A few days after I got my diagnosis, I checked out a stack of books about bipolar from the library. I quickly returned the large percentage that seemed to equate having bipolar with being an idiot.
The ones that were left all said pretty similar things. Take your medications. Learn to manage stress. Keep a regular schedule. Take your medications. Get plenty of sleep (but not too much!). Track your moods. Find a therapist. Take your medications. Recruit your family to be your allies in managing your illness. Be suspicious if you start to feel too confident. And above all, take your medications.
Some of these I was already doing. Others were more challenging.
Here are some of the lifestyle changes that I implemented or to which I recommitted when I started taking mood stabilizers:
Bed by 9:45pm, up by 5:45am, seven days a week. At least, that’s the plan. But bedtime has always been my nemesis, and sometimes I just don’t feel like going to bed at 9:45, so this is, as it was before my diagnosis, hit or miss.
Regular daytime schedule.
Theoretically, I wake up at 5:45, put on exercise clothes, and take my first medication. Then I write for a half-hour, eat breakfast, and exercise. Then I shower, brush teeth, take my second medication, do the standard chores, and am ready to start the meat of my day by 8am (mmm…meat). I eat lunch between 11 and noon most days and dinner between 5pm and 6pm. Any evening activities I schedule so that I can be home by 7:30 so I can get ready for bed and avoid screens after 8:00pm, when I take my third medication. Then journaling and bed at 9:45pm. The evening is the time that the schedule is most likely to get derailed. That and the morning. And sometimes we eat lunch at 2pm. But other than those, I am very good at keeping a regular daily schedule.
Mood swings can be associated with blood sugar dips and spikes, so I try to eat to keep my blood sugar steady. Lots of whole fruits and veggies, protein, whole grains in moderation. I avoid all sweeteners, caffeine, and alcohol. Of all of these things, I miss the alcohol the most, especially on a warm, sunny day when a beer on the patio would be just about perfect. It’s safe to drink in moderation* on my medication, but the idea of adding more tipsiness to the already cognitively challenging and physically unbalancing side effects doesn’t sound appealing. Getting enough water isn’t a problem as my medication parches my mouth and throat and I’m constantly drinking water in an attempt to moisten my mucous membranes. I even search for water in my dreams.
Like a good little mentally ill person, I downloaded a Mood Tracker from Gary Sachs, MD, of the Massachusetts General Hospital Bipolar Research Program. I print it off a little smaller than full size and tape it into my Bullet Journal because a Bullet Journal is way more hip than a regular day planner. I fill out the tracker every evening before bed. Or most evenings. It helps me to track shifts in my mood and connect them with other variables, like illness, menstruation, travel, stress, medication changes, and sleep. And because some side effects—like sleepiness or cognitive slowing—can also be symptoms of depression, it helps to track my side effects alongside my mood so I can get a better sense of whether they’re caused by the medication or by my mood. My psychiatrist says it’s a good idea but doesn’t look at it.
I’ve added yoga back into my schedule and try to practice three days a week or more. In the old days (like, in 2012) I meditated every morning, and it’s a great idea but I haven’t been able to figure out how to work regular meditation into my schedule yet. I do find the breathing and mindfulness techniques helpful when I’m on the verge of a panic attack on an airplane, for example. They aren’t as effective in staving off bipolar rage, but that’s what the mood stabilizer’s for. That and eliminating the delicious days of confidence and euphoria that used to be the bright sunshine in my otherwise overcast existence.
Every day I try to walk or run for at least thirty minutes, during which time I listen to audiobooks or podcasts. In the past month, I’ve finished two books and all of S-Town this way (and with a little listening while doing dishes and driving to the few things I do without my children in tow). I also do yoga, strength training, and HIIT workouts. The exercise is the easiest for me to keep up with.**
These are the things I’m trying to do to manage my moods while living the rest of my life, but sometimes these things feel like the focus of my life. There is little room for spontaneity when I follow all of these good ideas. I have less time alone and am able to read fewer books now that I have a regular, reasonable bedtime, and I have trouble seeing that as self-care rather than self-punishment.
I’m used to indulging my moods by sitting around all day if I’m feeling down or staying up half the night reading or rearranging furniture if I’m feeling up, and it feels unsatisfying to deny these inclinations. They say that by indulging these habits, I only make things worse, but not doing so feels like having an itch on my nose and my hands tied behind my back.
I start to wonder, was it really so bad before I knew I had bipolar and started pharmacologically stabilizing my mood and making these lifestyle changes? My journals (and my husband) say yes, it was so bad.
Even asking this question is the cliched response of the mentally ill. But cliche or not, I still wonder: am I taking my medications and making these changes to help myself or for other people? And does the answer really matter?
*Whatever that means.
** Of course, I’m writing this while wearing workout clothes because I meant to exercise but ended up blogging instead. It is possible I’m just a big liar.