5 Things That Can Sabotage Your Bipolar 1 Disorder Treatment

Setting up a care plan for a mental health condition such as bipolar 1 disorder can be challenging. And sometimes, despite the best intentions, it can be hard to follow that plan exactly.

To prevent bipolar 1 disorder mood episodes, you can try to avoid or minimize some habits that may affect your treatment. Here’s what to keep on your radar — and what you can do to take back control.

1. Not Taking Medication as Directed

“Mood disorders, including bipolar 1, are some of the most treatable conditions we see in medicine,” says John Zajecka, MD, a professor of psychiatry and behavioral sciences at Rush University Medical College in Chicago. “There is no reason why people can’t be in charge and in control of their moods and illness and live normal, happy lives.”

The key to this, though, is taking your medication regularly. “[It] is imperative,” Dr. Zajecka says. When it comes to keeping your mood stable, he notes, “It’s not a good idea to try to manage without medication.”

That said, some people find that they don’t want to take medication during an episode of hypomania or mania, when they may feel like they don’t need it, or during a depressive episode, when they may feel as though medication will not help.

2. Not Sticking to a Consistent Sleep Schedule

Good sleep is crucial when you have bipolar 1. “Keeping this illness under control requires good sleep hygiene,” Zajecka says. When you’re sleep deprived, you’re more likely to “cycle up” into hypomania or mania. On the other hand, too much sleep can cause you to “cycle down” into depression, he says. Over time, you should notice a pattern in your moods based on your sleep.

3. Not Asking People You Trust for Help

Your healthcare provider may be fully focused on getting an episode of mania or depression under control, “But the next step should be, ‘How do we prevent further cycles?’” says Zajecka. That’s where trusted people in your circle can help.

As someone with bipolar 1 disorder, you should have two people to turn to when you recognize your mood is cycling: someone on your healthcare team, such as your therapist, as well as a family member or friend who knows your history with bipolar 1 disorder. This person has a responsibility to be open and up front. Zajecka says that they should be able to gently describe what they see going on. For instance, they might say: “I hope you don’t mind, but I notice you’re going on a spending spree, and I’m worried about you.” They can then help connect you with your doctor or therapist, if needed.

“You don’t want to be alone in this,” Zajecka says. For more support, he also recommends the Depression and Bipolar Support Alliance (DBSA), which is a patient-run advocacy organization. “This is a phenomenal source of information, and they have so many support groups,” he says.

4. Not Keeping a Mood Journal or Life Chart

Zajecka recommends that all of his patients with bipolar 1 track their mood daily. “This seems to be one of the early predictors of where their mood may be going,” he says.

A life chart, as Zajecka calls it, comes in handy to pinpoint how environmental and lifestyle behaviors influence your mood. “People will learn patterns and learn how to manage their illness better,” he says. At the end of each day, spend three to five minutes describing your mood; you should also note whether you exercised, drank alcohol, got enough sleep the night before, and took your medications.

The DBSA offers free downloadable wellness trackers, including a mood tracker.

5. Not Focusing on What Makes You Feel Good

While it’s important to recognize the patterns or behaviors that make bipolar 1 worse, it’s also helpful to find the patterns that make you feel good.

You shouldn’t “feel as if [you’re] being put under a microscope about what’s wrong,” Zajecka says. “Rather, let’s reinforce what’s working in the right way.” For instance, if you notice that your mood cycles into depression or mania at certain times of the year (like in the fall or spring), then at those times you can make a point to focus on the lifestyle habits that make you feel great when done alongside your usual treatment, such as getting good sleep, eating a healthy diet, or sticking to your exercise routine.