Living with Bipolar Disorder
With proper treatment and self-management strategies, people with bipolar disorder can lead fulfilling, productive lives. These evidence-based approaches can help you maintain stability.
The Foundation: Treatment Adherence
The single most important factor in living well with bipolar disorder is sticking with treatment—even when you feel better. Stopping medication is the #1 predictor of relapse.
Tips for Medication Adherence
- Use a pill organizer and set daily reminders
- Link medication to a daily routine (morning coffee, brushing teeth)
- Keep a backup supply when traveling
- Talk to your doctor about side effects—there are often alternatives
- Remember: feeling good is a sign treatment is working, not that you no longer need it
Sleep: Your Most Important Routine
Sleep disruption is both a trigger and an early warning sign of mood episodes. Protecting your sleep is one of the most powerful things you can do to prevent relapse.
Sleep Hygiene for Bipolar
- Consistent schedule: Go to bed and wake up at the same time every day—even weekends
- 7-9 hours: Most adults need this amount; track what works for you
- Wind down routine: Start relaxing 1 hour before bed
- Dark, cool bedroom: Optimize your sleep environment
- Limit screens: Blue light can disrupt sleep; use night mode or stop screens 1 hour before bed
- Avoid caffeine after noon: Caffeine has a long half-life
- No alcohol before bed: It disrupts sleep quality
⚠️ Sleep Changes Are Warning Signs
If you're sleeping much less than usual and don't feel tired, contact your treatment team—this is often the first sign of an impending manic episode. Conversely, oversleeping can signal depression.
Tracking Your Mood
Mood tracking helps you identify patterns, triggers, and early warning signs. It also provides valuable information for your treatment team.
What to Track
- Daily mood (scale of 1-10, or descriptive)
- Hours of sleep
- Medication taken (yes/no)
- Energy level
- Anxiety level
- Irritability
- Significant events or stressors
- Substances used (caffeine, alcohol, etc.)
Recommended Apps
- Daylio — Simple, visual mood tracking
- eMoods — Designed specifically for bipolar disorder
- Bearable — Comprehensive symptom and factor tracking
- Moodpath — Includes CBT-based exercises
Identifying Your Triggers
Triggers are factors that can precipitate mood episodes. Common triggers include:
Common Manic Triggers
- Sleep deprivation
- Stimulants (caffeine, ADHD medications, cocaine)
- Travel across time zones
- Major life changes (even positive ones)
- Spring/summer (for some people)
- Starting antidepressants
Common Depressive Triggers
- High stress
- Loss or grief
- Social isolation
- Fall/winter (seasonal pattern)
- Physical illness
- Alcohol or drug use
Your triggers are individual. Use mood tracking to identify your personal patterns over time.
Building Your Support Network
Social support is crucial for managing bipolar disorder. Build a network that includes:
- Treatment team: Psychiatrist, therapist, primary care doctor
- Trusted friends and family: People who know your warning signs
- Peer support: Others who understand (support groups, online communities)
- Crisis contacts: People you can reach in an emergency
Share Your Warning Signs
Create a list of your personal warning signs and share it with trusted loved ones. Ask them to gently alert you if they notice these signs—and agree in advance how you'd like them to approach you.
Support Groups
- DBSA Support Groups — In-person and online
- NAMI Support Groups — For individuals and families
- r/bipolar — Online peer community
Lifestyle Factors
Exercise
Regular physical activity helps regulate mood, improves sleep, and reduces anxiety. Aim for 30 minutes most days. Any movement counts—walking, swimming, yoga, dancing.
Nutrition
While no specific diet treats bipolar disorder, healthy eating supports overall brain health:
- Regular, balanced meals (blood sugar stability)
- Omega-3 fatty acids (fish, walnuts, flaxseed)
- Limit processed foods and sugar
- Stay hydrated (especially important with lithium)
Avoid Substances
Alcohol and recreational drugs can trigger episodes, interfere with medications, and worsen symptoms:
- Alcohol: Depressant that disrupts sleep and mood stability
- Cannabis: Can trigger psychosis and worsen anxiety
- Stimulants: Can trigger mania
Stress Management
- Mindfulness meditation (apps: Headspace, Calm, Insight Timer)
- Deep breathing exercises
- Setting realistic goals and boundaries
- Learning to say no
- Regular breaks and leisure time
Create a Wellness Action Plan
A Wellness Recovery Action Plan (WRAP) helps you stay well and respond to warning signs. Include:
Wellness Plan Checklist
- Daily maintenance activities (sleep, medication, routine)
- Personal warning signs for mania
- Personal warning signs for depression
- Trigger list
- Coping strategies that work for you
- Support people and their contact info
- Treatment team contact info
- Crisis plan (what to do, who to contact)
- Preferences for crisis treatment
Share your plan with your treatment team and trusted support people. Review and update it regularly.
Work & Relationships
Employment
- Know your rights: ADA protections may apply
- Disclosure is a personal choice—you're not required to share your diagnosis
- If you do disclose, focus on what accommodations you need, not your diagnosis
- Maintain regular work hours when possible
- Build recovery time into demanding periods
Relationships
- Educate partners and family about bipolar disorder
- Communicate openly about symptoms and needs
- Consider couples or family therapy
- Apologize for past behavior while unwell, but don't carry excessive guilt
- Make decisions about disclosure timing in new relationships
Resources
Books
- The Bipolar Disorder Survival Guide by David Miklowitz
- An Unquiet Mind by Kay Redfield Jamison (memoir)
- Take Charge of Bipolar Disorder by Julie Fast