Support Forums
  • Best for a personal approach: DailyStrength
  • Best for inclusivity: Mental Health America (MHA)

Bipolar disorder affects about 2.8 percent of the population in the United States, with the average age of diagnosis at 25. Almost 83 percent of people have severe symptoms.

While not everyone with bipolar disorder experiences depression, the symptoms of mania can last a week or more and include elevated or irritable moods. The time between symptoms can vary, sometimes lasting years without experiencing any symptoms.

If you suspect you may have bipolar disorder, it’s important to get an official diagnosis and treatment from a psychiatrist or other mental health professional.

However, support groups can be an important part of your treatment plan.

Bipolar support groups offer emotional support from other people who understand what it’s like to live with bipolar disorder. They aren’t a substitute for professional care or therapy, but they’re a place to get support and ask questions.

Some groups are run by mental health professionals, but others are led by volunteers who live with bipolar disorder as well.

To select the best bipolar support groups, we looked at:

  • privacy
  • the website’s usability and accessibility
  • the education and support each one provides

We reviewed the type of support group offered, if they’re virtual or in-person if they’re led by volunteers or licensed professionals, and the cost.

The variety of these support groups allows for options that fit a person’s unique needs.

Read more about our vetting process for brands and products.

Best for all-encompassing support, a subset of BP Magazine, has won awards for their community-focused mission on empowering people with bipolar disorder, offering hope, and working to increase awareness.

In addition to helping people with bipolar disorder, the group also provides support for family members, caregivers, and healthcare professionals offers informative articles, blog posts from people living with bipolar disorder (including a section of celebrities with bipolar disorder), and the latest news and research. There is a section for kids that offers information and educational videos.

In the peer support section, users can read articles on bipolar disorder and leave comments and questions for others.

The brand’s Facebook page offers additional online groups that people can join.

According to a magazine subscriber, “ [is] another part of my support network — as important to me as my family, friends, or even my doctor!”

Price: Free

Get started with

Best for face-to-face support

The Depression and Bipolar Support Alliance (DBSA)

Formerly known as the National Depressive and Manic Depressive Association, this non-profit provides support and advocacy for people with bipolar disorder. Their website offers educational materials, like videos, podcasts, and webinars.

DBSA also offers tools and support for friends and family members. Users can search for a support group both locally in-person and online. These support groups are peer-led, which means the leaders understand what it means to live with bipolar disorder.

In addition to the general support groups, they also offer specialized groups for friends, family, and caregivers, as well as for people in the military or those who are veterans experiencing bipolar disorder.

Reviews of DBSA are mostly positive. Users say it’s a great source of support and education with passionate, real-life stories. Some users report feeling overwhelmed for their first few meetings when hearing the experiences of other participants.

Price: The use of the website and support groups is free, but users need to sign up in order to attend groups.

Get started with DBSA

Best for education and advocacy

The National Alliance on Mental Illness (NAMI)

NAMI is the largest mental health organization in the United States. They began in 1979 with a small group of families, and they now have 600 local affiliates.

They provide support, advocacy, and education for those in the mental health community and their families. Community members and healthcare professionals can also participate in classes and training.

In addition to a magazine, fundraising events, and a help line for free information and support, NAMI includes forums to connect people with others who have bipolar disorder.

Their website has information on bipolar disorder, including treatment options and current research. You can go to the “Online discussion groups” section to sign up to chat with others.

Overall, users say NAMI is a great organization “to find support for continued recovery of any mental health disorder.” Some users say they feel there isn’t a lot of legal advocacy available to them.

Price: Free

Get started with NAMI

Best for online chatting

7 Cups

7 Cups provides therapy services from licensed professionals and trained volunteer listeners. They provide counseling and guidance for a community of people who understand what it’s like to live with bipolar disorder.

There are chat rooms and forums specific to bipolar disorder where people can ask questions, share knowledge and support each other.

7 Cups is available as an app as well.

7 Cups encourages users to meet others and check in as often as they want to share their stories, or to let others know they understand.

While forums aren’t run by mental health professionals, you can receive counseling with a licensed therapist for $150 per month. With this, you can chat with a therapist in unlimited messages.

As a free option, volunteer listeners are available for emotional support 24 hours per day and can talk with people who are 13 years of age and older. However, therapy services are only for people over 18.

Some users report it can be confusing when you first join, and that there are too many rules put in place. But they report benefits to their emotional health and say volunteer listeners are helpful.

Price: Volunteer listeners and forums are free. Mental health counseling from licensed therapists costs $150 per month, and they don’t take insurance.

Get started with 7 Cups

Best for quick pairings

My Support Forums

My Support Forums is a mental health network of social forums where members can chat with each other 24 hours per day. The site’s content is run by mental health professionals who provide informative articles and forums, including some specific to those with bipolar disorder.

As a member, you can search for topics and keywords or post new threads. You can reply to posts or send virtual hugs.

My Support Forums has been around for several decades and gets high numbers of traffic every month, so there is plenty of information and support.

Some users report verbal attacks and rudeness from other members and that the volume of members can be concerning with moderating comments.

But others say they appreciate the work moderators do to keep people safe and comments from being abusive.

Price: Free

Get started with My Support Forums

Best for a personal approach


DailyStrength provides support groups in the form of a social network of others who live with various mental and physical health conditions.

Their bipolar support group contains thousands of members and actively provides a place to give and receive encouragement, answer questions, and get contact information of different medical professionals.

There are professionals who specialize in bipolar disorder that you can reach out to by clicking on the link to DailyStrength’s parent company, Sharecare.

As a member, you’re encouraged to remain anonymous. You can also read and leave messages on different forums for a variety of different health conditions. There are tabs for general and crisis topics within the bipolar section for everyday issues or more serious ones.

Finally, within the site, you can create a journal and set your settings to private or public, depending on how open you’d like to be. You can also send virtual hugs for encouragement to other members.

Most users say DailyStrength is great for peer support and information. One user states, “Even though there are a few cliques, some of the people are amazing!” Other users report bullying and harmful behavior within forums.

Price: Free

Get started with DailyStrength

Best for inclusivity

Mental Health America (MHA)

Mental Health America was founded in 1909 and is now the leading non-profit for those living with mental health conditions.

Their focus is on mental health prevention, early intervention, and integrated support “with recovery as the goal,” according to the website.

MHA’s philosophy focuses on treating conditions before they get to critical stages. They’re committed to addressing racial injustices and the intersection with mental health.

Their website contains a blog discussing all aspects of mental health conditions with numerous informative articles on bipolar disorder. They also host webinars, podcasts, and a peer-support community called Inspire.

These online support groups are moderated by MHA staff. Inspire’s platform shares your email address with MHA if you decide to join.

You sign up with a username and, you’re free to chat with others in the forum specific to those with bipolar disorder.

They don’t have chapters in every state and one user review on Facebook says they wished they had a chapter in their area.

But overall, users say MHA is a supportive organization that contains the latest information and trends in the mental health system.

Price: Free

Get started with MHA

What is the purpose of a bipolar support group?

Coping with a mental health condition can feel isolating, and sometimes, friends and family members may have a hard time understanding.

It can help to meet with others who also have bipolar disorder and who are dealing with the same symptoms and concerns.

It’s also a good place to discuss medication side effects, treatment options, self-care, and coping strategies.

Is a bipolar support group right for me?

It can be beneficial to join a support group when you have bipolar disorder.

Kruti Patel, PhD, a clinical psychologist, explains that, with this type of support, people feel understood and learn from others how to cope with their various concerns.

“Joining a support group can really help with feeling less alone and finding a community that will understand what you’re experiencing,” Patel says.

How do online support groups differ from in-person support groups?

An in-person support group can be led by a mental health professional or by a layperson. Mental health professionals may be nurses, licensed therapists, or social workers.

Peer-led groups are usually run by volunteers who have some sort of training and share common experiences with group participants.

These groups tend to be scheduled at certain times. You would need to find one that’s available in your area.

Online support groups can consist of chat rooms and forums, social media groups, or virtual video calls. These online groups usually allow more flexibility, and you can get support more frequently than if you attended in-person groups.

How do I decide which option is best for me?

Patel explains that if your bipolar disorder symptoms are more severe, you may benefit more from in-person groups because they allow for less distraction and more direct engagement with others.

However, if you feel overwhelmed by an in-person group, online groups may help you get started with sessions.

Also, if you’re very independent “online groups will still be able to capture all the benefits of a group experience,” Patel says. If you’d like support but are very independent in your life or already feel supported by your individual therapist, a virtual group might be more appropriate.

Patel adds that it’s important to also consider how often group meetings are held and if the group is led by professionals or peers. If possible, you should try to opt for a group led by professionals.

Whether you’re looking for an in-person support group or a chat room led by volunteers or professionals, there are many options to try out. The majority of them are free — except for those including professional counseling.

It’s important to note that support groups are only proposed as a supplement to professional treatment and not a replacement.

But with access to so many support groups online or on your phone, it’s easy to get the additional support you need.

Risa Kerslake is a registered nurse, freelance writer, and mom of two from the Midwest. She specializes in topics related to women’s health, mental health, oncology, postpartum, and fertility content. She enjoys collecting coffee mugs, crocheting, and attempting to write her memoir. Read more about her work at herwebsite.

Support group for people with bipolar disorder in Yekaterinburg. December 16, 2021 - December 16, 2021

Face-to-face meetings of the group are held in Yekaterinburg twice a month


A support group for people with bipolar affective disorder (BAD) has started working in Yekaterinburg. Meetings last two hours: participants get to know each other, tell what they think is necessary about themselves, ask questions to other visitors, and suggest topics for discussion. Often people with mental disorders face rejection and devaluation, so they are afraid to tell even their relatives about their condition, or do not receive support from them. In such cases, the support group is often the only place to open up and gain understanding, this is very important. nine0003

“The group works according to special rules,” Alena Shibarshina, director of the system support center for people with mental disorders and their loved ones, told E1.RU “How are you?”. - Firstly, it is confidentiality: what was at the meeting remains at the meeting. Secondly, the lack of advice, you can’t say who needs to do what and how to act, but you can talk about your experience, about how a person himself acted in some situation and what he felt. Through these stories, participants gain experience, draw conclusions for themselves. nine0003

Meetings are held twice a month in a peer-to-peer format, and the moderator is also a person with bipolar disorder.

- All participants are people with one disorder, and there is no one in charge. This is not therapy, many say that they come to the group precisely because they are afraid to go to a specialist, and among their own they can open up, - said Alena Shibarshina. - It should be clarified that only a psychiatrist can make a diagnosis, and the treatment of bipolar disorder consists of medication, psychotherapy and a built-in regimen. The Peer Support Group is a great addition to all of this. nine0003

In order to join the support group, you need to join the closed community on VKontakte, after which the organizers will tell you about the time and place of the meeting. This is done so that random people do not get there and the group passes safely for the participants.

Also in the How are you? there are online groups for people with bipolar disorder and for their loved ones and relatives, you can learn more about this on the center's website.

We have previously published the story of a girl with bipolar disorder. Read an interview with a psychiatrist about how to spot possible disorders in a teenager in time. nine0003


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symptoms, how does it take place. and treatment

Victoria K.

lives with bipolar disorder

The first signs of the disease appeared in my teenage years, and the psychiatrist diagnosed BAD at the age of 26.

According to WHO, 45 million people worldwide suffer from bipolar disorder. This disease greatly reduces the quality of life: in some periods you are overly energetic and do things that you can regret, in other periods you are not able to get off the couch to do everyday things.

I will tell you how I have BAD and what I do to cope with the disorder and live like all ordinary people. nine0003

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

What is Bipolar Affective Disorder?

Bipolar Affective Disorder, or BAD, is a mental disorder with alternating emotional ups and downs in mood. It is affective just because it is associated with violations of the emotional state, that is, mood - in psychiatry, the manifestation and experience of emotions is called affect. Previously, this disease was called manic-depressive psychosis. nine0003

Bipolar Disorders - A Physician's Guide MSD

Why bipolar disorder develops is not exactly known. Among the reasons are heredity, traumatic events, violations of the production of neurotransmitters - substances due to which signals are transmitted between brain neurons. The disease often manifests itself in adolescence or in the period between 20 and 30 years.

How bipolar affective disorder manifests itself

BAD usually begins abruptly, followed by periods without signs of illness and periods of exacerbations. The peculiarity of the disease is that during periods of exacerbations there are episodes, or phases, with different emotional states that can replace each other in an arbitrary order. nine0003

Bipolar Disorder - Mayo Clinic Blog Article

For example, when the illness escalates, the following conditions may occur.

Mania - a state of elevated or irritable mood. The person feels energetic, actively engaged in something, such as finding a new hobby or even trying to open a business. As a rule, he sleeps little, is self-confident, talkative, he has a lot of ideas, often crazy. Risk sensitivity may decrease - for example, a person invests all the money in a hopeless business or gets into a loan. Hobbies for gambling, extreme sports are not uncommon. At the same time, a person feels great, but often cannot concentrate on one thing, work productively. nine0003

The extreme degree of mania is manic psychosis, when delusions of persecution, hallucinations, excessive activity develop, a person can become dangerous to himself or others.

Hypomania is a kind of mild mania. A person is in a state of emotional uplift, but this uplift is not so pronounced. However, the mood still improves, the need for sleep decreases, the person is creative, relaxed, feels euphoric, and his productivity increases. Although in some people such periods may be accompanied by irritability and a decrease in concentration. nine0003

Depression - low mood, loss of interest in life, fatigue, guilt, indecision, decreased concentration. Sleep and appetite disturbances may occur. Sometimes there are thoughts of suicide, the futility of one's own life.


“It reminded me of a strict regime sanatorium”: how much I spent on treating depression

Between exacerbations, a person can return to normal, although it happens that his performance is still reduced. nine0003

Manifestations of the phases of bipolar disorder according to the National Institute of Mental Health USA

Parameter Mania Depression
Mood Excitement, joy, irritability, resentment Sadness, depression, emptiness, anxiety, hopelessness
Sleep Reduced need for sleep Trouble falling asleep, getting up early or sleeping too much
Appetite Loss of appetite Often increased appetite, weight gain
Communication Talkativeness Slow speech, forgetfulness
Concentration Feeling of jumping thoughts, multitasking Problems with attention and decision making, distraction
Behavior Risk appetite, runaway spending, promiscuous sex Lack of pleasure and interest in anything, decreased libido
Subjective feelings Feeling of self-importance, talent and power Feelings of worthlessness, suicidal thoughts, suicide attempts


Excitement, joy, irritability, resentment


Decreased need for sleep


Loss of appetite




Feeling of thoughts, multitasking


Risk, unbridled sex

Subjective sensations

Feeling and power



Sadness, depression, emptiness, anxiety, hopelessness


Trouble falling asleep, getting up early or sleeping too much


often increased appetite, weight gain


Slow speech, forgetfulness


Problems with attention and making decisions, Dispersibility


Lack of pleasure and interest in something, decrease in libido

Subjective feelings

Feelings of worthlessness, suicidal thoughts, suicide attempts

There are two main types of bipolar disorder according to how the disease manifests itself:

  1. When there has been at least one manic episode and depressive episodes recur.
  2. When there are periods of depression and at least one episode of hypomania, but without full mania.

Bipolar Disorder - National Institute of Mental Health USA

I just have bipolar affective disorder type 2. This means that there are no full-fledged manias, but there are hypomanias and severe depressions.

Hypomania is a very cool time for me. You can do everything: get a second degree, run a marathon, learn English, go on an unplanned trip. And so for several months during which you do not sleep, do not eat, acquire new friends, start novels, end old relationships. You feel all sensations in the maximum range. During the day, it can throw several times from tears and the desire to die to incredible happiness. nine0003 This is what mania looks like in BAD. Source: Twitter

After hypomania comes depression. And immediately there is not enough strength not only for what was started during the previous phase, but also for ordinary things. The most understandable image of depression for me is “pressed down by a concrete slab. ” It becomes hard to do the simplest things: wash the dishes, change clothes, go to the store.

Unfortunately, the brighter the hypomania goes, the worse the depression gets later — that's why, with experience, I stopped enjoying the active phase. nine0284 Now it is even more difficult for me: I understand what is happening with my brain, but I cannot control it.

As I remember now, my first hypomania happened at the age of 12. Then there were periods of exacerbations clearly in a year and a half: hypomania lasts 2-3 months, usually May - July, depression - 5-6 months, usually in October - March, in between remission occurs when I feel normal. If I am in a long-term remission, then I hardly notice phase changes: mood swings are smoothed out with the help of medications or psychotherapy. nine0003

10 podcasts about health and medicine

The usual course of bipolar affective disorder

Viktor Lebedev

psychiatrist, science journalist

During an exacerbation of bipolar disorder, episodes of mania or hypomania and depression may alternate. There is a clear separation of phases: first a hypomanic or manic episode, then a depressive episode, it happens that there are recurring episodes of depression, then hypomania. In the latter case, hypomanic phases are sometimes not noticed, a person may be diagnosed with recurrent, that is, recurring depression, and may be prescribed the wrong treatment. nine0003

In fact, in BAD, the phases can alternate in any order, the diagnosis is made if there is any combination of manic and depressive episodes. The first time the disease usually begins with an episode of mania or hypomania, which develops into depression. Less commonly, it starts with depression, then mania or hypomania occurs. But in any case, there must be affective disturbances, that is, mood disturbances.

The exacerbation of the disease lasts from several weeks to several months. This also depends on whether the person is receiving medical treatment. If you respond quickly to an exacerbation, you can sometimes return to normal health in a week. If not treated, the exacerbation can last for several months - especially the depressive phases, episodes of hypomania and mania usually pass faster. nine0003

Seasonality of phases, when there is a connection between the manifestations of the disease and the change of seasons, occurs, but not all patients with bipolar disorder notice it.

How I suspected I had BAD

The first time I thought I was going crazy was when I was 18 years old. Painful relationships ended, obsessive thoughts and images swirled in my head, I listened to the same song in the player, walked for hours and could not stop. This went on for so long and was so unbearable that I almost decided to go to a psychiatrist. However, they didn’t talk about mental disorders then, so I didn’t even know where to turn. Then this state passed by itself. nine0003

I did not see a psychiatrist until seven years later, when I again had a similar severe condition: obsessive thoughts, inability to control emotions, self-harm, sleep and appetite disturbances. Before that, I had three episodes of hypomania every two years, but after them there was no severe depression, and therefore no reason to seek help.

Then I just went to the district polyclinic - it turned out that a psychotherapist was there. She checked my symptoms on the Beck scale, diagnosed me with an anxiety-depressive disorder, and prescribed a common antidepressant that is often prescribed for depression. nine0003

Beck Depression Scale - online test

It seemed to me that antidepressants helped me immediately: my mood improved, I got energy, I talked a lot with friends, hung out, worked. Now I know this is a bad sign. Antidepressants usually take a long time to work: it takes about three weeks for the effect to appear, and I got better after a few days. In addition, in bipolar affective disorder, antidepressants can cause hypomania if not mitigated by other drugs. nine0003 This meme is well understood by those who were not immediately given the correct diagnosis. If you add Mentos to Coca-Cola, you get a foamy fountain that will splash out of the bottle. Antidepressants, in particular SSRIs - selective serotonin reuptake inhibitors - have the same effect on the mood of people with BAD

I went to this psychotherapist several more times, but she did not track my sharp mood swings, and I had one of the most severe hypomanias . I drank and smoked a lot, I had incredible emotional swings, I ruined my relationship with my best friend, I stopped eating and sleeping. nine0003

After a couple of months, my condition stabilized a little, but I continued to take antidepressants: I knew that they should not be stopped abruptly. Before canceling, I went for a consultation with another doctor, already at a paid clinic. She turned out to be a good specialist: she asked questions about mood swings, found out if I had previously had mood swings, ups and downs, depressions. Then everything was fine because of taking antidepressants, so I denied everything.

A year later, as the doctor ordered, I smoothly stopped taking antidepressants, and a few months later I was overcome by one of the most severe depressions. If last time I could attribute depression to circumstances - burnout, relationship difficulties, fatigue - now there was no reason for it. I had a job I loved, a great relationship with my husband, financial stability, a new city. And I wanted to die. nine0003


How to choose a psychotherapist

This moment became a turning point in the diagnosis. I already knew that there is such a disease as bipolar affective disorder, what are its symptoms and features. Information about BAR appeared in the media field: I read articles and blog posts, watched videos on YouTube.

I was able to describe the last 10 years of my life in phases: there was a strong rise, followed by a decline. For example, in the hypomania of 2012, I worked two jobs, passed the state exams, wrote a diploma, hung out with friends until the middle of the night and completely took care of the life of the family. In hypomania in 2014, she entered the magistracy, graduated from a driving school, traveled, and also ran a marathon. nine0003

Every upswing was followed by a downturn: I stopped running, didn't pass the exam in the traffic police, and dropped out of the master's program. Each such exacerbation generally lasts a year and a half, and then repeats.

How I was looking for a suitable psychiatrist

After collecting information about BAD, I decided to find a psychiatrist to confirm or deny my diagnosis. It didn't happen right away.

First I went to a psychiatrist on the advice of a friend, he helped her with depression. The doctor saw me in a paid clinic, the appointment cost about 3000 R. The consultation was unsuccessful: the doctor was clearly not interested in my condition, he indifferently asked questions about depression and prescribed antidepressants. And not the ones that were assigned to me last time, but others. I was too depressed to stand my ground, so I just started looking for another doctor. nine0003

6 useful services for finding a psychotherapist

The second doctor was in a state clinic, she was recommended to me on Facebook. At first, I waited a long time for an appointment - the doctor was half an hour late, then I started asking about birth injuries and vascular dystonia. This consultation didn't work for me either. I paid 2,000 rubles for her.

The third appointment was successful: I found a psychiatrist, whom I still go to. She works at the State Institute of Psychiatry, but I see her for a fee. One consultation costs 2500 R.

2500 Р

I pay a psychiatrist for one appointment

The institute where the doctor sees, I was advised somewhere in the comments on the Internet. I called the reception and asked to sign me up for a doctor specializing in affective disorders as soon as possible.

The search for a suitable psychiatrist took about a month, so I went to see a doctor in a completely crushed state, in tears and hysteria. The psychiatrist asked me about the illness, listened to me and offered free hospitalization. However, I refused: I felt that I was controlling myself so as not to commit suicide, and my husband was also nearby, who understood the seriousness of the situation. As a result, I continued the treatment at home. nine0003

When Bipolar Disorder Needs Hospitalization

Viktor Lebedev

Psychiatrist, Science Journalist

Bipolar Affective Disorder may require hospitalization if during a manic episode the patient develops strong arousal, completely loses critical attitude to his condition, and hallucinations appear rave. Such a condition can end badly for the patient himself or his relatives. In a depressive episode, indications for hospitalization will be suicidal thoughts or suicide attempts. nine0003

Inpatient treatment may also be needed in case of a severe decrease in working capacity.

If you suspect you have bipolar disorder, but are not in the acute phase of the disease, help is not urgent, it is better to spend time looking for a psychiatrist who specializes in bipolar disorder or affective disorders in general. Such a doctor is likely to quickly make the correct diagnosis and select the best treatment.

Before taking, it is worth writing down all the symptoms that bother you, and also, if possible, make a retrospective graph of the expected phases - mania and depression, write down when they occurred and how long they lasted. This will help the doctor understand if this is BAD or something else. nine0003 This is how the BAR phase sequence looks like in my case

BAD treatment

Consultations with a psychiatrist and drug therapy

The psychiatrist first wrote me a prescription for several drugs: antidepressants and mood stabilizers. They are usually prescribed to people with affective disorders.

As explained to me, treatment is, among other things, checking for the correctness of the diagnosis, a way to distinguish depression from bipolar disorder. If the prescribed drugs help, the diagnosis is correct. nine0284 About two months later, my diagnosis was officially confirmed: bipolar affective disorder type 2.

How bipolar disorder is diagnosed

Viktor Lebedev

psychiatrist, science journalist

Bipolar affective disorder is diagnosed by the problems that bother a person. His story should contain a description of typical mood and behavioral disorders, usually there is an alternation of phases of the disease.

Complaints and a history of the disease are enough for diagnosis, sometimes the testimonies of relatives are also taken into account, which can tell about a person's behavior. It happens that a doctor can send you to a clinical psychologist for a psychological examination, but usually an ordinary psychodiagnostic conversation is enough. nine0003

You can suspect the disease on your own, although with hypomania or mania, criticality to one's condition often decreases, that is, a person does not understand that something is wrong with him. Sometimes relatives of the patient come for help, and not he himself. It is better to apply for a diagnosis to a specialist who has worked with BAD, knows what the manifestations of the disease look like.

In general, drug therapy for bipolar disorder consists of several types of drugs that relieve different manifestations of the disease. These are normotimics that stabilize mood, antidepressants that help to cope with depression, antipsychotics that relieve excessive arousal. nine0003

Medication for Bipolar Disorders - MSD Handbook

Bipolar Disorder in Adults: Choice of Therapy - Article for Physicians Uptodate

The doctor selects the type of medication and dosage based on the phase the patient is in. Antidepressants are usually used in depressive phases and in combination with mood stabilizers. Antipsychotics - only in manic episodes and also together with normotimics.

In severe cases, a person with bipolar disorder may take up to six different drugs. But you need to strive to get by with one or two. nine0003

I started taking prescribed antidepressants and mood stabilizers immediately after seeing a psychiatrist. This time, the process of getting out of depression was long and smooth.

How therapy is selected for bipolar affective disorder

Viktor Lebedev

psychiatrist, scientific journalist

The psychiatrist selects treatment individually, taking into account the clinical picture: in the depressive phase - some drugs, in the hypomanic phase - others, in mania - still others.

It is important to combine drugs correctly. So, if a patient with bipolar disorder is prescribed only antidepressants, this can worsen the situation, even if he is depressed. Antidepressants can "disperse" his condition to hypomania or even mania. It is necessary to normalize a person’s well-being, and not throw him into a state with the opposite sign, so therapy includes normotimics. nine0003

The fact is that depression in BAD is not the same depression as usual, they are not always similar even in external manifestations, there are differences from a biological point of view, that is, in how processes in the brain change.

I visit my psychiatrist regularly: she adjusts the doses of drugs and monitors my condition. In the first year, I visited her six times - it cost me 15,000 R. Now I go to the doctor only during an exacerbation or a presumptive phase change - about four times a year, once every three to four months. It costs 10,000 R per year. In total, I have been seeing a doctor for three years now. nine0003

For two years, until recently, I took antidepressants and mood stabilizers in the minimum dosage. A pack of antidepressants for a month cost about 400 R, mood stabilizers - 600 R. That is, during the period of remission, the pills took 1000 R per month.

1000 R

I spend on pills a month in remission

My prescriptions for drugs

However, a few months ago I had an exacerbation, I went into hypomania, so the regimen and dose of drugs had to be changed on the go. Within two weeks, my psychiatrist and I canceled antidepressants, significantly increased the dose of mood stabilizers - 2.5 times, and added antipsychotics. During the exacerbation, which lasted two months, 4000 R per month was spent on tablets. Now 2000 R will go away - the dose of mood stabilizers has been reduced by one and a half times and neuroleptics by half, antidepressants have been removed. nine0003

It is interesting to observe how quickly drug therapy changes the state of the body and how it then returns to normal. Often, drugs do not fit the first time, so you need to regularly visit a psychiatrist and monitor your well-being. But after choosing the right therapy, you can live almost as before, except that you need to be more attentive to yourself.


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BAD treatment cannot be found once and for all

Each patient who is responsible for the treatment of bipolar disorder and is in contact with the doctor has his own scheme for changing the dosage or types of medications, taking into account well-being. For example, if you cannot sleep for more than a few days and stop eating, you add an antipsychotic. If you fall into an abyss of self-hatred and don’t swim for more than a week, an antidepressant will help.

Of course, this does not cancel regular meetings with a psychiatrist, because the process of choosing drugs and dosages is very complicated. Now I can regulate a lot myself, depending on how I feel, but I still see a specialist. nine0003

At the same time, bipolar affective disorder cannot be cured once and for all - you can only go into a long remission. As my doctor told me, this is five years without pronounced phases. In my case, I lasted two years without episodes, and now I need to start the countdown again.

Also, as far as I know from my experience and the experience of people with the same diagnosis, at some point there is an illusion that everything is cool, there is no illness, it seemed to you that you are doing great. At this point, people stop taking pills - this is a bad decision, never do this. If you feel good, first of all, you should check if this is the beginning of hypomania. And secondly, be glad that you have entered remission. nine0003

During these three years, I once stopped drinking pills - I got depressed, once I did not pay attention to the symptoms - I got severe hypomania, now I'm trying to go into remission again.

BAD treatment


The effectiveness of treatment of bipolar affective disorder can be increased by combining drug therapy with psychotherapy. Cognitive behavioral therapy is often used for bipolar disorder. It teaches you how to cope with stress factors, monitor your condition, manage the symptoms of the disease. Even during the sessions, together with the doctor, they work out trigger situations, that is, what can provoke an exacerbation of the disease. nine0003

Bipolar affective disorder and supportive psychotherapy - article on the Uptodate physician website

For example, I have trouble admitting my own mistakes. Every mistake for me is a tragedy, and it seems to me that those around her will never forget. It is difficult for me to admit my own mistakes, oversights cause great anxiety. I also have an ideal image of what I should be: read a lot, earn money, keep my house perfectly clean, have six-packs, study, know two foreign languages, go to exhibitions. Obviously, this is impossible, but a persistent desire to reach an unattainable height is also stressful. I work through all this with a psychotherapist. nine0003

I started therapy only six months ago, on the advice of a doctor, before that I thought that I could cope on my own. At first she was in therapy with a psychotherapist, whom she found through the Inhale project, which helps burnt out employees from the charitable field. I worked with her on this project, then continued after completion.

We looked at situations that increase my anxiety, including fear of making mistakes and being judged, as well as difficulties in life in general. The cost within the project was 400 R per meeting, there were about ten of them in total, then, already outside the project, the price increased to 2400 R.


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Now I went to another psychotherapist - she has a more applied approach, we are looking for my cognitive distortions and trying to remove them. For example, we work with my excessive anxiety about the impression I make on other people, and the fear that I cannot control it.

The cost of sessions with this specialist is 2500 R per visit. Now I go to her every 10-14 days, that is, 2-3 times a month. In general, I have been working with my condition on my own for quite a long time, so the therapist only directs me in the right direction. nine0003

Is psychotherapy mandatory for bipolar disorder

Viktor Lebedev

psychiatrist, science journalist

Cognitive behavioral therapy is most often prescribed for bipolar disorder. This is an optional therapy, that is, an auxiliary method of treatment, you only need to take medication. However, psychotherapy can greatly improve the quality of life: it complements the action of drugs well, helps to control and change those things that pills do not work on. First of all, cognitive-behavioral therapy helps to control emotions, better cope with your illness. nine0003

Many also benefit from support groups for people with bipolar disorder. I tried to go to such a meeting, but it didn’t work for me: I don’t want to define myself through illness, this is part of my life - but not me.

The largest project holding such meetings is Sunday BAR. They support not only people with bipolar disorder, but also their loved ones. Meetings are held online and offline.

List of support groups in different cities for people with BAD and other disordersPDF, 275 KB

BAD treatment


Universal advice given for bipolar disorder and more includes: sleep and work-life balance, eat right, avoid alcohol, exercise.

All this really helps, but in fact, organizing your life is difficult: meetings with friends, vacations, unexpected work do not fit into the routine, you want to work more, and alcohol looks like a great way to cope with anxiety, although in fact it can lead to depression. nine0003

I try to keep the correct regimen to the best of my ability. True, according to my feelings, depression comes by itself, without any triggers from the outside, and I cannot influence it. But hypomania is fueled by new projects, loves, and other emotions. For example, even a small amount of falling in love causes hypomania, which, in turn, increases falling in love. It doesn't end well.


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I lived in St. Petersburg for quite a long time, there during the white nights you don’t feel like sleeping at all - and this provokes hypomania. One of the psychiatrists even forbade me to go to St. Petersburg for some time.

Now I have an established sleep and eating regime, I quickly notice its violation - this is a signal that an exacerbation has begun. Unfortunately, sometimes the regime is knocked down by external circumstances, then it is more difficult to notice the exacerbation of BAD.

Sleep is very important to me, it is my priority. I try not to hang out until the middle of the night, and if I didn’t manage to get enough sleep, then I try to sleep in the afternoon. I usually go to bed around midnight, get up at 8-9hours of the morning is a comfortable mode for me and my work. I very rarely stay awake at night or wake up later than 10 am.

I have a fitness bracelet that tracks the phases and amount of sleep - it helps to see the dynamics and notice deviations. When I see a sleep disorder, I start drinking light tranquilizers and antipsychotics to return to a comfortable mode.

Sleeping less than seven hours on pills indicates an episode of hypomania, without drugs in this phase I would sleep less than four hours And sleep for more than seven hours is already the normalization of the state after the addition of other tablets
Sleeping less than seven hours on pills indicates an episode of hypomania, without drugs in this phase I would have slept less than four hours And sleeping more than seven hours is already normalization of the state after adding other pills

Everything is more difficult with food: I have a difficult relationship with my own body, so I perceive a decrease in appetite with enthusiasm. I am working on the problem with a psychotherapist, how to solve it, until I figured it out. My psychiatrist believes that first sleep, and then everything else, and my experience confirms this: sleep disturbances have a stronger effect on well-being. I also keep a record of alcohol consumption in the Alcogram application - abuse negatively affects my condition. When I see how many sober days there were, it motivates me to control myself. nine0003

I am lucky that I take my job seriously: it is responsible and resource-intensive, it is important for me to be productive, it disciplines and helps me to keep the regime.

What to do to reduce the frequency of exacerbations

Viktor Lebedev

psychiatrist, science journalist

In bipolar disorder, the daily routine is important, which allows you to maintain normal behavior. This reduces the frequency of exacerbations, sometimes helps to completely avoid the recurrence of episodes of the disease. In addition to quality sleep and proper nutrition, you need to avoid overwork, work in an exhausted state, give yourself a rest. Doctors usually insist on the exclusion of alcohol, drugs are also dangerous, especially stimulants, which can cause psychosis in a healthy person. nine0003

Exacerbations of the disease can occur on their own, without the influence of external factors, or they can be caused by external events, both tragic, such as the death of a loved one or a break in relationships, and joyful. Therefore, it is important to learn to recognize your emotions, to identify in time what provokes a new episode, both independently and with the help of psychotherapy.

How I live with BAD now

Accepting the diagnosis was not easy: on the one hand, it finally became clear what was happening to me and that it could be regulated. On the other hand, this is a diagnosis for life. You need to constantly monitor your condition, take pills, consult with doctors. nine0003

The most difficult thing for me was the inability to separate myself as a person from the disease. What of what I did in life was the result of my choice, and what was a symptom of the disease? Moving from city to city, changing jobs, partners, hobbies - what if all this is just a disease, and I'm not behind it? Three years have passed - and I still cannot separate myself from BAD, it seems impossible.

Now life has become easier: now I know what to expect in the near future, because the phase schedule is still respected. It is clear when to slow down with the pace of life, and when to add antidepressants. nine0003

My work is related to people. Of course, the disease affects my mood and state: in depression I have less strength and the ability to give out emotions, in hypomania, on the contrary, there are a lot of emotions, but there is not enough concentration. It's good that work allows you to vary the load depending on the phase: in depression I can work a little less, and in hypomania - a little more.

At the time of my first diagnosed depression, I had an unloved job, it took the entire resource. I cried in the mornings, afternoons and evenings because it was difficult for me to keep working. Now I really love my job, it gives me more resources than it takes. nine0003

I continue to take medication, see a psychiatrist several times a year and a psychotherapist several times a month. In March, at the most difficult moment of the exacerbation, I spent on medications, an appointment with a psychiatrist and three meetings with a psychologist 13,000 R.

13,000 R

I go into remission and spend about 8,000-10,000 R per month on medications, a psychologist, and periodic appointments with a psychiatrist. A significant amount, but it allows me to remain in a resourceful and efficient state. nine0003

The unobvious difficulty of living with bipolar disorder is the need to strictly control one's financial situation. In hypomania, money flies away easily, you make decisions instantly - for example, you can decide in a minute to fly to Spain and buy tickets. When you are depressed, you spend less, but it is also difficult to earn money. I try to keep a financial cushion in case of an aggravation, and also take into account all expenses in the application so as not to get into debt. Fortunately, so far my financial anxiety is stronger than bipolar, so there has never been a credit card debt. nine0003

I spent 58,800 rubles on BAD treatment in a year

Treatment Price
Psychiatric appointment 10 000 R, total 4 receptions of 2500 R
Psychotherapist appointment 25 000 R, total 10 receptions of 2500 R
Antidepressants 4800 R, 12 packs of 400 R
Antipsychotics 7000 R, 7 packs of 1000 R
Normotimics 12000 R, 15 packs of 800 R

Reception of a psychiatrist

10 000 R, total 4 receptions of 2500 r

Psychotherapist reception

25 000 R, total 10 doses of 2500 r


4800 r, 12 packages of 400 p


7000 R, 7 packs of 1000 R


12000 R, 15 packs of 800 R

Books I recommend reading about bipolar affective disorder

The most famous book about living with bipolar disorder is The Restless Mind.

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