McMan's Eight-fold Path to Living Well

John McManamy Health Guide
  • My colleague at BipolarConnect, GJ Gregory, in a recent blog posted a list of six crucial strategies he employs to manage his illness, which I strongly urge you to read. GJ got me thinking about MY strategies, which largely overlap with his, which in turn largely overlap with those of “successful patients” I have talked to over the years. For managing my own illness, I regard each one of the following as every bit as important, if not more so, than the meds I take:


    Knowledge is Necessity.


    Studies have found that “expert patients” who put in the effort to learn about their illness and actively manage it have far better outcomes than “passive patients.” Everything about managing our illness – from establishing good working partnerships with our clinicians to how we choose to lead our lives - depends on our willingness to educate ourselves.

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    Personal note: With this blog, an email newsletter, a website, and a book, “Knowledge is Necessity” is my mission. I learn as I write.




    Several years ago, Melbourne researcher Sarah Russell, Ph.D surveyed 100 “successful patients” with bipolar. What they told her essentially boiled down to “mindfulness.” In the context of our illness, this involves being microscopically attuned to subtle shifts in our moods and energy levels and behaviors. We need to pick these up before our clinicians do, or our friends and family.


    For instance, if you spot yourself sleeping less or getting angry more, you need to do something about it right away, while the situation is manageable, before your mind spirals out of control. Often, the solution may be as simple as “stopping to smell the roses” or getting a good night’s sleep.


    Personal note: For me, mindfulness is the ultimate mood stabilizer.


    Avoiding and Managing Stress


    The brain in crisis or overload is probably the greatest risk factor for a mood episode. With mindfulness techniques, we can often avoid stress before it eventuates, or manage the stress we can’t avoid. This is where a whole range of personal coping skills comes into play, from learning to substitute erroneous thoughts with rational ones, to developing better interpersonal skills, to finding ways to gain control over your life, to learning how to relax.


    Personal note: I will not hesitate to take a day off if I feel stress is getting to me.


    Good Sleep is Crucial


    Sometimes I am convinced that sleep is the main illness and that the mood disorder is the downstream effect. The one ironclad statement I can make about our illness is this: If you struggle with your sleep, you are certain to be struggling with your illness. Stick to a daily routine and a regular sleep schedule, and practice good sleep hygiene


    Personal Note: One bad night’s sleep turns me into Satan. You definitely don’t want to know me in this situation.


    You Are What You Eat


    There is no one right diet, but there are millions of bad ones. The excessive sugars and saturated fats in our diets set us up for everything from sharp mood and energy swings to mental sluggishness, jitters, low self-esteem, to medical complications galore. A 20-oz Coke contains the equivalent of 15 teaspoons of sugar. And you wonder why kids bounce off the walls at school.


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    Be careful about diets that set you up to fail. It may be better to set modest goals and to aim for eating a bit smarter.


    (Check out HealthCentral’s FoodFit for some good nutrition tips and healthy recipes.)


    Personal note: I do a lot of my own cooking, which allows me to control the ingredients that go into my food.




    Numerous studies have linked exercise to elevated mood and reduction of depression. This includes aerobics, walking, and yoga. Simple advice: Find something you like to do (such as walking) and fit it in to your daily routine. Find an activity that is fun to do with others (such as dance lessons).


    Personal note: When I miss my daily walk, I feel it way more than when I accidentally miss a meds dose.




    This includes being connected with who you are, with other people, and with something greater than yourself (be it God or your own intuition). Without these connections, you are inviting in depression and frustration and anger.


    Fittingly, all these levels of connectedness interconnect. Finding personal piece of mind has a lot to do with seeking out and maintaining the type of relations that nurture and challenge us. Be ready to step outside of your comfort zone – if you are standing still you are going backwards.  


    Personal note: I am very prone to isolating. These days, in the wake of a recent marriage break-up, I place great emphasis on seeking out people and talking to my friends.




    We may be a vulnerable population, but you are a lot tougher than you think. Take credit for the strength and courage you have already displayed in the teeth of one of the worst illnesses on earth. Even the best of us enter states of hopelessness. But even in our worst states, we have a small element of control, and that is cause for hope.


    Personal note: I try to focus on living in the present. 


    Final Word

    Your illness will always remain a challenge, but you can take comfort in the fact that the world’s foremost expert in the art of being you is hard at work on your case. Live well …  


Published On: May 04, 2007