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 Bipolar Disorder in Women

Definition and Types of Bipolar Disorder

Bipolar disorder is a complex mental health condition characterized by extreme mood swings, including emotional highs (mania or hypomania) and lows (depression). It is categorized into several types, primarily Bipolar I disorder and Bipolar II disorder. Bipolar I involves manic episodes lasting at least seven days or manic symptoms that are so severe that immediate hospital care is needed. Depressive episodes may occur as well. On the other hand, Bipolar II is defined by a pattern of depressive episodes and hypomanic episodes but no full-blown manic episodes.

Prevalence Among Women

Women are disproportionately affected by Bipolar disorder, with studies showing they may experience symptoms differently than men. For instance, women often report more depressive episodes and rapid cycling between highs and lows. This can lead to unique challenges, such as hormonal fluctuations from menstrual cycles or pregnancy, impacting mood stability.

Unique Challenges Faced by Women with Bipolar Disorder

In addition to the biological factors, societal expectations and stigma can exacerbate the challenges faced by women. Many women report feeling pressured to fulfill roles as caregivers or professionals, leading to additional stress and potentially worsening their mental health. The need for balance can often feel overwhelming, leading to a sense of isolation, particularly during acute episodes.

The Crisis: Recognizing the Need for Help

Signs That Indicate a Crisis

Recognizing when one is in crisis is vital. For me, the signs included insomnia, substance use, and delusions, sometimes manifesting as visual and auditory hallucinations. Other signs can include elevated moods, hypersexuality, hyper-spending, and medication mismanagement. During these periods, reaching out for help is crucial.

I’ve learned the importance of connecting with someone—be it a friend, my mental health mentor, or a family member—during these difficult times. A wellness check, initiated by myself or someone close, can provide immediate support, although the experience can sometimes be stigmatizing.

Stigmas and Misconceptions Surrounding Mental Health

The stigma surrounding mental health issues, especially for women, can be profound. Many women report feeling judged or misunderstood when seeking help, which can prevent them from accessing necessary care. Misconceptions about mental illness often lead to fear and avoidance, creating barriers to open conversations about our struggles.

The Importance of Seeking Immediate Care

When faced with the signs of a crisis, seeking immediate care is essential. It can be challenging to navigate the hospital system, especially when in distress. Yet, getting the right support can be a critical step towards recovery. It’s okay to ask for help and to advocate for oneself during these vulnerable times.

Hospitalization: What to Expect

Overview of the Hospital Admission Process

When you arrive at the hospital, whether brought in by police, emergency services, or loved ones, the first step typically involves checking into the emergency room (ER). Here, healthcare professionals will assess your vital signs and ask about any medications or substances you may be using.

After this initial assessment, you may be moved to a separate area of the ER designated for patients with mental health concerns, where you will wait for a psychiatric assessment. This part of the process can feel isolating, as it is often part of what is known as a 72-hour hold (Form 1 assessment) designed to ensure your safety and the safety of others.

Types of Treatments Available in Hospitals

While in the hospital, treatment options can vary. Medication management is mandatory, often involving mood stabilizers and antipsychotics to help manage symptoms. Psycho-education and support groups are also typically offered, helping patients gain a better understanding of their condition and coping strategies.

Occupational therapy, which may include art therapy, yoga, and social activities, is often available but usually on a voluntary basis. These therapies can be invaluable in helping women express themselves and connect with others.

Support Systems: Role of Healthcare Professionals

Healthcare professionals play a pivotal role in the recovery process. Psychiatric nurses and social workers are often at the forefront of providing emotional support and advocacy during your stay. Case management services can help address other concerns, such as addictions or housing needs, ensuring a holistic approach to care.

Personal Stories: Women’s Experiences

Testimonials from Women About Their Hospital Experiences

Many women have shared their hospital experiences, highlighting both the positive and negative aspects of their treatment. For some, the supportive environment fostered by understanding staff can make a world of difference. Others have described feeling dehumanized, especially when restraints are used during acute episodes.

Common Themes and Lessons Learned

Common themes often emerge in these personal narratives. Many women emphasize the importance of feeling seen and heard during their hospital stays. The presence of empathetic healthcare professionals can foster a sense of safety and understanding, which is critical during times of crisis.

The Impact of Supportive Networks During Recovery

Support networks, including friends, family, and peer support groups, can significantly impact recovery. Sharing experiences with others who understand the journey can help women feel less isolated and more empowered.

Recovery: Paths to Healing

The Role of Therapy and Counseling in Recovery

Therapy and counseling are essential components of recovery from Bipolar disorder. Through talk therapy, many women find a safe space to explore their feelings and develop coping strategies. Cognitive-Behavioral Therapy (CBT) is particularly beneficial, helping patients reframe negative thoughts and behaviors.

Importance of Medication Management

Medication management remains a cornerstone of effective treatment. For those of us living with Bipolar I disorder, taking mood stabilizers and antipsychotics can help maintain stability and reduce the frequency and intensity of manic and depressive episodes.

Strategies for Self-Care and Support Post-Hospitalization

Post-hospital care is critical for long-term recovery. Engaging in self-care practices, such as regular exercise, mindfulness, and maintaining a structured routine, can significantly improve emotional resilience. Moreover, staying connected with supportive friends and participating in peer support groups can foster a sense of community and belonging.

Final Thoughts

The hospital experience can be a turning point for many women living with Bipolar disorder, providing them with critical support and a path toward recovery. Through shared stories, we gain a deeper understanding of the resilience of these women. If you or someone you know is struggling with Bipolar disorder, don’t hesitate to seek help. Remember, you are not alone in this journey. Together, we can move beyond the stigma surrounding mental health and empower women to share their stories.

For a deeper understanding of how to manage Bipolar disorder, consider reading How to Start Managing Bipolar Disorder: A Comprehensive Guide. Additionally, check out Best Tools and Resources for Managing BipolarDisorder in 2024 for helpful strategies and tools.

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.

Best Tools Bipolar Disorder Management

Managing Bipolar I Disorder is a deeply personal journey. As I’ve shared in my previous post, How to Start Managing Bipolar Disorder: A Comprehensive Guide, the tools and resources you use are an essential part of your daily routine. What works for me may not be what works for you, and vice versa. In this article, I’ll share my personal experience with some of the best tools and resources I’ve found helpful in 2024, touching on medication management, teletherapy, community support, education, and self-care. I hope that by sharing my journey, you can find tools that suit your needs, whether you prefer digital solutions, community-based support, or natural practices like I do.

Medication Management Tools: From Alarms to Blister Packs

When I first started managing my medication, I used multiple alarm notifications on my iPhone to remind me to take my meds. But, let’s just say, it was a bit of a mess. I had so many alarms going off throughout the day, and it felt overwhelming, to the point where I was constantly snoozing them. My cousin, who’s more tech-savvy than I am, saw the chaos and did some research on medication management apps. He recommended a few options like Medisafe, CareClinic, and Dosecast, which are fantastic for people who prefer digital tools to help manage their routines.

But for me, technology isn’t always the answer. After trying out some of these apps, I found that the constant reminders just didn’t suit my lifestyle. That’s when I discovered blister packs at my local pharmacy, and they’ve been a game-changer. With blister packs, all my meds are sorted and scheduled for the week, which takes the guesswork out of my daily routine. If tech isn’t your thing, I highly recommend asking your pharmacist about blister packs—they’ve truly been my savior in staying consistent.

Teletherapy Services: Balancing Cost and Accessibility

Teletherapy is another valuable resource when managing Bipolar I disorder, but I know first-hand that it can be expensive. Services like BetterHelp offer convenient online therapy sessions, but the costs can add up if you’re paying out of pocket. Someone from my team (who I mentioned in my comprehensive guide) has had amazing results using BetterHelp for non-Bipolar therapy, so it’s definitely worth considering if private teletherapy is within your budget.

For those of us who are mindful of costs, there are also free teletherapy options available through outpatient services. I’ve personally reached out to local community health centers for free or low-cost teletherapy options. Depending on where you live, you might find similar services through outpatient resources connected to your healthcare provider. In my area, Durham Region in the GTA, there are great resources like Distress Centre Durham and Durham Mental Health Services (DMHS), both of which offer teletherapy at no cost.

Community Support: Recovery Colleges vs. General Support Groups

While community support groups can be incredibly valuable for some, I’ve personally found that they’re not always the best fit for me. One of the challenges I’ve faced in general community support groups is the risk of becoming overwhelmed by hearing other people's stories. Sometimes, it’s easy to feel re-traumatized by the intense and emotional sharing that happens in these spaces.

That’s why I’ve turned to recovery colleges, where the focus is more on recovery education. Recovery colleges provide structured courses designed to empower people living with mental health challenges to take control of their journey through education. The shift from storytelling to learning has been a much better fit for me, and I’ve even had the opportunity to help build and facilitate these types of courses. My goal is to eventually share this with others by creating a supportive community focused on recovery education.

If you’re in Durham Region, consider reaching out to organizations like Durham Mental Health Services (DMHS), Ontario Shores Centre for Mental Health or CAMH for recovery-based education and support options. It’s been life-changing for me, and it might be for you too.

Education and Understanding: Finding the Right Resources

When it comes to managing Bipolar I disorder, understanding your condition is key. I always recommend connecting with a Peer Support Specialist through your outpatient services, which you can often access by referral from your psychiatrist. A Peer Support Specialist can help you navigate the sometimes overwhelming mental health care system and offer support from someone who has lived through similar experiences.

If you’re in the Durham Region like me, resources like CMHA Durham and Durham Mental Health Services (DMHS) can connect you with Peer Support Specialists to guide you on your journey.

In addition to personal support, I’ve found these books incredibly helpful for deepening my understanding of bipolar disorder:

• An Unquiet Mind: A Memoir of Moods and Madness by Kay Redfield Jamison, PhD

• Spiders, Vampires, and Jail Keys: Bipolar Disorder: A Story of Hope, Recovery, and Inspiration by Brooke O’Neill

• Fast Girl: A Life Spent Running from Madness by Suzy Favor Hamilton

These memoirs offer real, raw insights into living with Bipolar disorder and can serve as both educational tools and sources of inspiration.

Self-Care and Wellness Practices: Natural, Tech-Free Tools

In my personal experience, self-care and wellness practices are just as crucial as any other tool in managing Bipolar I disorder. While I’ve experimented with meditation apps like Muse and Insight Timer, I’ve found that technology can sometimes feel overwhelming. I really enjoyed using the Muse meditation headset, but after I broke mine, I couldn’t justify the high cost of replacing it. So, I stuck with Insight Timer, which offers over 3,000 meditations, YouTube integration, daily challenges, and courses. It’s a great low-tech option if you’re looking to incorporate mindfulness into your routine.

However, some of the best tools for me are tech-free. Aromatherapy has been a powerful tool in my self-care toolkit. For example, lavender essential oil helps me relax and sleep better, and it’s something I can easily incorporate into my day-to-day life.

I also find that hiking in nature has a profound effect on my mental health. There’s something about being surrounded by trees and fresh air that helps me reset. If I’m feeling especially off, I’ll take a long walk and listen to one of my favorite podcasts or some calming music on Amazon Music. Sometimes, just getting out of the house and moving can make all the difference.

Sleep and nutrition are also vital parts of managing Bipolar disorder. I’ve learned over time that without good sleep and a balanced diet, my mood tends to fluctuate more, making it harder to stay grounded. Ensuring that I get quality rest and eat well is one of the most important non-negotiables in my wellness routine.

Final Thought

Build Your Own Toolbox

In the end, managing Bipolar I disorder is all about building a toolbox that works for you. Whether you prefer digital solutions like medication apps, community-based support like recovery colleges, or natural approaches like aromatherapy and hiking, there are so many tools and resources available to help. While the journey can sometimes feel overwhelming, remember that you don’t have to go it alone. As I mentioned in How to Start Managing Bipolar Disorder: A Comprehensive Guide, reaching out for support is one of the best things you can do.

How to Start Managing Bipolar I Disorder: A Comprehensive Guide

Living with Bipolar disorder is a unique journey that comes with its own set of challenges and lessons. I’ve been navigating Bipolar I disorder for over 20 years, and during that time, I’ve learned a lot about how to manage this condition effectively. As a 42-year-old woman, born in Georgetown, Guyana, and now living in Durham Region, Ontario, my journey has been shaped by both personal experience and professional growth. Today, I’m a Peer Support Specialist, a daughter, sister, granddaughter, aunt, cousin, and friend, using my lived experiences to help others.

In this guide, I’ll share my insights on how to manage Bipolar I disorder, including my personal experiences with Hypomania, Mania, psychosis, delusions, hallucinations, and suicidal ideations. I’ll also touch on Bipolar II disorder and Cyclothymic disorder, although I’m not an expert on those. Through self-advocacy, a structured routine, medication management, and the support of a strong team, it’s possible to build a more stable life.

Understanding Bipolar I Disorder

Bipolar disorder is a mental health condition characterized by extreme mood swings that include emotional highs (Mania or Hypomania) and lows (Depression). Bipolar I disorder, which I live with, involves episodes of Mania lasting anywhere from 6 days to 8 weeks. Hypomania can last for months before progressing into full Mania, which often leads to hospitalization. During these manic phases, I’ve experienced delusions, hallucinations, and psychosis, often accompanied by suicidal ideations.

Bipolar II disorder, on the other hand, involves Hypomanic episodes followed by severe Depressive episodes, while Cyclothymic disorder is characterized by numerous periods of Hypomanic and Depressive symptoms lasting at least two years, though less severe.

For a long time, I kept a copy of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) on my nightstand—my reference to understanding the medical definitions and criteria for Bipolar and other mental health disorders. If you haven’t familiarized yourself with the DSM-5 yet, it’s a helpful tool for understanding the nuances of these conditions.

My Experience with Triggers

I’ve learned the importance of identifying triggers that can lead to mood swings. For me, triggers include lack of sleep, seasonal changes, traveling, and even daily changes in routine. Substance use has also played a role in triggering episodes. I don’t have a history of alcohol abuse, but marijuana was my drug-of-choice and a gateway into my first manic episode at 21-years-old. I later struggled with cocaine use, which became a significant trigger for Mania. Today I am proudly sober, however self-medicating with substances is often a slippery slope that leads to serious and life-altering episodes. Recognizing these patterns and avoiding triggers is critical for managing my Bipolar disorder.

Medication Management

When it comes to medication management, it’s essential to build a relationship with your doctors and communicate clearly when medications aren’t working or when side effects are unbearable. I’ve experienced side effects ranging from weight gain, insomnia, a zombie-like state, tremors, and even suicidal thoughts. Currently, I’m on a cocktail of mood stabilizers and antipsychotics to balance my brain chemistry, but it took time and advocacy to find what worked for me. Self-medicating, especially with marijuana or other substances, can be the downfall of managing the condition, as it was for me.

My Support Team

Your support team doesn’t have to be large—it can consist of 2-3 people with different roles. In my case, my substitute decision-maker is someone I met during my third manic episode in 2009. She handles my home, medications, and doctor communication when I’m hospitalized. I also have a wellness support friend who pushes me towards positivity, and my cousin provides spiritual counseling, helping me recenter on my faith.

In addition to my main support team, I have a few others who provide intellectual stimulation, motivation, and caretaking. For mental health professionals, I work with psychiatrists, therapists, and counselors, though it’s important to note that there can be long wait times and high costs. Alternatives like counselors, caseworkers, and social workers are available through outpatient services.

Hospitalization Experiences

I’ve had 13 manic or psychotic episodes that required hospitalization, and they are often deeply isolating experiences. Hospital stays can last anywhere from 2 to 3 months, and I’ve been restrained, sedated, and placed in isolation during these periods. These experiences are difficult, and they underscore the need for a crisis plan that outlines your preferences for which hospitals to go to and which to avoid. It’s also important to have a plan for who will manage your bills and speak on your behalf during these times.

Structure, Routine, and Habits

Maintaining structure and routine is a crucial aspect of managing Bipolar I disorder. Personally, after major episodes, I’ve found that going back to school provided the structure I needed to regain stability. It’s through this cycle that I found my passion—helping others through peer support. I’ve since become a Peer Support Specialist through Peer Support Canada, and it’s a designation I’m incredibly proud of. Building a routine centered around spiritual practices like daily prayer and meditation, self-care activities, medication management, nutrition and exercise, psychoeducation, self-reflection and counseling I continue to build good habits that help me thrive in my Bipolar I disorder.   

Crisis Planning

A comprehensive crisis plan includes regularly updating it with your doctors and counselors and ensuring that the important people in your life know how to act during a crisis. For example, in Ontario, we can use outpatient services to work on crisis plans, and in Durham Region specifically, I rely on Durham Mental Health Services (DMHS). Familiarizing yourself with local resources can be life-saving. You should also share your crisis plan with those close to you, including information on wellness checks and preferences for hospital care.

Emergency Resources

It’s vital to be aware of what emergency resources are available in your community. In Durham Region, Ontario, I rely on Durham Mental Health Services (DMHS). They provide support for individuals experiencing mental health crises and connect people with the resources they need. These services have been a cornerstone in my crisis planning and overall management of Bipolar I disorder.

Final Thoughts

Managing Bipolar I disorder is a complex journey that requires self-awareness, a strong support system, and effective strategies for coping. By understanding the condition, identifying triggers, and advocating for yourself in medication management, you can work towards a more balanced life. My experiences have taught me the importance of connection, both with others and with myself. As I continue on my journey, I hope that sharing my story and insights will help others navigate their own paths with Bipolar I disorder. Remember, you are not alone, and there is a community of support available to help you through.