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How can I manage urges if I have bipolar disorder?

Sheri Van Dijk
Psychiatry
Urges can occur because of bipolar disorder. For example, you may experience urges related to depression (such as wanting to isolate yourself), mania (such as wanting to smoke or drink), or mixed episodes (such as having the urge to cut yourself). But they also happen outside of this illness. For example, if you're feeling bored, you may have an urge to eat or to do something else to ease the boredom. It doesn't matter whether an urge is connected to your illness or not -- there are things you can do about urges when they arise.

When you first notice an urge, rate its intensity on a scale from 0 to 10 (where 0 means you aren't experiencing an urge and 10 means the urge is highly intense). After rating your urge, remember that the key is not simply to avoid acting on the urge, but to try to put some time between when you notice the urge and engaging in any behavior. The idea here is not to simply say, "I will never again give in to this urge." If this is a behavior that's been with you for a while and has helped you cope in the past, saying you're just done with it will likely feel overwhelming and probably won't be effective for very long. Instead, promise yourself that you will not act on the urge for just fifteen minutes. That is, for the next fifteen minutes you will act as skillfully as you can to prevent yourself from falling back into that old behavior. This will hopefully seem much more doable, since you're not saying forever, but instead you're putting some time between the urge and your action. This waiting period gives you a chance to use skills instead of automatically acting on the urge. It can be useful if you set an alarm clock or timer of some sort, as time can do funny things when your emotions and urges are intense. It's important to wait a full fifteen minutes before making any further decisions. During those fifteen minutes, you'll want to use distress tolerance skills to help you not act on the urge.
The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder: Using DBT to Regain Control of Your Emotions and Your Life (New Harbinger Self-Help Workbook)

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The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder: Using DBT to Regain Control of Your Emotions and Your Life (New Harbinger Self-Help Workbook)

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.