One of these diseases is Bipolar Disorder or Bipolar Mood Disorder. It is called bipolar because during the disease attacks, there is either extreme enthusiasm, energy and confidence, or extreme sadness, hopelessness, insecurity and low energy. From time to time, a mixed picture with characteristics of both periods can be seen. These attacks are often accompanied by thought disorder, which can lead to exhausting and damaging consequences for the person and his/her environment.
The good news is that these attacks can be controlled with treatment, and as long as the treatment continues, the person with this disease is most likely to have this disease. Being able to continue life in its normal course. The annoying part is that there is a possibility that the attacks may recur.
A genetically sensitive biology can be easily affected by external factors, and external factors that are challenging for some people can be a trigger for a new attack in these people. For example, stress factors such as seasonal transitions, especially spring and autumn months, disruption of sleep patterns, problems in relationships, conflicts, difficult living conditions, and financial difficulties can invite a new attack.
Additionally, the diagnosis of a disease is now an invitation. and the labeling it brings, the changes in work, family, social life following separation, the losses and the struggle to adapt to them. So, no longer endure the consequences of a disease and try to live with it. Of course, this is not such an easy process and from time to time it is one of the difficulties that pave the way for new attacks. In other words, the weight of other loads added while trying to lift a load.
On the other hand, it is possible to spend many years without attacks by recognizing and understanding the disease, recognizing and controlling the sleep-wake rhythm, and social triggers, along with continuing the appropriate drug treatment. It is quite possible.
At this point, Interpersonal Relations Social Rhythm Therapy, or IPT-SRT for short, used together with drug therapy, comes to our aid. Because, as many patients with bipolar disorder and their relatives clearly state, using medication alone is not enough.
Persons. Relationships between Social Rhythm Therapy, Prof. in the 1990s. Dr. Interpersonal Relationship Therapy is a psychotherapy developed by Ellen Frank and the staff of the Western Psychiatric Institute (USA) to be applied to bipolar disorder patients, and later research has proven its protective effectiveness against new attacks in this patient group.
Interpersonal Relations Social Rhythm Therapy aims to make the patient realize that the interpersonal problems experienced by the patients and the disruptions in their sleep and social rhythms trigger the attacks, and thus facilitate the treatment process by making adjustments in their lives.
Sleep. Irregularities in social timing, such as waking up time and meal time, also negatively affect the body's regular, time-dependent functioning. Social events and stressful situations can disrupt this order; When this order is disrupted, the body's biological rhythm can also be affected, which can negatively affect the mental state.
Especially nowadays, our sleep and meal times are instead of sunrise and sunset; Being adjusted to flexible working hours, delayed meal times, skipped meals, and TV programs already negatively affects our biological rhythm. Although these disruptions in biological rhythm cause attention and emotional difficulties in someone without the disease, they may remain limited, whereas they may trigger a new attack in those diagnosed with or prone to bipolar disorder.
In Interpersonal Relations Social Rhythm Therapy, sleep-wake hours that may be triggers for attacks. , social activity hours and patterns are revealed and their effects on the disease are understood. Social rhythm is tried to be regulated through adjustments. The patient is informed by explaining the symptoms of the disease, the effects and side effects of the medications, the course of the disease, and the importance of regular medication use.
Since stress is an important trigger, it is also important for the patient to understand and establish a connection with the stress factors that trigger attacks. One or more of the problem areas such as grief, conflicts, role transitions and interpersonal relationship/skill deprivation, which are also studied in Interpersonal Relations Psychotherapy, are studied. Thus, it is important to study these areas and apply them in social rhythm. It is possible to reduce attacks by making necessary adjustments.
In the period after the diagnosis of the disease, grief is worked on when there is a loss of the perception of "healthy self" or the loss of a loved one.
Especially at the beginning and during the attack, the patient may enter into more conflict with his/her environment, and therefore relationships may deteriorate in the long term. Additionally, the burdens and changes brought about by the disease can lead to conflicts. In this case, the focus is on interpersonal conflicts.
The role change that occurs in situations such as divorce, children leaving home, retirement, birth, starting to work, promotion can also change the social and biological rhythm of the person. Anxiety related to the disease can also cause difficulty in adjusting to this situation. In these cases, role changes are studied as a stress factor.
I hope more mental health professionals can convey this to more patients….
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