Bipolar Disorder: What I can do to prevent future episodes?

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Bipolar disorder can be a challenging illness to manage. One way you can help to stay healthy is to learn more about when your symptoms tend to develop and what this looks like for you. This knowledge is invaluable to helping you to plan for future mood changes. You can use problem-solving strategies to determine ways you can help prevent symptoms from becoming full blown. Knowing what triggers or sets off your symptoms and learning to recognize early signs can help to smooth down bumps on the road.

How can I find out what triggers my symptoms?

Think back on your past mood episodes and can ask yourself the following questions:

  • What was going on in my life?

  • What set me off?

  • Were there particular stressors?

  • How did I respond to the stress (e.g., what did I think, feel, do?)

  • Did it upset my sleep?

  • Did it upset my eating or other daily habits?

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How can I tell my healthy good moods apart from my symptoms of mania acting up?

Although monitoring yourself for signs of early mania is important, you do not want to be fearful of every positive state of mind you experience. You may need to think about a way of recognizing your “normal” good moods; you do not want to miss enjoying satisfaction and piece of mind in your everyday life.

You may find it helpful to ask yourself some of these questions:

  • Am I able to sit down and enjoy reading a newspaper or book without becoming bored or terribly distracted?

  • Am I able to have a conversation in which I do most of the listening?

  • Can I complete tasks without repeatedly becoming sidetracked by other ideas or projects?

  • Am I worried about some things in my life?

  • Can I enjoy moments of quiet and serenity?

  • Am I sleeping well and for regular amounts of time?

  • Can I accept well-meaning criticism from others without becoming unduly irritated?

  • Do I feel more contented with life and not have the urge to ‘stir things up’ or do something risky?

If you answered yes to most of these, you are probably experiencing a healthy good mood. If you answered no to many of these questions, you will want to take a closer look at your thoughts, feelings, and behaviour for any early warning symptoms of mania. It is also helpful to ask your family and friends if they have noticed any changes in you that are worrisome. Sometimes it’s hard to see the changes in yourself.

Possible Early Warning Signs of Mania

  • Feeling on top of the world, even when events in your life are not going very well.

  • Being much less anxious than you usually would be about important situations. For example, not being worried about an exam at school or a performance evaluation at work that usually would make you nervous.

  • Feeling that your thoughts are racing.

  • Sleeping less.

  • Feeling more irritable.

  • Talking a lot more and finding it hard to spend time just listening in a conversation.

  • Talking fast.

  • Increased purposeful activity, such as cleaning.

  • Using more alchohol or drugs, especially if these have been used to calm yourself in the past.

  • Spending less time caring for yourself.

  • Increase in sexual drive.

  • Increase in risk taking behaviours such as reckless driving, going home with strangers, or other dangerous activities.

  • Increase in impulsive behaviours, such as over-spending or making big decisions without taking the time to think things through.

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Examples of strategies for dealing with early symptoms of mania

  • Explore medication solutions. Review with your doctor possible changes in dosages or a change to different medications.

  • Give yourself a break. Review your current life situation and problem solve any stressful events

  • Slow down life. Better to take off a little time now, than a lot of time later if symptoms become severe.

  • Challenge overly positive thoughts. Look for evidence for and against extremely positive thoughts.

  • Review your decision to try to avoid manic episodes. List advantages and disadvantages of manic episode when you are feeling well. Write this out on a flashcard to use as a prompt when you are feeling tempted to ignore the signs of oncoming mania.

  • Maintain adequate sleep. Use sleep management strategies to establish a healthy sleeping routine and increase time spent sleeping.

  • Increase time sitting and listening. For example, make an effort to listen more in conversations, spend time listening to some favourite music, or watch a favourite TV show or movie.

  • Use relaxation techniques

  • Avoid or minimize drug/alcohol use.

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How can I successfully manage the rest of my life

Stress has been found to worsen bipolar symptoms and make relapses in symptoms more likely. This is why general stress management and taking good care of yourself is important. This may mean making some hard decisions about your lifestyle choices. The aim is to find ways to live well with bipolar disorder. This may include many possibilities such as the following:

  • Deciding whether some life style choices will not work for you (e.g., shift work, staying up all night writing exams).

  • Making a special effort to eat and sleep regularly.

  • Aiming for stable life style.

  • Having regular exercise.

  • Spending time with family and friends.

  • Learning from others who are living successfully with bipolar disorder.

  • Using stress management strategies.

 

For information on support for people with mood disorders and their families, please visit the Mood Disorders Association at www.mdabc.net or call us at 604-873-0103.

 

Developed by the Mood Disorders Association of British Columbia. Funding for this fact sheet was made possible by the Provincial Health Services Authority.