15 Self-Care Tips for People Living with Bipolar Disorder

Over the holidays, I searched for recipes several times, for dishes like pecan-glazed pumpkin spice bundt cake, flawless vegetarian-field roast or the best Dutch baby pancakes. Each recipe began with grandma’s life story, then how the writer’s second cousin shared the recipe with her husband, who swore he’d never eat vegetarian-field roast and was shocked to discover how marvelous it tasted. You get the idea. There are too many paragraphs, advertisements, pop-ups and fast-moving recipe videos to scroll through. All I want is the recipe.

• What is Bipolar disorder?

When I spiral north or south with bipolar disorder, I don’t need cute anecdotes. I need a recipe. I recommend that others living with bipolar disorder craft their own recipe for self-care, as I have done. You may find some of my practices useful. Feel free to adopt them, or design a way to recognize your symptoms, accept them, investigate which tools to use and nourish yourself with loving kindness and discipline when you need it most.

These are my daily practices:

• I maintain a consistent sleep and wake schedule. Circadian rhythms can be interrupted by the hypomanic symptom of sleep interruptions, caused by racing thoughts and the depressive need for more sleep. Scheduling 7 hours of sleep, shutting down electronics 30 minutes before bedtime and practicing “BFMT” (brush, floss, meditate, and tuck in) make a big difference. If I still have difficulty, I take melatonin and listen to a guided sleep meditation.
• I make my bed every morning. It’s a task I can accomplish. When I feel hypomanic, it centers me. When I’m depressed, it’s a gentle reminder that I can do hard things.
• I check in. I document my daily moods in the E-mood app. Every morning, I wake up with a song in my head. Often the song in my head will predict if I am ramping up or sliding down. For example, if it’s “Toxic” by Britney Spears — possible hypomania. If it’s ”Ordinary World” by Duran Duran, depression might be on the way.
• I text a daily gratitude list. I name six things I’m grateful for and text the list to six friends. Some friends text their gratitude as well. I highly recommend this.
• I meditate daily. When meditation feels like trying to move a boulder, the I can’t do this message is loud. I pause, breathe and turn toward resistance with the compassion of a caregiver. I say, “This is hard, I know. Find just one thing to be grateful for today.” On days when mania tells me I can move boulders with my mind, I meditate with a guided, centering, anxiety-lowering meditation. If I’m too antsy to sit, I choose walking meditation or run on the treadmill.
• I take care of my body. I take my medicine. I shower, brush and floss. I wear fresh clothes, drink lots of water and limit caffeine to two cups a day. Preparing a healthy breakfast, lunch and dinner are acts of kindness for myself — and healthier than ordering “a depression pizza” or skipping meals.
• Whatever the mood, I go with the flow. This means facing what’s happening, rather than fighting, fleeing or freezing. One of my acceptance phrases is This is happening now, and this will pass. Facing what’s really happening keeps me present in the now. Going with the flow doesn’t mean feeding mania or wallowing in depression. I use the presence of symptoms to navigate from nowhere to now here, rather than isolating myself in numbing depression or allowing mania to drive the bus.
• I play with Elvis. Elvis is my 17-pound cat. Playing with him creates immediate connection with a dear animal who offers unconditional love (mostly … he’s a cat after all). Petting Elvis as he purrs on the couch is as calming as meditation.

These are tools I use on a regular or as-needed basis:

• Therapy. I schedule twice-monthly talk therapy and monthly calls with my psychiatrist.
• I journal. Writing about my sadness and longing helps loosen depression’s icy grip. When I’m feeling hypomanic, scattered and agitated, journaling is the last thing I want to do. Even so, it calms me and helps organize and release my racing thoughts.
• I’ve developed a support team. I text or call my 12-step sponsor and two other fellowship contacts at least once a week. I’ve shared with my partner and some friends about my struggles and have asked for support before, during and after a cycle. Their empathy lowers my stigma and shame and has deepened these relationships.
• I watch informative videos and read articles about bipolar disorder. These resources educate me in an easy-to-understand, non-clinical way. They’ve helped to reduce the shame and stigma of living with mental illness and offer tools to recognize symptoms of mania and depression before they start. I’ve found mental-health resources on the NAMI website, The Mighty, YouTube videos by Dr. Tracy Marks, Kati Morton and TED Talks. They are all helpful in educating myself and others.
• I’ve left social media. I left Facebook, Twitter and Instagram three years ago. They are bipolar triggers for me. I would stay up mindlessly scrolling until the wee hours of the morning and often became obsessed with following and messaging certain users. I worked through social media withdrawal with the help of my therapist, adjusted my usage and eventually let it all go. Now I participate in healthy online forums and publish articles. I text, email, call and mail handwritten cards to friends and family. 
• I’ve set boundaries. I share what I am feeling with one person. It usually dissolves obsessive thoughts and compulsive spending. Admitting when I have these urges takes courage, vulnerability and holds me accountable. Another boundary addresses depression. Regret, shame over past actions and the loss of motivation and self-worth sometimes arrive out of nowhere. When cycles arise, I practice “RAIN.” I recognize the symptoms, accept and face them with compassion and awareness, investigate what’s happening in my body and ask, What’s the unmet need right now? Then I nourish myself with healthy options.
• I’ve made an honest assessment. I’ve composed lists titled “Signs of Mania” and “Signs of Depression” and shared these with my trusted friends, so they can help when they notice I’m ramping up or spiraling down. 

At first, you may resist some of these practices. For example, when a hypomanic cycle began, I wouldn’t always reach out for support. The option didn’t always occur to me. A regular check-in with someone who understands has become a habit, no matter how I’m feeling, so I’m more likely to call a friend when I need one. When I’m feeling depressed, positive self-talk and affirmations are difficult to believe. Gratitude is a different practice. If I can’t look inside and find one thing I love about myself, I can look outside at Elvis the cat, the cup of hot coffee or the opportunity to connect with others through texting. I breathe in, breathe out and find small moments of thankfulness. For more gratitude practice, I recommend “The Book of Delights” by Ross Gay. 

I hope you find these useful. When we connect as a community, we end the disconnection and isolation of bipolar disorder. Please share with others what works for you, and strive for balance.