Tips for Managing Bipolar Disorder

Bipolar disorder is a lifelong condition. An evaluation should include a physical exam, psychiatric assessment, mood charting, and a symptom comparison completed by a psychiatrist using the criteria from related disorders from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

A physical exam will include a lab test that could uncover any medical problems which could mimic symptoms. A psychiatric assessment will include a discussion on thoughts, feelings, and patterns of behavior. It will also include a self-assessment or questionnaire. With your permission, assistance from family members or close friends may provide helpful information about symptoms. Mood charting helps keep a record of moods, sleep patterns, or other symptoms.

Tips for Managing Bipolar Disorder

Tips for managing bipolar disorder are to become an expert on the disorder who is dedicated and involved in treatment. You should monitor symptoms and moods, reach out to other people for support, develop and maintain a daily routine, keep stress to a minimum, and maintain a healthy diet.

Other tips include keeping realistic expectations and requiring being patient with the treatment process. Keep communication open with your treatment provider. Take medications as prescribed. Get into therapy to learn new skills which help with regulating moods, learn new coping skills, ways to challenge negative thinking, and learn new ways to improve interpersonal relationships.

Becoming dedicated to treatment is a dedication to self. The first step to the commitment to self is to research the disorder. Learn what the latest interventions are, and which interventions have the highest success of providing stability, continuity, and mood stabilization. Become an expert on the disorder.

Study the symptoms so you can recognize them in yourself. Research all treatment options. Other research opportunities should include diving into the types of medications. Learn which have the greatest success of symptom management with the least amount of side effects. If you are already taking medication, do not skip or change your dose without talking to your provider first.

With all the collected information, use the data to collaborate with your doctor or therapist during the treatment building process. Do not be afraid to voice your opinions or ask questions. It is most beneficial to have a partnership with your provider, especially when outlining your goals during the treatment planning process.

The largest research project to assess treatment methods for bipolar disorder is the Systematic Treatment Enhancement for Bipolar Disorder, otherwise known as Step-BD, and is followed by over 4,000 people with a diagnosis over time with different treatments.

Another trick to managing bipolar disorder is to monitor your symptoms and moods. It is especially important to stay closely attuned to the way you feel. Once the obvious symptoms of mania or depression appear, it is often too late to intervene in the mood swing. Keeping a close watch on the subtle changes in mood, sleep, energy, diet, and thoughts, is key to catching the problem early.

This provides an opportunity to quickly prevent a minor mood change from becoming a full-blown episode of either a manic or depressive state. Tracking mood changes also tracks the other conditions people with the disorder can experience, such as anxiety, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), or diagnosis of a substance use disorder.

People can also be misdiagnosed with Borderline Personality Disorder or schizophrenia. The treatment for these disorders could exacerbate bipolar symptoms or trigger a manic episode.

Other triggers or early warning signs of a manic or depressive episode should be monitored and tracked. Early recognition included identifying triggers or outside influences such as stress, financial difficulties, arguments with loved ones, problems at school or work, seasonal change, or lack of sleep. Common red flags statements for bipolar disorder depression episode are statements such as:

• I quit cooking.
• I don’t want to be around people.
• I have been craving a lot of chocolate.
• I have been having headaches.
• Who cares about anyone else?
• People bother me.
• I need more sleep and naps during the day.

Depression behavior red flags are:

• depressed mood
• changes in sleep
• changes in eating
• fatigue or lack of energy
• loss of pleasure in activities once enjoyed
• restlessness or slowing down
• feelings of guilt or worthlessness
• indecision or difficulty concentrating
• thoughts of suicide

Common red flags or warning signs statements for mania or hypomania are:

• 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.

Common red flag or warning sign behavior for mania or hypomania are:

• increased talkativeness
• increased self-esteem or grandiosity
• decreased need for sleep
• increase in goal-direct activity, energy level, or irritability
• racing thoughts
• poor attention
• increased risk-taking (spending money, risky sexual behaviors, etc.).

It is a good idea to create a wellness toolkit, which consists of coping skills and activities to help maintain a stable mood when feeling a bit off. Many individuals with bipolar disorder have found the following tools helpful for reducing symptoms:

• Self-talk
• Doing something fun and creative
• Taking medication as prescribed
• Getting a full 8 hours of sleep
• Breathing, sound, thought mindfulness exercises
• Take time for yourself and be dedicated to self-care routines
• Increase or decrease the stimulation in your environment

Create a safety plan. Sometimes no matter how well we plan, a full-blown episodic relapse of mania or depression occurs. Having an emergency action plan is key, especially where your safety is at risk. In these times when assistance is needed from a family member, loved one, doctor or counselor may have to take charge of your care, a plan of action should include:

• A list of emergency contacts (your doctor, therapist, close family members, etc.)
• 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, etc.)

Another tip is to reach out to other people. Having a strong support system is vital, and a supportive environment includes more than those you surround yourself with. It is just as important to limit contact with people who emotionally drain you, discourage you, or make you feel guilt or shame.

Spend time with people who make you feel better. Turning to friends and family for support in rough times helps prevent depression, loneliness, or isolation. Joining a bipolar support group can be beneficial in the collective with the “shared” experiences, and advice from other members of the group. Build new relationships by taking a class, joining a church or civic group, volunteering in the community, or becoming a mentor.

Interpersonal and Social Rhythm Therapy (ISRT) is a therapy designed around the importance of maintaining a routine. It is founded on the belief that interruptions in circadian rhythms and sleep deprivation provoke or exacerbate the symptoms associated with bipolar disorder.

Once routines are identified, cognitive-behavioral techniques help the individual recognize antecedent events that trigger an episode. This intervention builds structure into life, provides a regular time for exercise, maintaining a strict sleep schedule, and healthy eating times.

Keep stress to a minimum. The first step is to learn to relax by practicing deep breathing, guided imagery, yoga, or meditation. A daily practice of 30-minutes a day has shown to be most effective in managing stress.

Make leisure time a priority. Play is an emotional and mental necessity. Examples are lighthearted and funny movies, laughing with friends, taking a walk on the beach or in nature, reading, or spending time with a beloved pet. Participate in things that appeal to your five senses, sight, sound, touch, smell, and taste. Go to a favorite place to eat, relax in the garden, and listen to your favorite music.

The last tip is to watch what you put in your body. It is commonly known that there is a 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. Take omega-3’s. 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. Eat soybeans, flaxseeds, canola oil, pumpkin seeds, and walnuts.

Avoid drugs and alcohol. 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 careful when taking over-the-counter medications. Certain prescription and over-the-counter medications can be problematic for people with bipolar disorder. Be especially careful with antidepressants, which can trigger mania. Other drugs that can cause mania include over-the-counter cold medicine, appetite suppressants, caffeine, corticosteroids, and thyroid medication.

For more in-depth planning when treating a bipolar disorder diagnosis, let your mental health provider work with you to design a personalized daily health routine.