Bipolar disorder is one of the most difficult illnesses to treat because by addressing the depression part of the condition, you can inadvertently trigger mania or hypomania. Even in Bipolar II, where the hypomania is less destabilizing than the often-psychotic manic episodes of Bipolar I, persons often suffer from a debilitating depression that can’t be lifted by mood stabilizers and antipsychotics. Antidepressants, though, can cause a person with bipolar to cycle between hypomania and depression.
I have worked with psychiatrists that were too afraid of cycling to risk using antidepressants for bipolar patients. They put me strictly on mood stabilizers and antipsychotics. However, I did not get well. I stayed depressed, and all original thoughts in my brain vanished. My current psychiatrist knows that depression is my primary threat, not so much the hypomania, so she was able to pull me out of the depression with the right combination of antidepressants, but is vigilant for any signs of hypomania. Because I know how vulnerable I am to hypomania, I have learned several strategies to help me stay grounded. By making them part of my life, I have been able to take less lithium, my mood stabilizer, which ensures that I continue producing original thoughts and not get too medicated. Here are 10 tools I use to avert hypomania.
1. Practice Good Sleep Hygiene
Developing good sleep habits is by far the most potent tool for preventing mania and hypomania. There are a handful of studies documenting that sleep deprivation is associated with hypomania and mania. For example, in a study in the Archives of General Psychiatry, nine manic-depressive patients who were in a depressed phase stayed awake for 40 hours (one night’s total sleep deprivation). This triggered mania or hypomania in seven of the nine individuals.