9 Ways to Reduce the Risk of Maniaby Therese Borchard Health Writer & Patient Advocate
It’s simple physics: What goes up must come down. The initial lift of mania can feel euphoric — as if you’re endowed with super powers. But the inevitable crash is usually devastating — with a mess of consequences to deal with. How, then, does a person with bipolar disorder prevent mania? Mood stabilizers offer some protection. However, certain behavioral modifications can also reduce your risk. Here are some.
Sleep, even when you don’t want to
Sleep is the single most effective thing you can do to prevent mania. Multiple studies have demonstrated the relationship between sleep deprivation and the risk of mania and hypomania. But it's not as easy as it sounds. Sleep disturbances are highly prevalent among those with bipolar. Many people with depression feel best at night, so they stay up. Practicing good sleep hygiene requires discipline.
Avoid stimulants, including caffeine
Using stimulants, especially methylphenidate or amphetamine, can increase the risk of mania for persons with bipolar disorder. In one study of bipolar patients who received stimulant treatment, stimulant-associated mania or hypomania was as high as 40 percent. Even "benign" stimulants, like coffee and energy drinks, can pose risks if consumed in large amounts and close to bedtime.
Limit your exposure to sunlight
Some psychiatrists lower the dose of antidepressants for their bipolar patients in the spring and summer months because too much exposure to sunlight can increase risks for mania or hypomania. “When sunlight hits the retina, it affects the hypothalamus, which then affects the mood and is considered to cause mania,” Julie Fast, mental health coach and bestselling author of “Take Charge of Bipolar Disorder,” tells HealthCentral.
Track your mood
Keeping a mood journal helps me to recognize behavioral patterns pointing toward mania or hypomania so that I address it before problems surface. My red flags usually include reduced sleep, a noticeable spike in productivity, increased spending, and any kind of unusual activity. I use an old-fashioned notebook, but there are all kinds of sophisticated mood apps available today, too.
Designate a lifeguard
Even with a journal, I’m usually not the first person to spot signs of my own hypomania and mania. Rather, my husband notices the increased speed of my thoughts and speech, a surge of energy, and other changes. The perspective of a spouse, friend, or parent is key to staying on track. Designate a loved one as your personal lifeguard — to blow the whistle when you’re swimming beyond the marked buoys.
Stick to a routine
Routine is critical for persons with bipolar. Our circadian rhythms — the internal body clock or timekeeper — get grumpy when we shake things up too often. “Travel and time changes are a recipe for mania — especially in the summer in the northern hemisphere where you can visit places that stay light until 10 p.m.,” says Fast. Travel prudently. Allow some rest to adjust to new time zones.
Unplug, especially at night
Too much exposure to blue light from computer screens, especially at night, can interfere with sleep and therefore increase risks of mania. In a 2014 study, Harvard University neuroscientist Ann-Marie Chang and her colleagues found that the use of portable light-emitting devices immediately before bed contribute to sleep disturbances and have an adverse impact of general health and performance.
Know your triggers
Mania manifests itself differently in each person. You must know your triggers or sources of overstimulation. “My advice on preventing mania is knowing what triggers your mania and keeping away from the triggers — online dating, gaming late into the night with blue light from computers, travel, working the night shift, etc.,” says Fast. My triggers? Too much sugar and caffeine and places like Chuck E. Cheese.
Reduce your stress
Stress has the potential to worsen any health condition, bipolar disorder included. Knowing how to reduce your stress — through relaxation techniques like yoga and deep breathing — makes you more resilient to life’s inevitable bumps, including episodes of mania. But don’t wait until you are experiencing symptoms of mania to begin learning how to manage your stress. Do it now.
Manage your symptoms
While you may not be able to completely avert a manic episode, you do have some control. With behavioral interventions such as good sleep hygiene, vigilance, and stress reduction, you may be able to lessen the severity and duration of a manic episode, or even nip hypomania in the bud. As with most health conditions, managing manic symptoms requires self-knowledge, discipline, and much support.