They say that the first step in solving a problem is in admitting that the problem exists. And so it is with bipolar.

Getting someone who is bipolar to acknowledge that they are are in fact bipolar, and agree undergo treatment, is a major step forward. As anyone who has suffered from this disorder, or who loves someone with it knows, bipolar seems to have built-in trip wires against its own treatment.

Mania and hypomania tend to be characterised by beliefs of high self worth and competence, and it is difficult to accept that these feelings are in fact due to some kind of disease. Mania is often accompanied by irritability and distrust of others, so when someone else offers the opinion that the manic person has a mental illness, this can be met with disbelief, contempt, and outright hostility.

Even after the battle is won, the victory may be temporary. Many people with bipolar happily begin a course of treatment, but months or years later, after successfully avoiding any further episodes, begin to question the diagnosis, or to believe that it is a thing of the past and they now have it under control. Once off the medications, if they become hypomanic or manic they become increasingly convinced of their own mastery of the situation and less inclined to restart medication. Only when they crash back into the depths of depression does that once again become a possibility.

So what is the solution? If you know someone who is bipolar, what is the correct course of action? The fact is that there is no easy fix for the problem of backsliding. The best solution in the long term is to maintain a relationship that involves trust, and where mental illness isues can be discussed openly.

For someone who has a bipolar diagnosis and who is wanting to abandon their course of treatment, the following tips should be useful:

Look at lifestyle factors for managing bipolar and make sure that you are serious about implementing them.

Don’t play doctor. Remember that even if you’re right, you’re not the best person to judge if the diagnosis is correct. If you’re questioning the diagnosis, seek out alternative opinions from other health professionals who may overturn it. Having an independent third party give a differing opinion will not only be more convincing to others – it should be more convincing to you.

Don’t forget the past: you got to this point for a reason. It is very easy to downplay the past as it fades from memory and as wounds heal, but remember the pain that you caused yourself and possibly others around you.

Denial is a powerful thing. It allows us to feel better about ourselves and makes our worries seem to evaporate. It also stops us managing the real problems in our life, giving us happiness today, but increased pain tomorrow, or at some other time in the future that we cannot predict.

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