What do you do with your life now?

Part of being diagnosed bipolar is realizing you have to make serious changes to keep from ending up in the same holes over and over again. You have to start taking care of yourself and making your health a priority, even if the people around you have less fragile systems and can sustain a more punishing lifestyle. And when you're trying to crawl out of the hardest places, your health needs to be the biggest priority in your life, even if you think you don't have time for it, even if you define yourself as someone who stays up all night and drinks coffee and smokes cigarettes instead of eating meals, even if lots of people depend on you. You must carve out some time to heal.

The diagnoses they give us are useful to a degree"”they allow us to navigate the system, and if we do our research and read up on the words they're using they can allow us to make good choices about getting medical help when we need it"”pharmaceutical drugs that might overpower the demons or the depression, or therapy that might help us get a clear look at our history. But drugs and doctors are only the beginning"”once you know you have this delicate, powerful, and potentially devastating tendency in your blood, you need to start looking at yourself as a whole person and start seeking ways to heal your body and mind. You need to define for yourself what healthy means, what an "appropriate level of functioning" is for you and your beliefs, and then try to take what you can from any tradition that might help you get there, whether it's Western medicine or Chinese herbs. We're going to talk about psych drugs in the next section, but for right now we want to focus on the things you can do to help yourself.

Patience, Hope, and Holding On

The weeks and months after a serious crash or a period of intense cycling are fragile, slippery, and frustrating. Things will start getting better, but whether you're taking Depakote or herbal tinctures, nothing is going to fix you immediately. If you choose to go on medicine it often takes months to find a combination and dosage that works, and you will probably have a bunch of side effects at first"”often they will taper off after a few weeks. For people more prone to rapid-cycling, the introduction and withdrawal of various medications can intensify cycling for a while. You might feel much better for a week and then hit a low again. You might have to change doctors or acupuncturists or schools. You might not make any sense to the people who love you and consistency might seem like a castle in the clouds. This process requires patience, persistence, and a lot of hope. But know that so many of us have been there before, riding the strange strung-out purgatory between the flights and falls of madness and the awkward days of re-learning to walk"”and eventually we all remembered how to dance.

One Good Day

First you need to focus on getting through each individual day. Just that. Keep it slow and simple. It's so much easier to take care of things before they get totally out of hand then it is to do the damage control after the fact"”so start with the basics. Try making a list of things you HAVE to do everyday to keep yourself healthy. These are things that are actually MORE important than all those projects you wish you were doing or all those people you want to be hanging out with"”you need to do this stuff first. This was the list they gave Sascha in the halfway house last time around:

• get enough sleep
• eat enough good food
• take my drugs
• go to work
• exercise
• talk to friends

These are some of the really important basics that you should consider putting on your list, but you'll probably want to come up with some of your own. The important thing is that you have structure to refer back to when you mind is slowly unclouding and basic routine is something that can orient you. This way, if you're feeling off, you can go through the list and figure out if there's anything that you might have forgotten to do.

Routine

"I've been so confused, cycling (or so they tell me, I just know I spent 45 straight hours in bed with no energy but so many ideas I couldn't keep track of my head), trying to figure out how to "manage" this shit. Trying to decide if I should keep living in my wonderful crowded chaotic punk house or go somewhere a little more mellow and discipline-friendly. How important has getting on a schedule been for people? How important has discipline been? i.e. how much of my live-only-in-the-present-all-night-projects-dumpstering-extravaganza life can I hold onto?"-eris Across the board it seems that Having a Stable Routine is Really Important for folks who are trying to put their lives back together. A set time to get up in the morning, a set time to go to sleep at night, and a relatively organized and consistent set of things to do during the day.

"For me, caring, supportive, challenging environments, a fairly consistent routine of eating sleeping exercising and herbing, and some responsibility or situation where my presence is necessary and desired, these are all things that, while in the depths of a severe depression won't have an outwardly visible immediate or dramatic effect that any number of meds would, but they WILL serve as the almost invisible underpinning of increased well-being that I may not even be able to see until they've been "on board" for several months."-permafrost

One of the big distinctions it seems important to make is between the needs of someone who's in a crisis period and trying to get their life together and the needs of someone who's relatively stabilized.

"I don't exactly have a schedule now, but the biggest thing is I try to get 8 hours of sleep every night. And I save staying up past 12 for an occasional thing, not a consistent thing. And what I've always found is that the longer I'm stable the more flexible I can get with my schedule, but that when I'm coming out of hell I have to be more consistent about going to bed at a reasonable hour and showing up somewhere every day to work or get my hands dirty. You do not need to be a member of the 9 to 5 beehive to be functional."-icarus

A lot of people who are bipolar have a hard time focusing on everyday work, and that probably explains partially why so many of us naturally gravitate towards subcultures with standards of living that deviate from the mainstream. While having a lifestyle where more freedom is permitted, like being self-employed, or where very little money is needed, like living in a collective house, dumpster-diving, riding freight trains and hitchhiking etc., might feel more true to your soul and who you eventually want to be, when you're coming out of a crisis it's often much easier to get your life together if you accept a little structure from the outside, whether in the form of a consistent job or regular yoga classes.

Work can be really healthy sometimes - it builds self-esteem, teaches us lessons about having to get along with other people, and directs our energy away from the problems in our brains and towards something outside ourselves. When you're in a rut it's an excuse to get out of the house.

Another note about routine"”our routines aren't limited to some major activity we do for 8 hours every day. Making little routines for yourself, whether it's drinking a cup of tea every day at 5:00, checking in with your seedlings, or riding your bike to the library, can be so helpful. Make plans to check in with a friend every Tuesday, sign up for a dance class and actually go twice a week, join a group like Food Not Bombs and cook food with a group of people every Friday, play online bingo, whatever it takes to know you've got some commitments to keep and some deliberate moments to punctuate your days.

Exercise

It's seems pretty obvious that a huge factor in so many people feeling so crazy all the time is that our society has "evolved" to the point where most people don't have to use their bodies for work anymore. That means most of us spend a lot more time in our heads, which isn't necessarily always the best place to be!

Physical exercise can be one of the most important aspects of anyone's mental health.

"One of the most important things I ever did, when I wasn't even sure I wanted live and felt out of mind self-conscious and alienated from other people, was start draggin' my ass to an incredibly intense Capoeira Angola class. I was completely lost but fully engaged and absorbed in learning the difficult movements"¦for the time I was in the class I entered a truly transcendent space where all I could hear was my breathing and all the insidious poison negative thought loops completely receded- there simply wasn't room for them.

Studies show that exercise at least 3x a week is a better anti-depressant than any of the SSRI's, and the mood-elevating effects kick in quicker and last longer. And it comes from you, not a pill, which is a very different high. Even when happiness or peace still seems elusive you can gird yourself with the sense of achievement in making physical progress, not to mention zero side-effects and detoxing yourself from years of accumulated pharmaceutical build-up. Try pursuing a class with a reputable teacher of chi gong, tai chi, yoga "”or if you're up to something more energetic, a dance class you always wanted to take. At least these are pro-active healing modalities and not passive recipient-healer set-ups. It's good to have a balance of both in your life-- even at your sickest.

And also-- don't set yourself up for failure, start with a small goal and get support for it from family friends or therapist. Also, joining a class is much easier when you're seriously depressed than trying to focus on something alone-- every time you quit you'll beat yourself up-- you're much less likely to do so when surrounded by a bunch of other people with a teacher to focus on." -permafrost

Even if sports aren't something you've ever been into, using your body can make a big difference in your life.

A few words from the kid who always got picked last on the teams and didn't climb a tree till he was 15: I always associated exercise with the jock kids in my school, and I hated them. I always felt really awkward and shameful of my body. I hung out with the punks, and we were too cool to play sports. Quitting smoking cigarettes and swimming everyday when I was 22 years old saved my life. Everything's so connected -personally, I've learned to go running when my mind is starting to race - exhaust myself, burn up some of that manic energy so that my body can't help but fall asleep when I needs it. And I get so much of my best thinking done when I'm running or swimming. I discovered some years ago that YMCA's are actually really cool places that give you access to a whole diverse community of people who are all striving to be healthy. They have affordable scholarship memberships, and once you have a card you have access to any YMCA in the country. Having a place to exercise and take a shower everyday has been so good for me at times when my life at home or on the road has been really chaotic.

Exercise doesn't have to be something you set aside as a separate activity - you can make it part of your daily work whether you're doing construction or digging in the dirt. You can do simple things like walk or ride a bicycle rather than drive. You can take the stairs rather than the elevator. Stretching in the morning is a simple way to reconnect with your own muscles and calm your mind. Just remember that you are a whole person and not just a brain and finding balance involves healing all of you.

Sleep

Sleep is usually one of the first things to go at the beginning of a manic cycle and one of the only things we can manage to do when we're miserably depressed. Sleep can clue us in to where we are on our personal ups and downs"”you might notice that when you're starting to get manic you stay up later and later, or wake up earlier every day. You might notice that being unable to get out of bed every morning or wanting to crawl back into bed by sunset means you're starting to get depressed.

Having regular sleep cycles is definitely key to holding ourselves together. Those of us who are bipolar seem to have really sensitive "internal clocks" and losing even a single night's sleep can disrupt our whole rhythm and start us down that path to mania. Don't ban yourself from the space after midnight forever"”just think of it as a powerful place to visit that isn't safe to stay. Staying up late can be intoxicating and some of the best ideas and most amazing experiences seem to come out of that edge space, but if we let ourselves go there too often or for too long we're likely to end up in trouble"”walking around feeling the whole world creeping under our fingernails and unable to shut off our brains. Good sleep is important to everyone, but to us it's precious.

"Sleep deprivation is such a problem that before modern treatments were available, roughly 15 percent of manic patients lost their lives to physical exhaustion."

(from Bipolar Disorder Demystified, p. 170)

How do you get yourself better sleep when you need it?

Here are few suggestions that don't involve psych drugs: get more exercise during the day, opt out of activities that start late at night, drink herbal teas like chamomile and valerian, tie something over your eyes to keep the light out in the morning, run a constant noise like a fan or a noise machine, ask a friend for a back-rub before bed, set regular times that you go to bed and wake up that correspond to daylight and stick to them, don't start fascinating activities after 8:00 PM.

And what about psych drugs? All the methods we listed above might help us out when things aren't too serious, but don't necessarily do the trick for everyone when we're really having problems. For some of us, taking psych drugs for sleep seems to make sense when it's an emergency; for others, taking them at the first signs of a problem keeps us from hitting the stage where we really crash. Once you get to know yourself well, you might notice one day that you've been hearing three cds playing in your head for the last 48 hours, your eyes and are getting wilder, and your words are getting faster every time you talk. For you this usually means you're starting an upswing"”but if you take an extra pill to help you sleep tonight it might disrupt the process. You have to get to know yourself and recognize when things like trans-continental plane flights or nasty breakups or the first day of summer mean you're likely to get triggered and might want to start getting extra sleep sooner rather than later. And if you find that these drugs are helping you, it might be good to carry a couple extra pills with you in case you end up crashing on someone's couch.

Here's an excerpt from a letter Sascha wrote to an 18-year old kid who'd just gotten out of the psych ward and was struggling to figure out what role he wanted drugs to play in his life:

"And this is the most important thing I'll tell you: you need to get enough sleep, okay? Even though that edge space of night and day is where most of the good stuff happens, you can't be there all the time. Not everyone can do what you do, but you gotta save all that ability for when you really need it. That's where the Zyprexa they're giving you comes in. If you want to get scientific about it, Zyprexa or olanzapine, dulls the dopamine receptors in your brain, keeps them from firing out of control, because people like us have too much too fast going on. We overheat and catch on fire. We see too much and take in too much until we're blind and burnt out. Zyprexa itself isn't evil. Eli Lilly, the company that makes it, definitely is evil, but the drugs are just tools. If you catch it early enough they say you can do the same thing with meditation and yoga and tai chi and herbs. But I know for myself that I can take all the valerian and skullcap and California poppy and kava kava and blue vervane I can stomach and I'm still clawing at the walls and wandering the late night streets. I take 2.5mgs of Zyprexa when I can't sleep sometimes and it knocks me on my ass. Which is just what I need periodically to get me back on track. Sweet sleep brings me back down to earth speed. Which is really important to be able to do if you want to make your way around this world."

Paying attention to our sleep can help us learn our own cycles, and learn to control the extremes and take advantage of the creative energy of our manias and the depressive energy that draws us back into ourselves. The modern medical model sees our moods as dysfunctions, but those of us who know better see potential in our internal changes and sensitive chemistry. We just have to be more careful than other folks. It's the responsibility that comes with having extra gifts.

Dreams

(For more on dreams, visit our Dream Section)

There's something very strange about the fact that our culture doesn't take dreams more seriously. Dreams are full of clues if we allow ourselves to see them. All masked in layers of metaphor and symbol. Keep a pad and paper by your bed and write your dreams every night - just start with whatever little fragment comes out, it gets easier the more you do it. It's like exercising a muscle, you get more control after awhile. Dream journals are a whole other set of maps, maps to the underground unconscious each of us carries around with us. Sometimes dreams can even let us know where we are and where we might be going.