Being able to vent and give and receive feedback has definitely improved my quality of life DBSA Greater Houston participant

1. What is Recovery
2. Setting Goals
3. Treatments
4. Lifestyle
5. Five Stages
6. Helping a Loved One

1.  WHAT IS RECOVERY?
Relief of symptoms is only the first step in treating depression or bipolar disorder. Wellness, or recovery, is a return to a life that you care about. Recovery happens when your illness stops getting in the way of your life.

SAMSHA (the Substance Abuse and Mental Health Services Administration/Center for Mental Health Services) (http://www.samhsa.gov/) defines recovery as:

• Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.

Next Steps in Recovery

Depression and bipolar disorder are mood disorders, real physical illnesses that affect a person’s moods, thoughts, body, energy and emotions. Both illnesses, especially bipolar disorder, tend to follow a cyclical course, meaning they have ups and downs.

Treatment for these illnesses can also have ups and downs. As much as we may want it to, wellness often does not happen overnight. It is normal to wish you could feel better faster or to worry that you will never feel better. However, know that you can feel better, and that ultimately you are in charge of your recovery. There are many things you can do to help yourself.

Relief of symptoms is only the first step in treating depression or bipolar disorder. Wellness, or recovery, is a return to a life that you care about. Recovery happens when your illness stops getting in the way of your life. You decide what recovery means to you.

You have the right to recover according to your needs and goals. Talk to your health care provider (HCP) about what you need from treatment to reach your recovery. Your HCP can provide the treatment(s) and/or medication(s) that work best for you. Along the way, you have a right to ask questions about the treatments you are getting and choose the treatments you want.

It can also be helpful to work with a therapist, family member, friend, and peer supporters to help define your recovery. This is why DBSA Greater Houston provides over 55 free weekly support groups. Peer support groups facilitated by previous attendees are a wonderful and comforting way to work on recovery with people who have been where you are. The DBSA Greater Houston support group system brings together diagnosed individuals, as well as family members and friends, in an environment that fosters empathy, education and empowerment. Not only can people can share their thoughts and feelings, but they can also share information on topics such as treatment plans, medication, doctors, exercise and eating habits.

Sometimes it might feel almost impossible to think about the things that you hope for or care about. But goal setting is an important part of wellness, no matter where you are on your path to recovery.

2. SETTING GOALS
It is important to set goals along the way to recovery as you see and experience progress along the way. Identifying life goals is the heart of the recovery process. When you envision a future for yourself, you will begin to become motivated to do all that you can to reach that future. Goals can be big or small, depending on where you are in your recovery journey.

It can help to start small and work up to larger goals. You might want to begin by setting one small goal for yourself at the beginning of each day. As you move forward with your recovery, look at the different areas of your life, and think about your short and long term goals.

Ask yourself: What Motivates me? What interestes me? What would I do more if I could? What do I care about, or what did I care about before my illness? Where do I want my life to go? What brings me joy? What are my dreams and hopes?

Short term goals might include: Be out of bed by a certain time in the morning Finish one household chore Attend a DBSA support group

Long term goals might include: Get training or experience for a job Change a living situation, e.g., find an apartment Build a relationship with a friend or family member

Remember to break your goals down into small steps at first. Looking at a goal such as 'move to a new city' can be difficult to visualize and plan all at once. Ask yourself what you need to do first. What can you do now that will help you eventually reach this goal? Not only will this help move you closer to your goal, but it will also help give you a positive feeling of accomplishment.

3. TREATMENTS

What are some things I can do that might help me feel better?
Know the difference between your symptoms and your true self. Your health care professional can help you separate your true identity from your symptoms by helping you see how your illness affects your behavior. Be open about behaviors you want to change, and set goals for making those changes.

Educate your family and involve them in treatment when possible. They can help you spot symptoms, track behaviors and gain perspective. They can also give encouraging feedback and help you make a plan to cope with any future crises.

Work on healthy lifestyle choices. Recovery is also about a healthy lifestyle, which includes regular sleep, healthy eating and the avoidance of alcohol, drugs and risky behavior.

Find the treatment that works for you. Talk to your health care professional (HCP) about your medications' effects on you, especially the side effects that bother you. Remember to chart these effects so that you can discuss them fully with your HCP. You might need to take a lower dosage, a higher dosage or a different medication. You might need to switch your medication time from morning to evening or take medication on a full stomach. There are many options for you and your HCP to try. Side effects can be reduced or eliminated. It is very important to talk to your HCP first before you make any changes to your medication or schedule.

Talk with your HCP first if you feel like changing your dosage or stopping your medication. Explain what you want to change and why you think it will help you.

Treatments can include some or all of these elements: talk therapy, medication, knowledgeable support and overall lifestyle changes.

Medications for Depression and Bipolar Disorder
Your HCP might prescribe one or more medications to treat your symptoms. These may include:

• Mood stabilizers: These medications help balance your highs and lows. Some mood stabilizer medications are called anticonvulsants, because they are also used to treat epilepsy

• Antidepressants: These medications help lift the symptoms of depression. There are several different classes (types) of antidepressants

• Antipsychotics: These medications are primarily used to treat symptoms of mania. Even if you are not hallucinating or having delusions, these medications can help slow racing thoughts to a manageable speed

Talk Therapy
There are many types of talk therapy that can help you address issues in your life and learn new ways to cope with your illness. Goal setting is an important part of talk therapy. Talk therapy can also help you to:

Peer Support
Support from people who understand is another important part of recovery. There are many ways to get this support. DBSA Greater Houston offers a variety of ways to interact with your peers, such as support groups and discussion forums. Learn more about our free weekly support groups in Houston and find one near you.

Find a support group 

4. LIFESTYLE

Lifestyle
A healthy lifestyle is always important. Even if symptoms of depression or bipolar disorder make things like physical activity, healthy eating or regular sleep difficult, you can improve your moods by improving your health. Take advantage of the good days you have. On these days, do something healthy for yourself. It might be as simple as taking a short walk, eating a fresh vegetable or fruit or writing in a journal. A talk about lifestyle changes should be a part of your goal setting with your health care professional (HCP).

You have the power to change. You are the most important part of your wellness plan. Your treatment plan will be unique to you. The plan will follow some basic principles and paths, but you and your HCP can adapt it to fit you. A healthy lifestyle and support from people who have been there can help you work with your HCP and find a way to real and lasting wellness

5. FIVE STAGES

Five Stages of Recovery
It can be helpful to view recovery as a process with five stages. People go through these stages at different speeds. Recovery from an illness like depression or bipolar disorder, like the illness itself, has ups and downs. Friends and family who are supportive and dependable can make a big difference in a person’s ability to cope within each of these stages.

1. Handling the Impact of the Illness

2. Feeling like Life is Limited

3. Realizing and Believing Change is Possible

4. Commitment to Change

5. Actions for Change

1. Handling the Impact of the Illness
Being overwhelmed and confused by the illness.
An episode of mania or depression, especially one that causes major problems with relationships, money, employment or other areas of life, can be devastating for everyone involved. A person who needs to be hospitalized may leave the hospital feeling confused, ashamed, overwhelmed and unsure about what to do next.

What friends and family can do:

Your loved one’s illness is not your fault or theirs. It is a real illness that can be successfully treated. Resist the urge to try to fix everything all at once. Be supportive, but know that your loved one is ultimately responsible for his or her treatment and lifestyle choices.

2. Feeling Like Life is Limited
Believing life will never be the same.
At this stage, people take a hard look at the ways their illness has affected their lives. They may not believe their lives can ever change or improve. It is important that friends, families and health care providers instill hope and rebuild a positive self-image.

What friends and family can do:

A mood disorder affects a person’s attitude and beliefs. Hopelessness, lack of interest, anger, anxiety and impatience can all be symptoms of the illness. Treatment helps people recognize and work to correct these types of distorted thoughts and feelings. Your support and acceptance are essential during this stage.

3. Realizing and Believing Change is Possible
Questioning the disabling power of the illness and believing life can be different.
Hope is a powerful motivator in recovery. Plans, goals and belief in a better future can motivate people to work on day-to-day wellness. At this stage people begin to believe that life can be better and change is possible.

What friends and family can do:

• Empower your loved on to participate in wellness by taking small steps toward a healthier lifestyle. This may include:

•	Sticking with the same sleep and wake times
•	Consistently getting good nutrition
•	Doing some sort of physical activity or exercise
•	Avoiding alcohol and substances
•	Finding a DBSA Greater Houston support group
•	Keeping health care appointments and staying with treatment
•	Offer reassurance that the future can and will be different and better; remind them they have the power to change
•	Help them identify things they want to change and things they want to accomplish

Symptoms of depression and bipolar disorder may cause a hopeless, “what’s the point?” attitude. This is also a symptom of the illness. With treatment, people can and will improve. To help loved ones move forward in recovery, help them identify negative things they are dissatisfied with and want to change, or positive things they would like to do. Help them work toward achieving these goals.

4. Commitment to Change
Exploring possibilities and challenging the disabling power of the illness.
Depression and bipolar disorder are powerful illnesses, but they do not have to keep people from living fulfilling lives. At this stage, people experience a change in attitude. They become more aware of the possibilities in their lives and the choices that are open to them. They work to avoid feeling held back or defined by their illness. They actively work on the strategies they have identified to keep themselves well. It is helpful to focus on their strengths and the skills, resources and support they need.

What friends and family can do:

• Help people identify:

•	Things they enjoy or feel passionate about
•	Ways they can bring those things into their lives
•	Things they are dissatisfied with and want to change
•	Ways they can change those things
•	Skills, strengths and ideas that can help them reach their goals
•	Resources that can help build additional skills

• Help them figure out what keeps them well
• Encourage and support their efforts

The key is to take small steps. Many small steps will add up to big positive changes. Find small ways for them to get involved in things they care about. These can be activities they enjoy, or things they want to change, in their own lives or in the world.

5. Actions for Change
Moving beyond the disabling power of the illness.
At this stage, people turn words into actions by taking steps toward their goals. For some people, this may mean seeking full-time, part-time or volunteer work, for others it may mean changing a living situation or working in mental health advocacy.

What friends and family can do:

• Help your friends or family members to use the strengths and skills they have
• Keep their expectations reachable and realistic without holding them back
• Help them find additional resources and supports to help them reach their goals step-by-step
• Continue to support them as they set new goals and focus on life beyond their illness
• Help them identify and overcome negative or defeatist thinking
• Encourage them to take it easy on themselves and enjoy the journey

People with depression or bipolar disorder have the power to create the lives they want for themselves. When they look beyond their illness, the possibilities are limitless.

6. Helping a Loved One
Helping and getting help
As a friend or family member you can provide the best support when you’re taking care of yourself. It helps to talk to people who know how it feels to be in your situation. Talk with understanding friends or relatives, look for therapy of your own or find a DBSA Greater Houston support group.

DBSA Greater Houston support groups are run by people, families and friends affected by depression or bipolar disorder. They are safe, confidential, free meetings where people can learn more about depression, bipolar disorder and how to live with the illnesses.

One father of a daughter with bipolar disorder says, “DBSA support groups help take a lot of stress out of your life. As a family member, you have to be as prepared as possible, and accept that things will still happen that you aren’t totally prepared for. Do all the research you can. Build a long list of dependable resources and support people, so when a situation arises, you know where to turn and how to take the next step. This really helped my family when we needed it.”

A mother of a son with depression says, “When you are in the middle of a situation, it’s hard to see what’s happening, but when you sit in a support group meeting across from someone who is going through the same things, it gives you perspective.”

DBSA Greater Houston has a complete section with information for family and friends to help a loved one on their recovery to wellness. Click here to view the family and friends recovery information page.