the first thing I do is try to get a hold of my pdoc for a meds check and twek. Then try to spend as much time outside as I can washing the car or cutting the grass the sunshine seems to really help.

for me its trying to see the joy in the world again... sometimes unacheivable but I still try

spending time with my man..... loving my beautiful cat..... listening to music... going for a walk.... doing gentle exercising... watching a feel good movie... coming onto DS and talking with friends.... eating well

when its really bad I just take it hour by hour... and usually know that this too shall pass

youtube and my friends on DS

I've learned to put one foot in front of the other and keep walking. I eventually end up somewhere better!

Thanks this is good stuff =)

The Handbook of Self-Help Therapies, edited by Patti Lou Watkins, PhD, Assoc. Prof. at Oregon State University and George A. Clum, PhD, Prof. at Virginia Polytechnic and State University.
This book reviews clinical studies done with self-help books and programs for psychological and behavioral problems.

This is from its chapter on self-help for depression.

FEELING GOOD: THE NEW MOOD THERAPY by David D. Burns, MD. Of the books studied, two were shown to be effective, Feeling Good by Burns and Control Your Depression by Lewinsohn. Feeling Good has been so much more successful than Control Your Depression that we are inclined to see it as the more desirable of the two.

The article David D. Burns in Wikipedia says

Feeling Good: The Mood Therapy ... has sold 45 million copies worldwide. It was named as one of the top ten behavioral science books of 1980 by the journal Behavioral Medicine and was named by The Authoritative Guide to Self-Help Books as the book most frequently recommended for depressed patients by mental health professionals in the United States. It was also rated as the top self-help book for depressed individuals. This rating was based on a national survey of more than 500 mental health professionals evaluations of 1,000 self-help books. His Feeling Good Handbook was rated #2 in the survey.

Cognitive therapy and behavior therapy [delivered with the use of reading material] are equivalent to therapist-administered treatments in adults, adolescents, and the elderly suffering from mild to moderate levels of depression. Treatment effects are maintained over time.

Little information exists indicating who profits from self-help treatments, but higher levels of depression, negative expectation for outcome using self-help approaches, as well as reading level and ability to concentrate may all predict outcome and attitude toward self-help treatments.

These findings are indicative of a reliable, robust effect ... that rivals that of other more traditional treatment modalities for depression. These findings are based on studies that included adolescents, adults, and older adults.

Therapeutic Lifestyle Change

http://www.redorbit.com/news/health/851310/psychologist_seeks_stone_age_solutions_to_depression/index.html

http://www.psych.ku.edu/tlc/

Dr. Stephen Ilardi and his University of Kansas team say that their program Therapeutic Lifestyle Change is effective in treating depression. TLC, conducted at the university, is based on the idea that human evolution hasnt caught up with civilization. People today are, genetically, much the same as the people of the Stone Age. Certain things that cave men took for granted have become harder to come by. TLC identifies six as critical in preventing and recovering from depression: exercise, omega-3 fatty acids, light, social support, sleep, and anti-rumination behaviors -- habits that defeat negative thinking.

The significance of these six elements can be illustrated by comparing life in a modern city with the way people lived a half million years ago. People walked for miles at a time, had diets that were not like ours, and slept when the sun went down. Living in bands of about 100 people, loneliness was not likely to pose a problem.

In some ways, our needs are like those of our prehistoric ancestors. By denying those needs, Ilardi says, the modern world makes us more susceptible to depression.

Depression is more frequent in developed countries than in developing ones and worse among city people than among rural people. An anthropologist who studied a hunter-gatherer tribe in Papua New Guinea found that depression was virtually nonexistent.

Individually, the benefits of the TLC elements are supported by research findings. As for the TLC theory, that cases of depression can be treated effectively by restoring what technology and culture take away, the results have been described by University of Kansas psychologists as promising and impressive.

Always consult with your doctor before starting an exercise program or use of a dietary supplement.

A Note on Rumination

Rumination is the tendency to dwell on negative thoughts. Episodes of rumination occur most often when alone. Depressed people often don't realize the amount of time they spend engaged in such thoughts or the amount of distress it causes.

The report on The Handbook of Self-Help Therapies posted above describes the success of Feeling Good, the book by David Burns that offers cognitive therapy in written form.

Every time you feel depressed about something, try to identify a corresponding negative thought you had just prior to and during the depression. Because these thoughts have actually created your bad mood, by learning to restructure them, you can change your mood.
-- David Burns, MD in Feeling Good

Mindfulness Based Cognitive Therapy (MBCT) is the name of a program developed at the University of Oxford. The stated purpose of MBCT is preventing cases of depression.

The United Kingdoms National Institute of Clinical Excellence has recently endorsed MBCT as an effective treatment for prevention of relapse. Research has shown that people who have been clinically depressed three or more times (sometimes for twenty years or more) find that taking the program and learning these skills helps to reduce considerably their chances that depression will return.
-- the MBCT website

The researchers who developed MBCT also wrote The Mindful Way Through Depression, a book that presents the MBCT principles.

Through simple lessons drawn from both eastern meditative traditions and cognitive-behavioral therapy, [the authors ] demonstrate how to sidestep mental habits such as rumination and self-blame that inevitably lead to despair, so you can face lifes challenges with greater resilience.
-- the MBCT website

To those who wish to contact the TLC program at the University of Kansas,

Andy Lehman, Project Coordinator
telephone 785-864-4274 or
e-mail kalehman@ku.edu

The Handbook of Self-Help Therapies (above)
chapter on insomnia

It is essential to identify the primary problem if insomnia is the result of another medical or psychological condition. Other disorders can have similar nocturnal and daytime characteristics as insomnia. For example, unrefreshing sleep and daytime fatigue are symptoms of both insomnia and sleep apnea. An individual with undiagnosed sleep apnea attempting to apply behavioral techniques developed for managing insomnia would likely experience little benefit. Most self-help books for insomnia include a section on other sleep disorders with the intention of helping readers to detect and seek treatment for conditions other than insomnia.

There is sufficient empirical evidence to support the classification of cognitive-behavioral therapy (CBT) for insomnia as a well-established treatment.
-- The American Psychological Association

CBT for insomnia has four basic principles.

-- stimulus control
One rule is that the bed should not be used for various non-sleep purposes, such as reading, so that going to bed is a cue for going to sleep.

-- sleep restriction
This includes nightly pre-sleep routines and preparing for bedtime by avoiding naps.

-- relaxation training

-- cognitive restructuring
Some people use bedtime as a worry zone. Alternatives to the worry habit and reassuring facts about sleep and insomnia are taught.

Research on Self Help

Nine studies of self help for insomnia are reviewed in the chapter. All show improvements of sleep, although findings indicate that in-person therapy is more effective, especially for those on sleep medications and the elderly.

Access to CBT is extremely limited. Less than 15 percent of sleep clinics provide psychological treatment for insomnia. The services of a psychologist or sleep medicine specialist are not always covered by health insurance plans.

Self-Help Books

Although none of the popular books has been tested, some are based on the principles that have been shown to work in clinical studies.

No More Sleepless Nights was written by Dr. Peter Hauri, a Mayo Clinic Sleep Disorders Center researcher. The book contains all the CBT strategies for sleep, with a particular emphasis on stimulus control. Stimulus control is said to be the the core intervention in CBT.

Say Goodnight to Insomnia by Dr. Gregg Jacobs has very thorough and comprehensible chapters on cognitive restructuring and establishing sleep-promoting habits.

Cant Sleep, Cant Stay Awake: A Womans Guide to Sleep Disorders by Meir Kryger is one of the top three books on Curries list.

-------

Advice from the University of Maryland Sleep Center

http://www.umm.edu/sleep/sleep_hyg.htm

-------

CAUTION: A person with sleep apnea, a potentially fatal disorder, may assume that the problem is insomnia. About 3 percent of the U.S. population have sleep apnea. If untreated, sleep apnea can lead to high blood pressure and other serious consequences.

I try to spend a special day with my kids or/& my family, it makes me realise i have lots of good things in my life & the bipolar can go and jump for a few hours. love & hugs to you all xx

I agree......youtube..have some music and call the Pdoc....

b

I am struggling with that now so I can share what I do while in the midst of it.

1. Get adequate sleep
2. Eat well even if I dont feel like it
3. Take meds as directed
4. Find easy, enjoyable activities and space them out
5. Meditate to calm but NOT sad music
6. Do some mild to moderate exercise like yoga or walking
7. Avoid sugar that might give me a quick high then a crash
8. Talk to my loved ones and let them know how I feel so they can pick up where I cant.
9. Watch uplifting movies and listen to uplifting music
10. Use positive affirmations to counter negative thoughts
11. Journal and read past journals from good days
12. Remind myself that it will pass, I may not like what it feels like, but it will pass, and any negative thoughts now are not of me but of the depression.
13. Seek support from friends in my life and friends on DS
14. Seek support from my husband and sons
15. Call my doc and keep open communication with him about how I feel.
16. See my therapist to talk through my feelings.
17. Remember that I have enormous strength within to use in times like this.
18. Sketch or paint my feelings onto paper.
19. Read a good, uplifting book, read the bible.
20. Pray and reflect on my blessings.

Diet and Dietary Supplements

Psychiatrist Candida Fink is co-author of The Ups and Downs of Raising a Bipolar Child and Bipolar Disorder for Dummies. In Alternative and Complementary Treatments for Bipolar Disorder, she discusses dietary supplements and a variety of alternative treatments, some of which she warns against.

http://www.finkshrink.com/blog/treatment/alternative-and-complementary-treatments-for-bipolar-disorder.html

Minerals for Bipolar Disorder is a PsychCentral post by Jim Haggerty, MD, with links to related posts.

http://psychcentral.com/lib/2007/minerals-for-bipolar-disorder/

I asked my pdoc today when he said he thought I was doing better, but it was a "slow process" is this as good as it gets???? cause if it is then I quit.....