7 Ways to Stay Steady With Bipolar Disorder in 2021
If you are one of the 5.7 million people living with bipolar disorder, or a friend or family member of someone who has the condition, then you know it can play out like the wildest of rides—teetering at the summit of high moods and then plummeting to the lowest of lows, with multiple twists and turns along the way (none of which you asked for). The more you can do to minimize these swings, the better off you’ll be.
It’s tricky, though, because moods can swing unexpectedly with bipolar. “The onset of a new mood episode can happen overnight,” says Aimee Daramus, Psy.D., a psychotherapist in Chicago and adjunct professor of psychology at City Colleges of Chicago. Typically, mood episodes can last weeks or months and occasionally longer. By spotting and minimizing triggers in advance, you can keep on top of this condition. Here, 7 ways to help you cruise into the new year in control.
Mind Your Signs
The hallmarks of bipolar disorder are periods of mania and bouts of depression. Recognizing these moods can help you them control more quickly. “With mania or hypomania, you may feel more confident or impulsive, or even angrier than usual,” Daramus says. Signs of a depressive episode include sadness, emotional numbness, and lack of motivation. “Over time, people with bipolar will be able to be more specific about their signs,” she says. “For example, someone might know that he’s shifting to a depressive episode if his taste in music or food changes.”
Watch Out for Sleepless Nights…
One of the most predictable indications of bipolar swings is a disruption in normal sleep patterns. For example, if you have trouble sleeping at night but you still feel fine during the day—or even feel a surge in energy—you could be shifting into a manic episode, Daramus says. In fact, research shows that 69% to 99% of bipolar individuals report less need for sleep during a manic episode or have difficulties falling and/or staying asleep.
…And Sleep-Filled Days
On the flip side, if you suddenly need more sleep than usual or you’re feeling super tired during the day, even though you got plenty of sleep the night before, you may be moving to a depressive state. During depression cycles, studies show 38% to 78% of bipolar patients suffer from hypersomnia (excessive sleepiness). On the other hand, in some cases people with bipolar say their depression cycle causes severe insomnia instead. Bottom line: Changes in sleep schedules correlate with changes in mood.
Chart Your Course
Tracking mood changes and medication use via a journal or app can help you stay steady and notice any signs of swings. Give each symptom you want to track a rating from 1 to 10, with 1 being severely depressed, 5 being stable, and 10 being severely manic or hypomanic. “If you haven’t had a mood episode in months and you feel pretty stable, it might be enough to track once a week,” says Daramus. “If you’re still working on getting your moods stable, track symptoms once a day.”
Check in with Family
Your nearest and dearest often notice changes in mood before you do, says psychiatrist Lindsay Israel, M.D., chief medical officer of Success TMS in Palm Beach Gardens, FL. Maybe your mania has you talking so much friends can’t get a word in, calling loved ones in the middle of the night, or buying a swag new handbag every week. Or friends may see you crying out of the blue and avoiding invites to get together. If your closest crew spots these trends, let your prescriber know—a simple tweak in meds could help.
Pay Attention to Time Changes
Something as simple as a time change, like traveling to another time zone or even turning the clock back for daylight savings, can set a bipolar patient off kilter, triggering a manic episode, Dr. Israel says. Time changes affect the body’s circadian rhythm, the internal alarm clock that regulates our sleep-wake cycle. “Staying up later or trying to sleep when your brain wants to do the opposite throws off your rhythm and you can end up inducing a decreased need for sleep, which is a symptom of a manic state,” Dr. Israel says.
Drinking alcohol has been shown to increase the severity of bipolar symptoms both on the depressive and manic spectrums. Because alcohol is a known depressant and has sedating effects, it can trigger a depressive episode in those with bipolar, Dr. Israel says. And on the other side of things, studies have shown individuals with bipolar who drink alcohol can be more violent, more impulsive, and more likely to engage in other types of substance abuse—and they exhibit more manic symptoms than those with bipolar who don’t drink alcohol.
“Sticking to a routine that includes daily activities and steady sleep patterns can help to regulate your mood,” Dr. Israel says. “We know exercise and sleep are very good together. If you’re getting better sleep, you’ve got more energy to exercise. And when you’re exercising, you typically have better sleep. And if you’re exercising and sleeping, then typically that lends itself to having a better diet.” Exercise also releases neurotransmitters like dopamine in the brain, which helps maintain an elevated mood.
Effects of Sleep on Bipolar: Nature and Science of Sleep. (2016). “The Role of Sleep in Bipolar Disorder.” ncbi.nlm.nih.gov/pmc/articles/PMC4935164/
Alcohol and Bipolar: Bipolar Disorders. (2002). “Impact of Concurrent Alcohol Misuse on Symptom Presentation of Acute Mania at Initial Evaluation.” pubmed.ncbi.nlm.nih.gov/12519103/
Impact of Exercise on Bipolar: Journal of Psychiatric Research. (2016). “Lifestyle Interventions Targeting Dietary Habits and Exercise in Bipolar Disorder: A Systematic Review.” ncbi.nlm.nih.gov/pmc/articles/PMC4744495/