diagnoses emphasized equally. • Empowerment. Individual responsibility encouraged and demanded. Modified with permission from Elsevier, Inc., Copyright © 2007. 8 ADVISORY Behavioral Health Is Essential To Health • Prevention Works • Treatment Is Effective • People Recover Exhibit 3. Dimensions of Recovery and Dimensions of Wellness71,72,73 Dimensions of Recovery Dimensions of Wellness Health • Physical: Recognizing the need for physical activity, healthy foods, and sleep; managing chronic illnesses • Emotional: Coping effectively with life and creating satisfying relationships Home • Environmental: Occupying pleasant, safe, stimulating environments that support well-being • Financial: Obtaining satisfaction with current and future financial situations Purpose • Intellectual: Recognizing creative abilities and finding ways to expand knowledge and skills • Occupational: Obtaining personal satisfaction and enrichment from one’s work or daily activity • Spiritual: Expanding one’s sense of purpose and meaning in life Community • Social: Building a sense of connection and belonging; building a welldeveloped support system Health Services Administration has identified several essential dimensions of a holistic approach to recovery and wellness (see Exhibit 3). Conclusion Bipolar disorder can be difficult to diagnose and treat. When bipolar disorder co-occurs with SUDs, the complexities only increase. These complexities reinforce the importance of collaboration between the medical and behavioral health services professionals who provide treatment to individuals with these co-occurring disorders. For example, clients may see behavioral health professionals more frequently than they see medical providers; consequently, behavioral health professionals may become aware first of new symptoms, medication side effects, or other problems requiring medical attention. Integrated treatment, collaboration between professionals and the client, and attention to the various aspects of recovery can all work together to facilitate the management of these co-occurring disorders. Resources Behavioral Health Treatment Services Locator https://findtreatment.samhsa.gov Bipolar Network News www.bipolarnews.org Depression and Bipolar Support Alliance www.dbsalliance.org National Alliance on Mental Illness www.nami.org/Learn-More/Mental-Health -Conditions/Bipolar-Disorder National Institute of Mental Health www.nimh.nih.gov/health/topics/bipolar-disorder National Institute on Drug Abuse www.drugabuse.gov/news-events/nida-notes/2010/04 /attention-to-bipolar-disorder-strengthens-substance -abuse-treatment SAMHSA-HRSA Center for Integrated Health Solutions www.integration.samhsa.gov/integrated-care-models An Introduction to Bipolar Disorder and Co-Occurring Substance Use Disorders Summer 2016, Volume 15, Issue 2 9 Behavioral Health Is Essential To Health • Prevention Works • Treatment Is Effective • People Recover Notes 1 Miklowitz, D. J., & Johnson, S. L. (2006). The of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602. 15 Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the is a brain disorder that causes unusual shifts in a person�s mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives. More than 2 million American adults, 1 or about 1 percent of the population age 18 and older in any given year, 2 have bipolar disorder. Bipolar disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them late in life. It is often not recognized as an illness, and people may suffer for years before it is properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person�s life. “Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide. “I am fortunate that I have not died from my illness, fortunate in having received the best medical care available, and fortunate in having the friends, colleagues, and family that I do.” Kay Redfield Jamison, Ph.D., An Unquiet Mind, 1995, p. 6. (Reprinted with permission from Alfred A. Knopf, a division of Random House, Inc.) What Are the Symptoms of Bipolar Disorder? Bipolar disorder causes dramatic mood swings�from overly �high� and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania