11 things I’ve learned living with bipolar disorder for 24 years

1. Psychiatric meds are not the only answer to mood stability: there are several things you can do each day that supplement and accompany the good effects from meds. For example:

• Long, brisk walks 5–6 days a week have helped to keep my storms calm and always improve my mood for the remainder of the day. After walking, I have more energy and I’m more willing to stay busy with my writing and doing chores around the house.
• Meditating 15 minutes every morning for the past several months has helped me immeasurably: to stay calm and focused, to be present/live in the moment, and to not let stressors bother me as much as they have in the past.
• Trying to eat healthy every day: not overeating or not eating enough, staying on schedule for 3 meals a day; not too much sugar, salt or snacking in-between meals; trying to avoid eating anything 2–3 hours before bed. I recommend reading The Bipolar Diet book by Sarah Freeman available at https://www.bipolar-lives.com/.

Freeman writes that people with bipolar disorder have heightened sensitivity to unhealthy foods such as refined carbohydrates and saturated fats. The more we eat these unwholesome foods, more frequent and severe mood swings will result. Bipolar Diet Book (2016), Sarah Freeman

Drs Fred Goodwin and Kay Redfield Jamison have documented a pattern of reactive hypoglycemia in people with bipolar disorder. Reactive hypoglycemia is low blood sugar that occurs 1–3 hours after a meal. The symptoms include fatigue, depression, anxiety, irritability, craving sweets, poor concentration and confusion, panic attacks, clumsiness, pounding or racing heart, numbness or coldness in the extremities, and outbursts of rage. Eat in a way that stabilizes insulin and blood sugar as much as possible. Bipolar Diet Book (2016), Sarah Freeman

A 2009 study showed that people with bipolar disorder are 1.5–2x more likely to die from physical diseases such as heart disease, stroke, and diabetes than are members of the general population. Heart disease, hypertension and diabetes are at epidemic proportions in developed countries like the US to begin with. For people with bipolar disorder, it is twice as urgent to follow a food and exercise plan that will manage these risks. Bipolar Diet Book (2016), Sarah Freeman

2. I am honest with myself about my limitations and the things I cannot do if I want to maintain mood stability. For years I did not want to believe I was bipolar: I tried to convince myself that it was only drugs or difficult life situations that caused my volatile mood swings. But, yes, I am bipolar and I practice acceptance every day in order to live the best life I can.

“I’m just glad I’ve come to this place of acceptance in my life. I wake up every morning and say, okay — I’m a lesbian. I’m a black woman. I have mental health issues. This is who I am. So let me step into the world and live my truth.” — Chamique Holdsclaw, WNBA player & Olympic medalist

“One of the things that baffles me (and there are quite a few) is how there can be so much lingering stigma with regard to mental illness, specifically bipolar disorder. In my opinion, living with manic depression takes a tremendous amount of balls.” — Carrie Fisher

“What do you do, then, if demands on your time and energy are too much? If being strict about your routine keeps your stress level down, do that. If being flexible about your routine works better, do that. Try one. Try the other. Prioritize your well being, whatever that means.” — Ellen Forney, Rock Steady: Brilliant Advice From My Bipolar Life

3. After 20+ years, finally being 100% honest with my psychiatrist about my moods, about taking my meds, about my alcohol consumption and if I had been using any street drugs in-between visits (I have not in more than a year!)

4. Limiting my time on social media to brief (5–10 minute) Instagram visits (mainly with bipolar and recovery followers); using the Moodnotes app (a daily journal of what is going on in my life); and the Huddle app (its bipolar group: an honest discussion about the illness by people who suffer from it). Both have helped me to learn more about myself and my illness and how it affects others. I try to help other people with what I have learned and experienced over the years.

• Moodnotes first asks: “How are you?” You answer by adjusting the emoticon’s facial expression: sad or happy or in-between. Then you’re asked: “What’s happening at the moment?” I usually write the hours I slept; anything that may have triggered me in the past 24 hours to feel sad, depressed, happy, hypomanic or stable; the meds I’m taking, any side-effects I may be experiencing, dosages and anything new; info about appointments with my psychiatrist or gp; anything happening or looming that’s causing me concern with my moods; my exercise routine; any notable events with my daughters or girlfriend; positive things I have planned for the day
• The ability to go back and read these entries as time passes enables me to see patterns, good and bad, and how my mood stability has benefited or suffered
• Next you’re asked “Which feelings fit your mood?” There are a couple dozen positive and negative feelings you can select (as many as you see fit). Then you can “Enrich this entry by practicing a healthy thinking habit that promotes positive mood.” For example: “What goal would you like to set that is realistic and consistent with your values?” “What’s the first step you could take towards achieving this goal?”
• From a menu you can see “moodtrends” (a summary of past weeks and months) and “insights” (a snapshot of your moods over time, how you usually feel and any thinking traps you’ve encountered)
• Members of the bipolar group in the Huddle app can make video and/or text posts about what is going on their life at the moment, what has happened in their past, or worries about their future. Other members can comment on the posts or directly message another member about a topic or situation.

5. Keeping a blog about my bipolar experiences for a few years that allows me to write openly and honestly about my illness in a public forum. I always feel better when I’m able to get something off my chest or discuss something that’s been on my mind for a while. 6. Reading memoirs and non-fiction books about mood disorders and addiction, including:

• Rock Steady: Brilliant Advice From My Bipolar Life and Marbles: Mania, Depression, Michelangelo & Me, by Ellen Forney
• Clown & I: Riding The Wilding Spirit, by Ryan Heffernan
• Birth Of A New Brain, by Dyane Harwood
• Mental: Lithium, Love and Losing My Mind, by Jaime Lowe
• I’m Not Crazy Just Bipolar, Wendy K. Williamson
• Two Bipolar Chicks Guide To Survival, Wendy K. Williamson & Honora Rose
• Owning Bipolar, by Michael Pipich
• An Unquiet Mind and Exuberance, by Kay Redfield Jamsion
• Electroboy, by Andy Behrman
• Tristimania, by Jay Griffiths
• Strictly Bipolar, by Darien Leader
• Hurry Down Sunshine, by Michael Greenberg
• Detour: My Bipolar Road Trip in 4-D, by Lizzie Simon
• Madness, by Marya Hornbacher
• Manic, by Terri Cheney
• The Eden Express and Just Like Someone Without Mental Illness Only More So, by Mark Vonnegut
• Bipolar Happens: 35 Tips and Tricks to Manage Bipolar Disorder and Loving Someone With Bipolar Disorder, by Julie. A Fast
• Buzzkill, by Peter Goodman
• More, Now, Again: A Memoir of Addiction, by Elizabeth Wurtzel
• Long Shot, by Sylvia Harris
• A Brilliant Madness, by Patty Duke
• We All Fall Down, by Nic Sheff
• My Fair Junkie, by Amy Dresner
• The Recovering: Intoxication and Its Aftermath, by Leslie Jamison
• Drinking: A Love Story, by Caroline Knapp
• The Heroin Diaries, by Nikki Sixx
• Out Came the Sun, by Mariel Hemingway
• These Are The Days, by Markus Almond
• Another Bullshit Night In Suck City, by Nick Flynn

7. Getting a good night’s sleep, consistently (the #1 priority for people with bipolar disorder). I know my mood is easily off with too little or too much sleep. The meds trazodone and melatonin; white noise from a fan; and a cool place to sleep all help me. I keep regular hours of waking and going to bed. I’m a morning person and I am almost always awake by 6 a.m. 7 hours of sleep is optimal for me to have positive days with less frequent vacillations in mood.

8. Music is the melody of my life: whether it’s in my headphones when I’m walking or through my car’s speakers when I’m driving. And playing my acoustic guitar and (trying to) sing a few times a week, just for me, is an enjoyable and relaxing experience.

9. Drugs and alcohol, to combat depression or mania/hypomania, are never the answer (but I used to think they were the only answer). I’ve learned that I must limit my alcohol to just a few glasses of wine a week, if any, and avoid all street drugs and addictive prescription drugs. This has greatly improved my life and lessened my mood swings.

10. Paying attention to my cat: petting her regularly and playing with the odd toy with her.

11. I now take quick notice the first signs of a mood swing and I make appropriate changes to my day: rest more than usual, try to eat healthier, more exercise sessions, meditate more or for longer durations, cut even further back on my alcohol intake, and talk to someone who understands the illness and who knows me.

Mood stability is a life-long journey, not a destination. Every day is another page in a new and improved memoir each of us is writing.

- — — I am the host of the Mindful Bipolar podcast and writer for the mindfulbipolar.com blog.