With its swinging moods, shifting energy levels, sleep difficulties and intrusive anxiety, bipolar disorder can feel overwhelming. Managing it can feel the same.“There is so much to take care of, so there are so many ways to mess up,” said Julie A. Fast, a bestselling author of books on bipolar disorder, including Take Charge of Bipolar Disorder andLoving Someone with Bipolar Disorder.

1. Seek professional help.

If you’re not receiving any treatment for bipolar disorder, contact a practitioner. Medication is crucial for managing bipolar disorder. As psychologist John Preston, PsyD, has noted: “Bipolar disorder is probably the main psychiatric disorder where medication is absolutely essential. I’ve had people ask me if there’s any way to do this without medicine. [My answer is] absolutely not.”

2. Take medication as prescribed.

Follow your doctor’s precise instructions when taking medication. Don’t ever discontinue medication on your own (which can worsen symptoms and trigger an episode).Instead, if you’re struggling with troublesome side effects or other concerns, talk to your doctor. Write down your specific concerns and questions, and call your doctor to schedule an appointment.

3. Organize your medication.

Make it easy to take your medication. Fast fills three pillboxes at a time and keeps them in different places, such as her car, purse and kitchen. (Here are additional strategies on remembering to take your medication.)

4. Remind yourself racing thoughts are part of the illness (not the truth).

Fast, who also pens a blog on bipolar disorder, calls her brain racing “brain chatter.” “Imagine having a super noisy gymnasium in your head, and the main voice is your own.” Depression is an inflated inner critic.This kind of chatter is typical of bipolar depression. When her negative thoughts start swirling, Fast reminds herself: “This is the depression, Julie.

5. Chart your symptoms.

Keep a daily chart of your mood, sleep, irritability, anxiety, exercise and other important symptoms or habits, Van Dijk said. This is a helpful way to prevent a mood episode or lessen its severity. A chart provides you with information about your personal symptoms and how they manifest.It helps you spot patterns as well. For instance, if you notice that your mood is lower,

6. Focus on the present.

“Focusing on the present, rather than allowing yourself to get stuck in thoughts of the past and future…help to reduce the emotional pain in your life,” according to Van Dijk. It also helps you notice your racing thoughts and take healthy action more quickly, Another way is to take a mindful walk. “Instead of letting your thoughts wander like you normally would, focus on the walk.

7. Create a bedtime routine.

A bedtime routine is an effective strategy for facilitating sleep. It signals to your brain and body that it’s time for rest, relaxation and slumber. The key is to engage in calming activities. You might take a hot bath, meditate, say a prayer and do some light reading (but outside the bedroom), she said. (Find more sleep tips here.)

8. Avoid alcohol and drugs.

Both worsen symptoms of bipolar disorder and disrupt sleep. Alcohol and drugs elevate mood instability and impulsivity, and might even lead to a manic or depressive episode. They also sabotage treatment. If you’re struggling with substance abuse, contact a mental health professional.

9. WATCH your emotions.

Some individuals with bipolar disorder have a hard time experiencing their emotions. In her book The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder, Van Dijk features many valuable exercises for healthful coping.

  • Watch: Watch your emotions by noticing the physical sensations in your body and the thoughts running through your head.
  • Avoid acting: Don’t act right away. Instead, remind yourself that emotions are not facts. You don’t have to do anything about them.
  • Think: “Think of your emotion as a wave. Remember that it will go away on its own as long as you don’t try to push it away.”
  • Choose: Choose to let yourself feel this emotion. Remind yourself that it’s best to experience your emotions, instead of avoiding them.

10. Work on activities that build mastery.

Building mastery gives you a sense of accomplishment, Van Dijk said. What activity you choose “will just depend on where [you are in your] life and what will create that feeling of being productive.”For instance, she said, this might mean volunteering, getting out of bed at 9 a.m. instead of noon or going to the gym three times a week. Or it might mean checking “the mail if that’s something you’ve been avoiding,

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