Beyond the Medication

A few days ago, I wrote a blog discussing the importance of medication in managing bipolar. I acknowledged that not all with bipolar experience it the same way I do. In fact, no one experiences it the same way. I only write according to my own experience. I write the things that have helped me in the hopes that someone may find it helpful for them.

Managing bipolar is like putting together a huge puzzle. It is difficult to piece together, but it is necessary in order to find your own balance. Medication is, I think, like putting the edge pieces together- finding a framework in which to place the other pieces. But there is more to managing bipolar than just taking meds. This blog will discuss several management strategies or tools that I have used and find helpful in keeping my moods stable. For the most part, I consider them maintenance tools, and I do them whether or not I’m currently experiencing symptoms, but I’m sure they can also be used when in the middle of an episode. I think many of this can also be applicable to other struggles: depression and anxiety disorder are clear examples.

1.     Medication. I have talked already about the importance of finding the right medication. This is a difficult uphill battle for many. It’s important to find a good psychiatrist that can help with medication management: finding the right med, then the right dose.

2.     Therapy. My therapist is a rock star. In fact, many of the management strategies you’ll find on this list have come from her. She is a specialist in mental illness, and that’s why she was able to find me some tools to put into my management toolbox. A therapist can help one to positively process the many emotions that come with bipolar, and help one realize what may or may not be normal for the disorder. The important thing about getting a therapist is finding a good one. It’s easy to get attached to one’s therapist because you discuss intimate details of your personal life, and your illness. However, if you’re not making progress with your therapist- FIND A NEW ONE! Find one that works with you- one that will help you accomplish your goals, give you the tools you need, and treats you with respect.

3.     Chart My Moods. I must admit, I’m having a more difficult time with this one. I chart my moods every day for the purpose of seeing any patterns emerging. I have yet to find any patterns, but I understand the reasons we do it. Once patterns are found, we are able to better prepare ourselves for what’s coming. Whether that means gathering a good support group, taking extra medication, hiding your credit card, etc.

4.     Journal Writing. This is the reason that I am doing this blog. Journal writing can help make sense of what we’re experiencing. Just like talking to a therapist, writing in a journal is a way to positively process any outrageous, or simple, emotions we’re having. One journal strategy that my therapist has recommended is if I’m thinking obsessively about something (a frequent occurrence with me), I should simply write down the one or two sentences describing it, and crumple up the paper and throw it away. It sounds ridiculous, but it actually makes me stop thinking about things. It’s amazing how the simple things can help us make sense of what’s going on in our brains.

5.     Positive Self-Talk/ Reframing. I have a terrible habit of talking in negatives; especially when it comes to my feelings about myself, my looks, my impact on the world, etc. When I catch myself (which, again, I don’t realize very often) or am caught by my husband talking negatively about myself, I stop, and reframe. I take the same thought and paint it a different color. The point is to take the thought on a slightly different trail- not turn it completely around. For example, if my thought is “they hate me”, my reframe might be “that’s not my problem”, or “no one can be loved by everyone”. The reason this is important is because we very easily defeat ourselves with the thoughts that go through our heads. If we can put a more positive spin on that thought, we will have more control of our day, and our attitudes.

6.     Routine. Another difficult one for me. I hate routine. I got so tired of doing the same thing at the same time every day, so I never did it. Then, I had twins. The only way I surv

ive with them is by having a schedule. And you know what I realized? I’m much more stable when I know what is coming next in my day. I think it allows the brain to be a little more calm when I’m not searching for what to do next. I think it also allows me a structure that I can follow whether I’m manic or depressed. I don’t have to think about what comes next, I can just do. So, on those days that I feel so down that I don’t want to shower- it’s not a question as to whether I do it or not- it’s what comes next in my day. All I need is a little follow through, and most of the time, it works.

7.     Sleep. Every bipolar managing website I’ve been to says to get the same amount of sleep. I think it boils down to routine again. My body functions more evenly if it gets the same amount every night.

8.     Diet and Exercise. Good diet and exercise are an essential part of any well-balanced lifestyle. And when I say diet, I don’t mean Atkins, or Paleo, or whatever the new diet is at the time. I just mean eating healthy overall. Making sure the body gets essential nutrients and following basic diet rules help the body to function well, even when the brain is a little off. In addition to a well-balanced diet, I’ve read that for those who have bipolar should consume little to no caffeine. Though caffeine cannot cause mania, it could escalate an already existing mania. Being a dancer, I understand the reasons for exercise as well. It gives the manic energy an outlet. It also releases well-needed endorphins when one is depressed. As part of maintenance therapy, it gives a consistent connection between the body and the brain, allowing one to think more clearly.

9.     Monitor Myself in the Moment. I’ve already discussed this a little in a previous blog, but it’s a very important part of my bipolar management. There are times, particularly when I’m manic, that I have desires to take on projects. Normally, doing these projects wouldn’t cause a problem, but if these ideas come with feelings of urgency or irritability at others for not being on board, I need to slow down and do the opposite of what I’m feeling. Instead of doing projects, I do one of these management techniques. Sometimes, I do nothing, just to keep myself in check. It’s hard to go against what feels good and natural, but if I know I could potentially cause myself or my family harm by indulging, it’s best I go against my instincts.

10. Slow movement. Much like exercise, doing movement can help create a feeling of connectedness between the body and the brain. The added benefit of doing slow movement, such as Yoga or Tai Chi, helps to slow down the brain, thus allowing me to feel more in control. I’ve also been advised to teach this one to my children. When my girls seem to be getting agitated, I pull out a ball and slowly roll the ball back and forth. They calm down fairly quickly. Not only does this benefit them now, but I am also teaching them management strategies for when they get older, and might have to deal with full blown bipolar.

11. Meditation/ Guided Imagery/ Deep Breathing. This was a new one to me. My therapist recommended doing meditations a few times every day. Meditation is not always the sitting with crossed legs with your hands open on your knees. I started with simple deep breathing while reciting a mantra- such as “everything will be okay”, or “calm mind, relaxed body”. This helped me every day to re-focus myself and remind my mind and my body where I wanted to be. Later, I started using podcasts for my meditations. My favorites are the ones where I am asked to check in with my body- doing progressive muscle relaxations, or a strong focus on different body parts. I think this echoes back to my dancing days- being connected with my body. I unfortunately don’t do my meditations as often as has been recommended (after all, how do you meditate with 13 month old twins crying in your ears?), but I make time to do at least one focused meditation or guided imagery a day. I have seen a difference in my attitude when I do them, and feel a greater irritation building inside of me when I don’t.

12. Other Stress Management Strategies. I’m not very good at recognizing when I am stressed, but I have found that managing stress can be very similar to managing bipolar. Taking a break from life for a minute will help the brain re-focus and calm down from the mania and be distracted from the depression. Be careful with what the choice. If something will make you more irritated or escalate you further into mania or depression- don’t do it. I, for example, should not choose to start an art project when I’m manic, because my mania will only get worse. However, starting one when I’m depressed can help pull me out of depression. The point here is to be nurtured and slow down. Nurturing my bipolar self is a necessity, not a luxury.

·      Practice some Brain Gym (I’ll explain more about these in a future blog)

·      Go for a walk

·      Spend time in nature

·      Get sunlight

·      Take a long bath

·      Play with a pet

·      Work in garden

·      Get a massage

·      Read a book

·      Listen to music

·      Light scented candles

·      Watch a comedy/laugh

·      Go for a drive

·      Dance

·      Play an instrument

·      Pray

·      Play a sport

·      Do a craft

·      Bake

·      Lavender oil

·      Ride a bike

·      Go swimming

·      Service

·      Clean the house

·      Fold and iron laundry

·      Watch a favorite tv show

·      Smell a flower

·      Hug someone

·      Start an art project

·      Play a game with family or friends

·      Sew, knit, or crochet

·      Get organized

·      Practice gratitude

This list is only a starting point. Feel free to add to it as you find new ways to manage your disorder- whether it’s bipolar or otherwise. I’m always open to finding new techniques. I just know that these are working for me so far. I hope you can find it useful.