After a month or more of stay-at-home orders — with daily onslaughts of news about the coronavirus pandemic and the fraying economy — almost everyone is reaching new levels of frustration, fear, and grief. With no clear endpoint or idea of what comes next, uncertainty is becoming a constant in our lives, which drains a lot of personal bandwidth. “Not knowing” keeps our nervous systems on high alert. Fear of the unknown is a built-in survival instinct — but one that’s built for instant challenges like a bear in the bushes, not for the 24/7 news cycle. Chronic elevation of our alert system is exhausting, and it’s often running in the background, so we don’t even realize what’s making us so tired and cranky.
The current level of disruption and uncertainty puts particular kinds of pressure on the nervous systems of people living with bipolar disorder. It also turns carefully crafted life skills strategies upside down. Living with bipolar disorder, managing it, usually focuses on maintaining some degree of predictability. But routines and rhythms have unraveled, and social distancing and staying at home all the time run counter to many of the recommended day-to-day interventions for managing bipolar symptoms.
So, what options are available? What can be done to mitigate the risks during these unprecedented times? You’ll find so many recommendations and ideas that they can begin to feel overwhelming and seem like “more of the same.” Living with bipolar, you already have some ideas about skills and strategies for mental health, such as mindfulness and routines, but they’re harder to do now.
What I recommend is to keep it simple. In this post, I present four simple strategies for managing bipolar disorder when the stay-at-home orders disrupt your routines.
First: Be kind to yourself.
Over the last couple of months, I have repeated one sentence over and over to myself, my family, my patients, and my friends: “Be kind to yourself, no matter what.”
Self-compassion — kind words to yourself — helps save bandwidth and keeps you a step away from a negative spiral. It’s a powerful tool.
So if you feel like you can’t get anything done — if you can’t follow routines, if you are sleeping too little or too much, if you are irritable, if you hide from phone calls, if you eat comfort food all day, if you cry a lot, or whatever you feel like you are doing wrong that you’re beating yourself up for — try talking to yourself like you might to a friend. Try words of forgiveness, acceptance, and encouragement. Remind yourself that, no matter what, you still deserve to be loved and respected by yourself and others.
Second: Stop comparing yourself to others.
All those people on Instagram with their exercise routines and daily walks and meditation — they are struggling too, in their own way. Everyone struggles. No one has it all figured out. No one. We don’t know their full story, and no one knows yours.
One of the most common “thought errors” that comes into play in treating depression and anxiety is that “Everyone else has it together except me.” This has always been a tough one to get rid of — and it has become even more difficult in an era of Instagram and Facebook and YouTube. It seems like everyone’s life is all happy and put together. But those are curated stories made to present the happy/good stuff. It’s a bias — people don’t usually post the ugly crying in the car moments. Or the screaming at the TV or the computer moments. Or the hiding in the couch in pajamas for three days moments.
Your story is complicated — and human and no less than anyone else’s. Living with bipolar disorder is a challenge that many people will never experience. Other people have whatever challenges in their lives; we don’t know them. But people don’t know yours either.
Third: Start very small.
Do tiny amounts of things that help — do the smallest things if you can. One minute of a big body stretch. Count five breaths — (in fact — do that now). Stand up for a minute or two. Turn off your screen — for a few minutes. Connect with a friend — even for a moment — even a text if not a call. Take a nap if you are tired. Eat if you are hungry. Listen to a song that you love.
Last: Ask for help.
Your care team, your family, your friends — they want to support you, but they need to know that you need help. Don’t try to tough this out.
If you can’t go to the pharmacy, and you are running out of meds, let someone know. If you aren’t sure about your doctor or therapist appointments, call or email them and find out what’s happening — maybe they are doing telemedicine.
If you’re struggling financially — reach out to someone. There are resources and help but they can take time and energy that you may not have right now, so let others help you.
You have nothing to be ashamed of — asking for help is a key skill in managing bipolar disorder. It’s not something you have to do alone.