Bipolar disorder can feel like a roller coaster in the dark. You don’t know when the turns or drops are coming. You don’t know when you’ll be flipped upside-down. And once you do, it’s too late. You’re in a manic episode, doing things you’ll regret. You’re in a depressive episode, too exhausted to get out of bed.
You feel like you’re being whipped around by an erratic condition, and you have zero control. You’re simply along for the ride. Which is why self-awareness is so vital. Self-awareness is essential to successfully managing bipolar disorder—and not feeling like you’re plunging headfirst into an abyss.
You can learn how your bipolar disorder manifests and functions. You can identify your personal triggers and red flags that signal an episode coming on. You can begin understanding how certain behaviors, habits, relationships, stressors may be exacerbating the condition. And you can intervene. You can find coping strategies that work best for you. You can create a preventative plan.
While there are commonalities among people with bipolar disorder, your illness is as unique as you are. “People living with bipolar disorder experience their own unique set of symptoms and mood fluctuations,” said Colleen King, LMFT, a psychotherapist, artist, and nature lover living with bipolar disorder and passionate about helping others with mood disorders live a full and joyful life.
And, thankfully, as you develop a better, deeper understanding of your bipolar disorder, you can use self-care practices and healthy coping strategies “to gain a sense of control over it, and increase your self-confidence and self-worth,” she said. Here’s how.
Practice 5-1-7 breathing. Deep breathing is a powerful way to pause, and give yourself the space to self-reflect. Deborah Serani, Psy.D, a psychologist who specializes in mood disorders, suggested this exercise: Find a quiet place to sit comfortably. Close your eyes. Place one hand on your heart, and the other hand on your belly. Count to 5 as you inhale. Hold your breath for 1 second. Then exhale for 7 seconds. Focus on your body and the experience of peace in your mind. Repeat this exercise several times.
Learn to listen mindfully. Practice tuning into pleasant sounds in your environment. For instance, you might notice the birds chirping, kids laughing or rain falling, said Serani, who’s written several books on depression. “If your space doesn’t have such sounds, create it by playing soundscape music.”
Pay attention to dates. Serani suggested looking at the calendar and marking dates that may be difficult for you. This might be a date your loved one died. It might be the birthday of an ex, a time you’d do something special. It might be “the season of year an accident happened,” she said.
Then think about what you need on this day. Serani shared this example: The day your mom passed away is very upsetting for you, so you remind others a few weeks before, and ask for extra support and love.
Pay attention to your emotional experiences. Serani stressed the importance of noticing the experiences that make you emotional—and considering these questions: Do I get emotional when someone treats me a certain way? Do certain words set me off? Which scents do I find comforting or distressing?
Serani encourages her patients to use their senses to understand how different moments can cause distress. “When you do this, you become more detailed about what your triggers are and how they feel to you.”
And you can do something about them. Serani shared this example: A certain situation leads you to feeling bad about yourself. Your automatic response is to tell yourself: “I don’t care about myself anymore.” Instead, you say: “I’m having a negative response, but I don’t have to be negative to myself.”
Identify your episodes. “It’s crucial to learn to become a keen observer of how bipolar disorder shows up in your life and how you respond to it,” King said. Which includes knowing what your episodes look like. For instance, how long does an episode last? It might be one month or one year. Do you have mixed states? Maybe you experience intense depression with coinciding anxiety, she said.
Pinpoint your red flags. Try to identify the specific symptoms that precipitate an episode. King shared these examples: When you’re hypomanic, do you eat less, sleep 3 hours a night and feel compelled to start new projects? When you’re manic, do you have racing thoughts, feel paranoid and have strong beliefs that your loved ones dismiss? When you’re depressed, do you withdraw, feel utterly exhausted, have a hard time concentrating and stop caring about the quality of your work?
Pay attention to your sleep and diet. “Having a regular bed time and awake time (even if you’re not sleeping), along with a consistent nutritional diet for your body can have an immensely beneficial effect on the outcome of the illness,” King said.
She suggested noticing your mood when you wake up and the quantity and quality of your sleep. Note how you feel when you’ve kept a regular sleep routine and when you’ve slept irregularly. “Pay attention to how you feel when you skip meals or eat a diet with poor nutrition for your body, and how or if it affects your mood.”
Enlist help. Talk to your treatment team and loved ones about their observations. Ask them to identify the signs and symptoms they notice before and during a mood shift, King said.
Take advantage of electronic tools. King strongly encourages her clients to use a mood charting app or website to record anything that affects their mood. This includes: sleep, meals, menstrual cycle (when applicable), and any stressors or important events.
List symptoms and strategies. An alternative to mood charting is writing down a list of symptoms and coping strategies that you’ll use to address them, King said. She shared this example: A person who regularly cooks notices they’re slipping into a depression when they start avoiding grocery shopping, cooking less frequently, eating fast food and skipping meals. To help them cope, they ask loved ones for help; explore possible depression-sparking stressors; meet with a doctor; buy nutrient-rich, ready-made snacks; and set phone reminders to eat them.
Pay attention to different stimuli. According to King, “Getting to know what helps you function better allows you to be able to be more in charge of arranging your life to create as much stability as you can.” Which is why it’s important to look at all areas of your life, and the details of your days.
For instance, you might explore these questions, King said: Does social interaction boost my anxiety or fatigue? Do I typically procrastinate? Do meetings with many people motivate or overstimulate me? How does alcohol and caffeine affect me?
Do a body scan. King underscored the importance of doing daily check-ins to identify physical sensations—like headaches and hunger—and emotional states—like irritability and overwhelm. (She also suggested noticing “what feels positive, such as getting a good night of sleep, feeling confident, or happy that you made it to work on time.”)
Start by scanning your body from head to toe. Focus on one body part at a time. Bring awareness to any pain or tension. Then scan your body for emotions. Name what you’re feeling (without judgment).
“When you stop to tune into your body and mind, you can take stock of how you’re doing, and then empower yourself by taking good care of you,” King said.
Which is important because many times you might feel utterly powerless—as though your illness is the boss, and you’re sitting in the backseat as the car careens into oncoming traffic. You might, understandably, feel overwhelmed and frustrated. But by building your self-awareness muscles, you take back your power, you feel better and you get off the roller coaster.