There’s one word that people with bipolar disorder know and it’s triggers—those things that set off a bipolar episode. While everyone with bipolar is different, there are some very common triggers. I’ve condensed these into four principal areas as they can relate to travel.
Perhaps you’re wondering, isn’t medication the stuff that’s meant to help reduce relapse and keep things steady? Yes, of course. Still, two possible concerns immediately spring to mind.
The first is that any change in medication has the potential to cause disruption. For example, even if there’s no change to your bipolar meds it is possible that treatment for something else could have a negative effect. Antibiotic use, for example, is increasingly being linked to a higher risk of manic episodes. A recent systematic review examining the effects of antibiotics and mania concluded that antibiotic treatment can be associated with hypomania. The cause, however, is unclear. Researchers from Johns Hopkins Medicine published an article in the July 18, 2016 edition of Bipolar Disorders in which they noted “several ways that infection and antibiotic use could directly or indirectly impact psychiatric symptoms.” Both the infection and the disruption caused by antibiotics themselves may be responsible.
Other things to consider are any modifications to existing medication. If at all possible these changes should be undertaken well in advance of travel. Also, if you feel you might need anxiety medication due to travel, speak to your doctor well in advance about the pros and cons. You may find greater benefit from learning relaxation and distraction techniques.
Sleep disruption is often cited as the number-one trigger for bipolar episodes. Any sudden or dramatic change to sleep patterns can result in mood changes. For this reason it is very important that you consider the impact of time-zone differences on your sleep routine. Depending on where you’re traveling in the world, these differences can be as big as plus- or minus-13 hours. If it’s not possible to break up the journey to allow your body to adjust to these changes gradually, then try to adapt your sleep pattern well in advance.
Also consider the impact of flight times on your sleep pattern and plan accordingly. Unfortunately the cheaper flights tend to depart very late at night or very early in the morning. You may need to pay a little more for a flight that allows for better sleep but that’s better than increasing your relapse risk.
We can’t avoid stress but there are ways to minimize it when traveling. Finish your preparations well in advance. Make sure you’ve got enough medication to last the trip and pack what you need. If you require a passport make sure it’s up to date and you can lay your hands on it. Get to the airport early, but accept the fact that delays happen. If you build the potential for delays into your schedule it’s a bonus if they don’t occur. Airports are busy places and long lines and waits are commonplace so pack your favorite distractions in terms of books, music, and movies, and time will pass more pleasantly.
If your vacation involves lots of lazing around then there’s very little to plan. If, however, it’s more of a sightseeing adventure, you need to understand how the system works. People with bipolar do much better with a structured day, so a long, tiring hike into the jungle may not be the best idea. Ideally your vacation schedule should broadly map against your typical everyday activities. It should involve regular meals, rest periods, some exercise, and, of course, regular bedtimes.
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Jerry Kennard, Ph.D., is a chartered psychologist and associate fellow of the British Psychological Society. Jerry’s clinical background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of positivityguides.net.