A Bipolar Care Plan That Works


By Lois Caniglia RN      https://www.facebook.com/pages/Mental-Illness-Living-Lets-Talk/349925245188610 or Twitter @blackboxRN /Inside Black Box RN

It’s been my experience as a nurse and the research I’ve conducted on my disorder that I understand there is no cure for bipolar. Getting a full psychological workup has been an imperative start to towards achieving recovery. After following up with the same psychiatrist all these years, I am adamant about maintaining my continuity of care. I’m not going to expand upon this as I have written about this subject titled, “Why is My Insurance Company Deciding on My Treatment Plan”.

My psychiatrist and therapist have set up a helpful tool box that effectively manages my symptoms. However, I know that I am accountable to provide my doc with symptoms I may still be struggling with or new symptoms that I’v developed. My doctor is only as good as the information I provide him. Not holding back and being honest has been beneficial to my recovery.

Taking my medications as prescribed is another critical aspect in my care plan. I found purchasing a 7 week pill box that is kept in the same place, and an alarm to alert me at the time my medications are due. This is the best intervention for me to stay compliant with my medication regimen. My daughter, who stuffers with mental illness as well, isn’t very good at following up when taking her medications. Her fiancé helps her with reminders of when she should take her next pill. And this works for her quite well. I have set up an auto refill system through my pharmacy’s phone app. Even when there are no refills left for a medication, the pharmacy will automatically contact my psychiatrist for a renewal. Still, I feel more comfortable calling my psychiatrist when a renewal for a medication is due.

It’s in my nature to maintain a daily routine. I find that being determined to stay healthy helps me to plan a routine schedule that keeps me on track. Setting a daily time for meditation, a little yoga, and walking my dogs helps keep me active. Doing activities I enjoy makes my compliance easier to handle. Believe me, this regimen is much easier on paper than in reality. Keeping busy with follow up appointments, errands, and daily responsibilities of keeping house makes all those little pleasures even more challenging. Still, this is a goal worth attempting to achieve everyday. I don’t beat myself up for not staying on task when other events are more pressing than these. Like the ol’ saying said by character, Scarlett O’Hara, “After all, tomorrow is another day.” 

During every followup appointment, my doctor will ask about my sleep schedule. From someone whose been a pro at running on empty- sustained only on 4-5 hours or even less sleep-I know the repercussions of a bipolar and her lack of proper sleep. I acknowledge the experts recommendations that a proper sleep should be 8-10 hours/night. This requirement went right out the window as a nurse. Conversely, a retired RN, has the time to evaluate the quality of sleep and the effectiveness of the prescribed medication provided for sleep. Keeping a sleep schedule helps me monitor my cycles and helps me evaluate if my pill is effectively working. 

Lastly, only I can be the most effective interdisciplinary member with my care plan. I must have said those very same words when education my patients own plan for recovery with every discharge instruction I conveyed. This is no less true with recovering from mental illness. Keeping a care plan provides me a direction and maintaining my continuity of care. By being diligent I am able to outline my observations, take action with what’s needed for implementation, and what information I need to convey to my doctor or therapist. These steps are the skills I have developed to become a more effective caregiver for myself.


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