Bipolar Management
You Have the Power to Change
Whether you are newly diagnosed with a mood disorder or have been managing depression or bipolar illness (also known as manic depression) for years, you can benefit from a healthy lifestyle. While you cannot change your diagnosis, you can change aspects of your life to manage or lessen your symptoms and improve the quality of your life.
When you were first diagnosed with a mood disorder, you may have felt powerless or afraid. This brochure will suggest ways to empower yourself and play an active role in the way you live day-to-day with your illness. Regular appointments with your health care provider and attendance at DBSA support group meetings, in addition to the suggestions outlined here, can put a healthy lifestyle within your reach.
This web page was developed from a survey of DBSA support group members people living with a mood disorder just like you as a resource on the lifestyle issues they said were of greatest concern. Add a few ideas of your own, or ask for suggestions from your doctor or DBSA support group. Use the checklist found at the end of this brochure to periodically evaluate your lifestyle. Many of the suggestions detailed here may become habits after a period of time, and healthy habits help build a healthy life.
Reducing Stress
Stress can cause or worsen symptoms of mania or depression. It is important to learn what causes your stress, ways to identify and deal with stressors and ways to minimize your overall day-to-day stress level. Stress may be caused by a variety of factors, both external and internal some of which you may not be aware of. Repeated or constant stress can lead to tension, chronic pain, anxiety and an inability to enjoy life. With the right treatment and therapy, you can learn to anticipate and deal with stress, and with support, you can work on breaking out of stressful patterns or situations.
Recognizing and Handling Causes of Stress
Learn how to recognize causes of stress, or “triggers,” such as difficult people, financial matters, noise, lack of time or high pressure situations. Review your daily activities periodically in search of triggers you may not be aware of look for patterns in your symptoms and stress levels. You may want to discuss your stressors with your doctor or therapist.
Keeping a journal of the time of day and what you were doing when you felt stress can be helpful. Many people have also found a mood calendar to be a great help. DBSA offers a Personal Calendar to track symptoms of mania and depression, mood swings, medications taken and co-existing symptoms. Contact DBSA for more information.
Whenever possible, develop ways to control when and where you deal with stressful situations or people, choosing times when you are as calm and rested as possible.
Develop ways to prepare yourself for stressors that can’t be avoided, such as talking with a trusted friend before dealing with a stressful situation, setting aside time to be alone after stressful incidents or taking a break during the day for a brief rest or meditation.
Canceling or postponing a stressful encounter if you are not feeling well is a legitimate way of taking care of yourself.
Communication
Arrange to have a supportive “buddy” (possibly someone from your DBSA group) and set aside time to talk to one another about stressful issues and offer support and guidance.
When things are troubling you, talk about them with a trusted friend (your “buddy” or another good friend), family member or health care provider before stress builds up and leads to a crisis.
If you are not ready to talk about a troubling issue, write down your feelings and thoughts in a journal or on paper you throw away. Writing can be a good release, and reading your journal entries over a period of time can give you some insights into some of your thought, feeling or behavior patterns.
It may be easier for you to express yourself through music, art or other creative activities. It is not necessary for you to worry about the quality of your work or share it with anyone when you are finished.
Relaxation
Allow yourself to relax and set aside time for relaxation. Make a commitment to spend some time relaxing at the same time each day or week. Write it on your schedule or calendar if you need to be reminded.
Experiment with different relaxation methods until you find the one that is right for you. Some methods that have worked for others include:
-
Walking
-
Listening to music
-
Light exercise such as dancing or bicycling
-
Breathing, muscle tension or visualization exercises. These involve taking deep breaths and concentrating on your breathing; or tensing, then relaxing muscle groups one by one, from toes to head; or visualizing a calm, safe, stress-free place. Ask a therapist for suggestions or instructions.
-
Meditation or yoga
-
Music
-
Art
Spend some time using your relaxation techniques immediately before or after stressful events.
Don’t use alcohol or illegal drugs to cope with stress.
Other Stressors
Evaluateyour money management and ask yourself if it could be contributing to your stress level. Learn ways you can get out of debt. Consider budgeting: calculate the money you need for fixed monthly expenses such as rent/mortgage, utilities, transportation and food, and try to set aside money for these things before the bills are due.
Evaluate your time management and ask yourself if it could be contributing to your stress level. Consider keeping a personal planner or calendar. Leave notes for yourself as extra reminders of important tasks, phone calls or appointments.
Remember to set aside time in your schedule to relax.
Set realistic expectations for yourself. No one can “do it all.” Perfection is impossible, yet many people believe they must be perfect and put themselves under stress trying to achieve perfection. Work on accepting yourself as you are and not punishing yourself for your mistakes. Concentrate on being satisfied with your accomplishments rather than feeling inadequate because of things you have not done. Break large tasks down into small, manageable steps.
Physical Well-Being
Healthy sleeping, eating and physical activity habits do not have to be complicated, depriving or uncomfortable, and can make a big difference in the way you feel. Many people have found that simple changes such as eliminating caffeine or taking walks regularly have helped stabilize their moods. Though symptoms of your mood disorder may disrupt sleeping, eating or physical activity, making things as consistent as possible, especially sleeping, can help keep your symptoms from worsening. Regular habits can also help you spot the beginning of a manic or depressive episode more quickly.
Sleep
Lack of sleep or too much sleep can worsen moods. Keep a regular sleep schedule whenever possible. Set an alarm if necessary, and try to get up at the same time every morning, even on weekends, and go to sleep around the same time every night. If you tend to have insomnia, try avoiding naps during the day, since they can interfere with nighttime sleep.
Adopt bedtime rituals or ways that you can slowly wind down from your day and ease yourself into bed. Try using relaxation exercises to get to sleep.
Avoid over-the-counter sleep medicines, unless your doctor has recommended them and is monitoring your use of them.
Avoid caffeine, especially near the end of the day. Check ingredients certain sodas and teas can contain as much caffeine as a cup of coffee. Large meals may keep you awake; light snacks may help you sleep (milk and turkey are often helpful).
Changing the time of day you take your medication may help you sleep. Discuss your medication, its side effects, dosage and time of day taken with your doctor.
If at all possible, avoid late evening or overnight shift work. If you must work a late shift, try to work the same hours every night, so you are asleep at the same time, for the same amount of time each day.
If you wake up early in the morning and are unable to get back to sleep, it may be helpful to get out of bed and do a quiet activity like reading.
If you find yourself needing significantly more or less sleep than usual, you may be experiencing symptoms of depression or mania. Be aware of any changes in your sleep patterns and discuss them with your doctor or mental health professional.
See also: Sleepless In America
Eating Right
Eat a variety of foods daily to get the energy, protein, vitamins, minerals and fiber you need. Include plenty of vegetables and fruits (preferably raw) and whole grains.
Moderate your intake of fat, cholesterol, sugars and salt.
Drink at least 8 glasses (64 oz.) of water per day, more if you exercise. If you are taking certain types of medication, you may require even more water. Check with your doctor or pharmacist.
Moderate your intake of alcohol and caffeine, or better yet, avoid them completely.
Avoid crash diets that deprive you of food, or of one or more food groups. Instead of radical diets, use a combination of regular physical activity and smaller portions at mealtimes if you are concerned about your weight.
Be aware of changes in your appetite. Loss of appetite or overeating may be symptoms of depression. Discuss any changes with your doctor.
Don’t skip meals, even if your energy and appetite are low.
If you tend to overeat, look for stressors or triggers that may cause overeating. Discuss ways to avoid or cope with these triggers with your doctor or therapist. It may be useful to write down how you are feeling or what has been happening at the time you overeat to help determine your triggers.
Have food on hand that is healthy, quick and easy to eat, such as fresh fruit, yogurt, whole grain bread, crackers or bagels for times when you are in a hurry or don’t feel like preparing a meal. Try to schedule regular grocery shopping trips so you don’t have to eat fast food or junk food just because you are hungry.
Exercise
Choose a method of physical activity that you enjoy one that will not feel like a chore. You may want to choose several activities so you have variety.
Focus on making the experience as pleasant as possible. For example, if you feel self-conscious exercising in a gym or outdoors, begin by exercising at home. If you feel you need extra motivation or company, try exercising with a friend or family member.
Consult your doctor before beginning any exercise regimen. Do not choose a method of exercise that puts your health at risk. Consider all of the medications you are taking and be sure that factors such as increased heart rate and sweating will not cause problems with your medication. You may need to take special precautions when you exercise, such as drinking extra water.
Start slowly and work up to a healthy frequency. Pace yourself so you don’t run out of energy and become discouraged early.
Don’t ignore your own physical limitations or exercise to the point of pain.
A good exercise goal to work toward is 30 minutes a day, 3 times per week.
Work more physical activity into your daily routine. Take the stairs instead of the elevator, get off the bus before your stop and walk an extra block or park at the far end of the parking lot.
Treatment
A good treatment plan is the foundation of a healthy lifestyle. Though it may take time to adjust to medication and therapy, they are your best defenses against symptom recurrence. Everyone has a different physical and emotional makeup, so it often takes time and patience for you and your doctor or mental health professional to find the right treatment strategy for you. It is most important that you communicate your needs to your health care providers and work with them to discover the best possible approach to symptom management. Your loved ones can play an important role in your treatment plan, too. You can help them to help you by making them aware of your medication needs and having them watch for signs of symptom recurrence.
Your Health Care Provider
Talk with your doctor about your medication and any side effects you may be experiencing. It may be helpful to write down your questions and bring your list with you to your appointment. Take notes on what your doctor tells you.
If you have trouble talking about particular concerns, you may want to bring a trusted friend or family member to the appointment with you or request that your appointment begin in the doctor’s office rather than the examination room. If you need extra time to discuss particular concerns, let the doctor’s office know when you make your appointment. If questions arise after your appointment and your doctor is unable to speak with you, see if a nurse is available to address your concerns.
If you are dissatisfied with your health care provider or the treatment plan you have been given, talk with him or her about it. If your difficulties cannot be resolved, seek another health care provider. For interpersonal or “talk” therapy, choose a therapist who treats you with respect, listens to you, recognizes your needs and is skilled in treating people with mood disorders.
Medication
Learn the facts about medication from your doctor, pharmacist or DBSA. Ask your doctor or pharmacist to give you the detailed written materials that are packaged with your medication. DBSA also publishes several brochures describing the various treatment options. Know what side effects to expect and what to do if these side effects interfere with your daily activities. Talk to your doctor about ways to minimize any uncomfortable side effects. If you have particularly troublesome side effects, see if other treatment plans are available.
Never stop taking medication or alter your dosage without talking to your doctor first. Never augment your medication with herbal or over-the-counter remedies without first checking with your doctor.
Know what time(s) of day to take your medication(s) and take them at the same time every day. If you have trouble remembering, use a wristwatch with an alarm or place a reminder note in a highly visible place.
Find out if there are any specific foods or activities you need to avoid. Some medications may reach high levels in the body if you become dehydrated or sweat excessively. Others may react with certain foods or alcohol or cause you to be sensitive to sun or light.
|
