# 10 Bipolar Disorder Self-Help Tips



## David Baxter PhD (Dec 23, 2008)

10 Bipolar Disorder Self-Help Tips
by Candida Fink MD 
December 23, 2008 
Syndicated from the _Bipolar Blog_

Whether you’ve been recently diagnosed with bipolar disorder or have been dealing with it for a long time, it’s likely that nobody has taken the time to sit you down and explain what you can and should be doing to help yourself. We’ve put together this Top 10 list to bring you up to speed on bipolar self-help strategies that really work:


*Take ownership of your illness*. No, it’s not your fault you have bipolar disorder, but now that you have it, do your part to get help, lead a healthier lifestyle, and follow your treatment regimen. 
*Take your medications as prescribed*. Most of the medications used to treat depression or mania need to be taken daily, not just when you think you feel depressed or manic or think you need them. 

*Warning*: If you can’t tolerate the side effects of a particular medication, consult your doctor – he or she may have suggestions on how to reduce or eliminate the side effects without stopping the medication. See _Managing Bipolar Medication Side Effects_.
*Don’t drink alcohol*. (This is a biggie.) Drinking alcohol can neutralize the beneficial effects of the medications and interact with some medications to cause liver damage, seizures, unpredictable shifts in mood, and other health problems. (Avoid other substances, as well, including medications that your doctor has not prescribed for you.) 
*Sleep seven to eight hours per night… every night*. Sleep deprivation can really throw your moods out of whack. For tips on getting some restful sleep, visit www.SleeplessInAmerica.org (now part of DBSA – the Depression and Bipolar Support Alliance). 
*Steer clear of stimulants*. Caffeine, nicotine, and other stimulants could tip your mood balance, especially if they cause you to lose sleep. Yep, those energy drinks gotta go. 
*Establish healthy routines*. You’ll be surprised at how much a daily routine can relieve stress and level your moods. Exercise can help, too. If you have trouble establishing healthy routines, consider consulting a therapist who’s trained in Interpersonal & Social Rhythm Therapy (IPSRT), as we discuss in _Bipolar Disorder For Dummies_. 
*Avoid triggers and stressors*. Situations or people that get you hyped up, agitated, or upset can trigger mood episodes. 
*Team up with your doctor and therapist*. They can provide much more effective treatment if you make and keep regular appointments, consult them prior to making any medication or treatment changes, and are honest about what’s going on. 
*Educate yourself*. The more you and others around you learn about the disorder, the better equipped you’ll be to keep it under control. 
*Ask for help*. Your friends, family members, and the people you work with probably want to help but don’t know what to do. Let them know what they can do to help you (and when you need them to back off).
These ten tips may sound pretty easy in theory, but can be very difficult to put into practice, particularly if your moods are currently cycling. If you happen to wander off course, don’t beat yourself up over it. Nobody’s perfect, and you are battling an illness that can be very difficult to manage.

If you have any self-help tips that you have found useful in the course of your journey with bipolar disorder, please share them here.


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## amastie (Dec 24, 2008)

I think sometimes that therapeutic techniques work across a spectrum of mental illness, and one that I always have to keep in mind is how not getting enough sleep *always* leaves me much more fragile.

Some things are universal.

Thanks again,

amastie


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## stargazer (Jan 1, 2009)

David Baxter said:


> *Avoid triggers and stressors*. Situations or people that get you hyped up, agitated, or upset can trigger mood episodes.



What if you live with one?  

It is true that I've been generally happy to have gained some stability by having maintained a single residence for the better part of a year now.  It's also true that most of the time, my housemates have not provided a problem for me.  However, at the present time (as of yesterday), as well as at another time (around a month ago), I have become concerned that depressive episodes are being triggered by the actions of one or more of my housemates.  Look how bad it got a month ago:



stargazer said:


> ...rght now's the worst.  My daughter doesn't talk to me anymore, and neither does my stepdaughter.  Everybody has abandoned me.  My issues are too much for them.  I make these appeals to my friends and my family, I say please say something, please stop ignoring me, please show me I'm worth something to somebody.  But nobody ever writes back or returns my calls.  Nobody ever makes any suggestions how I can get any help.  Everybody just ignores me.  Right now I'm sitting in some stupid motel room somewhere in California, I have no home, and  before I know it I'll have run out of money again.  Life seems pointless, meaningless, futile.  And I'm not getting any younger....



That quote is full of absolute statements - most of them untrue.  These statements resulted from distorted thinking that emerged from a seriously depressed condition.  I believed I had "no home" anymore, when in reality I still had my room in this house, and I didn't even have to move.  But because of a problem with a housemate, I spent two nights on a motel room in a distant town, only to return to the house three days later.  And it cost me money!!

Historically, I've done better when I've lived alone, since there can be no event of feeling hassled ot disempowered by the overwhelming force of a roommate.  I also don't think that I am "inherently unstable," as it might once have seemed.  I believe that every time I have moved back to the Bay Area (four times since I've been active on this forum), it did me more harm than good, and I am content to remain here in the Valley.

But should I continue to live with someone who is going to trigger depressive episodes?  Even on occasion?  Last night was bad.  I avoided the house completely, for several hours.  Even this morning, I am afraid of what I will encounter when my landlady wakes up.  

I could conceivably start looking for a studio apartment, but I wonder if I'm asking too much of life.  Good deals like this present one don't arise too often, and I suppose I can always hide out in my room for hours or days on end.  I've actually resorted to that sometimes.  It doesn't feel right, however, when I do.


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## Daniel (Jan 1, 2009)

> I suppose I can always hide out in my room for hours or days on end.  I've actually resorted to that sometimes.  It doesn't feel right, however, when I do.


That may not be much different than staying in some studio apartments, though obviously the kitchen isn't there in your bedroom.


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## stargazer (Jan 1, 2009)

LOL that's true.  Seriously though, in the past I was usually permitted a microwave.  In the cottage, where I last lived before subjected to an "owner move-in," I had my own microwave, and so with a room fridge I did not need to use the kitchen.  Here, without the permission of those provisions, I must share the kitchen.  When I'm in the kitchen trying to focus on what I'm doing (not my forte, by the way), and the landlady is in the living room watching TV (which she does 24/7 - another thing, I can't stand TV), she constantly nags me about this & that, making it even harder for me to focus.  I almost blew up at her yesterday, but instead was able to simply verbalize that I wasn't in a very good mood.  The force of my verbalization might have deterred her from further verbalizations of her own.  But need I be in battle with this person?

And it's only going to become more difficult once the third housemate moves to the Midwest one week from today.  I won't have his influence to buffer the battle any longer.


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## Meggylou (Jan 11, 2009)

Living with triggers and stressors really is a miserable thing. As much as I love my sister she is a huge trigger for me and I'm much happier now that she has moved out and is living with our parents again and it's just hubby and me. My problem is I want to eat healthy but healthy foods cost SO much money, and that stresses me out and eating crap makes me feel like poop. Gah!!


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## Daniel (Jan 11, 2009)

> My problem is I want to eat healthy but healthy foods cost SO much money, and that stresses me out and eating crap makes me feel like poop. Gah!!


BTW, a recent blog article:

Healthy Foods for Under $1 - Psychlinks


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## stargazer (Jan 18, 2009)

A couple things:

(1) I realized later that my hassle with the landlady was a typical tenant-landlord hassle, unrelated to one's mental health condition.  However, it reached a peak, and there was a knock-down drag-out between the two of us (figuratively speaking.)  Words were exchanged, and I wound up calling my therapist.

It gets tricky.  My sister no longer wants to be the Payee for my disability checks, and I had asked my landlady to do so.  My therapist had already advised me against this, and now that the landlady and I have had a hassle, the therapist's counsel makes even more sense.

The problem is: I can't find anyone else who wants to do it - including brother and daughter.  But my sister has her own physical and mental health issues, and I cannot consciably insist that she continue in this role.

Now, the landlady and I are getting along again, and I feel strongly that she ought to do it.  That way, when the check comes, she can just take the rent, and leave the rest to me.  (It's always gone by the fifth day of the month anyway, what with bills.)

(2) Getting seven hours of sleep a night seems impossible.  I'm lucky if I get more than three hours at any given shot.  Usually, I sleep for three hours, then am awake for four or five hours, then sleep for three more hours.  I am constantly falling asleep at various junctures during the day.  Why is this?

It did not used to be so bad, but it started with this particular combination of meds.  Something tells me it has something to do with the wellbutrin, because the depakote alone did not result in this pattern.


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## Daniel (Jan 18, 2009)

stargazer said:


> The problem is: I can't find anyone else who wants to do it - including brother and daughter. But my sister has her own physical and mental health issues, and I cannot consciably insist that she continue in this role.



I would have reservations, as well.  Certainly, at least according to Social Security, the ideal is to have a non-profit agency be the payee if family or friends are not available:

Social Security - Representative Payee Program - When People Need Help Managing Their Money

Social Security - Representative Payee Program - Fee For Service

My reservations would be that when it comes time that you want to move out, the landlord may start getting ideas about "security deposits" or, similarly, want compensation for the condition of the carpeting, etc.        Also, it doesn't seem like a very long term solution if you don't plan on staying there for more than a year.



stargazer said:


> Getting seven hours of sleep a night seems impossible.  I'm lucky if I get more than three hours at any given shot.  Usually, I sleep for three hours, then am awake for four or five hours, then sleep for three more hours.  I am constantly falling asleep at various junctures during the day.  Why is this?
> 
> It did not used to be so bad, but it started with this particular combination of meds.  Something tells me it has something to do with the wellbutrin, because the depakote alone did not result in this pattern.



As you may have read, difficulty sleeping is one of the more common side effects of Wellbutrin, at least in the beginning of treatment:

http://www.wellbutrin-xl.com/prescribed/side_effects.html

Personally, I experienced insomnia myself with Wellbutrin, but it went away in a few days. And my relative with bipolar disorder seemed to do well on Wellbutrin when he was depressed.  OTOH, my relative may have also been taking Klonopin at night at that time.


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## David Baxter PhD (Jan 18, 2009)

It may help to take the Wellbutrin in the morning instead of afternoon or evening.


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## Halo (Jan 18, 2009)

SG

Do you normally take the Wellbutrin in the morning or at night?  It might be a possibility to switch it to mornings if you are taking it at night currently however I would suggest talking to your doctor for sure.

Either way, I hope that you get the medication/sleep issue resolved and you can catch up on your much needed rest.

Added:  Obviously David and I think alike, he just typed faster


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## boi (Jan 18, 2009)

Hi Stargazer,
I take wellbutrin as well and I have some sleep issues, I wake up alot during the night. Maybe your sleep or rather no sleep issues are a side effect


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## stargazer (Jan 20, 2009)

Daniel said:


> Social Security - Representative Payee Program - Fee For Service



That's the program my therapist is suggesting.  My hesitancy has been along the lines of the transportation problem I will have in getting to the office where these people are, from where I am now.  But that's probably a relatively small problem in the greater picture.  Also, the fee will probably be less than the fee that California Check Cashing takes whenever I go there to negotatiate my sister's check, which is drawn on a credit union that is local to her vicinity, but that doesn't exist in mine.  Me, not having a checking account of my own, therefore have to go to a place like CCC to cash the check.  They take 4% plus a $3 fee, which amounts to more than forty dollars.  I hear the Fee-For-Service payees only take $25, so that would actually be better.

In any case, the sooner I let my sister off the hook, the better things will be.



Daniel said:


> My reservations would be that when it comes time that you want to move out, the landlord may start getting ideas about "security deposits" or, similarly, want compensation for the condition of the carpeting, etc.   Also, it doesn't seem like a very long term solution if you don't plan on staying there for more than a year.



I hadn't thought of that.  It's a good point.  I've been scared of certain conditions I might have left anyway, and a landlord is always on the special lookout for such things, being as they have a need to rent the room once more.  

Also, I'm not even sure I'm going to stay here more than another month, much less a year.  It's a constant question in my head.  She's not very easy to get along with consistently, and she seems to demand more from me than a simple landlord-tenant agreement.  I often leave the house after lengthy argumentative conversations with her, totally hassled.  She seems to thrive on dissonance.  The sense of chaos is almost too much for me, when there's enough chaos in my head to begin with.  

SHe's the type of person who seems intent on disagreeing with you, whether she's actually heard what you have said or not.  It honestly zaps me of all my energy sometimes.  But then, if I avoid her, she picks up on that, too; and is offended.  So she's even more nasty when I run into her after long periods of isolation.  Suddenly, it's BAM BAM BAM!! - She lays into me with a good weeks' worth of criticism at once.

At those times, I react reflexively.  My voice quivers, my hands and fingers start shaking, my breathing becomes difficult.  And she seems to enjoy it.  I keep thinking, given all factors - especially a non-ideal location for a non-driver - there has got to be as more ideal place for me to live.

On the other hand, I've been homeless five times in the past five years, and I'm lucky to have a roof over my head at all.



David Baxter said:


> It may help to take the Wellbutrin in the morning instead of afternoon or evening.



That occurred to me as well, but I wanted to speak with the doctor first.  However, I tried it anyway, and last night (the second night of taking the Wellbutrin only in the morning), I slept like a rock, solidly, for at least six hours.  So, I'll call the doctor, and maybe she'll agree.  



Halo said:


> Obviously David and I think alike, he just typed faster



Or rather, he typed "sooner."  I have no idea as to an actual wpm comparison.  I do know that my own wpm is a bit too fast for my own good sometimes.  :juggle:


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## stargazer (Jan 26, 2009)

I spoke with the hospital psychiatrist, and she said that I'm not supposed to take the wellbutrin at night.  She said that, since it's time-released, I'm supposed to take all 300mg in the morning.  The only reason they had me taking it twice a day at the hospital was because they didn't have the time-released tablets.  And even then, the second tablet was supposed to have been taken at four in the afternoon.

It will work better this way.  I slept eight and a half hours last night, in fact, which is unheard of.


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## Halo (Jan 26, 2009)

I am glad to hear that you got that sorted out and are getting some much needed rest :2thumbs:


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## amastie (Jan 29, 2009)

stargazer said:


> ...I slept eight and a half hours last night, in fact, which is unheard of.


That's wonderful stargazer!  :2thumbs:


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## stargazer (Jan 30, 2009)

stargazer said:


> I slept eight and a half hours last night, in fact, which is unheard of.



Even more unbelievably, this happened three nights in a row.  Each night, I fell asleep naturally at around eleven-thirty; and awoke right at 8:30am.  I guess that's actually 9 hours, come to think of it.   (Didn't do the Math right earlier.)

On the third night, however, my sleep was sporadic, with some periods of being awake during the night.  (This might have been because there were troubles on my mind, however.)  Then, the fourth night (the night before last), I was back to my old pattern, except for that I didn't wake up in the middle of the night (which I always used to do, when I had been taking the Wellbutrin at night).  But I only slept four hours - from 11:30 till 3:30.

That caused me to conk out twice during the day, which would have been almost impossible, had I not been in transit and on the train to Berkeley and back.

Last night I fell asleep again at around 11:30, then awoke at 4:45, which is a little more typical for me.  I still didn't wake up in the middle of the night, though, so it's still better than what was happening when I was taking the wellbutrin at night.  

But could five hours possibly be enough sleep for me?  I know myself, and I probably won't tire today.


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## amastie (Jan 30, 2009)

I'll keep you in my thoughts to get *plenty* of sleep and wake refreshed each day


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## stargazer (Jan 31, 2009)

amastie said:


> I'll keep you in my thoughts to get *plenty* of sleep and wake refreshed each day



Thanks for your positive thoughts, Amastie.  But I think it's unlikely.  I didn't tire much yesterday, and I got all my work done, though sometimes I was a little unfocused and more-than-a-little stressed.  Last night I didn't conk out till midnight, then fell asleep suddenly, and awoke at 3:30am thinking it was "morning."  I've been awake since then - it's about 5:30am.

I've always been *somewhat* like this - but this time it's extreme.  I wonder if it's because I'm having to think about moving, and so naturally I am under greater stress, consciously or unconsciously.

My situation isn't nearly as bad as it was when I was trying to find a place from having been homeless, and my sister had limited funds to put me up in a motel room several nights in a row so I could make a better presentation while looking for a room.  In that case, I was desperate, and I took the first room I could find on the last day that her money for my motel rooms was running out.  And look how it turned out - bad location, and all kinds of difficulties.  Ex-roommate was a methamphetamine dealer/user, had just gotten out of jail, etc.

I honestly think it helped me for a while to be living here - thickened my skin or something.  But now that I have all the way till March 1st to find a place to live, it just seems to me that in that length of time, with rent here already paid for February, I ought to be able to find a more ideal place.

Also, because I'm on SSDI, and have MediCare, and work from my laptop on the "side" (or maybe the SSDI is on the side) - it really doesn't matter anymore where in the United States I live.  A change of scene sounds good.  If I move to a larger city, I can probably always find a psychiatrist who accepts MediCare.  

Because of my "MediCare with Medi-Cal" dilemma, I will always be prone to "falling through the cracks of the system" as long as I remain in California.  It might actually be easier if I were to move to another State.

Well, obviously my living transition is always on my mind.  That's got to have something to do with the sub-standard amounts of sleep I've been getting.


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## amastie (Jan 31, 2009)

I can't stay right now stargazer, but I forget, are you taking meds to help you to sleep.  If I had more time I'd do a full reading of the thread but my mind isn't working well at present.  *I'm* needing to go to bed <lol>

Take care


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## stargazer (Jan 31, 2009)

amastie said:


> Are you taking meds to help you to sleep?



No, I'm not.  I usually fall asleep readily enough - it's just that I awaken about fours later, and I don't *want* to sleep anymore.  I strongly feel like getting up and doing things, so I do.

The meds I'm taking are strictly for Bipolar One / hypomanic, and for anger issues, in combination with therapy, once it gets rolling.


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## amastie (Jan 31, 2009)

stargazer said:


> No, I'm not.  I usually fall asleep readily enough - it's just that I awaken about fours later, and I don't *want* to sleep anymore.  I strongly feel like getting up and doing things, so I do.
> 
> The meds I'm taking are strictly for Bipolar One / hypomanic, and for anger issues, in combination with therapy, once it gets rolling.


If your meds are for hypomania, then I'm guessing that their purpose is to slow you down and to relax you.  Are you taking enough of them to fully give you the opportunity to sleep fully.

I imagine that you know that hypomania is a reason for *not* sleeping well, that as well as you feel  when you wake that is not necessarily a sign of *being* well for you.

And as for the irritability/anger that you speak of in your other posts, that too is very typical of hypomania.  Have you discussed with your doctor/psch whether you are on enough of the meds for the hypomania?  Because, to me, much of what you describe is the sort of symptoms I would expect to see being due to hypomania.  And as much as those symptoms don't necessarilly feel "bad" they can incur problmes nonethless.  But I fully expect you to know that


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## stargazer (Feb 6, 2009)

This is getting too complicated for me.


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## amastie (Feb 7, 2009)

Sorry stargazer.  I think when I posted that earlier post I was having trouble myself focussing 

Take good care


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## Always Changing (Jun 28, 2009)

Is it possible to make the First post on this thread a sticky?


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## Into The Light (Jun 28, 2009)

thread has been made a sticky  thanks for the suggestion!


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## kelsischanging (Jun 29, 2009)

> *Don’t drink alcohol*. (This is a biggie.) Drinking alcohol can neutralize the beneficial effects of the medications and interact with some medications to cause liver damage, seizures, unpredictable shifts in mood, and other health problems. (Avoid other substances, as well, including medications that your doctor has not prescribed for you.)
> *Steer clear of stimulants*. Caffeine, nicotine, and other stimulants could tip your mood balance, especially if they cause you to lose sleep. Yep, those energy drinks gotta go.



Wow, I'm glad I read this list.  I know that all the medications I take for my bipolar disorder say not to drink alcohol but I never knew why and I certainly did not listen to that warning.  When I felt my mood getting worse or myself getting manic I usually increased the amount of alcohol I consume a day so obviously this was having the opposite effect than I wanted it to.  Also I drink about four pots of coffee a day and I never thought about the effect of caffeine.....

Thanks for posting this list! :cool2:


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## Missed Link (Jul 1, 2012)

Something I've learned that helps me a great deal:
When depressed, anxious or in a mixed state, I used to think about how I felt a lot saying to myself many times during the day things like, "Why do I have to be so tired?" or "I feel like I'm in a dark and desperate pit", etc. When would try to suppress what I was feeling, which was a losing battle--it only fueled the problem, empowered it.  What I finally started doing instead was replacing my negative self talk with something positive, like "I'm so happy the sun is out" and then go to the window and look at the sunshine in the trees. Or, "I love the smell of vanilla extract, it is so comforting" and then go to my cupboard and smell it. It didn't matter that I didn't feel happy or comforted and saying those things didn't change how I felt. What it did do as I practiced it day after day, week after week, was to change my focus. I was no longer reinforcing negative thinking and that helped to stop the downward spiral of depression, and/or the escalating intensity of anxiety or mixed moods. I was no longer giving the moods extra fuel. I took back some control. It was hard work for a couple of months to make myself do this, but now it is second nature and I am mentally and emotionally healthier for it.


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## abram (Jul 25, 2012)

thats really good advice I like the part about having healthy routines, easier said than done, you know what i mean, for me cause I lost my drivers license, 
       I used to drive to town for fun in the evening, instead now i stay home all weekend, easy to get sucked into unhealthy habits.
thanks for reading abram


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