Keys to Keeping Stress Away With Bipolar
When it comes to setting off a bipolar swing, stress can be a major culprit. According to the International Bipolar Foundation, people with bipolar are more prone to stress than the average person and they have a tougher time bouncing back from a stressful situation. Studies have also found that patients suffering from bipolar experience more stressful life events than those who don’t have the condition, and depressed bipolar patients have more stressful life events than manic patients. So, in addition to staying on your doctor-approved treatment plan, it can be super helpful to reduce stress where you can.
Why Stress Is Bad for Bipolar
The consequences of stress on bipolar patients can be serious, says Lindsay Israel, M.D., chief medical officer of Success TMS in Palm Beach Gardens, FL. Bipolar is a serious mental condition characterized by extreme highs, or mania, and extreme lows, or depression. “When stressed, bipolar patients will often, out of desperation, reach for anything to calm themselves or take away the stress even for a moment. Drugs, binge-eating, or excessive shopping can be unhealthy coping mechanisms that can bring on mood episodes,” Dr. Israel says. Which is why it’s so important to find easy ways to deal with stress.
Check In on Your Sleep
Shifts in sleep patterns can have consequences, says Chicago-based Aimee Daramus, Psy.D., clinical psychologist and author of Understanding Bipolar Disorder. “Inflammation from stress can disturb sleep and other regular body cycles,” she says. “Once sleep is off, it can trigger new episodes. And it makes new episodes harder to identify early, since excessive sleep in depressive episodes or reduced sleep in mania and hypomania are often the first signs that an episode is beginning,” she says. Not to mention, stress can also put a strain on relationships, further destabilizing someone's moods.
Sleep + Mania
And then there are the effects of sleep and stress on mania. “Lack of sleep is a common trigger for a manic episode,” says Dr. Israel. Research shows that up to one in four people with bipolar disorder may be at risk of a manic episode following sleep loss. “Often a manic episode wreaks havoc on the lives of patients and their families because of impulsive and often dangerous behaviors,” Dr. Israel says. The body can only push itself so far and then crashes—triggered by the stress of poor choices, like impulsively purchasing three homes at once, spurring debt, she says.
Maintain a Consistent Sleep/Wake Pattern
Keeping a regular sleep/wake cycle is one of the most important things you can do to keep stress at bay. “Sleep disturbances are usually one of the first signs of a new mood episode, so a regular sleep schedule can help you notice a new mood episode early,” Dr. Daramus says. “Sleep also helps prevent mood episodes because it keeps other body rhythms like appetite and energy levels even,” she says. Use the times between swings to strengthen meditation, relaxation, and other sleep management skills, so you know how to cope when you need to most, Dr. Daramus says.
Don’t Keep Stress to Yourself
Being open about anything that’s giving you angst can stop stress from mounting and festering in your mind. “Whether with a family member, friend, therapist, or any medical professional, it’s important to think out loud and not stay in your head,” Dr. Israel says. Journaling is another healthy (and relaxing) outlet to get your thoughts and feelings out from your head and onto paper, she says. Make it a part of your daily routine—even five minutes in the morning can make a difference.
Stick to a Routine
For those with bipolar, a consistent routine can be a lifesaver. “By reducing unexpected stress and chaos, you avoid triggering the changes in sleep and energy and the chaotic relationships that can trigger a new mood episode,” Dr. Daramus says. A regular schedule also helps people stick to their meds, since they’re less likely to be asleep, distracted, or too stressed to care when it's time for medication, she says. “Routine keeps the brain in a good rhythm and prevents disruption, which can trigger a mood episode,” Dr. Israel says. A mental-health professional can help you devise a schedule you’ll stick to.
Do Something You Enjoy
Find a hobby, such as yoga, jogging, or art that keeps you engaged, interested, and focused—a good go-to strategy if you find yourself under stress, Dr. Israel says. And then make it a part of your weekly routine. Find ways to keep a consistent schedule more fun by filling it with your favorite hobbies or plans with friends and family. And if you can get behind exercise, in whatever form you like, it not only helps you sleep better, but it releases neurotransmitters like dopamine in the brain, which can help maintain an elevated mood.
Lean on Others for Support
Spend quality time with your most-supportive friends and family and look for ways to make those relationships strong, so you have support when you need it, Dr. Daramus says. It goes without saying, but make sure you minimize the amount of time you spend with toxic people as much as possible, Dr. Daramus says. “When stress is putting a strain on your supportive relationships, it can be an important predictor of new episodes and of hospitalization,” she says.
Rely on Relaxation Techniques
It's good to have a few different relaxation techniques to match different energy levels, Dr. Daramus says. “When you're hypomanic or manic, mindful meditation is probably not realistic. Dance, exercise, art, or writing might match your energy levels better,” she says. “When you’re depressed, it might help to use online classes or apps to lead you through relaxation, since your energy levels are probably lower.” Playing with pets also has a measurable effect on stress levels, Dr. Daramus says.
Stay on Track
Being organized can help you get a handle on stress. “Use phone apps to help you keep track of meds, sleep, moods, and symptoms over time,” Dr. Daramus says. For example, eMoods is an app designed to help track moods. Users can see their mood changes on a color-coded monthly calendar and export a summary to see specific triggers. Whether you use an app to help maintain a routine, exercise regularly, engage in fun activities, practice relaxation techniques, or stick to a consistent sleep schedule, getting a handle on stress can go a long way towards an even state of being.
Effects of Stress on Bipolar: American Journal of Psychiatry. (1997.) “Stress Reactivity in Bipolar Patients and Its Relation to Prior History of Disorder.” https://ajp.psychiatryonline.org/doi/pdf/10.1176/ajp.154.6.856
Stressful Life Events & Bipolar: International Journal of Geriatric Psychiatry. (2008.) “Stressful life events in older bipolar patients.” https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.2062
Sleep & Mood Episodes in Bipolar: The British Journal of Psychiatry. (2017.) “Sleep loss as a trigger of mood episodes in bipolar disorder: individual differences based on diagnostic subtype and gender.” https://pubmed.ncbi.nlm.nih.gov/28684405/