Living with bipolar disorder: What you can do to help yourself
Living well with bipolar disorder requires certain adjustments. Like recovering alcoholics
who avoid drinking or diabetics who take insulin, if you have bipolar disorder, it’s
important to make healthy choices for yourself. Making these healthy choices will help
you keep your symptoms under control, minimize mood episodes, and take control of your
Managing bipolar disorder starts with proper treatment, including medication and
therapy. But there is so much more you can do to help yourself on a day-to-day basis.
The daily decisions you make influence the course of your illness: whether your symptoms
get better or worse; whether you stay well or experience a relapse; and how quickly
you rebound from a mood episode.
Bipolar Disorder: Key Recovery Concepts
- Hope. With good symptom management, it is possible to experience
long periods of wellness. Believing that you can cope with your mood disorder is
both accurate and essential to recovery.
- Perspective. Depression and manic-depression often follow cyclical
patterns. Although you may go through some painful times and it may be difficult
to believe things will get better, it is important not to give up hope.
- Personal Responsibility. It’s up to you to take action
to keep your moods stabilized. This includes asking for help from others when you
need it, taking your medication as prescribed and keeping appointments with your
health care providers.
- Self-Advocacy. Become an effective advocate for yourself so
you can get the services and treatment you need, and make the life you want for
- Education. Learn all you can about your illness. This allows
you to make informed decisions about all aspects of your life and treatment.
- Support. Working toward wellness is up to you. However, support
from others is essential to maintaining your stability and enhancing the quality
of your life.
Source: Depression and Bipolar Support Alliance
Bipolar disorder support tip #1: Get involved in your treatment
Be a full and active participant in your own treatment. Learn everything you can about
bipolar disorder. Become an expert on the illness. Study up on the symptoms, so you
can recognize them in yourself, and research all your available treatment options.
The more informed you are, the better prepared you’ll be to deal with symptoms
and make good choices for yourself.
Using what you’ve learned about bipolar disorder, collaborate with your doctor
or therapist in the treatment planning process. Don’t be afraid to voice your
opinions or questions. The most beneficial relationships between patient and healthcare
provider work as a partnership. You may find it helpful to draw up a treatment contract
outlining the goals you and your provider have agreed upon.
Other tips for successful bipolar disorder treatment:
- Be patient. Don’t expect an immediate and total cure. Have
patience with the treatment process. It can take time to find the right program
that works for you.
- Communicate with your treatment provider. Keep the lines of communication
open with your doctor or therapist. Your treatment program will change over time,
so keep in close contact with your provider. Talk to your provider if your condition
or needs change and be honest about your symptoms and any medication side effects.
- Take your medication as instructed. If you’re taking medication,
follow all instructions and take it faithfully. Don’t skip or change your
dose without first talking with your doctor.
- Get therapy. While medication may be able to manage some of the
symptoms of bipolar disorder, therapy teaches you skills you can use in all areas
of your life. Therapy can help you learn how to deal with your disorder, cope with
problems, regulate your mood, change the way you think, and improve your relationships.
Bipolar disorder support tip #2: Monitor your symptoms and moods
In order to stay well, it’s important to be closely attuned to the way you feel. By the time obvious symptoms of mania or depression appear, it is often too late to intercept the mood swing, so keep a close watch for subtle changes in your mood, sleeping patterns, energy level, and thoughts. If you catch the problem early and act swiftly, you may be able to prevent a minor mood change from turning into a full-blown episode of mania or depression.
Know your triggers and early warning signs – and watch for them
It’s important to recognize the warning signs of an oncoming manic or depressive
episode. Make a list of early symptoms that preceded your previous mood episodes. Also
try to identify the triggers, or outside influences, that have led to mania or depression
in the past. Common triggers include:
- financial difficulties
- arguments with your loved ones
- problems at school or work
- seasonal changes
- lack of sleep
Common Red Flags for Bipolar Disorder Relapse
Warning signs of depression
- I quit cooking meals.
- I no longer want to be around people.
- I crave chocolate.
- I start having headaches.
- I don’t care about anybody else.
- People bother me.
- I start needing more sleep, including naps during the day.
Warning signs of mania or hypomania
- I find myself reading five books at once.
- I can’t concentrate.
- I find myself talking faster than usual.
- I feel irritable.
- I’m hungry all the time.
- Friends tell me that I’m crabby.
- I need to move around because I have more energy than usual.
Clinicians Guidebook: Bipolar Spectrum Disorders
Knowing your early warning signs and triggers won’t do you much good if you
aren’t keeping close tabs on how you’re feeling. By checking in with yourself
through regular mood monitoring, you can be sure that red flags don’t get lost
in the shuffle of your busy, daily life.
Keeping a mood chart is one way to monitor your symptoms and moods. A mood chart
is a daily log of your emotional state and other symptoms you’re having. It can
also include information such as how many hours of sleep you’re getting, your
weight, medications you’re taking, and any alcohol or drug use. You can use your
mood chart to spot patterns and indicators of trouble ahead.
Develop a wellness toolbox
If you spot any warning signs of mania or depression, it’s important to act
swiftly. In such times, it’s helpful to have a wellness toolbox to draw from.
A wellness toolbox consists of coping skills and activities you can do to maintain
a stable mood or to get better when you’re feeling “off.”
The coping techniques that work best will be unique to your situation, symptoms,
and preferences. It takes experimentation and time to find a winning strategy. However,
many people with bipolar disorder have found the following tools to be helpful in reducing
symptoms and maintaining wellness:
- talk to a supportive person
- get a full eight hours of sleep
- cut back on your activities
- attend a support group
- call your doctor or therapist
- do something fun or creative
- take time for yourself to relax and unwind
- write in your journal
- ask for extra help from loved ones
- cut back on sugar, alcohol, and caffeine
- increase your exposure to light
- increase or decrease the stimulation in your environment
Create an emergency action plan
Despite your best efforts, there may be times when you experience a relapse into full-blown
mania or severe depression. In crisis situations where your safety is at stake, your
loved ones or doctor may have to take charge of your care. Such times can leave you
feeling helpless and out of control, but having a crisis plan in place allows you to
maintain some degree of responsibility for your own treatment.
A plan of action typically includes:
- A list of emergency contacts (your doctor, therapist, close family members)
- A list of all medications you are taking, including dosage information
- Information about any other health problems you have
- Symptoms that indicate you need others to take responsibility for your care
- Treatment preferences (who you want to care for you; what treatments and medications
do and do not work, who is authorized to make decisions on your behalf)
Bipolar disorder support tip #3: Reach out to other people
Having a strong support system is vital to staying happy and healthy. Creating a supportive
environment includes not just who you surround yourself with, but who you choose to
avoid. In order to take care of yourself, it’s necessary to limit your contact
with people who drain your emotional energy or leave you feeling discouraged, ashamed,
or guilty. Instead, spend time with people who truly value you and make you feel better.
- Turn to friends and family – Support for bipolar disorder
starts at home. It’s important to have people you can count on to help you
through rough times. Isolation and loneliness can cause depression, so regular
contact with supportive friends and family members is therapeutic in itself.
- Join a bipolar disorder support group – Spending time with
people who know what you’re going through and can honestly say they’ve “been
there” can be very therapeutic. You can also benefit from the shared experiences
and advice of the group members. To find a support group in your area, see Resources and References below.
- Build new relationships – Isolation and loneliness make
bipolar disorder worse. If you don’t have a support network you can count
on, take steps to develop new relationships. Try taking a class, joining a church
or a civic group, volunteering, or attending events in your community.
10 tips for reaching out and building relationships
- Talk to one person about your feelings.
- Help someone else by volunteering.
- Have lunch or coffee with a friend.
- Ask a loved one to check in with you regularly.
- Accompany someone to the movies, a concert, or a small get-together.
- Call or email an old friend.
- Go for a walk with a workout buddy.
- Schedule a weekly dinner date
- Meet new people by taking a class or joining a club.
- Confide in a counselor, therapist, or clergy member.
Bipolar disorder support tip #4: Develop a daily routine
Your lifestyle choices, including your sleeping, eating, and exercise patterns, have
a significant impact on your moods. There are many things you can do in your daily
life to get your symptoms under control and to keep depression and mania at bay.
- Build structure into your life. Developing and sticking to a
daily schedule can help stabilize the mood swings of bipolar disorder. Include
set times for sleeping, eating, socializing, exercising, working, and relaxing.
Try to maintain a regular pattern of activity, even through emotional ups and downs.
- Exercise regularly. Exercise has a beneficial impact on mood and may reduce the number of bipolar episodes you experience. Aerobic exercise
is especially effective at treating depression. Try to incorporate at least 30
minutes of activity five times a week into your routine. Walking is a good choice
for people of all fitness levels.
- Keep a strict sleep schedule. Getting too little sleep can trigger
mania, so it’s important to get plenty of rest. For some people, losing even
a few hours can cause problems. However, too much sleep can also worsen your mood.
The best advice is to maintain a normal sleep schedule, going to bed and waking
up at around the same time each day.
sleep habits for managing bipolar disorder
- Go to bed and wake up at the same time each day.
- Avoid or minimize napping, especially if it interferes with your sleep at night.
- Avoid exercising or doing other stimulating activities late in the day.
- No caffeine after lunch or alcohol at night. Both interfere with sleep.
Bipolar disorder support tip #5: Keep stress to a minimum
Stress can trigger episodes of mania and depression in people with bipolar disorder,
so keeping it under control is extremely important. Know your limits, both at home
and at work or school. Don’t take on more than you can handle and take time to
yourself if you’re feeling overwhelmed.
- Learn how to relax. Relaxation techniques such as deep breathing,
meditation, yoga, and guided imagery can be very effective at reducing stress and
keeping you on an even keel. Studies show that a daily relaxation practice of 30
minutes or more can improve your mood and keep depression at bay.
- Make leisure time a priority. Do things for no other reason than
that it feels good to do them. Go to a funny movie, take a walk on the beach, listen
to music, read a good book, or talk to a friend. Doing things just because they are
fun is no indulgence. Play is an emotional and mental health necessity.
- Appeal to your senses. Stay calm and energized by appealing to the five senses: sight, sound, touch, smell, and taste. Listen to music that lifts
your mood, place flowers where you will see and smell them, massage your hands and
feet, or sip a warm drink.
Bipolar disorder support tip #6: Watch what you put in your body
From the food you eat to the vitamins and drugs you take, the substances you put in
your body have an impact on the symptoms of bipolar disorder – both for better
- Eat a healthy diet. There is an undeniable link between food
and mood. For optimal mood, eat plenty of fresh fruits, vegetables, and whole grains
and limit your fat and sugar intake. Space your meals out through the day, so your
blood sugar never dips too low. High-carbohydrate diets can cause mood crashes,
so they should also be avoided. Other mood-damaging foods include chocolate, caffeine,
and processed foods.
- Get your omega-3s. Omega-3 fatty acids may decrease mood swings
in bipolar disorder. Omega-3 is available as a nutritional supplement. You can
also increase your intake of omega-3 by eating cold-water fish such as salmon,
halibut, and sardines, soybeans, flaxseeds, canola oil, pumpkin seeds, and walnuts.
- Avoid alcohol and drugs. Drugs such as cocaine, ecstasy, and
amphetamines can trigger mania, while alcohol and tranquilizers can trigger depression.
Even moderate social drinking can upset your emotional balance. Substance use also
interferes with sleep and may cause dangerous interactions with your medications.
Attempts to self-medicate or numb your symptoms with drugs and alcohol only create
- Be cautious when taking any medication. Certain prescription
and over-the-counter medications can be problematic for people with bipolar disorder.
Be especially careful with antidepressant drugs, which can trigger mania. Other
drugs that can cause mania include over-the-counter cold medicine, appetite suppressants,
caffeine, corticosteroids, and thyroid medication.
Free Toolkit Program
Resources & References
Helpguide’s Yellow Pages
Resources for public assistance, social services, and other health and human services.
Living and coping with bipolar disorder
Effectively with Depression and Manic-Depression – Covers key recovery
concepts and strategies, such as mood and symptom monitoring and crisis planning.
(Depression and Bipolar Support Alliance)
Affective Disorder: A Guide to Recovery (Powerpoint Presentation) – Online
booklet covers bipolar disorder, treatment strategies, what to do when drug therapy
fails, and coping skills. (The Organization for Bipolar Affective Disorders)
Disorder: Stories of Coping and Courage – Read the personal stories of
real people dealing with bipolar disorder. Includes each individual’s experience
of what helps them feel better. (Depression and Bipolar Support Alliance)
Taking charge of bipolar disorder recovery
Your Balance – Australian government sponsored site offers a self-help
series on managing bipolar disorder. Includes cognitive and behavioral strategies
for managing and preventing mania and depression. (Centre for Clinical Interventions)
Toward Wellness – Online workbook you can use to track your treatment and
progress. Includes sections on identifying triggers, dealing with drug side effects,
and tracking your moods. (Depression and Bipolar Support Alliance)
Toolbox – Take charge of your treatment with wellness tools such as a symptom
management worksheet, medication information charts, and a personal wellness checklist.
(Depression and Bipolar Support Alliance)
Bipolar disorder mood and symptom monitoring
for Relapse Prevention (PDF) – Patient workbook with strategies for monitoring
your moods and spotting signs of relapse. (Centre for Clinical Interventions, Western
Australia Department of Health)
Healthy lifestyle choices for bipolar disorder
Lifestyles: Improving and Maintaining the Quality of your Life – Advice
on improving the quality of your life through healthy lifestyle modifications such
as eating right and exercising. (Depression and Bipolar Support Alliance)
Bipolar disorder support groups in the U.S.
About Support Groups and Chapters – Learn about DBSA (Depression and Bipolar Support Alliance) support groups and how they can help. Includes a Support Group Locator. (Depression and Bipolar Support Alliance)
Find a Support Group – Search for a support group for children and adolescents with bipolar disorder. (Child & Adolescent Bipolar Foundation)
Bipolar disorder support groups worldwide
Support Groups Outside the U.S. – Search for bipolar disorder support groups located outside the United States. (Depression and Bipolar Support Alliance)
Self-Help Groups in the UK (MDF The Bipolar Organisation)
Advocacy Support Groups in Australia (Bipolar Disorder)
Finding Help in Canada (Mood Disorders Society of Canada)