Survival Tactics: Bipolar Disorder Edition

In the first episode of this 2-part post on survival tactics, I went over a few things that I do to minimize the daily miseries of ADD. Today’s focus is on strategies for bipolar disorder, which is somewhat more tricky because the symptoms are more diverse and unpredictable.

Unlike ADD, which is a disorder that I literally struggle with every day, bipolar is something that comes and goes for me. It’s an issue much of the time, but not all of the time, so it’s harder to feel adequately prepared. Plus, I’m still getting used to this whole bipolar rigamarole from a formally diagnosed point of view. I’m hoping to learn a lot more in DBT later this spring.

Mood Swing Management Mechanisms

I’ve been slogging through depressive episodes for 20 years, but I’m only just now getting a grip on how to handle hypo/manic episodes. I don’t have as many explicit tactics for handling this stuff, though, and some of it is just setting firm limits to prevent my behavior from spiraling out of hand. A little is OK, but a lot is bad news when it comes to practically everything.

1. Problem: Too miserable. Can’t function.
   Solution: Set the absolute minimum requirements for the day at the outset: shower, dress, check email, do one work task, prepare something healthy to eat. Add other optional things to the list, just in case. Never, ever back down on the minimum requirements. I can do these things, no matter how bad I feel.
2. Problem: Too high. Can’t function.
   Solution: Set the completion tasks for the day, the things that absolutely have to get finished. Do not start anything else until those tasks are done. The anticipation is painful, but once the requirements are completed, flutter about to my heart’s content. I’m hyperproductive during these episodes, so it’s usually all good. Keep notes of all the other ideas that come up as they come up, but do not act on them until the requirements for the day are met.
3. Problem: Food preparation when depressed or stressed. Just because things are crap doesn’t mean I shouldn’t feed myself appropriately; failing to do so just makes everything worse.
   Solution: Plan ahead. I know the depression will come back, so why not be ready? When the produce is rolling in from my CSA during the summer, which is also when I generally feel pretty good, I freeze and can a lot of food. I make extra-large batches of soups, stews, and chili, and freeze half of them. This is how I prepared for the final sprint of dissertation writing; I knew I would often be low on time or energy for cooking and yet, I can’t tolerate over-processed foods, so it has to be homemade. Set a limit on how often I can go out to eat (once a week, usually) and make it a date with Mr. Chickadee. Buy frozen lunches for high-stress work periods; I choose the Kashi meals because they have few additives and are pretty good nutrition.
4. Problem: Binge eating with atypical depression and/or under stress.
   Solution: Portion control. I use silicone cupcake liners to hold a serving of M&Ms, nuts, dried fruits, or whatever other snacky thing. Never, ever eat out of the bag/jar/package. Take portion and sit down to eat it. Make myself get up and go to the kitchen to get more. Having to do that more than once makes a point that I need to stop.
5. Problem: Failure to eat when meds suppress appetite or manic, leading to low blood sugar meltdowns.
   Solution: Rely on others for cues about when to eat. Listen for growling tummy. Feed it when it cries out for nourishment.
6. Problem: Lack of motivation, typically due to depression.
   Solution: Explicit rewards – with limits. They can be substantive (buy a CD or go out for a bubble tea when I complete this chapter) or trivial (get up and clean something, make tea, anything other than work when I complete this task or set of tasks.)
7. Problem: Excessive consumption of intoxicants to self-medicate.
   Solution: Teetotalling if I really can’t handle moderation – cranberry juice and seltzer water looks like a mixed drink and tastes good enough to keep sipping. Trying strategies like Moderation Management if I feel I can exercise enough control. Setting limits in advance, and making a game plan for social events that will involve drinking. Having a default limit, e.g. never under any circumstance more than 3 drinks unless a different prior plan was established. During conferences or business trips, picking one evening to get rip-roaring drunk, and limit myself to 2-3 drinks for all other days.
8. Problem: Required business travel triggers mood swings.
   Solutions: Complex – see more details on my blog.

I’m sure other Canvas authors and readers have more great strategies for managing highs and lows. It’s hard, and we all have to approach it differently because of our symptoms, history, and skills. So, what works for you?

© DeeDee and A Canvas Of The Minds 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to DeeDee and A Canvas Of The Minds with appropriate and specific direction to the original content.

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