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• Psychotherapy • Research • Training
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Module 8: Coping with Psychosocial Stressors and Self-Management
COPING WITH PSYCHOSOCIAL STRESSORS
Research with people who have bipolar disorder suggests that stressful life events can play a
significant role in the development of symptoms, and that the prevention of depressive and
manic episodes can be partly achieved by controlling stress. People with bipolar disorder may
have problems in a number of different areas, including family, work, health, finances and so
on. One important way of controlling stress is to develop skills in identifying and addressing
problems that arise on a day-to-day basis.
Cues to Action
Identifying and defining problems requires an awareness that problems exist. There are various internal
and external cues that can be helpful for recognising problems as they occur. Internal cues include physical
bodily changes, such as muscle tension, headaches, changes in breathing, tightness in the chest. These
physical changes can act as signals of stress, and a cue that unresolved problems need attention. Emotional
changes (eg, feelings of hopelessness, anxiety, worry) can also act as a cue that problems exist. Other
people’s behaviour is also a useful indicator that difficulties exist. Family members, friends, and significant
others are often good observers, and may be able to identify problems earlier than the person concerned.
Unfortunately, it can often be hard to welcome the observations and comments of other people,
particularly if they are perceived as criticisms or complaints. Although comments from others may at times
be unjustified, they are useful because they indicate that something might be wrong.
Identifying and Prioritising Problems
It is common for people with bipolar disorder to experience significant problems following an episode of
mania or depression. For example, financial problems can develop from loss of employment caused by
tiredness and low motivation during depression. Likewise, financial extravagance and poor judgement
during an episode of mania can lead to financial problems that have to be dealt with afterwards. The feelings
of frustration, hopelessness, and being overwhelmed can make it seem impossible to address the difficulties,
or even know where to begin.
Having a clear procedure for identifying and addressing problems as they arise can help to minimise the
sense of hopelessness and feeling of being overwhelmed. So, once it has been recognised that problems
exist, it is useful to work through the following steps:
1. Prioritise the Problems
Often, people are faced with a number of difficulties and it is not clear which needs the most
immediate attention. To begin the process of resolving problems, it is necessary to identify a few
problems to work on, beginning with those of greatest urgency and importance. A useful way to
do this is to make a list of all the issues that have consumed a lot of physical, emotional, and
mental energy in recent times (eg, over the past week). The next step is to order the items on
the list according to the amount of energy that they have consumed. Then, prioritise the
problems in terms of their importance or urgency. Ideally, the greatest amount of energy should
be given to problems that are highest in priority and importance. If this is not happening, it may
indicate that a lot of time and energy is being spent doing things that are less important or urgent,
and would be better spent on high priority difficulties. The items that are ranked as highest in
priority or urgency should be selected as the first difficulties to address.
2. Identify Coping Resources
Coping resources refer to aspects of yourself or the environment that can help in overcoming the
difficulties you have identified. External resources include assistance from others, such as family,
