There are four basic keys to maintaing mood stability:
- sleep 8 hrs nightly: This is part of maintaining a healthy social rhythm. Erratic sleep-wake patterns exacerbate bipolar disorder tremendously.
- minimize stress through lifestyle changes
- exercise regularly
- participate in cognitive behavioral therapy : This is an important way to avoid the cognitive distortions that can lead to the ups and the downs. It is also an important way to monitor and gain feedback that mood is becoming unstable.
Invest in loving, trusting relationships.
One of the things that happens with bipolar disorderis that when a person with bipolar disorder starts to feel hypomanic that they lose insight about their illness. They are not aware that symptoms of illness are beginning to appear. In part, this is because being hypomanic feels good! If a person with bipolar disorder has trusting and loving relationships with others, they may be more willing to hear from them that their mood is destabilizing. The earlier the symptoms are identified, the less severe they are, and the less havoc they can wreak!
The people a person with bipolar disorder trusts can sit down with them and help them identify specific signs that may help to identify mania. Examples could be developing several new plans for activities at or after work or sleeping fewer hours and feeling good about it, or even believing that medication is no longer necessary.
Better still is if this person can provide your physician with specific examples, either in writing or by coming with you to your appointment, so that your physician will gain an understanding of where you are at.
Track your mood.
Aside from depending on those you trust, another important tool for staying better is to track your moods. There are several mood trackers, either electronic or paper. These may include recording how many hours you’ve slept, recording a number on a scale to determine how up or down your mood is, and identifying any reasons or stressors that may be contributing to a change in your mood, and how fast you feel your thoughts are moving (crawling, walking, running, driving, flying, for example). Women may also wish to record their menstrual cycles, since mood is often related to this.
Develop a plan to manage days that feel overwhelming, anxiety-provoking, and stressful.
It can be helpful to have a plan to help avoid a downward spiral, or to avoid past more maladptive decisions (such as self-medicating with substances, or attempting to seek rapid gratification (such as with sex, shopping, or gambling)
Some people do well with a short-term treatment of their anxiety with a benzodiazepine–but with a history of substane abuse this may not be an appropriate plan!
Some people may choose to work out longer, or contact their pastor for prayer, or phone a friend who is understanding.