A large part of self-care in bipolar disorder is recognizing and avoiding activities or circumstances that can trigger mood episodes. However, some of these situations are unavoidable. Life happens. When stressors occur without warning and the person with bipolar disorder cannot distance themselves, the next priority becomes self-care in order to help minimize the likelihood of triggering an episode or to help the person cope with an emerging episode.
- Stressful life events
- Chronic stress
- Changing sleep & eating patterns
- Changes in routine
- Season changes
- Medication changes
These are not the only triggers. Any situation that creates an abnormal amount of stress can act as a trigger. This stress can be rational or irrational and positive or negative. The higher amount of stress, the more likely it will cause a period of either mania or depression.
Sometimes triggers can be avoided. This is easier to do in a day-to-day routine. However, life does not revolve around bipolar disorder and sometimes we find ourselves in situations beyond our control. These circumstances can be positive or negative, for example, marriage, having a child, traveling for fun, the death of a loved one, ending a relationship or losing a job.
Here are some ways to take care of yourself during trying times:
Around 20% of people with bipolar disorder also have panic disorder. Fifty percent of people with bipolar disorder have other anxiety disorders. When anxiety-invoking events occur, it’s easy to get wrapped up in and consumed by them.
To try to avoid this, find a quiet place to avoid over-stimulation. Then practice calming techniques like holding an ice cube in your hand, practicing positive self-talk or using the 5-4-3-2-1 Method (List Find 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste.)
Mindfulness is all about acceptance- acceptance of the situation, acceptance of emotions and acceptance of the self. When practicing mindfulness, there is no right or wrong. There is no judgement, only facts. In mindfulness, you take the time to notice everything inside and around you. How do you feel? What are your physical surroundings like? What is the situation? Take these answers to help inform what your next move should be.
Create a New Routine
The situation in which a trigger may occur may not require a change of routine. It may just require returning to a previous lifestyle. Other life events may require new routines. Some may be temporary and some permanent. A temporary new routine may be applicable when traveling, for example. A permanent new routine may need to be established after a life-changing event. In either case, create and write down your new routine. Make sure to include the following:
- Regular and plentiful sleep
- When to eat and how much
- Medication (set an alarm)
Not all stressful situations will cause a relapse and relapses can happen without cause. It’s important to take care of yourself all the same. Do what you can to manage the situation, including calling your doctor.
Image credit: Benjamin Watson