Alcohol
Try to abstain from alcohol, or if you can’t do this, drink in moderation. People say alcohol is a depressant and therefore it makes you depressed. This is not the case, it is a central nervous system depressant which acts in a similar way to Diazepam (Valium). A hangover, however, can make you feel depressed if you over do it and can make you feel chronically ill for days, triggering behavioural and psychological changes. You can also regret behaviour that you carried out on a night out, making you feel embarrassed and therefore increasing your depression. I know alcohol can make you feel good and therefore less anxious or depressed in the short run, but it will not help you in the long run. There is a craze of alcoholic free beer and gin nowadays which is what I would suggest you buy if you are finding it hard to abstain from alcohol.
Smoking
Everyone says you should avoid smoking. I understand, however, that this is difficult as it can make you feel good and gives you something to do. If you are in hospital, smoking allows you more time to go outside and gives you a break. It is not uncommon for bipolar sufferers to smoke. Alternatively buy an e-cigarette and smoke this instead. This can help you give up cigarettes.
Recreational Drugs
Recreational drugs must never be taken if you suffer from bipolar disorder or any mental health disorder. Smoking cannabis in excess can bring on depression or even bring on mania. Drug induced psychosis can occur and is one of the main factors that contribute to mental health problems, especially bipolar – it makes you feel unstable. Drugs such as Ecstasy (MDMA) can even cause brain damage.
Antidepressants and antipsychotics
Antidepressants should not be used if you suffer from bipolar disorder, unless the sufferer is seriously ill with depression. Antidepressants are the main cause of hypermania, hypomania and mixed states. SSRIs such as Fluoxetine (Prozac) and Paroxetine (Paxil) are very strong and have many side effects such as weight gain. Instead of treating depression with antidepressants, it is thought some antipsychotics can treat bipolar depression such as Quetiapine and Lurasidone. Antipsychotics also can be used as mood stabilisers such as Olanzapine and Quetiapine. Monitor your side effects, some old first generation antipsychotics can give you Parkinson- type side effects such as trembling, strange movements of the mouth and tongue and bending hunched over. Traditional mood stabilisers like Lamotrigine, Sodium Valproate and lithium can help treat bipolar too.
Other Factors
Always take your medication. Put the pills in blister packs if you can. Download a phone pill reminder from the Apple Store (Medisafe). This will remind you when to take your medication.
Remember to book blood tests. You will need occasional blood tests if you are on antipsychotics as they can contribute to diabetes (because they cause substantial weight gain). You may also need an ECG to monitor your heart. This can be done every 3-6 months.
Exercise
Try and take part in some exercise. I really recommend swimming. It is a gentle exercise but can make you feel very energised when you get out. I recommend not doing too many lengths at the start, but build up over a few trips. There is music playing usually which helps add to the enjoyment. I understand though that you may not want to do exercise if you're finding it hard getting outside, especially if you have agoraphobia.
Panic attacks
Try listening to relaxing music or meditation. www.calm.com is good for this, or listen to Spotify. Try talking to people. This can really help.
If you are feeling panicky try and do A to Z of countries, names and foods, for example. This helps you focus on the here and now. Another tip is to use the App called ‘Quiz’ which can really help you focus on the present and not the panicky thoughts (https://apps.apple.com/gb/app/general-knowledge-quiz/id723491117) - I also play an XBOX driving game. It is something to focus on.
If you are feeling ill such as with bipolar, depression or schizophrenia make sure you do not drive as you could lose focus or attention and be involved in a serious accident.
Self-help groups
Join a self-help group near you organised by www.bipolaruk.org This can really help you to meet like minded people who might become friends. Chat to your friends and family on social media.
Samaritans
Phone The Samaritans if you’re feeling desperate on 116 123. There is always someone there for you, no matter how bad you feel.
Best wishes - you’re special and you shouldn’t let bipolar take you over.