When routines get out of whack (hello, holiday stress) it can cause you to forget to take your meds. Or you may be tempted to go without them. The fact is, this time of year is extra difficult for people with bipolar disorder, and that includes complying with their treatment plan. It’s also when they need to stick to it the most. “Bipolar individuals are easily challenged when their routines are disrupted,” says Julie Carbray, nurse practitioner and clinical professor of psychiatry and nursing at the University of Illinois, Chicago. “This illness really requires you to try to quiet your brain.”

That may be a tall order at the noisiest time of year. This year, COVID-19 may keep large gatherings at bay, but it can also create extra challenges at the holiday for someone who struggles with depression or mania. The holidays exacerbate what may already be difficult—managing money, regulating diet, moderating alcohol. The best way to cope and avoid relapse, say psychiatric professionals, is to stay on your treatment plan. We’ll help you do that, with timely tips and valuable wisdom about how to manage your medications, maintain your support system, and more.

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Quiet Your Brain

Stressful life events can trigger bipolar mood episodes, says Allison Nelson-Eliot, LICSW, at McLean Hospital in Belmont, Massachusetts. Says Nelson-Eliot, “The stuff that comes with year-end holidays such as missing medications, lack of sleep, conflicts with family or friends, more alcohol or other substances, financial stress, even the seasonal change at this time of year can trigger manic-depressive mood episodes.” Even without the usual December get-togethers, the pressure to get it all done and perfectly can be agitating to someone with bipolar disorder.

For someone with depression, “holiday time can be overwhelming,” says Merihan Raouf, PharmD, At this time of year, says Raouf, “[bipolar] depression can really hit, especially with COVID-19, if you’ve lost a job or loved one. Bipolar heightens the difficulties.” To lighten the load, simplify. Try to minimize your hosting and buying responsibilities, keep your calendar in check, and manage your expectations.

For someone with mania “who is barraged with sales and solicitations,” says Robert Goldstein, MD, a psychiatrist in private practice in the New York City area, “it’s easy to buy too much. The rapidity with which you can click on something and have it land on your doorstep is worrisome” for bipolar patients. To avoid overspending, he suggests simply, “set a budget for holiday shopping.”

“You need strategies for when your brain is excitable,” Carbray says. “For instance, promise yourself that you’ll leave [an event] early and be in bed by 11. You want to create some balance in a brain that seeks thrills by directing how your day looks.” And above all, she says, “follow your treatment plan.”

Updated: Jan 4, 2021
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