Coping techniques: Bipolar disorder

Please note that you should always consult with your physician before making any changes in your diet, your level of exercise and activity, medication or behaviors related to substance use.

The best way to make use of these techniques is to read through them, select three that stand out to you and practice them. I would be glad to hear from you on your responses.

  1. Consider consulting with your physician about medication. Currently medication is considered a key component of the most successful protocol for dealing effectively with bipolar disorder. It can be important to let your physician know that you experience mood swings—a hypomanic or manic component—rather than simple depression.
  2. If you notice that you feel a resistance to taking medication, consider if that might be because you don’t want to lose the hypomanic or manic parts of your cycle. Do you think of these as the reward for enduring the depressive periods?
  3. If you’d rather not take prescribed medication, but do feel comfortable self-medicating with alcohol or drugs, why do you think this might be?
  4. Increase your knowledge, comfort and sense of mastery by reading up on bipolar disorder (self-help books, text books, autobiographies). Suggest to the important people in your life that they increase their knowledge as well.
  5. Towards that end, here are some books that I’ve found to be very helpful. If you prefer reading a text written in clinical terms: Brock, K. (2014). Living with Bipolar Disorder: A Handbook for Patients and Their Families. McFarland and Company: Jefferson, NC. If you like reading texts written by a smart, funny and irreverent young author: Smith, H. (2010). Welcome to the Jungle: Everything You Ever Wanted to know About Bipolar but Were Too Freaked Out to Ask. Red Wheel/Weiser: San Francisco. And if you’re looking for a good workbook with explicit instructions on how to manage your symptoms: Sylvia, L. (2015). The Wellness Workbook for Bipolar Disorder. New Harbinger Publications: Oakland, CA.
  6. Reach out to the people in your life and let them know what you’re going through. Recommend books to them that you’ve found helpful, in order to increase their knowledge and ability to be of appropriate support.
  7. Establish and maintain a regular schedule, including bedtime and getting up time. Therefore consider using a daily scheduler. While regular sleep appears to be one of the greatest predictors of maintaining baseline mood, maintaining stable day-to-day activity is also useful.
  8. Therefore, be aware of changes in your schedule and how you respond to them. Changes can include noticing the beginning of a new season, or moving to a new home, starting a new relationship or ending an old one. They can also be personal anniversaries such as weddings or the death of a loved one.
  9. Notice if you’re beginning to increase your number of activities. Consider decreasing them, if possible. Some things need to be accomplished, such as going to work or taking children to school. But other activities are optional.
  10. Avoid doing things that require you to switch back and forth between tasks, or to multitask. Do one thing at a time. Keep things simple.
  11. Reduce your levels of stimulation. Avoid loud crowded environments. If you need to take the freeway, listen to soothing music on the radio or have some CDs available.
  12. Avoid people who are likely to involve you in risky behaviors.
  13. Before making any important decisions or taking action on a plan, including major purchases or changes in career or relationship, wait two days. Don’t act on the spur of the moment or in the throes of sudden inspiration.
  14. If you need to make a decision, consult with two people whom you trust before making it.
  15. Consider letting a trusted friend or family member have charge of your credit or ATM cards.
  16. For online activities consider having a trusted friend or family member set passcodes for you.
  17. Make a list of triggers for mood changes.
  18. In order to decrease the sense of unpredictability keep a journal of your moods and review it once a week in order to become more familiar with triggers, warning signs and the perceptions, thoughts and feelings that indicate a depressive or (sometimes more difficult to recognize as problematic) manic or hypomanic moods. Keep track of what you eat, medications you take, amount of sleep you get as well. Note your menstrual cycle and how it impacts mood. Knowledge is power. Maintain a mood chart.
  19. Many people make and consult a wellness plan for themselves. This can include a section on how you function on your best days, which can act as a potent reminder of hope during rough periods. It can also include warning signs for mood change, so that you’re able to take steps to decrease the severity of the mood.
  20. Maintain a daily exercise program. In the advent of a manic mood, consider substituting practices such as yoga for more strenuous forms of exercise.
  21. Consider decreasing use of alcohol and recreational substances.
  22. Remind yourself that your mood may be a symptom, that even if it’s powerful it’s not something you have to act on. Remind yourself not to make important decisions in the presence of intense moods.
  23. That said, allow yourself to observe the mood rather than try to push it away. You don’t need to act on it, but acceptance can be a step towards mastery.