The effect of coping mechanisms on the severity of bipolar disorder.

Based on the following article: George C. Nitzburg, Manuela Russo, Armando Cuesta-Diaz, Luz Ospina, Megan Shanahan, Mercedes Perez-Rodriguez, Meaghan McGrath and Katherine E Burdick, Coping strategies and real-world functioning in bipolar disorder, Journal of Affective Disorders, http://dx.doi.org/10.1016/j.jad.2016.03.028

Recent research has found that BD is one of the leading causes of disability and all the adversities that bipolars suffer only exacerbates the situation. Even when bipolars are stable they suffer from certain symptoms and neurocognitive deterioration which makes it hard to function.

It has been shown that bipolars engage in maladaptive coping (destructive coping mechanisms) such as catastrophizing, overthinking the upsetting side of an incident, self-blame, substance use, risk taking and giving up easier than controls (normal people). Positive coping skills like positive reframing, positive refocusing, keeping things in perspective, planning and seeking out support were less used by bipolars.

The use of maladaptive coping skills has been linked to the severity of the illness for example increased hypomania, depression, anxiety and stress levels. It also impacts the treatment in that denial leads to bipolars not adhering to their treatment plan, specifically taking their medication.

More examples of adaptive (good) strategies include active coping, acceptance, humour and religion. More examples of maladaptive (bad) strategies are self-distraction and venting. The study found that giving up and self-blame including self-criticism were strongly associated with a higher level of disability. A possible explanation for this is that defeatist beliefs contributes to functional deterioration in severe mental illness as was found with people suffering from schizophrenia. In studies concerning schizophrenia patients, it was found that the initial deficits (social, cognitive etc.) lead to negative experiences which in turn lead to defeatist beliefs, this contributed to the worsening of the illness and the defeatist beliefs. It is believed that the same mechanism may be at work in bipolars.

This article highlights the importance of guarding your thoughts and actively choosing not to engage in destructive coping mechanisms, most importantly self-blame and criticising. There are alternative positive coping skills and turning towards them can change things for the better. Do you recognise your behaviour in this article? There is hope, with a bit of effort and commitment, one can change the direction of the ship and try out the positive coping skills. I would suggest trying out support-seeking first. Having someone on your side who is with you on this journey towards positive coping can make it easier to move on to more difficult coping strategies and away from your old destructive ways.

Knowledge is power, you have been made aware of the impact of maladaptive coping mechanisms, the ball is in your court, and the power is in your hands.