5 General-Purpose Tips for Handling Mood Episodes

Photo by Marcos Paulo Prado on Unsplash

This post appeared on the International Bipolar Foundation’s website here.

As a woman with bipolar I disorder, I suffer stupidly high highs and even lower lows. I’m sure that if you have bipolar disorder, whatever the flavor, you’re no stranger to how debilitating a mood episode can be.

For a crash course on what symptoms mark bipolar disorder so you can be prepared next time a mood episode strikes, click here.

So how do you take care of yourself when you’re suffering a mood episode? Read on for 5 general-purpose tips for handling mood episodes.

I have used these five tips to manage my mood episodes for almost two decades:

• Communicate with your caregivers.
• Scale back on your to-do list.
• Manage your sleep.
• Stick to your daily routine.
• Don’t use drugs or alcohol.

No matter the episode, be it mania or depression, these five tips will help you.

Tip #1: Communicate with Your Caregivers

Whether you’re tripping into mania or slipping into depression, your caregivers need to know. If you’re blessed enough to have a treatment team of therapists and psychiatrists, contact them as soon as you notice your burgeoning symptoms of a mood episode so they can adjust your treatment and head the episode off at the pass.

Your family also needs to know what’s going on. They will be impacted if your episode gets worse, so don’t keep the fact that you’re struggling from them. If they’re not supportive of your mental illness, at least tell a friend so you can get the help you need.

Tip #2: Scale Back on Your To-Do List

If I’m suffering from depression, I’m in survival mode, and so are you. When getting out of bed in the morning is a challenge, that is not the time to clean out the storage unit. Scale back on your to-do list and only do the tasks that are necessary for you and those who depend on you (like kids and pets) to function. Don’t pile guilt on yourself for not accomplishing as many things as you can when you’re feeling your best.

Similarly, when I’m manic, that’s the time when I’m most tempted to get everything done. But I’ve learned that racking up the accomplishments makes my brain spin out even further and the mania worse. Manic episodes are made of borrowed energy; the more energy I steal from my future self getting things done in a whirlwind, the harder the depressive crash.

Don’t hamstring your future self by spinning out further tackling your to-do list. Spend your energy containing the mania instead, and that means taking it easy.

Tip #3: Manage Your Sleep

When I’m depressed, I can sleep all day, every day. Indeed, when my son was in kindergarten, I would drop him off in the mornings and sleep until I picked him up in the afternoon, and then sleep after I’d fed him. Not my best moments.

Managing your sleep when you’re depressed is so important. Sleeping all day feeds into depression; the more you sleep, the more and the longer you suffer. So set yourself some alarms and try to force yourself to get up and stay up.

Conversely, when I’m manic, I don’t sleep at all, which worsens the manic episode a hundred times over. The less I sleep – and the less you sleep – the more we’ll spin out.

I know how hard it is to sleep when you’re manic. That’s why tip #1 is so important: tell your caregivers so your medication can be adjusted just to overcome the mood episode.

Try to manage your sleep when you’re manic. Even lying in bed with your eyes closed helps rest your hyperactive brain.

Tip #4: Stick to Your Daily Routine

If you have a daily routine and you’re suffering from a mood episode, stick to it as much as possible. Meeting your rocks of the day will keep you grounded whether you’re suffering from mania or depression.

Making sure you shower every other day when you have depression, for example, is easier when you have a habit to do so and you don’t have to think about it.

Similarly, when you’re manic, eating can sometimes get lost in the shuffle; if you eat at the same time everyday, it’s like a reset for your brain and keeps your blood sugar on an even keel, crucial for preventing crashes and hanger.

If you don’t have a daily routine, click here for a post on how to create one and why they’re so important when you have bipolar disorder.

Tip #5: Don’t use Alcohol or Drugs

When you’re in the pits of depression, it’s tempting to use alcohol to help make you feel better. But alcohol and drugs complicate bipolar disorder; even one drink can mess up your medication or worsen symptoms of a mood episode.

Similarly, drinking or using drugs screws up sleep, which is crucial for mania to wind down (see tip #3). Using substances isn’t worth the temporary mood boost in the end, and people with bipolar disorder tend to get addicted to substances mcuh more quickly than people without the mental illness.

Let’s Recap

The five tips I use to manage a mood episode boil down to these:

• Communicate with your caregivers.
• Scale back on your to-do list.
• Manage your sleep.
• Stick to your daily routine.
• Don’t use drugs or alcohol.

These five tips, used in combination, will help you handle your bipolar mood episodes. You don’t have to use all of them, but even one step forward is a good one.

If you’ve found yourself struggling, make sure to let someone know. Help is out there for you, and it’s not too late to reach out to someone.

I wish you well on your journey.

Related Posts

• How I (Mis)managed my Bipolar Disorder During my Pregnancies
• How I Eliminate Stress in My Life to Better Manage My Mental Health
• New Year, New Me, New Ways to Manage My Bipolar Disorder

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How I (Mis)managed my Bipolar Disorder During my Pregnancies

Photo by Anna Hecker on Unsplash

Trigger Warning: This post contains a discussions of suicide. If you or someone you know is at risk of suicide, please:

• Call the U.S. National Suicide Prevention Lifeline at 800-273-8255
• Text TALK to 741741
• Or go to SpeakingOfSuicide.com/resources for additional resources. 

For a post with a list of domestic crisis lines, click here. 

For a post with a list of international crisis lines, click here.

—

This post appeared on The International Bipolar Foundation’s website, here.

Pregnancy.

It’s a time of joy for some, a time of horror for others, and a time of anxiety for most.

Becoming pregnant, regardless of the outcome, changes your life forever. And if you have a mismanaged mental illness that’s affected by maternal hormones like bipolar disorder, irrevocable damage can be done.

May is National Maternal Depression month in the U.S., a time to reflect and raise awareness for mothers who face challenges such as postpartum depression.

According to WebMD, “Pregnant women or new mothers with bipolar disorder have seven times the risk of hospital admissions compared to pregnant women who do not have bipolar disorder.” 

And I was one of them.

Here are my completely different experiences with my two pregnancies and how I managed and mismanaged my bipolar disorder–and what a difference that made.

During my first pregnancy, warning signs of an undiagnosed, worsening bipolar disorder were missed or ignored by my obstetrician. As I wasn’t aware that I had a mental illness, my anxiety, depression, and mania–a mixed mood episode–quickly grew out of control and ravaged my mind and body.

Because of lingering issues centered around going hungry as a child, my manic fear that my new family would go hungry forced me to build a balcony garden with recycled tin cans and bulk soil purchased for pennies. I was terrified that my husband and I would run out of money despite his stable, high-paying job.

The garden never took off, and due to my burgeoning depression, I quickly became suicidal. I became obsessed with a show I saw once a week on television, Avatar: The Last Airbender, living only for new episodes. I forced my husband to watch the show, saying I identified with the sociopathic character who has a psychotic break in the end because I was so numb and messed up.

Faced with decorating a nursery on what I perceived to be a shoe-string budget, I dove in our apartment’s huge dumpster for mismatched, broken lamps, bassinets, and other baby items. I crammed our guest room/nursery so full of filthy items, we couldn’t even walk through the room.

I could not bond with my baby, instead concentrating on how awful I felt. I was jittery, depressed, irritable, lonely, and physically sick–I suffered from a condition called hyperemesis, which means I threw up several times a day for nine months straight.

Rather than gaining weight like I was supposed to, I lost thirty pounds and only gained back ten, and was placed on bedrest four months in. I lost even more weight after the baby was born. I started out the pregnancy at 148 pounds and ended it at approximately 100–not exactly a healthy weight for a 5’7” woman.

Throughout the pregnancy, I faced challenges such as social isolation (my husband and I had just moved 1500 miles away from friends and family for his job), limited mobility (I sprained my ankle and couldn’t drive), and completely wild hormones. It’s no wonder that I suffered a psychotic break after giving birth!

Fortunately, I committed myself to a mental hospital with the help of my therapist, whom I’d started seeing at the beginning of the pregnancy. The doctors there gave me an official diagnosis–bipolar I–as well as medication that saved my life.

Following the pregnancy, I suffered from a crippling postpartum depression that rewired me completely. I went from a bold, confident, intelligent young woman to someone fearful and constantly seeking validation from others.

It took me three long years and several medication changes to recover–and even now, 13 years later, I’m not quite 100% back to my former self.

However, three years after recovering from postpartum depression, when my first child was six, I was ready to try for another baby. My husband had always encouraged me to be in control of our reproductive choices, so he willingly agreed to a second pregnancy.

For the second pregnancy, I insisted on taking medication. I didn’t want to go back into the depths of suicidal depression. And I faithfully attended therapy once a week, discussing coping strategies I could use.

During the second pregnancy, I once again suffered from hyperemesis. I threw up 6-8 times per day from the moment I conceived until the day I gave birth.

Despite that, I my spirits were high and I didn’t suffer a massive depressive or manic episode. I was no longer depending on a television show to emotionally sustain me.

My routine of medication, therapy, and self-care kept the awful mood episodes at bay. I was sane, stable, and dare I say, happy. I was able to bond with my baby and suffered no ill effects after giving birth.

All things considered, except for the hyperemesis and bedrest, the second pregnancy was much closer to “normal” and expected for a healthy pregnancy. I certainly didn’t suffer as much emotional pain!

My bipolar disorder diagnosis–and appropriate approaches to treatment–made such a difference in my two pregnancies. After the first one, I was terrified to have more children; after the second, I considered having a third.

If you have bipolar disorder or even think you do, carefully consider the risks of getting pregnant before you embark on that journey. It may take you somewhere you don’t wish to be.

But there are steps you can take to sustain a safe and healthy pregnancy. Low-risk psychotropic medications are available to you. Talk therapy poses no risk to the baby. And a self-care routine prioritizing sleep can do nothing but good for you.

I wish you well on your journey.

Related posts:

• National Maternal Depression Month: 9 Tips for Coping with Postpartum Depression
• National Maternal Depression Awareness Month: My Experience, and How to Get Support
• Pregnant While Bipolar

My Experiences with Mixed Mood States and How I Handle Them

This post appeared on the International Bipolar Foundation’s (IBPF) website, here. Graphics from the International Bipolar Foundation.

[Id: A blue graphic with two men in blue shirts high fiving over a woman in a blue shirt. The graphic says “3 Ways to Manage Mixed Mood States.”]

If you have bipolar disorder, it’s likely you’ve experienced some symptoms of mania while you’ve suffered depression, or vice versa, and believe me: it’s miserable.

This awful set of feelings is colloquially called a mixed episode or a mixed mood state, and they are common in people with bipolar disorder. Half or more of people with bipolar disorder deal with mixed episodes, and I am one of them.

Just because I suffer mixed episodes, however, doesn’t mean I don’t have “pure” episodes of depression or mania–I have those, too, and they are also detrimental to my mental, physical, and emotional health.

But there’s something about a mixed episode that’s just doubly bad.

Six days after the birth of my first child at 22, I suffered an intense mixed episode with psychotic features and committed myself to a mental hospital, where I earned a diagnosis of Bipolar Disorder I.

I was constantly on the move, hadn’t slept in a week, and ate very little food or drink other than chocolate milk. I made to-do lists of over 100 items each and filled up brand new journal in a few days. I spoke so rapidly that no one could understand me, and flitted from topic to topic like a hummingbird, frustrated and irritable.

These are all symptoms of–and in the case of the lack of sleep, precursors to–mania. But I also suffered symptoms of depression: I cried constantly, felt an overwhelming dread that awful things were happening to my newborn, and vacillated between absolute euphoria and crushing despair.

Any setback destroyed me. Something as simple as not being able to eat my condiment of choice on my meal was a cause for sobbing dejection. And I fixated on my feelings of guilt, anxiety, and low self-worth.

My mixed mood state nearly got the best of me. When I wasn’t bursting with energy, I was exhausted. Angry outbursts from me were common, and my mind raced so much, I couldn’t get to sleep easily.

Fortunately, I was given proper medication in the hospital that stabilized me. Since then, I’ve faithfully taken my meds at morning and night, and I haven’t yet experienced a mood episode that terrible again.

I have, however, suffered less intense mixed episodes since my stay in the hospital. The symptoms–irritability, inability to focus, vacillation between euphoria and despair–are similar.

But I don’t allow them to control me anymore.

3 Ways I Handle Mixed Mood States

I handle mixed mood states in the same way I handle “pure” manic episodes: once I realize what’s going on, I ensure I’m taking steps to get out of the mood state.

Here are three ways I do that:

[Id: A graphic of a man lying down with words that say, “I prioritize sleep. With mania, I frequently don’t need sleep–or, at least, that’s the lie that my brain tells my body. When I’m in a manic or mixed mood episode, I need sleep even more so than when I’m not, so I practice good sleep hygiene and force myself to lie down with my eyes closed until I’m out. Taking a hot bath right before bed also helps. Sometimes medication is involved in my sleep, which brings me to my next point…”]

[Id: A woman in a blue hijab speaking with a man and another woman with the words, “I inform my treatment team about my current struggles. My treatment team–my therapist, psychiatrist, and yes, even my husband–needs to know I’m experiencing a mood episode before they can help me. First, I tell my husband, as he’s the closest to me and is most likely to be adversely affected by my mood episode. Next, if the mood episode is truly terrible and I need to adjust my medication, I phone my psychiatrist and take his advice. After that, I make an appointment with my therapist to process the issues that cropped up during the episode.”]

[Id: A man and a woman standing next to a woman seated at a desk with a computer monitor with the words, “I pare down my to-do list. One of my manifestations of mania is to be insanely productive. But the more I accomplish, the more wound up I get, and therefore I accomplish even more, getting more wound up… It’s a vicious cycle. So when I recognize that I’m manic, rather than riding the high and getting a ton done, I scale back on my to-do list. I force myself to slow down and only get done what is absolutely vital. Slowing my brain down and deliberately paying attention to detail helps me conquer a manic or mixed mood episode.”]

Final Thoughts

My experience with mixed mood states has been awful. They’re like a manic episode turned up to eleven with all the worst parts of depression bogging me down.

When I’m suffering a mixed mood episode, I’m irritable, euphoric, and despairing. I can’t focus and I can’t sleep easily.

But the way I handle those states is similar to the way I handle manic episodes: I prioritize sleep, let my treatment team know and take their advice, and pare down my to-do list.

If you find yourself in a mixed state, prioritize sleep. Force yourself to lie down and close your eyes; try to slow your brain down as much as you can so your thoughts don’t run away with you. And don’t forget to take your medication!

You can survive a mixed mood state and even thrive afterwards. I wish you well in your journey.

Related Posts:

• My Manifestations of Bipolar Mania: Crafting and Frugality
• How and Why to Learn Impulse Control
• What My Experience Being Suicidal Taught Me — and What It Can Teach You, Too

World Bipolar Day – Time to Take Charge of Your Mental Health

Photo by Nick Fewings on Unsplash

Bipolar disorder.

To those newly diagnosed or with a loved one who has been recently diagnosed, those two words may sound like a prison sentence. You mean I’ll be ravaged by out-of-control moods for the rest of my life?

I am Cassandra Stout, and I have managed my bipolar I disorder, the most intense type, for 13 years–and managed it well. And I am here to say you absolutely do not have to live in chaos.

This World Bipolar Day (WBD), traditionally observed on March 30, take charge of your mental health. There are steps you can embark on to reign the illness in and make it manageable.

As I told my newly diagnosed relative, what a bipolar diagnosis really means is work. It’s an extra layer of work that a person living a mental illness must face and embrace in order to tame the chaos of the mood disorder.

But have no fear. The work becomes easier and easier to handle. For example, I am so in the habit of taking my meds in the morning that I don’t even give my pills a second thought.

I treat my evening dose the same way–every night at 6pm, I down my pills with a glass of water.

Done. Easy. Habitual. And you can get to this point, too.

Here’s what to do to take charge of your mental health this WBD.

Take Your Medications

No one likes admitting they need help, especially in the form of mind-altering drugs.

But if you have medications, you must have realized at one point that your brain chemistry needs them to be stable.

I certainly do. I thank God for my pills; without my antidepressant, I would be a disheveled mess in the throes of depression. Without my antipsychotic med, I would be completely out of control during a psychotic manic episode, which I’ve suffered before, endangering myself and my family.

I need my meds. I cannot function without them. And it took me a few years being ravaged by postpartum depression and bipolar I disorder to realize just what kind of effect my medications would have on my life.

Thirteen years after my breakdown, I am stable and happy. I haven’t suffered a debilitating mood episode in years. I am going back to school for my counseling degree and making a difference in the world as a good parent.

I don’t owe everything to my current medication cocktail, but it is a large part of why I am so high-functioning today.

Bipolar disorder is one of the most treatable and and therefore controllable disorders. Even if your illness is medication-resistant, there are electroconvulsive therapies available.

If you’re taking your pills regularly and they don’t work, don’t give up. Go back to your psychiatrist and ask for an adjustment. For a post on how to get a psychiatric evaluation, click here.

Figuring out the right cocktail of antipsychotics, mood stabilizers, antidepressants, and anti-anxiety meds–as well as electroconvulsive therapy–requires a lot of patience, as the testing process takes time and a toll on your body.

The first step in taking charge of your mental illness this WBD is taking the medication you’ve been given on a regular basis. Set an alarm for each dose and don’t ignore this. Taking your meds is crucial to managing your brain’s non-typical brain chemistry.

You deserve stability. You deserve a happy life.

Take your meds.

Attend Therapy

Some people are reluctant to see a therapist even when they’re drowning in unstable feelings like anger, sadness, guilt, and other painful emotions.

I’ve been attending therapy for 14 years, and my therapists have changed my life for the better. With their help, I’ve been able to identify my mood episodes, develop coping strategies for them, and bounce back from crippling depressions.

As she was the one who encouraged me to commit myself to the mental hospital during my postpartum psychotic breakdown, I owe my therapist my life.

I would have been unable to recover so well from my horrendous postpartum depression without (at the time) weekly therapy sessions in which my newborn was allowed to attend.

Talk therapy, especially cognitive behavioral therapy, is one of the best ways to learn how to manage the challenges of daily life. An unbiased, sympathetic therapist can help you understand patterns of your behaviors and help you correct said patterns.

Attending therapy is essential for daily functioning when you have bipolar disorder.

If you’ve been putting off the search for a therapist, please consider starting anew now. I know how much work it is to find one, especially given that many therapists are overburdened by new patients due to the COVID-19 pandemic, but a good therapist is worth the effort.

You may end up waiting for a while, especially when insurance is involved, but don’t give up your search. A worthwhile therapist can make a world of difference.

For a post on how to start seeing a therapist, click here.

Practice Self-care

Self-care is not limited to bubble baths and painting your nails. It’s taking responsibility for your physical and mental well-being.

The basics of self-care is just as it sounds on the tin: taking care of yourself. Self-care involves:

• sleeping enough (but not too much)
• eating a healthy diet
• spending time outside and with other people
• exercising
• and drinking plenty of water.

Practicing these tenants of self-care on a day-to-day basis is crucial for you to feel better. Even if you can’t do all five everyday, try to eat, sleep, and drink enough water. Your energy levels and mood may improve immensely.

When I don’t perform self-care, I feel the lack in my life, and I feel it fast and hard. I’m usually clued in by my lapse in self-care by my tense shoulders, a huge amount of anxiety, and finding myself snapping at my kids.

Realizing I haven’t performed self-care in a few hours is just the first step. The next step I do is always check on my hunger levels; as a Highly Sensitive Person (HSP), I am easily hangered.

Once I’ve had a snack, I drink at least 24oz of water. Then I check whether I’m needed for something from my kids or other duties, or whether I can do something relaxing, like take a hot bath or work on my writing.

The entire self-care process of snacking, drinking water, and checking takes all of five minutes for me (I eat fast), and often improves my mood by leaps and bounds. If I can relax, I generally relax for about thirty minutes at a time, and I have free time scheduled into my routine every evening.

For a post on how to make time for self-care as a parent stuck inside during the COVID-19 pandemic, click here,

Final Thoughts

World Bipolar Day, celebrated every year on March 30th, is a great time to take stock of the strategies you’ve used to cope with your mental illness. If you have bipolar, taking your medication, attending therapy, and practicing self-care will go a long way towards improving your ability to handle your condition.

There is no shame in having bipolar disorder. It just means your brain functions differently and you have an extra layer of work that neurotypical people just don’t have.

But you can control your illness. You can stabilize.

Take charge of your mental health on World Bipolar Day.

I wish you well in your journey.

Related:

• New Year, New Me, New Ways to Manage My Bipolar Disorder
• 11 Lessons I Learned from 11 Years of Managing Bipolar Disorder
• 5 Ways to Cope with a Diagnosis of Mental Illness

Why Hyperfocus Can be a Form of Self-Harm

Photo by Solen Feyissa on Unsplash

Brains function in weird ways sometimes.

Because bipolar disorder runs along similar pathways to ADHD, people with either mental health challenge tend to have difficulties with focusing on tasks in front of them.

When faced with a task our brains deem “boring,” we get distracted and do anything else to avoid the task.

However, sometimes, when enraptured with a project that engages our brains in just the right way, we can enter a zen state of hyperfocus, or “flow.”

In a flow state, everything but the task fades away. I myself have taken advantage of flow states many, many times, having written fanfiction in a blitz of 2200 words per hour or cross-stitched massive projects for hours on end without noticing my hands getting sore.

The neurochemistry of a flow state is super interesting. During a flow state, your brain is flooded with endorphins–nature’s heroin–and all tension in your body disappears, only to be replaced with pleasure.

I usually listen to music with noise-canceling headphones when I’m trying to concentrate a task. One way I can tell I’ve entered a flow state–aside from the massive amount of productivity–is that I completely tune out my music.

You don’t have to have a mental disorder to take advantage of a flow state, though they are common in people with bipolar disorder and ADHD, especially during times of bipolar hypomania and mania.

And trust me, flow states feel good. I love knocking my tasks off my to-do list and producing hundreds of words per hour. I love the endorphin rush I get from conquering my tasks. And I love how I feel afterwards, loose and relaxed and accomplished.

But how can this be a bad thing?

March is Self-Harm Awareness Month, celebrated in the US, Canada, and most of Western Europe. During the awareness month, mental health organizations around the world concentrate on informing the general public about non-suicidal self-harm, especially in youth.

Which why it’s a good time to explain how a hyperfocused, uber-productive state can be a form of self-harm.

Self-harm? Really?

But hyperfocus can be a good thing! You might be thinking. How can such a productive state be a form of self-harm?

It’s true that hyperfocus can be an excellent state to be in for productivity reasons. But hyperfocus can absolutely end up doing more harm than good.

Let me explain. When I’m laser-focused on a desirable activity, I narrow my attention down to what I’m doing in the moment to the exclusion of all else. I neglect to eat, drink, or even use the bathroom. I can’t recognize the flow of time, so it passes without my recognition.

And I get wired from the creativity and endorphin rush, making sleep difficult, which is dangerous for a person with bipolar disorder. Especially bipolar I, where manic episodes are more intense. If I don’t sleep, I quickly trip into mania, which helps me hyperfocus, which makes me manic… It’s a cycle.

When I’m hyperfocused, I not only neglect my own physical and mental needs, I also neglect the needs of my children. I get so wrapped up in projects, I forget to feed my kids until they not-so-gently remind me to do so.

I also hate people interrupting my flow states. When I’m jerked out of a groove, I get irritable and snappish. I have trouble pulling away. Changing gears to do things like “feed the five-year-old” is extremely difficult for me.

So flow states, though they feel great, are often sources of dysfunction for me–precisely because they feel so wonderful.

How to Manage Flow State Dysfunction

Even though I acknowledge these serious consequences from my dysfunctional patterns, I am reluctant to give up my flow states. They are addictive and a lot of my self-worth is wrapped up in my productivity, something I’m working on.

So while I’m keeping the flow states (when I can enter them), I’m setting limits on how long I produce in one.

Someone else watches my daughter from 1pm to 3pm on weekdays so I can study. This means I have a hard deadline to stop. I must stop working at 3pm.

And I am practicing patience by reordering my priorities. My children are more important than the studying, blogging, painting, sewing, or writing fanfiction–the sources of work or pleasure that sometimes trigger a flow state for me.

So I keep my children’s needs at the forefront of my mind and pull away from my screens thirty minutes before set meal times (8am, 12pm, and 5:30pm), so I can properly feed my kids.

We aim to eat at the same times each day. This regular schedule of cooking and eating meals means I have prescribed times to work on other things and maybe enter a flow state.

And I try not to work on fun, creative things–where I’m more likely to enter a flow state–until all my work is done first. I hold myself accountable and keep myself honest about what I accomplish on a daily basis, which helps with self-worth.

Limiting myself works for me. It may work for you, too. Try setting up a regular schedule of work, pleasure, and attending to your physical needs and the needs of others you’re responsible for. And set alarms if you need them–several if you’re in the habit of ignoring them.

Final Thoughts

Flow states–or hyperfocused states–feel wonderful.

They’re an endorphin rush for sure. While everyone can get into a groove, flow states are especially tempting for people with bipolar disorder and ADHD, who usually have trouble concentrating on and motivating themselves to perform day-to-day activities.

People with mental disorders need to be careful that flow states don’t become dysfunctional, which is more common than you might think. What’s more, if you find yourself entering flow states more and more often lately, track your other symptoms, as you may be entering a manic episode.

But you don’t have to give up flow states entirely. Just limit yourself.

Set alarms. Work on a regular schedule with hard stops. Hold yourself accountable for finishing work first before embarking on fun activities that are more likely to trigger a flow state.

I know it’s hard. If you’re anything like me, you’d prefer to be in a hyperfocused state all the time. I get it.

But you deserve better than your own neglect. And if you have kids, they do, too.

You can do this.

Related Posts:

• How Depression Interferes with Getting Things Done (GTD)
• New Year, New Me, New Ways to Manage My Bipolar Disorder
• My Top 8 Personal Needs During a Bipolar Depressive Episode

A Thank You Letter to My Husband for Helping me Manage my Bipolar Disorder

Photo by Annie Spratt on Unsplash

Dear Greeneyes,

Thank you for being patient.

Thank you for being patient with me as my moods ravaged me and stressed our relationship. Thank you for being patient with me as I suffered that postpartum breakdown and scared you. Thank you for being patient with me as I learned how to survive and even thrive afterwards.

I’m sorry I’m not the person you expected to marry. I wish I were her, and I’m trying to get back to that person again. Thank you for being patient with me while I relearn who I was and try to capture her essence.

I appreciate so much the fact that you stuck by my all this time through my various trials and tribulations, challenges that made you suffer as well as me. I am so grateful to you for being my first and most stalwart supporter.

Thank you for supporting me financially for so many years and allowing me to afford and use the mental health professionals and medications I needed to stabilize. That’s such a great boon to me; I know many people who are desperate to find a therapist but cannot afford one. Your working for over a decade at a job you don’t like helped me more than I can even conceptualize.

Thank you for encouraging me to follow my dreams of getting my counseling degree and becoming a therapist to help people manage their mental illnesses. I want to support you in your dreams, so thank you for letting me follow mine first so I can do that.

Thank you for listening to me gush about subjects that you have no interest in. You’re a fantastic listener, and I’ve often made your eyes glaze over by discussing my psychology courses or various friendship dramas. I will learn how to reign myself in for your sake.

Thank you for being a solid parent to our children. As you know, I often lose my temper and you are the patient one who steps in and smooths things over. Your presence as a father to our kids is so important in their lives, modeling to them appropriate behavior for every area of their lives, especially how to treat other people.

Thank you for teaching me so much. I’ve learned a range of subjects including computer science, math, baking, video games, things of a spiritual nature, how to be reliable, how to be patient, and how to love.

Finally, thank you for loving me. Thank you for always acting in my best interest even when it pained you or made you uncomfortable. Thank you for teaching me what love really means. Thank you for protecting me from the evils of the world and enabling me to blossom.

I love you. You are my rock, my love, and I would not be as happy as I am without you.

Cass

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New Year, New Me, New Ways to Manage My Bipolar Disorder

Photo by Andreas Dress on Unsplash

This post appeared on the International Bipolar Foundation’s website, here.

I used to look at the new year, especially the month of January, with trepidation.

When I was but a young college student dating my then-boyfriend–and now husband of several years–I had not yet been diagnosed with bipolar I because I hadn’t suffered a major manic episode, but I still suffered crushing depressive episodes.

I didn’t notice until several years later that these depressive episodes followed a pattern: I would be up, up, up, cheerful, social, and insanely productive, totally killing it on my tests and in my friend group.

Then I would crash and burn, and spend several weeks if not months not showering, self-isolating, and unwilling to get out of bed for any reason.

This pattern almost always manifested itself around the holidays. Until I started dating my husband, I didn’t celebrate Christmas because my parents didn’t for religious reasons. So when I was encouraged to celebrate the holiday season with my husband’s family in college, I went all out for years.

One of my expressions of frugality is crafting. I bought a ridiculous amount of crafting supplies, exhausting my budget and preventing me from eating food for weeks, and hand-crafted multiple intricate individual gifts for everyone in my husband’s family in a hypomanic frenzy.

Usually starting in November, I painted, cross-stitched, sewed, sculpted, decorated, baked, and crafted Christmas presents that were ultimately unappreciated–and rightfully so. Because I was rushing to complete these gifts and make more, more, more–because more is better, after all, my sick brain told me–their quality was shoddy.

I still recall my father-in-law on Christmas day trying on a too-small felt hat I’d simply hot glued together at midnight the night before without measuring. The hat fell apart shortly afterwards and was relegated to the trash, like most of the poorly-constructed presents.

My manic brain would not allow me to slow down and complete the work right rather than fast, and I had never been taught–or taught myself–to pay attention to detail, a skill I am still learning years later now that I’m healthier.

And after the insanity of the holidays, I always, always crashed.

Coupled with the weak winter sunlight and the hypomanic episodes I’d enjoy from November 1st until December 25th, January was always a miserable month for me. I suffered a depressive episode every year like clockwork for about 15 years, until I learned how to manage my bipolar disorder–and manage it well.

Now, for the first time in over a decade, I look back on this new year with contentment and excitement. I decided to purchase Christmas gifts for my family and give myself ample time to craft some for a few of my friends. I started in October, planned out my purchases and cross-stitching carefully, and made sure not to overwhelm myself with the holiday spirit that is so easy to get caught up in.

I now monitor my sleep, medication levels, and sunlight exposure throughout the year. I have a SAD light for the winter and take vitamin D3, which I need in the cloudy Pacific Northwest, as well as iron pills and a multivitamin. I also take my psychiatric medication faithfully and check in with my therapist when there are problems I cannot solve on my own. I communicate about my moods with my husband and children and socialize with my friends on a weekly if not daily basis.

By taking measures to protect my mental health this past year, I have earned a happy January. After decades of out-of-control moods bending me to their will, I have finally learned how to work with my bipolar disorder diagnosis rather than against it.

For the first time ever, I am happy, healthy, and well-balanced in January. Rather than facing the new year with fear and trembling, I am happy to say that I welcome what challenges I will face–and eventually conquer–including going back to graduate school for my counseling degree.

Bring it on.

Related Posts:

• 5 Tips to Make (and Keep!) New Year’s Resolutions with a Mental Illness
• Mental Wellness Month: How to Look After Yourself in the New Year
• Ring in the New Year By Writing Yourself a Mental Health Vision Statement

Bipolar Mania and My Need to Craft

Photo by Aneta Pawlik on Unsplash

When I’m suffering from a manic episode, I need to craft and I cannot prioritize.

Every task that my brain comes up with must be done right then. And, like most people suffering from a manic or hypomanic episode, I come up with a lot of tasks.

Many times, my brain thinks I should start new craft projects for friends. “The holidays are right around the corner!” my manic brain screams in November. “I must cross stitch something that’ll normally take me 30 hours to complete, but right now it’ll only take 5!”

Basically, my manic brain is too ambitious for its britches. When I’ve started new projects in a hypomanic state, where I feel euphoric and superhuman, I rarely finish them, leaving them–and their accoutrements like needles–around the house for anyone to step on.

During hypomanic phases, I’ve made oodles of poorly-sewed plushies (including a whole sushi tray); painted multiple canvases and glass pictures; and cross stitched coasters, QR codes, and a multitude of other fabric projects. I don’t properly prepare for these projects, and I also usually don’t clean up until the hypomanic phase is over.

I also feel a sense of urgency with the projects. They end up rushed: I pull the stitches too tightly, warping the fabric, or splash paint on the trim when painting awkward-looking trees on the walls–permanent fixtures in our dining room that my husband absolutely hates, haha!

Like many people dealing with mania, I’ve also purchased hundreds of dollars of supplies. I’ve cluttered up my garage and ended up buying so many duplicates, I ran out of space and ended up throwing them out in a moment when I was more stable and clearheaded.

I’ve even left my fabrics and embroidery threads on the floor for the cat to pee on, eventually tossing more than half of my massive collection.

One hypomanic Christmas, I thought my father-in-law and his wife didn’t have enough presents, so I stayed up on Christmas Eve making them pink and purple hats with spare fabric and hot glue–without measuring.

The hats turned out too small, were scratchy, and fell apart almost immediately after being opened. I still remember my father-in-law trying the hat on and having it not even cover the top of his head.

After we finished opening presents, the hats were unceremoniously placed in the trash. Christmas Day, I felt ashamed and embarrassed, my face hot and tears welling in my eyes.

Recognizing that almost all of the presents I’d made for family members were of poor quality and thus rightfully unappreciated, I stopped making presents and really participating in the holidays for years.

Years later, when my daughter was four months old, I entered a similar hypomanic state and decided to paint a cherry blossom branch on a huge canvas.

Putting her in my Ergo front-pack baby carrier, I hunched over the kitchen table and painted for 4 hours, losing track of time while she slept. The project felt so urgent, I didn’t stop to eat lunch, feed my child, or even go to the bathroom.

Cassandra Stout’s cherry blossom painting. Copyrighted under a Creative Commons license.

Realizing that I was only creating when my brain was sick, that was the last craft project–or art of any kind–I produced for four years.

Thankfully, I am now much more stable. Once I was on an more even keel and not in danger of going manic, I started writing fanfiction and enjoying creating again, writing quick short stories that I can produce and publish online for my fans in a few hours.

Since then, one year after I began writing for fun again, I’ve embarked on other art projects. I’ve painted small ceramics: tiny projects–fridge magnets and paperweights–things I can get done in small increments, and things that won’t trigger that sense of urgency again.

This past holiday season, I took up cross-stitching presents for Christmas gifts again, this time for fun, and the biggest project–which really did take me 30 hours–turned out beautifully. My stitches are straight and just tight enough to make the project look nice.

I earned this stability through hard work–taking and rebalancing my medication cocktail on a regular basis, checking in with my treatment team whenever I feel like I’m slipping into a mood episode, and engaging in psychotherapy.

I am happy to say that I am now creating again, thoroughly enjoying myself and taking my time rather than feeling pressured to complete things on an unreasonable timetable.

And when I do feel that invisible pull, that pressure, that sense of urgency that I feel sometimes even when stable because that’s what my sick brain associates with crafting, I set the project down and do something else.

I am much, much happier now.

Have you ever felt like this? What does your brain force you to do when you’re manic?

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How and Why to Create a Routine with Bipolar Disorder

Photo by Renáta-Adrienn on Unsplash

I can hear you now: Sticking to a routine is one of the most difficult things ever with bipolar disorder. Why do I have to do it?

I’ll tell you why: because your brain thrives on structure, and following a daily routine can help prevent and treat bipolar mood episodes, according to Ellen Frank, PhD, professor of psychiatry and psychology and director of the Depression and Manic Depression Prevention Program at the University of Pittsburgh School of Medicine.

In a study of interpersonal and social rhythm therapy (IPRST) and its effectiveness of managing mood episodes, Frank found that patients with bipolar disorder who followed a routine survived much longer without an episode than those who didn’t follow a rhythm, and that IPSRT was extremely effective at preventing mania and depression.

My therapist told me years ago that consistency would be the best gift I could give my children, and I despaired. How could I, being an inconsistent person based on my mental illness and habits developed in a chaotic childhood, provide them with a life with reliable “rocks,” or big activities that we did daily?

Finding–and sticking to–a pattern has been one of the most difficult things I’ve ever done. And as we’ve added to our family, I have changed the pattern. But I’ve noticed a stark difference in my own happiness and the happiness of my children when I create order in my life rather than submit myself and my family to chaos.

The importance of creating a daily routine–and following it!–can’t be stressed enough. But how do you create–and more importantly, stick to–a routine?

Read on for some tips and tricks based on my own personal experience.

Tip #1: Start Small

When I’m manic, I tend to want to organize my life. When I’m in this state, I suffer from the compulsion to make to-do lists and plan out my schedule and the schedules of my family.

So my first tip is probably obvious: don’t start planning your routine when manic. My next tip is probably less so: start small.

What I mean by that is don’t add a bunch of items to your to-do list all at once and expect to follow them daily. You’re setting yourself up for failure that way.

Start with the “rocks,” or big activities: meals, sleep, and work hours. Which leads into tip two.

Tip #2: Fix Your Sleep Hygiene

I could go on and on about how crucial sleep is for stabilizing your mental health. (In fact, I have, here and here.) Sleep hygiene is one of the easiest and most effective ways you can get yourself on an even keel and reduce the severity of mood episodes, even and especially preventing them.

Sleep is a rock in your day, so try to schedule sleep times. Schedule wake times. And try to stick to those. If you have sleep problems, talk to your doctor. You need enough sleep.

How much is enough depends on each individual person. Some adults need 7-8 hours, others need more. But if you’re not getting enough sleep, that’s a fast track to mania.

I go to sleep between 9-10pm every night. Approximately twenty minutes before bed, I shut off my phone and take a shower or bath, depending on my mood and how much time I have. I wind down at night by lying in bed by either praying or planning out my next fanfiction.

Waking up used to be much more difficult for me, but now that I’ve lowered the dose of one of my meds, I’ve been finding myself waking up with much more energy. But I still roll over and go back to sleep after turning off my alarm.

I’m telling you this tip–fix your sleep hygiene–but I’m also telling myself. I need to start waking up at 7am consistently like I used to and address the likely lingering slight depression.

Starting tomorrow, I will be waking up with my alarm at 7am and forcing myself out of bed rather than shutting it off and sleeping in. Wish me luck!

Tip #2: Schedule Meal Times

In addition to sleep, one of the quickest ways we can stabilize our moods is to keep our blood sugar levels stable. Being an Highly Sensitive Person (HSP), I know I myself am extremely susceptible to being hangry.

If you can, try to stick to regular meal times. Eating 3-4 small meals a day will help you keep an even mood, but not only that, it’ll help you lose weight or maintain a healthy one.

My meal routine is simple. I take my meds right before breakfast at 9:15am, eat a breakfast of a single egg and a glass of milk with sugar-free salted caramel syrup, and then take my daughter to the park until 12pm, at which point I eat lunch (usually last night’s leftovers). I eat a small snack at 3:30pm. Dinner, which I usually start making at 4:30opm, is between 5:30-6pm, depending on the recipe. I also drink about 144oz of water throughout the day.

This schedule works very well for me and my family, and helps keep me sane. Try scheduling your meals for regular times. You won’t regret it.

Tip #3: Schedule Your Work Hours

For most of us, work takes up most of our day. If you can schedule your own hours, do so. Whether you work in an office, attend school, or work from home, you need to set a start and end time.

According to Dr. Frank’s research, having a set work schedule will help you feel better. If you can, tap your colleagues, teachers, and family to help you meet your obligations with enough time for you to complete the day’s work at a set end time.

I’m a writer and a stay-at-home parent attending online psychology classes for my graduate degree, so my work day starts at 8am, when I wake up and make my daughter breakfast.

After that, we go to the park until 12pm, when we return home to eat lunch. Someone else watched my daughter from 1-4pm, during which I study. Then I make dinner at 4:30pm, eat at 5:30pm, and have time for relaxation with the rest of the family after the dinner dishes are done at 6:30pm.

At 8pm, the bedtime routine begins, including a bath for my daughter. She’s in bed by 9pm, and then I take my own shower and go to bed shortly afterwards on most nights.

My schedule is not very intense, and it leaves room for flexibility. But if you’re a homemaker, it’s especially important for you to schedule a set end to your workday. Without a specific time to stop and relax, you can easily work yourself to the bone.

Which leads to the next tip.

Tip #4: Schedule Time for Self-care

All work and no play makes Johnny a dull boy, or so it’s said. If you don’t schedule time for relaxation, you will burn out with stress, which is a known trigger for bipolar mood episodes.

As I said in the last tip, I have penciled in time to relax with my family from 6:30pm to 8pm. I also have a “night off” from the bedtime routine on Mondays, which I usually spend writing short stories or cross-stitching, hobbies I enjoy that chill me out.

Make time each day to do something you enjoy. Self-care is incredibly important in fighting mood episodes, especially depression.

There’s any number of things you can do for self-care. You could take a walk, indulge in a cup of tea or coffee, or do something creative, like painting or writing.

For a list of 100 Doable Ideas for Self-care When You’re Suffering from Depression, click here.

Tip #5: Forgive Yourself

If something throws you off your routine–and something always will eventually–don’t panic. Try to be flexible enough to roll with the punches.

Accept what has happened and then follow your routine as best as you’re able. Forgive yourself if you can’t quite make it one day. There’s always tomorrow.

When something interrupts my routine, I get crabby. That’s what I mean about feeling an impact to my happiness when my routine is altered, especially without my permission. But even with my permission, I struggle to remain happy with the change.

For example, Monday nights are my night off, and Tuesday is the night my husband shops. This Monday, the suggestion was made that he hit the store that night rather than Tuesday and give me a night off on Thursday, a change I agreed to because it would be better for my husband.

By the end of the night, while doing the unexpected bedtime routine with my daughter, I was cranky. She got on my nerves more than I care to admit.

But I bathed her and put her to bed, tucking her in and singing “Rock-A-Bye Baby” twice, as is her routine. Then, exhausted, I went directly to bed.

I made sure to give myself grace for being annoyed and reminded myself that this change was temporary and I agreed to it.

Sometimes routines don’t work out, and that’s okay. As long as you forgive yourself and get right back into it as soon as you can, you’ll be alright.

Make adjustments as needed, like getting a hotel room if you’re not going to get home on time to sleep. A hotel room costs less than a hospitalization if your mood destabilizes.

Let’s Recap

If you suffer from bipolar disorder, routines are crucial to your success in treating your mental illness. They prevent and treat mood episodes, keeping you stable and happy.

Think of following one for not only yourself, but also your family and those around you.

To follow a routine, start small, fix your sleep hygiene, set meal times, schedule a start and end times to the work day using your colleagues, and forgive yourself if the routine doesn’t go as planned.

You can follow a routine. You can be consistent, despite your mental illness making that difficult. Schedule your rocks and stick to those commitments. You will benefit from doing so.

I wish you well in your journey.

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Tips For Managing Romantic Relationships if You have Bipolar Disorder

This post appeared on the International Bipolar Foundation website, here.

If you suffer from bipolar disorder, then you may already know how difficult managing romantic relationships can be. Even being a partner with a bipolar disorder sufferer is difficult.

The manic and hypomanic phases of the disease can include lapses in judgment, promiscuity, overspending, risky behaviors like alcohol or drug abuse, and other problems which can wreak havoc on any relationship, especially a romantic one.

Depressive episodes can be frustrating for everyone involved because a person suffering from depression may withdraw from the world. If you’re partnered with a person going through a depressive episode, you may not be able to draw them out of their shell.

So how do you manage a romantic relationship if you have bipolar disorder? Here are some tips to do just that.

Tip #1: Communicate Honestly

Everyone involved in a romantic relationship needs to communicate honestly with their partners, but this is especially true when bipolar disorder is involved.

If you have bipolar disorder, be honest about your everyday feelings, and let your partner know when you’re tripping into mania or slipping into depression. Bipolar episodes can be disorienting to anyone, not just the sufferer, and especially when people are unprepared for them. Your partner needs to know if you’re becoming manic or depressed.

Financial concerns are also something to be honest about. If you don’t tell your partner that you overspent during a manic episode, he or she might be counting on money in the budget that you don’t have. Similarly, you need to be honest if you’ve cheated on your partner when you’ve been manic because you need to maintain trust in the relationship.

If you are partnered with someone with bipolar disorder, be honest about whether you’re overwhelmed by the disease. You can’t always be a rock, and your partner needs to know when you feel overwhelmed. Do your best to separate the illness from your partner and try not to judge him or her for suffering from bipolar disorder. But be honest with your partner about how the mental illness affects you.

Tip #2: Stick With Your Treatment Plan

Adequately treating your bipolar disorder with talk therapy and/or medication is crucial for managing romantic relationships. If you don’t have your disease under control and aren’t handling your mood episodes properly, then you run the risk of destroying everything you’ve worked for when it comes to your partner.

If you are dating or married to a person suffering from bipolar disorder, regularly ask your partner how they’re feeling and if their meds are working for them. Managing mental illnesses is much easier with an appropriate level of support. Oftentimes, the partner is the one who spots the manic or depressive episode.

But try to avoid nagging. Set up rules about communicating ahead of time, such as “I can only bring up meds three times, and then I need to let it go.”

Tip #3: Practice Self-care

Self-care isn’t limited to bubble baths and painting your nails. Self-care is taking responsibility for your well-being. If you can’t take care of yourself, your romantic relationships will suffer. People suffering depressive episodes especially need to commit to a self-care routine, as they tend to neglect themselves.

So, whether you have bipolar disorder or are partnered with someone with bipolar, practice daily self-care.

If you do these “big six” self-care steps daily, as outlined by a post about self-care at WellandWealthy.org then you will see improvements in your physical and mental health. These improvements will help you be a better spouse.

Every day, try to:

• eat a healthy diet
• get adequate sleep
• go outside
• move your body
• drink enough water
• and socialize with real people.

A special note for the partners of people with bipolar disorder: one way to practice self-care is to not be your partner’s only support. Make sure that he or she has a therapist and/or a psychiatrist to talk to, as well as supportive friends and possibly family. The more you can spread the support around, the better.

You can’t be everything to your partner. Setting up a codependent relationship will only harm you and him or her in the long run.

For a post on how to get a psychiatric evaluation, click here. For a post on how to start seeing a therapist, click here.

Final Thoughts

Managing romance when you suffer from bipolar disorder is not impossible. It just takes a little extra work and self-awareness from both people in the partnership. If you can communicate honestly, stick to your treatment plans, and practice the “big six” daily self-care tenants, then you will be able to better handle your romantic relationships.

I wish you well in your journey.

Related:

• Getting Support During a Bipolar Depression Episode
• Bipolar Disorder in Women
• Disclosing That You Have a Mental Illness, part II: How