Yes to sleep hygiene!!!! I can be stable off bipolar meds (well, in regards to bipolar, the comorbidities are more trauma/environmental based and more chronic/less episodic than bipolar is, so that's gonna be an issue regardless) if I am getting good quality sleep every night. The thing is, without meds I don't get good quality sleep every night. Haven't even taken something that specifically is used to treat bipolar in a while (not that I'm in any way stable these days), but I take clonidine for sleep and use diazepam as needed so when I'm in crisis mode and past a skills breakdown point, I have something to let me sit and get back to a place I can cope with for a little.

Maybe this is coming from someone who was initially thought to have severe bipolar or even schizoaffective, but now is thought to be more mild-moderate overall but just looks worse because of a strong foundation built on trauma and neglect and having a lot of past treatment providers that need to quit and get an overnight stocking job at Walmart, but when you're outside of episodes, still work on your other stuff. Everybody has their bad habits and automatic negative thoughts and cognitive distortions, etc. And the better you handle those, the more manageable bipolar gets, the better you can cope with the breakthrough episodes, and it's best to learn these things when you are not manic or depressed. No one says "I'm going to become a hiker" and goes straight to Everest successfully. They start with low elevation stuff, shorter stuff, and that gets easy, and as that gets easy, the more strenuous climbs become more of a possibility to accomplish. Same with mental health. You can't learn to deal with a crisis in a crisis.


I've never really been an overspender (unless you count when in active addiction and of course prioritized getting high over having savings), but I have struggled a lot with hygiene in the past and a lot of it is getting into habits and learning what works to motivate you. I'm in the habit of every day waking up, having some water, choosing the clothes I'm going to wear, and hopping in the shower. I know people who brush their teeth in the shower because that's killing two birds with one stone: you're already in there, the water's flowing, it's more accessible and easier to remember if "shampoo+soap up" just becomes "shampoo+soap up+brush teeth" all as one thing rather than having the shower and then a completely separate task.


There's a user here that used to have a problem with flossing, but now loves to do it because she does it while watching TV. She's not standing there in front of the mirror just focusing on the floss and her mouth wanting to do other stuff, but she knows her mouth feels better when she does it (and that reward enforces the behavior too).

I don't think a lot of people find a "perfect med combo" that as long as they take they never have any symptoms or hard to deal with side effects (I certainly don't), and like raspberrytorte said if you have those expectations and a doc into polypharmacy it is easy to find yourself on more meds than you like, and more meds than is necessary, and at that point you're probably getting a lot of side effects, maybe interactions, and it's hard to tell when something changes which meds are part of the solution (and there may be a med that's the problem, but if you're on 7 meds it's nearly impossible to know which one it is since a lot of them cause similar side effects). So look for adequate, not perfect, with med combos.

Learn what your early warning signs are for the different types of episodes (and even "types of types of episodes," like I can have euphoric manias or ragey manias or just plain chaos manias and the beginnings can sometimes look similar, but if I'm heading towards a "chaos mania" or a ragey mania, I probably won't feel as invincible and optimistic and confident as a euphoric one for example), and act early (lower stress levels, focus on getting the right rest/activity balance, and up the self-care some as some ideas) to keep things from getting worse. Sometimes this is enough, sometimes we DO need to make an earlier appointment with our doc for med change or at least a dose change. That's okay too. What isn't okay is ignoring things as they get worse and worse until you're a complete wreck.