Living with Bipolar Disorder can be extremely difficult, with recurring highs and lows in mood. Challenges include accepting the diagnosis, avoiding the risk of substance abuse, and managing variable moods. Learning various lifestyle tips to reduce the symptoms and make your life more enjoyable and fulfilling may be helpful.
What Is Bipolar Disorder?
Bipolar Disorder is a severe form of depression that includes extreme mood swings from extreme highs and low lows. There are three distinct types of Bipolar Disorder: Bipolar I, Bipolar II, and Cyclothymic Disorder. Each of these types has different symptoms and levels of severity for the bipolar cycles of mood swings. There are essential differences between Bipolar I vs. Bipolar II. For example, a person with Bipolar I will have at least one full episode of mania in their lifetime. In contrast, a person with Bipolar II will experience only hypomanic (less severe) episodes.
Some common signs and symptoms of Bipolar Disorder include: 1
- Euphoric mania or hypomania: This is an unusually high energy level and an elevated mood lasting at least four days.
- Dysphoric mania or hypomania: This is an unusually high energy level, together with an irritable mood, lasting at least four days.
- Inflated self-esteem: This occurs during a manic episode and involves feeling more special than others or invulnerable to the usual consequences of negative behavior.
- Grandiosity: A part of manic episodes when the person feels that they have a unique and vital message or idea to share with the world (similar to delusions of grandeur).
- Decreased need for sleep: During mania, the person has so much energy that they feel a reduced need for sleep.
- Pressure to keep talking: The pressured speech of a person in a manic episode may be excessive, louder than usual, and faster, to the point where it may be difficult to understand.
- Racing thoughts: Thinking during a manic episode can be faster than usual, along with a heightened level of creativity.
- Increase in goal-directed activity: Behavior may change during the manic episode toward taking on too many new occupational or social obligations and becoming over-extended.
- Psychomotor agitation: Behavior might include excessive pacing, messaging, or anxious restlessness.
- Distractibility: A person in a manic episode may become easily distracted or hyper-focused on one task, neglecting other tasks.
- Excessive involvement in enjoyable or risky activities: Manic behavior might include spending sprees, unprotected sex, driving too fast, or drug and alcohol binges. Judgment is impaired, and there is a lack of insight into the long-term effects of the behavior.
Challenges of Managing Bipolar Disorder
The symptoms of bipolar disorder can impact someone’s ability to manage daily activities at home, work, or school. Bipolar disorder might damage interpersonal relationships, disrupt routines, or drag others into the consequences of manic behavior.
Some of the biggest challenges faced by those with bipolar disorder include:
Difficulty Accepting the Diagnosis
Many people with bipolar have difficulty accepting the diagnosis. Some fear the stigma that might come with having a severe mental illness and the misunderstandings of general society about the illness—feeling the stigma can bring on feelings of shame.
Sometimes the diagnosis is not accepted by family members. Parents might fear their child will carry a mental illness label for a lifetime. Partners might worry that the diagnosis will be an excuse for poor judgments or risky behavior. A person with bipolar disorder should balance these concerns against the benefits of accepting the diagnosis and getting proper treatment.
The Love-Hate Relationship With Mania
It is not uncommon for a person with bipolar to develop a love-hate relationship with the highs that are part of the cyclic mood swings. While manic episodes might bring problematic symptoms such as agitation, distractibility, or dangerous risk-taking behaviors, they also bring high energy with heightened creativity. For someone struggling with periods of depressed mood and low energy, these periods of elevated mood can be tough to give up.
Some might even fear their life will become dull and unsatisfying without the highs of mania. They might find it difficult to imagine that life can be content, rewarding, and enjoyable when their symptoms are well-managed. However, once their sleep patterns are more regular, they are likely to have more consistent energy levels, allowing them to be more productive at work, home, or school.
Managing Depressive Episodes
A major challenge of living with bipolar disorder is managing depressive episodes, where one’s mood is often intensely sad and overpowering.
These depressive phases will also include other challenges, such as:
- Feelings of shame or despair that overtake manic feelings of invulnerability or greatness.
- Loss of interest in activities that the person usually finds enjoyable.
- Changes in appetite leading to unwanted weight gain or loss.
- Disrupted sleep patterns with too much or too little sleep create daytime fatigue.
- The altered ability to think, with self-critical thoughts and excessive thinking about life’s problems, can lead to decreased ability to focus and stay on task.
- Thoughts of self-harm or suicidal ideation.
Any thoughts of self-harm should be taken seriously and shared with a mental health professional as soon as possible.
Potential Risk for Substance Use
It is estimated that up to 60% of people with bipolar disorder also develop a substance use disorder at some point.2 Although substance use might be an attempt to self-medicate and cope with the challenges of bipolar, it interferes with treatment and worsens symptoms.
Substance use is known to cause disrupted sleep, which is already an issue for many people with bipolar. Different substances can trigger mania or depression or intensify the symptoms of a current mood swing. It can also interfere or interact with medications, usually mood stabilizers, reducing medication effectiveness and causing damage to the heart or liver.
Difficulty Raising a Family
A person with bipolar disorder faces particular challenges when raising a family. Family members might be prone to feeling frustrated or angry at the person with bipolar because of the disruptions in daily routines that the symptoms can cause. Or there might be a loss of income due to the disrupted work routines. The frustration and anger might later change into guilt when the person receives an official diagnosis, and the seriousness of the disorder is understood.
An additional family challenge is a generally higher anxiety felt by a spouse or by the children of a bipolar parent. Day-to-day life is more unpredictable when a parent’s mood is prone to dramatic changes. Expectations need to be adjusted to allow the family to set their values and reconsider their priorities.
Additionally, as bipolar disorder is known to be genetic, there can be a concern when deciding to have children. Passing on the genetic traits to a child can mean they may face the same challenges their parent has.
Getting the Right Medications & Dosages
Once diagnosed, finding the proper bipolar medications at the most effective dosages begins. This process can take weeks or months to finally find a medication regimen that works well for the person with bipolar and has minimal side effects. It requires patience and an optimistic attitude by both the person diagnosed and the family, friends, or coworkers of that person.
18 Tips for Better Living With Bipolar Disorder
Despite the challenges they face, people with bipolar disorder are still able to live full and meaningful lives with a combination of medication and psychotherapy. In addition to these treatments, using a full arsenal of self-help techniques and healthy coping mechanisms is extremely helpful.
The following are 18 tips for coping with bipolar disorder.
1. Learn About Your Disorder
Understanding the disorder’s nature will help you recognize and cope with the symptoms better. Once you can recognize the onset of symptoms faster, you can identify your triggers easier. Another benefit is that you’ll be able to educate those who live or work with you. Their knowledge will help them set aside assumptions about your behavior and be compassionate toward you.
2. Maintain a Healthy Daily Routine
A daily routine can help maintain a stable mood and accomplish everyday tasks. An activity schedule makes certain positive behaviors more likely to happen, even when you don’t feel like sticking to them. For those who struggle with varying energy levels, this can significantly boost productivity and well-being.
3.Get Good Sleep
Getting good sleep means getting enough hours and ensuring restful and rejuvenating sleep. Sleep has been shown to affect levels of neurochemicals such as serotonin in the bloodstream. Chemical imbalances correlate with mood changes, notably resulting in a depressed mood.
There are several ways to increase the likelihood of getting good sleep, including:
- Sleeping during the same hours or within close range of the same hours
- Not watching any screens within 2 hours of going to bed
- Substances such as caffeine and alcohol can disturb sleep and should be avoided or limited
4. Get Regular Exercise
Regular physical exercise can benefit mental health by boosting mood. It doesn’t have to be high-intensity aerobics or strenuous activity to be effective. Studies have shown that simple movements such as walking or doing housework for an hour per day can help prevent episodes of depression.3
5. Eat Nutritious Foods
While diet has not been directly linked to bipolar disorder, it is a factor that affects general well-being and mood in particular. There is consistent evidence of an association between a healthy diet and a lower risk of mood disorders.4
A healthy diet usually consists of a high level of
- Whole grains
- Nuts and seeds
- Lean proteins
6. Take Your Medications Consistently
Once you find the medication regimen that works for you, it’s imperative to take your meds consistently. Missing doses can make medications less effective. Abruptly stopping can cause new symptoms or a recurrence of past symptoms, such as depression relapse. If you’re not satisfied with the meds that you’re taking, talk with your treatment provider about alternative options.
7. Avoid Drugs & Alcohol
Alcohol and other drugs can interfere with your treatment and even make symptoms worse. Substance use has been shown to interfere with getting good sleep, which is critical in managing bipolar disorder. There is also the danger of overdosing and causing damage to the heart or liver.
8. Build a Support Network of Family or Friends
The emotional support of family and friends can be beneficial for those who are living with bipolar disorder. People with bipolar with a strong support network do better between episodes of depression than those without support. Higher levels of social support are also associated with a lower risk of relapse.5
9. Keep in Touch With Your Health Care Team
Communicate with your treatment team if you have questions about why they’re prescribing a particular medication or about the side effects you may experience from that medication. This communication is ideally done before starting a new drug, but it is also helpful to ask questions if you have further concerns after using the medicine.
Let the team know if you have any side effects which are difficult to tolerate, and don’t discontinue meds suddenly. You might also ask what to expect as a sign that the medication is working well, such as what symptoms will be reduced and how long it might take to see improvement. You should also let your care team know if you experience new or worsening symptoms.
10. Identify What Triggers You
Common triggers for symptoms of mania and depression include:
- stressful events
- sleep loss
- changes in season
Each of these situations can cause physiological changes, affecting emotional functioning. When these types of triggers are unavoidable, becoming aware of the increased risk of symptoms allows you to apply healthy coping mechanisms as soon as possible.
11. Practice Stress Management Skills
Many stress management skills exist, including relaxation exercises and practicing gratitude. Exercise is an excellent stress management skill and may be as simple as walking, particularly if you can walk outdoors.
12. Spend More Time Enjoying Nature
Research shows that spending more time in nature improves mental health and boosts mood. Even 15 minutes daily near plants, trees, or flowers has been associated with a better mood and clearer focus.6 Symptoms of anxiety, depression symptoms, and mood disorders have improved after exposure to the natural environment.
13. Practice Rhythmic Breathing
Breathing that is rhythmic and smooth has been shown to reduce blood pressure and feelings of stress and anxiety.7 Various breathwork exercises, including pursed lip, belly, and box breathing.
14. Set Boundaries for What You Will Do & Not Do
Knowing your limits and setting boundaries is another critical way to manage stress. Too many commitments can overwhelm you, creating toxic stress and sleep disruption. Learning and practicing assertiveness and communication skills may be part of setting boundaries and protecting your mental health.
15. Keep a Diary of Your Progress
Many people with bipolar find it helpful to keep a daily journal monitoring well-being, such as:
- Quality of sleep
- Level of energy
One tool for self-monitoring of symptoms of depression is the Patient Health Questionnaire (PHQ-9).8 This tool should not be used as a substitute for assessment by a mental health professional but only as a self-monitoring tool.
16. Find a Support Group
A support group can help get practical tips for living with bipolar as well as gain a sense of hope and optimism. Bipolar support groups are available online or in person and are known not only for the person with bipolar but also for their parents and families. The Depression and Bipolar Support Alliance (DBSA) is an excellent source for locating a Bipolar support group.9
17. Plan Ahead for Certain Situations
Certain situations might require more advanced planning for those with Bipolar due to the importance of regular sleep and consistent use of medication. Travel can be challenging when it involves long delays or changes in time zones. Try to plan your journey at less busy times of day and consider bringing extra medication in case of a last-minute change in plans occurs.
18. Practice Self-Compassion
Self-compassion involves acknowledging when you’re in a difficult situation and feeling overwhelmed. It also consists in using self-statements to calm and self-soothe yourself. For example, you might remind yourself that you’re not alone and that there are people who care about you. Sometimes, self-compassion means doing something to change your mindset, such as taking a walk or listening to music.
How Therapy Can Help
Regular meetings with a mental health professional are integral to managing bipolar disorder. Mood-stabilizing medications and a comprehensive psychotherapy approach are critical for coping with bipolar disorder. Therapy can help individuals with bipolar regulate their mood, change harmful ways of thinking, and improve relationships. You might ask your physician for a referral to a qualified therapist, or you might use an online therapist directory.
Bipolar disorder is very challenging, but there are effective ways to live well despite the difficulties. Coping with bipolar involves individual therapy, medication, family support, and self-help. These self-help tips for how to deal with Bipolar provide a full range of healthy coping strategies that you can use at any point in your mood cycles. When you find one that works, stick with it; if symptoms change, have more coping skills at your disposal to change with it.