Tips for Making Big Decisions With Bipolar

Tips for Making Big Decisions With Bipolar

Decision Making and Bipolar Disorder

According to the Depression and Bipolar Support Alliance, bipolar disorder affects 5.7 million adult Americans. The mean age of onset is about 25 years old, and it affects both genders equally – it is also found in all ages, races, social classes, and ethnic groups. Bipolar disorder does not discriminate.

Although all aspects of life are affected by bipolar disorder, making decisions is affected – and the various stages can impact the decision making as well.

Let’s take a look.

How Does Bipolar Disorder Affect Decision Making?

The ability to make a decision is greatly affected by bipolar disorder – and this ability changes based what state the person is in, according to Psych Central.

For example, during mania, the mind is moving very quickly. Thus decisions are made very quickly – and impulsively. Because of this, decision making is often poor; “stopping to think hard about a decision can be incredibly difficult. People may not consider the consequences of their actions.”

During depression, there is very little planning. There is also very little hope for the future. “In this state, there is little energy left to think and plan ahead, so decisions are made in the now, without forethought. This combination of hopelessness and impulsivity increases the risk for suicide.”

During euthymia, or the state between episodes of mania and depression, people are more likely to make better decisions, but some people still have mild symptoms of bipolar disorder, which can and do impact their ability to make sound decisions.


Bipolar Disorder and Impulsivity

Impulsivity is a hallmark symptom of bipolar disorder – especially of the manic phase. When it comes to decision making, making impulsive decisions is also a symptom.

According to Gerard Moeller, MD, professor of psychiatry and behavioral science at UT Medical School, Houston, impulsivity has four major dimensions:

  1. Urgency: Something is wanted immediately, not later. You act on this urge to avoid any negative feelings associated with waiting for this want.
  2. Lack of premeditation: You do not think about the future. Because of this, you act before you can make big plans. Thus these big plans do not take shape.
  3. Lack of perseverance: You have poor follow-through. You get bored with things easily, thus giving up on projects quickly.
  4. Sensation seeking: You are thrill seeking, with little regard to consequences.

Bipolar Disorder and Accountability

Accountability with bipolar disorder can be tricky.

If you do a Google search, some people fall on both sides of the fence – some people believe that regardless of the condition, we are all responsible for our actions, while others believe that we have no control over our actions when in certain states, such as a manic state.

Regardless of how you feel in this debate, one thing is for certain – you can take control of your condition – and be accountable for taking charge of your health. You can be responsible for learning how to make decisions to the best of your ability.

Learning decision-making skills can help you in all aspects of your life.

Learning to Make Decisions With Bipolar Disorder

First of all, it is of the utmost importance that you are taking your medications as prescribed. If you’re not taking them as prescribed, chances are, your bipolar disorder is not under adequate control, and you’re less likely to make a sound decision. Still feeling like your bipolar disorder isn’t under control? Talk to your physician before making any big decisions. Perhaps you need a medication adjustment.

Second, do not feel that you need to make decisions on your own. Discuss the decision to be made with a friend or family member. While doing so, perhaps write out pros and cons.

Third, take your time making the decision. When you take your time making a decision (especially a big decision!), you are less likely to make a decision irrationally.

Bipolar Disorder and Communication

Improving communication skills can help when trying to make a decision, especially if you are eliciting help from a friend or family member. These tips apply for people with bipolar disorder, as well as to family members and friends of people with bipolar disorder.

Here are some good communication strategies that you can employ:

  • Get right to the point rather than speaking in long-winded statements.
  • Express feelings explicitly using “I” statements. This ensures that your point is made clear.
  • Speak only for yourself.
  • Focus on behaviors as opposed to personality traits.

The Bottom Line…

Making decisions can be difficult, but by working on your skills, you can improve your ability to make decisions.


BP Magazine (Living with Bipolar: Acting on Impulse)

Depression and Bipolar Support Alliance (Bipolar Disorder Statistics)

Locus Therapy Center (How to Make a Better Decision When You are Bipolar)

Psych Central (Making Decisions with Bipolar Disorder)

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by Krystina Ostermeyer on March 20, 2018
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