Onika L. Dainty

Challenges and Triggers: Travelling with Bipolar Disorder

When you are in unfamiliar surroundings, away from the comforts of home this can signal a disruption in your daily routine, throwing off established habits around sleep, medication or self-care. Travel can be exciting however for individuals with Bipolar disorder it can also present many challenges. Whether you are crossing timezones or taking a cross-country trip in a car or on a train, it is important to know your triggers and the challenges you may face when exploring the road less travelled. 

New Environment: Being in a new place, away from your established structure routine and habits as well as dealing with jet lag can be stressful. The prolonged excitement from being in a new and different environment can act as a trigger for Bipolar disorder symptoms.  

Mood Episode: Travel can trigger manic or hypomanic episodes characterized by an extreme elevation in mood. 

Anxiety: Travel can trigger anxiety especially when crossing into new timezones. The process of travelling from start to finish, whether it’s packing for a new destination or navigating through a new place upon arrival can stir up anxiety. 

Sleep Disruption: Travel can interrupt the Circadian Rhythm (sleep pattern) and have a negative effect on medication management. 

A Bipolar Woman’s Travel Log: My Experience with Travel Mania

I’ve travelled quite a bit in my life. From family vacations to business trips, North American travel, Caribbean travel and most recently I travelled to my home country Guyana, South America. I’ve taken buses, trains and planes to reach my destination but regardless of the mode of transportation I have always found myself experiencing what I call “Travel Mania.” Travel Mania is when you experience symptoms of hypomania or Mania while travelling to an unfamiliar country where you may cross timezones, climate change or environmental differences that disrupt the routines and habits that you have structured at home. This can cause a shift in your baseline mood leading to a minor to severe Bipolar episode.

In 2007 my family travelled by plane to St Maarten for a family holiday. Well aware of my anxieties around flying, my mother managed my medication and monitored my sleep in the hotel upon arrival. I slept on the day of arrival and for part of the following morning, waking up energized and ready to enjoy my vacation. Before I had understanding of my Bipolar cycle I believed this was enough rest. However during the 10-day holiday I slept less and less each night, mismanaged my medication, participated in risky behaviours and my moods shifted from elation and excitement to anger and aggravation easily. I was experiencing hypomania which quickly turned into Mania and I was hospitalized within a few weeks of returning home. 

In 2022, I travelled by bus to New York City to visit family. It was a 13 hour bus trip that included two rest stops. Because of the cramped space on the vehicle, sleep was hard to come by and I experienced physical discomfort for the majority of the ride. When I arrived in New York City I was immediately overwhelmed by the amount of people and cars on the road and very over-stimulated by the shining lights on every corner. When I arrived at my family’s home outside of the big city I couldn’t manage to get more than 3-4 hours a night of sleep. I woke up extremely early, went out all day, ate very little and went to bed after midnight every night, often staying up with my cousins to spend quality time. 

I was taking my medication daily and on time however, the major change in my sleep hygiene elevated my mood giving me excess energy and leading to hypomania. When I returned home to the stresses of life, family and work I was physically depleted but couldn’t maintain any quality of sleep, the cycle I was on my vacation followed me home and within a month I was hospitalized and experiencing Mania.   

Recently, armed with a better understanding of my illness and how travel can affect my mood cycle, I booked a month-long vacation in my home county Guyana. It was a life-changing trip full of culture, good food and re-connection with family. I took daily walks for self-care, I managed my medication fairly well only altering the time on a few occasions, I tried to re-create my structure, routine and habit from back home into my temporary home in Guyana. However, I noticed after the first few weeks that sleep was not coming easy and eventually I was on a 2 hour a night sleep cycle. By day 15, I was energized when waking up, incorporating more activity into my daily routine, my thoughts and speech raced and I was beginning to neglect my normal medication management routine, still taking them consistently but at odd hours. I started to hyper-spend and on one occasion participated in risky behaviours. 

This scared me and I reached out to my support team in Canada and they recommended I sleep for as long as I could for as many days as I could. They recognized even if I couldn’t that sleep deprivation was at the root of this Travel Mania. So I slept, for hours and days only setting my alarm to wake me to take my medication. I slept for 4 days straight and when I woke up I felt like myself again. When I arrived back home I made an appointment with my psychiatrist and he confirmed that I had had a manic episode but it was self-managed. He advised me that this will likely happen again especially when crossing timezones but can be mitigated by my quality sleep and taking my medication correctly and on time.  

Final Thoughts 

Practice Travel Self-Care with Bipolar Disorder 

When travelling and managing a mental illness like Bipolar disorder it is important to practice self-care in a more creative way. Previously I believed the self-care practice was taking time for myself to go on a vacation but over the years I have gained perspective and a different attitude around self-care for travel. It starts with research, asking questions like where do I want to go and will it be conducive to maintaining positive mental health. Other things to consider is how long you will travel for and where will you stay? 

If you are interested in going somewhere that may be an overstimulating environment consider ensuring that the place you sleep in is quiet and calm. If you only have a short time for your vacation, less than 10 days consider planning a staycation rather than international travel. Ensuring that you have access to your medication daily regardless of where you are can be done by switching to blister pouches that you can carry on your person. When you are planning your trip try to make sure you get quality sleep both at your destination and when you return home, this might mean you have to come back a few days early to catch up on sleep before you return to your regular life. It may also be a good idea to review and update your crisis plan to refer to if necessary.  

Planning a travel experience when managing your Bipolar disorder can be challenging but not impossible. It is important to remember the world is yours to enjoy and experience but it is necessary to take the steps needed to ensure you are practicing self-care for your mental health while travelling. There are things to consider like environmental changes, crossing timezones, change in routine, anxiety, mood cycles, sleep disruption, medication management and crisis planning as elements in deciding where in the world you journey to next.

If you have lived experience with Travel Mania or want to share your Travel Self-Care tips please connect with me by leaving a comment. Remember we are on this journey together and it's important to continue having conversations that take us beyond the stigma of mental illness and what’s possible.

Understanding Your Bipolar Type

First and foremost, it's important to educate yourself on your specific type of Bipolar disorder. Each type—whether it's Bipolar I, Bipolar II, or Cyclothymia—comes with its unique patterns and challenges. Knowledge is empowering; by understanding your diagnosis, you can begin to identify your triggers, mood patterns, and effective coping strategies. Use your lived experiences as a foundation to build a toolkit that is unique to you.

Key Components of a Bipolar Management Toolkit

Mood Charting

One of the most impactful tools I've found is mood charting. Tracking your moods can reveal patterns and triggers that you might not notice otherwise. Whether you prefer using apps or jotting down notes in a journal, having a visual representation of your mood swings can empower you to understand your emotional landscape better. Over time, this chart becomes a valuable resource for you and your healthcare team, allowing for more informed discussions about your treatment plan.

Medication Management

For many of us, medication plays a crucial role in managing symptoms. A reliable medication management strategy is essential. This includes keeping track of your medication history and understanding what you are taking. Utilizing blister packs can simplify this process, ensuring you take the correct doses at the right times. It's important to maintain open communication with your psychiatrist and pharmacist, discussing any side effects or concerns that may arise. Regular reviews of your medication can help optimize your treatment plan and ensure that you are getting the most effective care. There are new advancements in mental health medications that can improve your quality of life so it is important to stay up to date through communication with your psychiatrist and pharmacist on how these advancements can benefit you. 

For me, blister packs as well as my pharmacy’s delivery service have been life-changing. Blister packs gives me ease in taking my medication daily as they are not only divided into pouches with the prescribed medication but also the time they need to be taken. Medication delivery by the pharmacy helps me avoid missing medication as delivery is usually scheduled for a day or two before my blister pack runs out.  

Access to Mental Health Resources

Having access to a trusted psychiatrist and counseling services is invaluable. Engaging in psycho-education through recovery colleges provides opportunities to deepen your understanding of Bipolar disorder. These educational resources can help you and your supporters learn about symptoms, triggers, and effective management strategies. Gaining access can sometimes be difficult due to waitlists but speaking with your healthcare team about what resources are available is a great place to start. 

Therapeutic Resources

Therapy can be a game-changer. Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are particularly effective for managing Bipolar disorder. These therapeutic approaches equip you with practical skills to handle challenges and regulate your emotions. Finding a therapist who understands your unique experiences can make a world of difference. Don't hesitate to shop around until you find someone you connect with. Usually there is a referral process for these types of therapy so it's important to speak with your psychiatrist to start the process when you are ready. 

Mindfulness and Grounding Techniques

Incorporating mindfulness practices into your daily routine can significantly enhance your well-being. Techniques like meditation, deep breathing exercises, and grounding exercises (such as tapping or the cold water trick) can serve as effective outlets for anxiety. Personally, I’ve found that dedicating time to creative expression—be it journaling or poetry—has been therapeutic.

Grounding exercises are particularly useful during periods of intense emotional distress. They help you stay present and can alleviate feelings of anxiety or panic. Simple techniques like focusing on your breath or engaging your senses by feeling the texture of an object can ground you in the moment.Something as simple as splashing freezing cold water on your face can bring you out of a dark or emotional place back to a more grounded and calm headspace.

Building a Support System

Building a robust support system is vital. Surrounding yourself with people who understand your struggles can alleviate feelings of isolation. I’ve created a team of supporters with clearly defined roles: family members, friends, therapists, and peer support members all contribute to my well-being. Peer support groups within the recovery college setting have been particularly helpful for me, allowing me to share my experiences and learn from others in similar situations.

Creating a Self-Care Toolkit

Self-care is an essential aspect of managing Bipolar disorder. Your self-care toolkit might include practices that nourish your body and mind, such as a regular exercise routine, healthy diet, and hobbies that bring you joy. Engaging in physical activity releases endorphins, which can positively impact your mood. Whether it’s yoga, walking, or any form of exercise, find what works best for you and make it a part of your routine.

Stable Housing and Nutrition

Stable housing is another critical component of managing your mental health. A safe, secure living environment allows you to focus on recovery without added stressors. Additionally, paying attention to your diet and nutrition can have a significant impact on your mood and energy levels. Consult a dietician if you need guidance on maintaining a balanced diet that supports your mental health.

Access to a Pharmacist and Reference Books

Building a relationship with a pharmacist can also enhance your understanding of your medications and their interactions. They can offer insights that complement your doctor’s advice. Additionally, having reference materials on hand—such as the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) or workbooks like Mind Over Mood (CBT) and The Dialectical Behavior Therapy (DBT) Skills Workbook, and reputable online resources—can provide valuable information and reassurance.

Mental Health Resource Guide

Creating a mental health resource guide can be a helpful tool for yourself and your supporters. This guide can include crisis lines, crisis beds, and planning resources for times of emergency. Having this information readily available can alleviate anxiety during moments of crisis, ensuring you know where to turn for help. You can start this resource guide by listing the services that have worked for you or anyone you know in the past. 

Crisis Planning and Advance Directives

Having a crisis plan in place is essential. This should outline what steps to take when you or someone in your support system recognizes that your symptoms are escalating. A Mental Health Advance Directive can be invaluable, detailing your treatment preferences in times when you may not be able to communicate them. Ensure that your supporters know where to find this document and what it entails.

Final Thoughts

Managing Bipolar I disorder is a journey filled with its highs and lows. A well-equipped Bipolar management toolkit can make navigating this path a little less overwhelming. By incorporating these essential components into your life, you can face the challenges of your condition with more confidence and clarity. Remember, you are not alone in this experience. I encourage you to share your own stories or ask questions in the comments. Let’s build a supportive community where we can all thrive, one toolkit at a time.