If you live with bipolar disorder, you may have wondered if you can prevent manic or depressive episodes. While everyone is different, there may be some options that can help you.
Bipolar disorder is a complex condition.
Some people may find that they are able to prevent some manic and depressive episodes.
Others may find that, while they are not able to prevent episodes completely, they can lessen or manage the symptoms. We asked two experts for tips on how to cope.
You may find that some depressive and manic episodes are preventable to some extent, though this may not be with 100% accuracy.
That’s because bipolar disorder is caused by a combination of factors that are unique to you — some factors that are in your control and some that are not.
- brain chemistry
- family history
- environmental factors
With that said, there are some preventive measures that can be put in place in order to decrease the frequency, intensity, or duration of manic and depressive episodes, says Chanel Johnson, a licensed professional counselor in Detroit, Michigan, who lives with bipolar disorder.
The most recent
A 2020 study noted that the earlier there is support and intervention, the better the treatment outcomes will be.
A word about prevention
If you are doing everything you can think of to manage symptoms, and you’re still experiencing bipolar episodes, there’s nothing wrong with you. This is not your fault and it’s not something you’re choosing.
Foremost you may consider revisiting your medication options with your prescribing psychiatrist.
It’s also recommended that you work with a therapist to find the most fitting treatment plan for your specific situation, as it’s going to be different for everyone.
You may find it helpful to try a combination of approaches to see what works best for you.
Try to seek out professional support
A number of self-care strategies can help prevent bipolar disorder episodes, but first, it’s important to accept your symptoms and seek professional support, says Dr. Lee Phillps, a psychotherapist and certified sex and couples therapist in Virginia and New York.
“Once you accept your diagnosis, you can work with a therapist on a treatment plan,” he says. “The most effective treatment for bipolar [disorder] is a combination of psychotherapy and medication management.”
While in therapy, says Phillips, you can build your coping skills to help prevent or lessen future episodes. “These coping skills can include joining a bipolar disorder support group, so you can be around others for support,” he adds.
Try to maintain a regular sleep schedule
If possible, try to wake up and go to sleep at the same time every night. Having a routine allows you to go on auto pilot and trains your body physiologically, says Johnson.
“If your body knows that you go to bed at 10 p.m., it knows to release some extra melatonin around that time, which certainly helps if you’re having racing thoughts (a symptom of mania) and having a hard time shutting things down,” she says.
Consider an exercise routine
“Staying active can be helpful because it can help prevent a depressive episode. If you’re [experiencing mania], exercise can help calm the nervous system,” he says.
Try to limit substance use
Research suggests that substance use may heighten some symptoms of bipolar disorder.
For example, a 2019 study noted that smoking tobacco (alone or while using other substances), was a risk factor for suicide attempts during depressive episodes.
You may find it helpful to reduce or limit substances, including:
- recreational drugs
Try a mindfulness-based activity
Stress can be a trigger for bipolar episodes.
Some studies suggest that regular mindfulness practice may help bring you into the present moment and feel more balanced, says Johnson.
“Adding meditation, yoga, and exercise to your daily routine is a great way to manage stress and help stabilize your mood. Activities that invoke mindfulness, focus, awareness, and physical activity help to soothe the nervous system,” she says.
Try to be mindful of the weather
Research shows that weather can be a trigger for bipolar disorder, like temperature and sunlight, says Phillips.
“During the winter months, you may feel more depressed. In the spring, you may become manic. Therefore, a therapist can help you prepare for these seasons with an action plan on how you are going to cope,” he says.
Try to balance your nutrition
A growing body of evidence suggests that a healthy diet of whole foods plays an important role in preventive maintenance, says Johnson.
“Processed foods wreak havoc on our gut microbiome, affecting the neurotransmitters and hormones that regulate and stabilize our mood,” she says.
“Processed foods often come in the form of simple sugars that cause insulin levels to spike and drop drastically. Unstable insulin levels lead to an unstable mood,” Johnson explains.
You may find it helpful to ask your doctor for a referral to a dietitian or nutritionist.
If possible, stick to your medication regime
There may be times when you feel like you don’t need your medication anymore.
“You may stop taking medication because you feel great while experiencing mania. But this may only cause your symptoms to become worse,” explains Phillips.
Instead, work with a doctor or therapist before making any adjustments to your medication. If necessary, ask a loved one to help keep you accountable.
You don’t have to do this on your own. In most cases, the prevention and treatment of bipolar disorder include a multi-pronged approach.
Therapy can help you identify your thoughts, feelings, and situations that may be triggering symptoms of depression and mania, and then challenge your thinking by introducing cognitive restructuring, says Phillips.
“Somatic therapy is great in helping you identify what is happening in your body first before naming your emotions. Mindfulness-based interventions are great because they can bring awareness of what is happening in the moment,” he says.
You may find it helpful to find a therapist who specializes in bipolar disorder.
A medication regime may be effective in preventing some bipolar symptoms.
Current research shows that combining certain types of medications can help prevent the onset of more severe symptoms, like hospitalizations during mania, or suicidal thoughts during a depression episode.
Medications for bipolar disorder may include:
- mood stabilizers
- antidepressant medications
For some, antidepressants alone can actually lead to a manic episode, says Johnson. The ideal combination is going to be different for everyone. It may take some time to figure out how you respond to certain medications.
“I was switched from an antidepressant and anxiety medication regimen to a mood stabilizer. I couldn’t believe it after 2 weeks. I felt like myself again. If you have bipolar disorder, you know what a huge deal that is,” says Johnson.
Bipolar disorder is a complex condition.
While there may be no way to prevent manic or depressive episodes 100% of the time, there are some supportive practices that may help, like keeping a regular routine, getting enough sleep, and balancing your nutrition, among other strategies.
Bipolar disorder, in general, is highly treatable and there is hope. A typical treatment plan includes a combination of therapy, medication, and lifestyle adjustments. Be sure to work with a professional to find the right treatment approach for you.