Steps to take to manage bipolar episodes

6 Jan 2019
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These are steps that I take when stressful events lead me from a 'normal/balanced' level to a more 'manic' state, due to my bipolar illness. Some of these events have been a parent's major injury, a close friend who has to move out of the USA due to his national origin, a sibling's divorce etc.

What I do:

1) Contact doctors/parent - I contact my psychologist, psychiatrist, my parents and few confidents (in and out of my immediate family circle) to let them know an event is impacting me emotionally.

2) Meds - Have back-up meds to take right away to ensure 8h of Sleep. Sleep is crucial the first night when I learn about the event, since it really helps prevent me from going into a manic state.

3) Support System - I contact a 'Listener', a trusted friend or family member who will listen, calm me down and support me.

4) Slow Down - I also limit social media ie facebook, watching the news on the TV... I usually take a day off from work (the day after I find out about the stressful event) since I do not want to act inappropriately at work while in a potential manic state. I do soothing activities: read a book, do a puzzle, listen to calm music, meditation tapes and eventually go back to yoga class...

What steps do you take to lower your manic state back to a normal/balanced state?

Christine

A Moodscope member.

A Moodscope member.

Thoughts on the above? Please feel free to post a comment below.

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Comments

David Gosling

Jan. 6, 2019, 2:27 a.m.

Hello Christine, We use the same the steps to control the mania mood, it is like looking at a mirror of myself. As you can see I have broken one of the steps by being awake now at 02.06 but I did catnap for 2 hours earlier! I have a network of friends who do not mind what time or what they are doing, to who I visit to support me as I have to release the pent-up energy somehow. At age 69 I have very much more control, but like you, I have to be careful with relationships and as a female that must be important to you! Please ask for my email address from Caroline as I work for the Ministry of Defence and have to comply with the Official Secrets Act and would like to share more confidential data if interested, if not pass that by. I have also had many unique working roles being in the right place at the right time and semi-retired at age 40 with a considerable financial package from Westminster City Council. I then worked as a close protection Officer for the Royal Household, lived in Australia for ten years, returned to work for the M.O.D. and still do so travelling all over the World. My main step now for coping is writing my Autobiography titled Simply the Best and the Best is yet to Come. Good Luck for the future and with all your steps. David Gosling.

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Maggie May

Jan. 6, 2019, 7:35 a.m.

Hi Christine, I am luckier than you in that I do not ( yet) have full blown bipolar disorder but my less extreme mood swings have similar triggers. I feel I could benefit from the same strategies employed by you the moment I feel a change in mood. I normally just hope it will pass and worry about thinking myself into a period of mania or depression. No offence to this site but I also now try to not fixate on reading all of the contributions to the blogs throughout my day as this is a warning sign for me . I still read the blog in the morning but do not look again until I go to bed. Thanks again - good tips.

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Jul

Jan. 6, 2019, 7:43 a.m.

Dear Christine. I am travelling today with no access to Moodscope except for now and being hassled to get ready to leave. Thank you for writing today and producing such a helpful blog. I'll try to reply on Monday. Jul xx

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Orangeblossom

Jan. 6, 2019, 7:54 a.m.

Hi Christine, thanks for your helpful suggestions. They are very practical and I do follow some of them already, like practising meditation using the Headspace app. Also Moodscope has become a daily ritual. I usually find it to be encouraging, helpful & thought-provoking.

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Sally

Jan. 6, 2019, 7:55 a.m.

Hi Christine, thank you, it’s very useful to have these steps for self help outlined in list form. I’d never thought of doing that but it makes entire sense. You are so right about the sleep, it’s one of the main things to get right, isn’t it? You are fortunate in having those trusted listeners. I never know who to turn to who will just listen without giving advice, so I cope alone mostly. That is why coming on here and venting or expressing is so invaluable. I know I’ll get a sensible and not a knee- jerk reaction. All the best, Christine. Xx

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Liz

Jan. 6, 2019, 8:06 a.m.

Hi Sally just wanted to say yes I definitely do come on here because I feel people really get what I'm saying. It's so much easier. Writing down my feelings helps and to have people that come back and acknowledge them in a heartfelt way is so encouraging.

Sally

Jan. 6, 2019, 5:15 p.m.

Thank you for that, Liz. I appreciate it.

Liz

Jan. 6, 2019, 8:03 a.m.

Hi Christine, very good suggestions. I think I need to put some of these into action because I am dreadful at not only remembering to take my meds but having back-up supplies. One thing I notice is that perhaps I get the warning signs physically when I am not well mentally... sometimes a very upset stomach and also very itchy and dry hands... they are only just starting to calm down after a month of it now due to the run up to Christmas. A safe place for me is very important - bed is my sanctuary and if I'm low, I tell my husband the reason why. I'm not so good at telling friends... for example if we are invited to something social, I usually use my husband being ill as the excuse. Being around nature is very soothing to me, especially just before dusk when all the birds come home to roost. I need to try the meditation I think! Liz x

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Valerie

Jan. 6, 2019, 3:16 p.m.

Hi Liz, I am the same in that physical signs are often a warning.Feeling light-headed,low blood sugar,floaters in the eyes,acid reflux.Like you,I have for some months now started to itch like mad,sometimes all over,when very anxious or angry.Trying to cope with socialising at such times is guaranteed to make matters worse.xx

The Gardener

Jan. 6, 2019, 4:28 p.m.

Valerie, the itching is awful, my doc says it is 'stress induced excema', disappearing now. Our swimming pool (20 kms) has a hammam, going to try that regularly - marvellous for back and arthrosis, might be good for skin as well. xx

Mandie

Jan. 6, 2019, 7:38 p.m.

Hi my anxiety also triggers itching something I find offers a little ease is a cool breeze over the tchy area and use a battery powered hand held fan . Don't know if it would help or maybe you've already tried this but hope it's a helpful suggestion X

Valerie

Jan. 6, 2019, 8:45 p.m.

There is saying I recall,something about difficult people who "bring you out in hives" Maybe these old wives tales have a lot of wisdom in them! xx

PeaceLoveRICHARD

Jan. 6, 2019, 8:05 a.m.

Dear Christine, Welcome to Moodscope. When manic... .... I am capable of... Walking across a pedestrian crossing in John Cleese silly walk fashion. When depressed... ...I cry a bit and don't get out of bed. If the world has a problem with either of these states, they can leave me alone. Love to all the bi-polar entertainers out there. Peace, Joy and Love, Rich x

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Molly

Jan. 6, 2019, 2:30 p.m.

Hi Rich, your comment made me smile, I had a friend with bipolar and she went on such a high, she went into this rather ‘out there’ shop and bought the most ridiculous hat and glasses and danced down the street, I really didn’t know what to do with her, as she had been let out of hospital for a couple of hours, so I got a taxi and took her back, it was quite funny though lol xx

PeaceLoveRICHARD

Jan. 7, 2019, 5:30 a.m.

Thanks, Molly. Throw in for buskers!

Rosemary

Jan. 6, 2019, 10:41 a.m.

Hi Christine. Thanks for your blog. I'm not diagnosed BP but do feel myself showing many of the traits. I have a similar list to you Talk to my hubby or closest friend Move away from social media and news Immerse myself in nature and our animals Do, as you say, soothing activities (love that description because it describes the feeling I get from them so well) - read, listen to soothing music, walk, write Sleep (not something that often alludes me, my nemesis is usually getting up) I know if I'm slipping; it's a feeling of jarred, sore, raggedy nerve ends where everything becomes heightened, and I need to act at this point (if not sooner) to prevent it becoming a long recovery. I will think more about this throughout the day :) x

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Rosemary

Jan. 6, 2019, 11:15 a.m.

..... Oh and THE most important one for me - slow down! (in my haste I forgot the one that's most vital for me haha)

The Gardener

Jan. 6, 2019, 10:48 a.m.

Hello Christine over 40 years ago I was ambulanced into the Westminster Hospital, spent a few hours there, and released clutching a piece of paper saying 'manic'. My GP and husband were instructed to put me to bed for a week, stuff me with Vallium and Mogadon, and hope it would go away. The cycles lasted 2 decades, until it was discovered I was 'mercurial' but not bi-polar. Few doctors recognised the state then, and the meds were awful. Now coping with a totally different lot of emotions.

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The Gardener

Jan. 6, 2019, 10:51 a.m.

My GP was marvellous - he was at Mr G's memorial service - I have a strong suspicion he was bi-polar himself - because he described a medical student 'friend' so well I think it was himself. I have a sad legacy in that with Mr G and others if there was something serious to discuss that they could say 'she is seriously depressed' therefore, not responsible for my actions, and they could wait for it to 'blow over'. Cont . . . I WILL get this time-out sorted

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The Gardener

Jan. 6, 2019, 10:55 a.m.

My initial reaction to the aftermath of Mr G's death and selling the house was to go off to the South of France for a month. Stupid. A parallel to Christine, I need the same 'rules' - routine, friends around me. If I had gone away, the grief would have been awful, because any place would have been a poignant reminded of all the fun we had had, the stupid things we did, taking fold-up bikes on trains, buses (the driver swore) taxis, boats - no, a list is right, live for the moment thanks :)

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Anonymous

Jan. 6, 2019, 10:56 a.m.

I have the same diagnosis and apart from doing your list of 4, I mediate daily for the last 6 years which has massively improved my ability to deal with stressful situations my last manic episode was 5 and half years ago and I’ve been well since then which is amazing for me. Also no alcohol ever and the 8+ hrs sleep are paramount. All the best to you.

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The Gardener

Jan. 6, 2019, 11:26 a.m.

Oh, my GP, when describing his student friend, said he would 'erupt from his room, saying "blessed mania, it's here" ' then work furiously, demand the same mad energy from his fellow students, then deflate.

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Molly

Jan. 6, 2019, 2:23 p.m.

Hi Christine I don’t have bipolar but I was diagnosed with BPD and cyclothymia, both of which have traits of bipolar. I used to have manic episodes, but not often, and not anymore (medication maybe) but I used to find them very scary. Apart from wanting to get everything done within a short space of time and burning myself out, I would also get that feeling of ‘ants in my pants’ where I just did not know what to do with myself. You seem to have a good plan strategy which is great. I think your tips could be used on the other end of the scale too, when we feel like we are going into a real low state. I’m not good at doing what I am supposed to do but I think your blog will stick in my mind as a helpful reminder. Molly xx

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Valerie

Jan. 6, 2019, 3:09 p.m.

Hello Christine, I am not bipolar,but cyclothymia pretty well sums me up.Your tips could be applicable to a few conditions.I tend to overcompensate for the lethargy that comes over me,and end up slightly manic,brain buzzing,no sleep-you know how it goes.Taking an extra Prozac,avoiding long conversations and some people,telling myself I don't have to let it control me,all can help.x

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The Gardener

Jan. 6, 2019, 6 p.m.

Valerie, interesting, during the last few years if I talk too much and too long I get tachychardia? racing pulse, difficult to calm - works both ways, gives other people a chance to talk!

Valerie

Jan. 6, 2019, 8:48 p.m.

When I was in the last months before leaving my ex husband I got what seemed like heart attacks-all the classic symptoms,terrifying and I was only 28.Turned out to be tachychardia,brought on by severe stress.xx

Maggie May

Jan. 6, 2019, 3:48 p.m.

It seems that the spectrum from The Gardeners’ mercurial personality through cyclothymia to bipolar disorder have all shared a benefit from your blog today Christine. Extra tips added along the way from other moodscopers pooling helpful tips . Thanks

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Maggie May

Jan. 6, 2019, 4:20 p.m.

Forgot BPD from the list - sorry Molly.

Molly

Jan. 6, 2019, 10:05 p.m.

No problem Jen

Maria

Jan. 6, 2019, 7:14 p.m.

HI Christine, I think your list is spot on and thank you for sharing. Meditation is huge for me and I love the insight timer app. I have a harder time recognizing the slowly building ramp up. I think it's important to know your red flags. One of mine is that if I start misspelling words that signals that I need to take action.

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Oli

Jan. 6, 2019, 9:28 p.m.

I do not experience BP but your blog Christine and the replies are interesting. I was interested to see if people used their moodscope scores to confirm personal insight into changing mood states -- I'd assumed it might be useful with BP but maybe not. And people seem to notice other indicators. I know for me I used to be a little slow to gain insight of falling mood so I'd notice a drop before I was able to name the feeling. That seems to have improved as it happens, possibly as a result of a daily check in with my moods.

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Ach UK

Jan. 7, 2019, 3:33 a.m.

Hi Oli, Yes I find the Moodscope scores help me manage my "mood" , in several different ways. I've been recording scores for about 18 months so I can now see where my normal ranges level out and this is now a helpful pointer to consider whether my "mood" is getting a bit out of kilter. I am getting better at recognising my thoughts and feelings by the practice of having to apply a score to each of the cards. I'm not a natural diary writer but it is very helpful to have the opportunity to make a comment on the graph , then I can look back and make better sense of events. ( And I can show my health professionals and carers/friends and family if needs be). And it makes me take time out to consider my day and the events therein and to feel the emotions generated and acknowledge them and settle my mind. For me doing the charts has been helping me, another useful tool. I don't do it every day, sometimes it gets missed when I have too much on ( yea I know, that's perhaps when I might be better to do it) as I have to "husband" my resources. XX Ach.

Ach UK

Jan. 7, 2019, 3:36 a.m.

Oh dear sorry , I put this in paragraphs but system has cobbled it all together! Shouldn't do this at 3am lol.

Oli

Jan. 7, 2019, 6:44 a.m.

Cheers Ach! Ah, I've found that only one's primary written reply retains my paragraphs. Secondary replies get rid of all that and turn it into one big over-excited sentence! I've sometimes wondered if there could be a tertiary mode which jumbles everything into word salad! :-) [****] And like you I've discovered a healthy-enough range of scores. I don't get too concerned with occasional outliers, and keep an eye for trends outside *my* range.

Ach UK

Jan. 6, 2019, 9:42 p.m.

Hi Christine, Thanks for your blog. I "live with" this annoying disorder too and find all your list helpful. Maria (above) mentioned finding it hard to recognise the "slowly building ramp-up" and in earlier episodes in my life neither myself nor nearest and dearest recognised I was becoming unwell until I was very ill indeed and by that time the early interventions are not effective and I needed hospitalisations. Now I am older I seem to be slightly better at noticing when I am overstretched and stressed. Definitely one must not bury one's head in the sand; if you become aware that you are heading for mania the sooner you put into place your "action plan" the less traumatic will be your ride. If you have an arrangement with your Psychiatrist to do so start your advised medications, reduce all stimulations as much as possible. Stay home , minimal phone calls. Maximum quiet, definitely alert your nearest and dearest / carer. Keeping calm and positively telling yourself you are looking after yoursrlf (difficult but reduces the rear factor) No alcohol or recreational drugs and push to see your Psychiatrist ASAP. Unfortunately there is no one cure all. As we a all individuals and all react according to life circumstances. Thank you for lots helpful answers Moodscopers. Also the Thought for the day was great. Thought for the day: “Put yourself at the top of your to-do list every single day and the rest will fall into place." Thank you. XX Ach.

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Ach UK

Jan. 7, 2019, 3:43 a.m.

Having a system to monitor one's early warning signs helps. See Oli's reply (and my comment) above re Moodscope's scores charts. Thank you Oli for that. Ach.

David Gosling

Jan. 7, 2019, 3:59 a.m.

Ach UK I can relate to many of your comments.

Ach UK

Jan. 7, 2019, 9:56 a.m.

Thank you David. Being on Moodscope has been invaluable in hearing so many people's stories. Often you make me stop and think and rethink some of my ways. People with a lifetime of experiences are well worth a listen. Ach.

Jul

Jan. 7, 2019, 6:39 p.m.

Hello Christine. Late to this. I get mania after a good night's sleep as my sleep is so light and unrefreshing most nights. However something stops me sleeping well two nights in a row so my mania is contained naturally. I wish I could detect signs of when I'm going to feel really depressed. I can in a way but it's more to do with anxiety than depression plus of course fatigue from not sleeping. I do know that certain events cause me anxiety and stress which results in depression and lethargy. Christmas is one example. Why won't I ever learn! However I don't think I'll change and have almost accepted how I am. I am sorry you have experienced severe mania before and admire your coping strategies greatly. Go well Christine. Jul xx

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