This stuff might seem obvious but sometimes the obvious is the most elusive:

Possibly as a bipolar I naturally release more stimulating chemicals into my system until those chemicals are drained (in a similar way to ecstasy drains serotonin) and that is when the crash happens and depression sets in. To control this in a non-pharmaceutical way I could recognize when I am going too far up (e.g. racing thoughts, anxiety, sleeplessness, frequent waking, taking on many new projects at once, urges to do impulsive and unusual things, grandiose thinking, etc.), catch it, and do things to slow down like take breaks, sleep, eat plenty, lay off the caffeine and sugar, breath deep, sit quietly, go to a peaceful place and try to relax, etc. Conversely, when I feel the crash coming on or depression sinking in (sadness, tearful, low self-esteem, thoughts of hurting myself, lack of motivation, extreme tiredness, waking in the very early morning and difficulty falling back to sleep, pending sense of doom, etc.) I need to recognize the symptoms and do things to feel better such as have a cup of hot chocolate, go for a brisk walk, do something fun that I enjoy, write down how I feel and then get up and be active, clean the house or do yard work, pet an animal, breath deep, take a bath, eat something I like, etc.

Personally, I wouldn’t want a flat-line existence. I wish I could always be in the up-swing of things, but that just isn’t how things are for me. So, on the other side of regulating myself to keep from the extremes of up and down, there is also making the best of my current mood. In the manic phase I tend to get many ideas; make plans to start new projects; do social networking; get inspired; work on creative endeavors; etc. The trick again is temperance. I have to remember my limitations and not make too many obligations or take on projects that I will not be able to carry out once I crash. 

When the down-side comes it can be a rude wake-up call to realize that I took on too much. I need to scale back where I can, but still push myself harder to complete the necessary tasks. Perhaps I could explain to myself and others, if necessary, that things are going a little slower than planned right now, but I am continuing on at the pace I am able. Of course I could see how in the ‘real’ world some people might not go along with this plan. There are schedules and deadlines to be kept. Another problem is when the down-side lasts a really long time and I wonder if I will ever get the energy or motivation to work on projects again. People want to see reasonable progress and there isn’t always room for someone that has been depressed for 6 months+ to break out of a depression and get energy to get things going at a faster clip. I need to be able to carry on even in a depressed state. Obviously at the lowest ends of depression this is not possible, but I’m talking about if one is able to keep the mood swings more moderate.

I guess for me it took years of seeing myself going up and down and pushing the limits too far on the up swing and letting myself fall too far down on the down swing to start to get a feel of what is too far up and what is too far down. It was really hard when I first started to realize what was going on because when I was up it felt so good I just wanted to keep going up higher and higher, but I didn’t realize at first what my realistic limits were. When I was falling down, down, down, it sometimes happened so fast or sometimes snuck up on me so I didn’t notice it, and I feel so lost in a quagmire of sorrow, it seemed that no reasoning could bring me out of this state. Saying to myself that I know this is a phase and will pass had very little meaning to me in those depths. The sadness was so intense and felt poignantly real, more real than any statements to myself that it is 2 days before my menstrual cycle and this happens almost every month.  After seeing it happen over and over again and believing myself (the doctors all completely brushed off and refused to address that my depression usually hit a couple days before menses.) I am starting to be able to reach myself at those points and break through that low-lying cloud with a little bit of reasoning, acceptance, and actions to ease and uplift myself.

Just in the last year, after maybe 20 years of this (I had a lot of other problems in addition to bipolar.) I have started seeing the cycles more clearly. So far I can see clear monthly cycles – up around ovulation, down a few days before menstruation; I see yearly cycles, but not certain exactly how they go yet – I usually get depressed in November and then by January I try to get indoor organizing and intellectual tasks done and become somewhat manic in my obsession with whatever I am working on; Spring is weird – I either get manic or dysphoric, almost as if the beauty of the spring contrasts with my dark winter mood and sets me into a deeper depression; I get irritable in August - who doesn’t when you are in a climate that has a hot August? I literally get hotheaded and lethargic.  I also have ups, downs, and mixed states throughout each day. I get into irritable slumps, I guess when my blood sugar is low or when I am tired. Getting enough sleep is imperative to me, which I can see could be a problem in academia where a whole bunch of work culminates at certain points and the deadlines cannot be flexible. Possibly I will just have to do my best to get sleep and otherwise be very aware of my irritability and not imposing it on people.

I know many people would wonder why I would go through all of this and not just take a medication. The answer is that it is not that simple for me. I have tried dozens of medications in various combinations and strengths and was not able to solve my problems that way. That way did not work for me. I am still willing to take medications when I get into acute states. I also notice on many medications a flattening of affect, less depth of thinking, general tiredness and lack of energy, and a multitude of other and sometimes unpredictable and dangerous side effects. 

How to keep going when you are depressed?