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Bipolar Disorder: Signs, Symptoms, and Causes of Manic Depression

Although bipolar disorder tends to be a lifelong, recurrent illness, you’re not powerless. There are many things you can do to help yourself. Beyond treatment you get from your doctor or therapist or the medication you take, self-help techniques and simple lifestyle changes can help you manage your moods and stay balanced. With good coping skills and a solid support system, you can live fully and productively and keep the symptoms of bipolar disorder in check.

Living with bipolar disorder: What you can do to help yourself

Living well with bipolar disorder requires certain adjustments. Like recovering alcoholics who avoid drinking or diabetics who take insulin, if you have bipolar disorder, it’s important to make healthy choices for yourself. Making these healthy choices will help you keep your symptoms under control, minimize mood episodes, and take control of your life.

Managing bipolar disorder starts with proper treatment, including medication and therapy. But there is so much more you can do to help yourself on a day-to-day basis. The daily decisions you make influence the course of your illness: whether your symptoms get better or worse; whether you stay well or experience a relapse; and how quickly you rebound from a mood episode.

Bipolar Disorder: Key Recovery Concepts

  • Hope. With good symptom management, it is possible to experience long periods of wellness. Believing that you can cope with your mood disorder is both accurate and essential to recovery.
  • Perspective. Depression and manic-depression often follow cyclical patterns. Although you may go through some painful times and it may be difficult to believe things will get better, it is important not to give up hope.
  • Personal Responsibility. It’s up to you to take action to keep your moods stabilized. This includes asking for help from others when you need it, taking your medication as prescribed and keeping appointments with your health care providers.
  • Self-Advocacy. Become an effective advocate for yourself so you can get the services and treatment you need, and make the life you want for yourself.
  • Education. Learn all you can about your illness. This allows you to make informed decisions about all aspects of your life and treatment.
  • Support. Working toward wellness is up to you. However, support from others is essential to maintaining your stability and enhancing the quality of your life.

Source: Depression and Bipolar Support Alliance

Bipolar disorder support tip #1: Get involved in your treatment

Be a full and active participant in your own treatment. Learn everything you can about bipolar disorder. Become an expert on the illness. Study up on the symptoms, so you can recognize them in yourself, and research all your available treatment options. The more informed you are, the better prepared you’ll be to deal with symptoms and make good choices for yourself.

Using what you’ve learned about bipolar disorder, collaborate with your doctor or therapist in the treatment planning process. Don’t be afraid to voice your opinions or questions. The most beneficial relationships between patient and healthcare provider work as a partnership. You may find it helpful to draw up a treatment contract outlining the goals you and your provider have agreed upon.

Other tips for successful bipolar disorder treatment:

  • Be patient. Don’t expect an immediate and total cure. Have patience with the treatment process. It can take time to find the right program that works for you.
  • Communicate with your treatment provider. Your treatment program will change over time, so keep in close contact with your doctor or therapist. Talk to your provider if your condition or needs change and be honest about your symptoms and any medication side effects.
  • Take your medication as instructed. If you’re taking medication, follow all instructions and take it faithfully. Don’t skip or change your dose without first talking with your doctor.
  • Get therapy. While medication may be able to manage some of the symptoms of bipolar disorder, therapy teaches you skills you can use in all areas of your life. Therapy can help you learn how to deal with your disorder, cope with problems, regulate your mood, change the way you think, and improve your relationships.

Bipolar disorder support tip #2: Monitor your symptoms and moods

In order to stay well, it’s important to be closely attuned to the way you feel. By the time obvious symptoms of mania or depression appear, it is often too late to intercept the mood swing, so keep a close watch for subtle changes in your mood, sleeping patterns, energy level, and thoughts. If you catch the problem early and act swiftly, you may be able to prevent a minor mood change from turning into a full-blown episode of mania or depression.

Know your triggers and early warning signs—and watch for them

It’s important to recognize the warning signs of an oncoming manic or depressive episode. Make a list of early symptoms that preceded your previous mood episodes. Also try to identify the triggers, or outside influences, that have led to mania or depression in the past. Common triggers include:

  • stress
  • financial difficulties
  • arguments with your loved ones
  • problems at school or work
  • seasonal changes
  • lack of sleep

Common Red Flags for Bipolar Disorder Relapse

Warning signs of depression

  • I quit cooking meals.
  • I no longer want to be around people.
  • I crave chocolate.
  • I start having headaches.
  • I don’t care about anybody else.
  • People bother me.
  • I start needing more sleep, including naps during the day.

Warning signs of mania or hypomania

  • I find myself reading five books at once.
  • I can’t concentrate.
  • I find myself talking faster than usual.
  • I feel irritable.
  • I’m hungry all the time.
  • Friends tell me that I’m crabby.
  • I need to move around because I have more energy than usual.

Source: BHI Clinicians Guidebook: Bipolar Spectrum Disorders

Knowing your early warning signs and triggers won’t do you much good if you aren’t keeping close tabs on how you’re feeling. By checking in with yourself through regular mood monitoring, you can be sure that red flags don’t get lost in the shuffle of your busy, daily life.

Keeping a mood chart is one way to monitor your symptoms and moods. A mood chart is a daily log of your emotional state and other symptoms you’re having. It can also include information such as how many hours of sleep you’re getting, your weight, medications you’re taking, and any alcohol or drug use. You can use your mood chart to spot patterns and indicators of trouble ahead.

Develop a wellness toolbox

If you spot any warning signs of mania or depression, it’s important to act swiftly. In such times, it’s helpful to have a wellness toolbox to draw from. A wellness toolbox consists of coping skills and activities you can do to maintain a stable mood or to get better when you’re feeling “off.”

The coping techniques that work best will be unique to your situation, symptoms, and preferences. It takes experimentation and time to find a winning strategy. However, many people with bipolar disorder have found the following tools to be helpful in reducing symptoms and maintaining wellness:

  • talk to a supportive person
  • get a full eight hours of sleep
  • cut back on your activities
  • attend a support group
  • call your doctor or therapist
  • do something fun or creative
  • take time for yourself to relax and unwind
  • write in your journal
  • exercise
  • ask for extra help from loved ones
  • cut back on sugar, alcohol, and caffeine
  • increase your exposure to light
  • increase or decrease the stimulation in your environment

Create an emergency action plan

Despite your best efforts, there may be times when you experience a relapse into full-blown mania or severe depression. In crisis situations where your safety is at stake, your loved ones or doctor may have to take charge of your care. Such times can leave you feeling helpless and out of control, but having a crisis plan in place allows you to maintain some degree of responsibility for your own treatment.

A plan of action typically includes:

  • A list of emergency contacts (your doctor, therapist, close family members)
  • A list of all medications you are taking, including dosage information
  • Information about any other health problems you have
  • Symptoms that indicate you need others to take responsibility for your care
  • Treatment preferences (who you want to care for you; what treatments and medications do and do not work, who is authorized to make decisions on your behalf)

Bipolar disorder support tip #3: Reach out to other people

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Having a strong support system is vital to staying happy and healthy. Often, simply having someone to talk to face to face can be an enormous help in relieving bipolar depression and boosting your outlook and motivation. The people you turn to don’t have to be able to “fix” you; they just have to be good listeners.

  • Turn to friends and family – Support for bipolar disorder starts close to home. It’s important to have people you can count on to help you through rough times. Isolation and loneliness can cause depression, so regular contact with supportive friends and family members is therapeutic in itself. Reaching out to others is not a sign of weakness and it won’t make you a burden. Your loved ones care about you and want to help.
  • Join a bipolar disorder support group – Spending time with people who know what you’re going through and can honestly say they’ve “been there” can be very therapeutic. You can also benefit from the shared experiences and advice of the group members. To find a support group in your area, see Resources section below.
  • Build new relationships – Isolation and loneliness make bipolar disorder worse. If you don’t have a support network you can count on, take steps to develop new relationships. Try taking a class, joining a church or a civic group, volunteering, or attending events in your community.

10 tips for reaching out and building relationships

  1. Talk to one person about your feelings.
  2. Help someone else by volunteering.
  3. Have lunch or coffee with a friend.
  4. Ask a loved one to check in with you regularly.
  5. Accompany someone to the movies, a concert, or a small get-together.
  1. Call or email an old friend.
  2. Go for a walk with a workout buddy.
  3. Schedule a weekly dinner date
  4. Meet new people by taking a class or joining a club.
  5. Confide in a counselor, therapist, or clergy member.

Bipolar disorder support tip #4: Develop a daily routine

Your lifestyle choices, including your sleeping, eating, and exercise patterns, have a significant impact on your moods. There are many things you can do in your daily life to get your symptoms under control and to keep depression and mania at bay.

  • Build structure into your life. Developing and sticking to a daily schedule can help stabilize the mood swings of bipolar disorder. Include set times for sleeping, eating, socializing, exercising, working, and relaxing. Try to maintain a regular pattern of activity, even through emotional ups and downs.
  • Exercise regularly. Exercise has a beneficial impact on mood and may reduce the number of bipolar episodes you experience. Aerobic exercise is especially effective at treating depression. Try to incorporate at least 30 minutes of activity five times a week into your routine. Walking is a good choice for people of all fitness levels.
  • Keep a strict sleep schedule. Getting too little sleep can trigger mania, so it’s important to get plenty of rest. For some people, losing even a few hours can cause problems. However, too much sleep can also worsen your mood. The best advice is to maintain a consistent sleep schedule.

Healthy sleep habits for managing bipolar disorder

  • Go to bed and wake up at the same time each day.
  • Avoid or minimize napping, especially if it interferes with your sleep at night.
  • Avoid exercising or doing other stimulating activities late in the day.
  • No caffeine after lunch or alcohol at night. Both interfere with sleep.

Bipolar disorder support tip #5: Keep stress to a minimum

Stress can trigger episodes of mania and depression in people with bipolar disorder, so keeping it under control is extremely important. Know your limits, both at home and at work or school. Don’t take on more than you can handle and take time to yourself if you’re feeling overwhelmed.

  • Learn how to relax. Relaxation techniques such as deep breathing, meditation, yoga, and guided imagery can be very effective at reducing stress and keeping you on an even keel. A daily relaxation practice of 30 minutes or more can improve your mood and keep depression at bay.
  • Make leisure time a priority. Do things for no other reason than that it feels good to do them. Go to a funny movie, take a walk on the beach, listen to music, read a good book, or talk to a friend. Doing things just because they are fun is no indulgence. Play is an emotional and mental health necessity.
  • Appeal to your senses. Stay calm and energized by appealing to your senses: sight, sound, touch, smell, and taste. Listen to music that lifts your mood, place flowers where you will see and smell them, massage your hands and feet, or sip a warm drink.

Bipolar disorder support tip #6: Watch what you put in your body

From the food you eat to the vitamins and drugs you take, the substances you put in your body have an impact on the symptoms of bipolar disorder—both for better or worse.

  • Eat a healthy diet. There is an undeniable link between food and mood. For optimal mood, eat plenty of fresh fruits, vegetables, and whole grains and limit your fat and sugar intake. Space your meals out through the day, so your blood sugar never dips too low. High-carbohydrate diets can cause mood crashes, so they should also be avoided. Other mood-damaging foods include chocolate, caffeine, and processed foods.
  • Get your omega-3s. Omega-3 fatty acids may decrease mood swings in bipolar disorder. Omega-3 is available as a nutritional supplement. You can also increase your intake of omega-3 by eating cold-water fish such as salmon, halibut, and sardines, soybeans, flaxseeds, canola oil, pumpkin seeds, and walnuts.
  • Avoid alcohol and drugs. Drugs such as cocaine, ecstasy, and amphetamines can trigger mania, while alcohol and tranquilizers can trigger depression. Even moderate social drinking can upset your emotional balance. Substance use also interferes with sleep and may cause dangerous interactions with your medications. Attempts to self-medicate or numb your symptoms with drugs and alcohol only create more problems.
  • Be cautious when taking any medication. Certain prescription and over-the-counter medications can be problematic for people with bipolar disorder. Be especially careful with antidepressant drugs, which can trigger mania. Other drugs that can cause mania include over-the-counter cold medicine, appetite suppressants, caffeine, corticosteroids, and thyroid medication.
Bring Your Life Into Balance

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Resources & References

Helpguide’s Yellow Pages
Resources for public assistance, social services, and other health and human services.

Living and coping with bipolar disorder

Dealing Effectively with Depression and Manic-Depression – Covers key recovery concepts and strategies, such as mood and symptom monitoring and crisis planning. (Depression and Bipolar Support Alliance)

Bipolar Affective Disorder: A Guide to Recovery (Powerpoint Presentation) – Online booklet covers bipolar disorder, treatment strategies, what to do when drug therapy fails, and coping skills. (The Organization for Bipolar Affective Disorders)

Bipolar Disorder: Stories of Coping and Courage – Read the personal stories of real people dealing with bipolar disorder. Includes each individual’s experience of what helps them feel better. (Depression and Bipolar Support Alliance)

Taking charge of bipolar disorder recovery

Keeping Your Balance – Australian government sponsored site offers a self-help series on managing bipolar disorder. Includes cognitive and behavioral strategies for managing and preventing mania and depression. (Centre for Clinical Interventions)

Working Toward Wellness – Online workbook you can use to track your treatment and progress. Includes sections on identifying triggers, dealing with drug side effects, and tracking your moods. (Depression and Bipolar Support Alliance)

Wellness Toolbox – Take charge of your treatment with wellness tools such as a symptom management worksheet, medication information charts, and a personal wellness checklist. (Depression and Bipolar Support Alliance)

Bipolar disorder mood and symptom monitoring

Self-Monitoring for Relapse Prevention (PDF) – Patient workbook with strategies for monitoring your moods and spotting signs of relapse. (Centre for Clinical Interventions, Western Australia Department of Health)

Healthy lifestyle choices for bipolar disorder

Healthy Lifestyles: Improving and Maintaining the Quality of your Life – Advice on improving the quality of your life through healthy lifestyle modifications such as eating right and exercising. (Depression and Bipolar Support Alliance)

Bipolar disorder support groups in the U.S.

About Support Groups and Chapters – Learn about DBSA (Depression and Bipolar Support Alliance) support groups and how they can help. Includes a Support Group Locator. (Depression and Bipolar Support Alliance)

Find a Support Group – Search for a support group for children and adolescents with bipolar disorder. (Child & Adolescent Bipolar Foundation)

Bipolar disorder support groups worldwide

Support Groups Outside the U.S. – Search for bipolar disorder support groups located outside the United States. (Depression and Bipolar Support Alliance)

Self-Help Groups in the UK (MDF The Bipolar Organisation)

Advocacy Support Groups in Australia (Bipolar Disorder)

Finding Help in Canada (Mood Disorders Society of Canada)

Authors: Melinda Smith, M.A., Jeanne Segal, Ph.D., and Robert Segal, M.A. Last updated: April 2014.

©Helpguide.org. All rights reserved. This reprint is for information only and NOT a substitute for professional diagnosis and treatment. Helpguide.org is an ad-free non-profit resource for supporting better mental health and lifestyle choices for adults and children.

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