Living with bipolar disorder can test your sense of hope. Yet with purpose, support, and connection, it can be rediscovered and renewed.
Hope guides us through our darkest times. Without it, we stay mired in despair.
Hope allows us to believe that change is possible — that even in the midst of a relapse, you will find your feet once more. Hope gives us the strength to get up and try again.
Hope actually has therapeutic value, says Michael Thase, MD, a professor of psychiatry at the University of Pennsylvania’s Perelman School of Medicine and director of its Mood and Anxiety Program.
“It’s long been known that when people feel hopeful they have much less risk of suiclde and a better response to treatment,” he says.
But what is hope, exactly, and how do you find and sustain it?
Nancy Snow, PhD, a professor of philosophy at the University of Kansas, has written about hope as a character trait that helps us thrive. Her definition of hope: “the desire to attain a certain end and the belief it is possible to attain it.”
In part, hope relies on what psychologists call “agency” — the conviction that you can exert control over your actions and your environment. Researchers who study hope use a scale that assesses how much influence people think they have over reaching a goal and what pathways they might use to get there.
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Optimism also plays a role — the confidence that things will, somehow, work out for the better. Or, as Dr. Thase puts it, “hope is a combination of lessening suffering and psychic pain and building more positive expectations for the future.”
In Dr. Snow’s view, an innate hopefulness may be established when we’re young.
“Hope is a pretty deep-seated part of our psyches that is developed in childhood,” she says. “Having supportive, encouraging parents, what is called parental scaffolding, helps us to be effective agents.”
But there are ways to build up your hope reserves later in life, too. Clinical psychologist Anthony Scioli, PhD, author of Hope in the Age of Anxiety and The Power of Hope, describes four foundational dimensions: setting and striving toward goals, acquiring coping skills, developing empowering relationships, and deepening your sense of faith.
When Faith and Clarity Bring Renewed Hope
For the Rev. Charles, a pastor in Arkansas, one source of hope is gratitude for his Creator’s gifts. “Hope lies in your ability to rise above the illness, to embrace the wonderful things God has given you,” says Charles. “And when you can see the beauty, you begin to find the hope.”
Charles experienced symptoms of bipolar disorder for years before he was diagnosed. During his seminary studies, he would do 100 push-ups a day — “my way of trying to deal with manic behavior,” he says in retrospect — and self-medicated with alcohol. After he was ordained in 1996, his symptoms became more noticeable.
He was finally diagnosed with bipolar 2 after a psychologist in his congregation noticed Charles was speaking fast and having trouble focusing and advised him to seek professional help.
Getting a medical explanation for his self-destructive behaviors and realizing he had a treatable illness planted the seeds for hope that he could take charge again.
“I’ll never forget the words my psychiatrist said: ‘Now that you’ve been diagnosed, you are accountable for your behavior. You need to take your meds and do your counseling or your life will always be spiraling in and out of control.’ I realized how much I had to lose,” says the pastor, who is married and has a family. “It forced me to create a whole new normal.”
Says Thase, “Many people feel more hopeful when their condition is understood and they feel some sense of figuring it out, or at least putting it in perspective. A sense of relief can be gained by realizing that one’s condition is not unique and that people recover.”
Finding Strength in What Matters Most
Thase notes that to sustain hope over time, the goals we set must be realistic and, above all, grounded in our own values and desires. He helps his patients explore what is deeply important to their well-being, whether that’s finding meaningful work or getting bipolar symptoms under better control.
Susan M. of Canada transformed her life when, in the midst of desolation, she formed a heartfelt goal: regain custody of her daughter. The girl, then 15, was removed from her care in 2011 and sent to live with Susan’s sister.
“I was a complete mess,” Susan recalls. “I felt like a failure as a parent. It broke my heart to hear my daughter asking me when this would all be over. I had no answer for her.”
Susan says hope of reuniting her family gave her the fortitude to end a cycle of mood episodes and hospitalizations that spanned decades after she was diagnosed with bipolar 1 at age 28. For Susan, hope grows from “constantly reaching out and looking for help. And when you have hope, you get support. Opportunities come your way.”
She obtained a caseworker and a mental health counselor, never missing an appointment even on days she dreaded going. She found further support from peers on a message board run by the Mood Disorders Association of Ontario. When she was unable to work, she found volunteer opportunities to stay busy and keep her skills honed.
Her hopes were realized, and then some. In 2012, she married a man she connected with through her involvement in the mental health community. With her husband’s aid, she regained custody of her daughter. She’s built up her career as a freelance graphic artist.
Her advice to others: “Even if you don’t have hope, seek out a place to go and show up and see what happens. Everything will grow from there.”
Finding Hope Through Shared Experience
Mutual support from those who face similar challenges has documented benefits across a range of chronic health conditions, including mood disorders. The Theory and Practice of Group Psychotherapy, a standard text in the field, notes that “instilling hope” is one of the benefits of group therapy with peers.
Research also shows that guidance from those with shared experience can nurture hopefulness. In an older trial, British researchers examined whether providing peer support after a psychiatric hospitalization would increase hope, reduce loneliness, and improve quality of life. They found that the greatest influence was on increasing hope.
More recent studies show that hope plays an essential role in finding stability with bipolar. Peer support, learning about the condition, and having strong emotional and social support — alongside medication — can all help nurture a greater sense of hope and confidence in managing symptoms.
One study looked at people living with bipolar depression and found that the more severe their symptoms were, the lower their levels of hope and resilience tended to be. The findings highlight the importance of including psychosocial supports to strengthen hope and emotional resilience.
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Chacku M. discovered the power of peer support as a 15-year-old dealing with mental and health and substance use issues. He recalls feeling welcomed and understood by other teens at a recovery center in upstate New York.
“Peer support is about recovering from the disabling messages we tell ourselves,” says Chacku. “It’s about having someone uncover my hopes and dreams with me.”
The most powerful help isn’t necessarily “been there, done that” advice, he adds. Through conversations free of judgment, “we discover how much we can really grow and change. … That’s what leads to hope.”
The treatment field increasingly recognizes the value of those peer-to-peer connections. Thus, the rise of certified peer specialists, who undergo 40-plus hours of training and pass a qualifying exam. The Veterans Administration has hired about 1,100 peer specialists, says Matt Chinman, PhD, a psychologist and researcher at the VA Pittsburgh Healthcare System.
People facing behavioral health challenges “can get demoralized-feel like they are never going to beat this,” Dr. Chinman notes. “They get that message conveyed to them by a lot of other people, too. Peer specialists are the living embodiment of the opposite. Just by being there, they give hope.”
Peer specialists may also provide practical assistance in navigating the mental health system, finding community resources, and getting to appointments. When the people they work with “see they have someone in their corner,” Chinman says, “they become more hopeful.”
Challenging the Beliefs That Hold You Back
Self-stigma — feeling like damaged goods because you have a psychiatric diagnosis, internalizing stereotypes — can be as harmful as societal prejudice. That internalized stigma is associated with diminished hope, says Philip Yanos, PhD, who researches the effects of self-stigma on recovery.
“People grow up in a world in which mental illness is looked at as somewhat shameful,” says Dr. Yanos, who is a professor of psychology at the John Jay College of Criminal Justice in New York City. “And when someone becomes ill, these notions take on personal relevance — ‘maybe these things apply to me.’”
A major psychiatric setback can cause individuals to “let go of their aspirations and buy into negative stereotypes,” he adds. Feeling like nothing will make a difference becomes a self-fulfilling prophecy.
“If, for example, people are getting helped with supportive housing and job skills, it will not be as effective if they have self-stigma — it’s what some [mental health professionals] call the ‘why bother?’ complex.”
RELATED: How to Stop Stigmatizing Yourself for Having Bipolar Disorder
Interventions that dispel or reduce negative associations with psychiatric conditions help counteract that kind of hopelessness, says Yanos. One example is Ending the Silence, a program run by the National Alliance on Mental Illness (NAMI) that sends young adults into high school classrooms to share their experiences.
“It’s important to target this group,” says Yanos. “They are at an age when a lot of mental health problems are developing.”
Yanos helped develop a type of group therapy called narrative enhancement and cognitive therapy that specifically targets internalized stigma. First, participants look at myths about psychiatric disorders and the truth about recovery rates. They learn how self-stigma influences attitudes and behaviors. They work on skills to manage feelings and challenge irrational beliefs.
Finally, participants write a description of themselves and a problem they need help with. When sharing these narratives, participants are encouraged to consider more hopeful possibilities.
Says Yanos, “People learn that their future is not written in stone.”
Small Reminders That You’re Not Alone
Lucy Ingram, training and program manager for the Depression & Bipolar Support Alliance (DBSA) and a certified peer specialist, stresses the importance of building a support network. She suggests recruiting various people you can count on if you begin to feel disconnected, hopeless, and helpless.
In addition to family and close friends, think about co-workers, roommates, a neighbor, a teacher or school counselor. And don’t forget your therapist or psychiatrist. Sometimes just scheduling an appointment can make you feel a little more hopeful, Ingram says.
Lisa W., a retired teacher from Florida, draws strength from the relationships in her life. When depression hits, she has people who remind her to keep doing the things that make her feel better, like taking a walk, writing, or going to the theater and museums.
Then there is her tiny, four-legged family: Junebug, her emotional support animal. Apart from providing lots of snuggles, the Yorkshire terrier is living evidence that Lisa can still feel love even when she’s dulled down inside. And it is hope, she says, that gets her through the worst.
“It reminds me I am capable of being balanced physically, mentally, and emotionally — that I can survive depression and hypomania because I have done so before.”
Shifting From a Hopeless to a Hopeful Mindset
In the midst of despair, it can be hard to find hope. Steven Dubovsky, MD, professor emeritus of psychiatry, Jacobs School of Medicine and Biomedical Science at the University at Buffalo, has this advice:
- Level the playing field: When you notice that you’re feeling hopeless, first consider whether you’re in a depressive episode that needs to be addressed.
- Seize control: Look at what decisions you can make, steps you can take, or changes you can put in motion to make your life better. Consider what you might be doing that makes your problems worse, such as drinking or getting involved in unhealthy relationships.
- Appreciate yourself: Gather evidence on what is good about you. Look inward at a time when you’re feeling generally positive. Poll your social circle for objective opinions. Keep a list for reference.
And here’s more from Ingram:
- Wait it out: Remember that most everyone experiences hopelessness at times, and those feelings do pass. Assure yourself that everyone matters, including you.
- Write it out: Creative writing, journaling, or making art can give you a sense of purpose and an outlet for your emotions.
- Pump it up: Make a list of what makes you smile or gives you a lift. Figure out how to incorporate more of those things into your daily life
Editorial Sources and Fact-Checking
- Simpson A et al. Results of a Pilot Randomized Controlled Trial to Measure the Clinical and Cost Effectiveness of Peer Support in Increasing Hope and Quality of Life in Mental Health Patients Discharged From Hospital in the UK. BMC Psychiatry. February 5, 2014.
- Favale D et al. Hope and Resilience Among Patients Affected by Unipolar and Bipolar Depression. International Journal of Social Psychiatry. January 6, 2023.
UPDATED: Printed as “Get your hopes up,” Winter 2018