Elizabeth Brondolo Ph.D.

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The World Isn’t Designed Well for People With Bipolar

There are gaps in products and services to help people with bipolar disorder.

Posted Sep 11, 2017

In the last post, we talked about how bipolar spectrum disorder makes it hard to develop reasonable expectations and plans for personal goals. This is a frequent topic in our bipolar spectrum disorders group. In one discussion, we identified some important barriers that make it more difficult to achieve personal goals.

We realized that sometimes the world isn’t designed to take into account the needs of people with bipolar spectrum disorder and many other health problems. Let’s look at some of the issues our group members face to understand this further.

Ruby is a peer counselor. She has trouble taking notes when her clients are talking or when she is in a training class. Tamar is an artist. She is having trouble using software that lets her modify photos and images. She used to be a whiz at these programs before she developed bipolar disorder. Maxine has difficulty taking notes in her math class. She can’t accurately and quickly write down the formulas the professor puts on the board.

Each of these difficulties reflect different problems that are common to people with bipolar spectrum disorder.

Both Ruby and Tamar take Lithium, and one side of effect of lithium is tremor. Ruby and Tamar have a mild tremor, it’s practically invisible. But the tremor makes Ruby’s handwriting hard to read. She feels as if she cannot get her fingers to do what she wants them to do. The tremor makes it difficult for Tamar to quickly and smoothly use the computer mouse, hindering her ability to use the software.

Ruby also has OCD, a condition that is common among people with bipolar disorder. In fact, studies suggest more than 20% of people with bipolar disorder have OCD.  Ruby’s OCD leaves her feeling as if she has to take as many notes as possible. She is afraid of leaving anything out, so the paper gets too crammed with information. And she feels more and more frustrated as she tries to get all the information down as fast as possible.

Maxine and Tamar have problems with their working memory, another common difficulty for people with bipolar spectrum disorder. In fact, 40-60% of people with bipolar disorder experience these cognitive problems. Problems with working memory make it hard for Tamar to keep the software commands in her head. And the tremor-related difficulties she experiences as she tries to manipulate the computer mouse cause just enough delay to create further memory problems. It seems as if the software commands evaporate from her memory.

Each of the problems we discussed require products and services better designed to meet the needs of people with bipolar disorder. We need gadgets that are still functional, even when someone has a tremor. And software that can prompt the person to remember the commands, despite problems with working memory. There are apps that can help with planning, but we need more effective products to help people overcome the effects of bipolar spectrum disorder on memory and organization. And we need devices that can help people recognize when anxiety symptoms might be getting in their way. We need to work together to advocate for new design solutions.

There are good devices to facilitate everyday activities, for people with a variety of difficulties, including tremor. But some of these devices are expensive. We need to advocate to make them more readily available.  

In group we had some fun experimenting with software products to help note-taking, and we tried to see if a bigger notebook might make taking notes easier. We tried some voice recognition programs. We talked about the support services available to students, like Maxine, who are registered with the disability/accessibility offices at their schools. Maxine can request a note taker or some of the electronic devices that can help her take notes.

We also talked about the frustration and disappointment that people with bipolar disorder feel when they are less productive and effective than they wish to be—or were before bipolar disorder struck.

We all need to be able to talk openly and clearly about some of the practical difficulties people with bipolar spectrum disorder face. These conversations can help people with bipolar disorder support each other. And an open discussion can give better guidance to people who want to provide help. Collaborative approaches can enhance productivity and enable everyone to achieve meaningful goals.

About the Author

Elizabeth Brondolo, Ph.D., is a psychology professor at St. John’s University and the author of Break the Bipolar Cycle: A Day-by-Day guide to Living with Bipolar Disorder.

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