Rebound From Crisis (The Living Well Series Book 6)

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His work studying athletes with a colleague, Alan St Clair Gibson, left them both convinced that, although there is a physical limit to what the body can achieve, the brain acts in advance of this limit, making us feel tired before any signs of damage occur. Most of the research into the idea of a central governor involves subtle shifts at the very limits of performance, often in elite athletes.

But what happens if that entire system crashes? The fatigue that normally protects us from pushing ourselves too far might instead become a prison. Whatever the trigger — virus, overwork, a genetic predisposition or most likely a combination of several factors — Noakes argues that in chronic fatigue the boundaries of physical activity narrow tremendously, to the point where patients are essentially immobilised. But it does hint that their condition might be influenced by psychological factors. Indeed, one of the most robust scientific findings regarding chronic fatigue is that, when patients are convinced that their condition is biological and untreatable, and fear that engaging in activity will be harmful, they are much less likely to recover.

Self-Help Tips for Managing Your Symptoms and Staying Balanced

If interval training works for athletes by teaching the central governor that ever-greater levels of exertion are safe, might it also work for patients with chronic fatigue syndrome? Samantha Miller made a deal with her partner and her sister. Please, just give him six months, they said. Independently of Noakes, White was developing similar ideas about chronic fatigue.

To try to reverse the change, he developed with colleagues an approach called graded exercise therapy GET , which is intended to work like an ultra-gentle form of interval training. The idea is to set a baseline of activity that the patient can maintain safely, then gradually increase it. Each step has to be small, so as not to risk a relapse.

Patients report feeling vastly more fatigued than healthy people for a set level of exercise. But White has shown that, after a course of GET, they feel less tired after the same amount of exercise, even though their physical fitness is unchanged. White also uses cognitive behavioural therapy CBT , in which therapists work with patients to challenge negative ideas and beliefs that they have about their illness. This is based on the finding that, as long as patients are terrified that any exertion will cause a crash, the fatigue will maintain its grip. CBT encourages them to try out other ways of coping, and to test whether small amounts of activity are all right.

The hope is that this will reduce their fear, helping them to realise that perhaps some exertion is safe after all and that they have the chance to recover. Her first exercise goal was simply to turn over in bed once an hour. Every few days, she increased her activity slightly until she was able to sit up for five minutes at a time.

‘It was like being buried alive’: battle to recover from chronic fatigue syndrome

Later, when she was out of bed, she might try cooking a meal, but the task would be split into parts. Go back upstairs and lie down. As a creative person, she found the total lack of spontaneity hard to accept. But the perfectionism that she feels contributed to her condition helped her. She kept an activity diary and as the months progressed she was able to do more. But walking five minutes might put you in bed for three weeks. If she pushed herself too hard, she would crash.

It took five years of grim determination, but she finally clawed her way out of the fatigue and back into a normal life. But instead of welcoming the findings, patient groups hated them. Instead, patient groups advocated an approach called pacing. This helps patients adapt to life within the physical limits set by the condition and encourages them not to do anything that pushes them close to exhaustion. This would make perfect sense if chronic fatigue were incurable.

White and his colleagues decided to do a definitive trial. They worked with the biggest UK patient charity, Action for ME, to design and run the five-year study. It included patients, divided into four groups. A control group just got routine medical care — advice on avoiding extremes of activity, plus drugs for symptoms such as depression, insomnia and pain as needed. The researchers published their results in the Lancet medical journal in They found that APT was ineffective; patients in this group did no better than the controls.

Living with Bipolar Disorder

But GET and CBT were both moderately helpful, reducing fatigue and disability scores significantly more than in the other two groups. If the previous trials had gone down badly, this one was received with absolute fury. Action for ME rejected the findings. After working for years to fund, organise and run a definitive trial, White finally had the data that he believed could help other chronic fatigue patients like Miller.

Patients attending his clinics welcomed the findings, but he could not persuade ME patient organisations to listen.

What can you do to cope with bipolar disorder?

The debate over whether chronic fatigue syndrome is biological or psychological still runs hot. This term was invented by the geneticist Richard Dawkins in his book The Selfish Gene to describe a psychological idea or behaviour that is transmitted from person to person.

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The best advice is to maintain a consistent sleep schedule. Stress can trigger episodes of mania and depression in people with bipolar disorder, so keeping it under control is extremely important. Know your limits, both at home and at work or school. Learn how to relax. Relaxation techniques such as deep breathing, meditation, yoga, and guided imagery can be very effective at reducing stress and keeping you on an even keel. A daily relaxation practice can improve your mood and keep depression at bay. Make leisure time a priority. Do things for no other reason than that it feels good to do them.

Go to a funny movie, take a walk on the beach, listen to music, read a good book, or talk to a friend. Doing things just because they are fun is no indulgence. Play is an emotional and mental health necessity. Using Your Senses to Alleviate Stress. Appeal to your senses. Stay calm and energized by appealing to your senses: Listen to music that lifts your mood, place flowers where you will see and smell them, massage your hands and feet, or sip a warm drink.

From the food you eat to the vitamins and drugs you take, the substances you put in your body have an impact on the symptoms of bipolar disorder—for better or worse. Eat a healthy diet. There is an undeniable link between food and mood. For optimal mood, eat plenty of fresh fruits, vegetables, and whole grains and limit your fat and sugar intake. Space your meals out through the day, so your blood sugar never dips too low.

High-carbohydrate diets can cause mood crashes, so they should also be avoided. Other mood-damaging foods include chocolate, caffeine, and processed foods. Omega-3 fatty acids may decrease mood swings in bipolar disorder. You can increase your intake of omega-3 by eating cold-water fish such as salmon, halibut, and sardines, soybeans, flaxseeds, canola oil, pumpkin seeds, and walnuts.

Omega-3 is also available as a nutritional supplement. Avoid alcohol and drugs.

Drugs such as cocaine, ecstasy, and amphetamines can trigger mania, while alcohol and tranquilizers can trigger depression. Even moderate social drinking can upset your emotional balance. Substance use also interferes with sleep and may cause dangerous interactions with your medications.

Attempts to self-medicate or numb your symptoms with drugs and alcohol only create more problems. Be cautious when taking any medication. Certain prescription and over-the-counter medications can be problematic for people with bipolar disorder. Be especially careful with antidepressant drugs, which can trigger mania.

Other drugs that can cause mania include over-the-counter cold medicine, appetite suppressants, caffeine, corticosteroids, and thyroid medication.

Living with Bipolar Disorder: Self-Help Tips for Managing Your Symptoms and Staying Balanced

Dealing Effectively with Depression and Bipolar Disorder — Covers key recovery concepts and strategies, such as mood and symptom monitoring and crisis planning. Depression and Bipolar Support Alliance. Stories of Coping and Courage — Read the personal stories of real people dealing with bipolar disorder. Keeping Your Balance — Australian government sponsored site offers a self-help series on managing bipolar disorder.

Includes cognitive and behavioral strategies for managing and preventing mania and depression. Centre for Clinical Interventions. Improving and Maintaining the Quality of your Life — Advice on improving the quality of your life through healthy lifestyle modifications such as eating right and exercising. Support Groups Outside the U. The content of this reprint is for informational purposes only and NOT a substitute for professional advice, diagnosis, or treatment. ORG Trusted guide to mental health Toggle navigation.

What can you do? Get involved in your treatment Monitor your symptoms and moods Reach out Develop a daily routine Keep stress to a minimum Watch what you put in your body Topic Page Bipolar Disorder. What can you do to cope with bipolar disorder? These tips can help you influence the course of your illness, enabling you to take greater control over your symptoms, to stay well longer, and to quickly rebound from any mood episode or relapse Living with bipolar disorder tip 1: Get involved in your treatment Be a full and active participant in your own treatment.

Improve your treatment by: A list of emergency contacts — your doctor, therapist, close family members A list of all medications you are taking, including dosage information Symptoms that indicate you need others to take responsibility for your care, and information about any other health problems you have Treatment preferences — who you want to care for you, what treatments and medications do and do not work, who is authorized to make decisions on your behalf. Help someone else by volunteering. Have lunch or coffee with a friend. Ask a loved one to check in with you regularly. Accompany someone to the movies, a concert, or a small get-together.

Call or email an old friend. Go for a walk with a workout buddy. Schedule a weekly dinner date Meet new people by taking a class or joining a club. Confide in a counselor, therapist, or clergy member.

How to Sleep Better: Healthy sleep habits for managing bipolar disorder Go to bed and wake up at the same time each day. Avoid or minimize napping, especially if it interferes with your sleep at night. Instead of viewing screens or other stimulating activities before bed, try taking a bath, reading a book, or listening to relaxing music. Limit caffeine after lunch and alcohol at night as both interfere with sleep. Recommended reading Dealing Effectively with Depression and Bipolar Disorder — Covers key recovery concepts and strategies, such as mood and symptom monitoring and crisis planning.

Depression and Bipolar Support Alliance Keeping Your Balance — Australian government sponsored site offers a self-help series on managing bipolar disorder. HelpGuide has no advertising or corporate sponsors.

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