Aim for the same bedtime each night and meditate, read, or take a bath before hitting the sheets, Dr. Daramus recommends. Basic sleep hygiene practices, like avoiding screen time before bed and sleeping in a cool, dark room, can also help counteract manic periods, she adds.
Other routines, such as enjoying regular meals and spending time with loved ones, can also keep your mood as stable as possible, Dr. Daramus says. For example, if you skip a meal, you might feel stressed, a common trigger for many folks with bipolar I. Plus, maintaining a routine sometimes makes it easy to spot a new episode coming on, she points out, since you’d be more likely to notice shifts in your habits.
Dr. Rubenstein recommends tracking your mood and symptoms regularly outside of manic episodes, too. “This can help identify early warning signs of a manic episode and allow for early intervention,” she says. “You can also identify and avoid triggers, such as alcohol and caffeine.”
Don’t stop taking your medications.
Maybe you love how mellow you feel when taking your mood-stabilizing medications, but you experience frustrating side effects. Or perhaps your current medications clash with another prescription you’re taking, like antidepressants, which can sometimes add to feelings of mania.3 Whatever the case, don’t stop taking your bipolar meds without your care team’s help: Disrupting your medication schedule could trigger or worsen a sudden manic or depressive episode, according to Dr. Daramus. Instead, if the side effects from your bipolar I medications are overwhelming, tell your doctor right away—they can potentially change your prescription entirely.4
Since bipolar disorder can also cloud your memory, Dr. Vas recommends using a pill organizer so you don’t miss a dose. “You may not be able to trust your memory for medication during a manic episode if your concentration is all over the map,” he says. Setting alarms on your phone, flipping pill bottles when you’ve taken a daily dose, and posting visible reminders on the refrigerator or bathroom mirror can also help. Remember that circle of loved ones you might have asked to look out for you? Don’t be afraid to loop them in on your medication tracking, too.
Be real with your health care providers.
Going through a manic episode can lead you to feel some conflicting, confusing things. You might feel ashamed to be vulnerable with a therapist or psychiatrist about them. Remember: Your care team knows that those behaviors and thoughts are symptoms of your condition—not a reflection of who you are as a person. Being open about how you feel and what you do in a manic episode can help you stay safe and better manage your bipolar I. “Ultimately, you need a therapist [or other health care provider] you can be vulnerable with, especially about the things you’re embarrassed about,” Dr. Daramus says.
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A compassionate, knowledgeable professional won’t judge or critique you when voicing your concerns or sharing your experience with bipolar I. If you don’t feel comfortable being frank with your care team, speak up to a trusted loved one. They can potentially help you find new health care providers to meet with.
Remember: You’ve got this.
The ups and downs of bipolar I can be exhausting. It may also take a little while for you and your care team to find a solution that works best for your unique triggers and symptoms, so it’s important to be patient.
A little self-compassion goes a long way, Dr. Rubenstein says: “[Your] symptoms are part of an illness, not a personal failure.” Would you judge a friend going through a similar situation? Obviously not! You’ve been taking steps to help yourself by getting treatment for bipolar I, and you’re on track to get better, even when manic episodes do strike. Give yourself some credit for how far you’ve come.
Sources:
- Clinical Psychology, Sleep Disturbance in Bipolar Disorder Across the Lifespan
- Journal of Affective Disorders, Stressful Life Events in Bipolar I and II Disorder: Cause or Consequence of Mood Symptoms?
- Molecular Psychiatry, Antidepressants That Increase Mitochondrial Energetics May Elevate Risk of Treatment-Emergent Mania
- Journal of Affective Disorders, Managing the Side Effects Associated With Commonly Used Treatments for Bipolar Depression
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