Living with Bipolar Disorder
Self-Help Tips for Managing Your Symptoms and Staying Balanced
No matter how down or out of control you feel, it’s important to remember that you’re not powerless when it comes to bipolar disorder. Beyond the treatment you get from your doctor or therapist, there are many things you can do to reduce your symptoms and stay on track, including educating yourself about bipolar disorder, surrounding yourself with people you can count on, and leading a healthy “wellness” lifestyle. With good coping skills and a solid support system, you can keep the symptoms of bipolar disorder in check, maintain your balance, and live fully and productively.
What can you do to cope with bipolar disorder?
Living well with bipolar disorder requires certain adjustments. Like diabetics who take insulin or recovering alcoholics who avoid drinking, 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 life.
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. These tips can help you influence the course of your illness, enabling you to take greater control over your symptoms, to stay well longer, and to quickly rebound from any mood episode or relapse
Living with bipolar disorder 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.
Improve your treatment by:
Being 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.
Communicating with your treatment provider. Your treatment program will change over time, so keep in close contact with your doctor or therapist. Talk to your provider if your condition or needs change and be honest about your symptoms and any medication side effects.
Taking 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.
Getting 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.
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
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 relapse|
|Warning signs of depression|
|Warning signs of mania or hypomania|
Source: BHI Clinician's 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, or write in your journal
- Take time for yourself to relax and unwind
- Increase your exposure to light
- Ask for extra help from loved ones
- Cut back on sugar, alcohol, and caffeine
- 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
Symptoms that indicate you need others to take responsibility for your care, and information about any other health problems you have
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
Tip 3: Reach out for face-to-face connection
Having a strong support system is essential to staying happy and healthy. Often, simply having someone to talk to face-to-face can be an enormous help in relieving bipolar depression and boosting your outlook and motivation. The people you turn to don’t have to be able to “fix” you; they just have to be good listeners. The more people that you can turn to who will be available and good listeners, the more likely you are to manage your moods.
Don't isolate! – Support for bipolar disorder starts close to 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. Reaching out to others is not a sign of weakness and it won’t make you a burden. Support for bipolar disorder starts close to home. Your loved ones care about you and want to help. In order to manage bipolar disorder, it's essential that you have people you can count on to help you through rough times.
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.
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.
Tip 4: Develop an active 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 frequently and avoid sitting for long periods of time. Exercise has a beneficial impact on mood and may reduce the number of bipolar episodes you experience. Aerobic exercise such as running, swimming dancing, climbing or drumming – all activities that keep both arms and legs active are especially effective at treating depression. Try to incorporate at least 30 minutes of activity into your daily routine. Ten minutes here and there is just as effective as exercising for longer periods of time. 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 consistent sleep schedule.
Healthy 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.
- Instead of viewing screens or other stimulating activities before bed, try taking a bath, reading a book, or listening to relaxing music.
- Limit caffeine after lunch and alcohol at night as both interfere with sleep.
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. A daily relaxation practice 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 your 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.
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—for better or worse.
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. You can 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. Omega-3 is also available as a nutritional supplement.
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 more problems.
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.
Resources and references
Dealing Effectively with Depression and Bipolar Disorder – Covers key recovery concepts and strategies, such as mood and symptom monitoring and crisis planning. (Depression and Bipolar Support Alliance)
Bipolar 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)
Keeping 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)
Mood Charting (PDF) – Includes printable copy of the NIMH Daily Mood Chart. (CQAIMH)
Healthy 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)
Support Group Locator – Find a support group in different parts of the U.S. or online. (Depression and Bipolar Support Alliance)
Support Groups Outside the U.S. – Search for bipolar disorder support groups located outside the United States. (Depression and Bipolar Support Alliance)
Find a Support Group in the UK (Bipolar UK)
Support Groups in Australia (Black Dog Institute)
Finding Help in Canada (Mood Disorders Society of Canada)