How to prevent/ease episodes besides just medications?

I thought it might be helpful for any lurkers here (or possibly regulars, too) to share strategies or things that help prevent or ease bipolar episodes besides just medications. Over the years, I found it crucial to combine the two. Could you share one or more of yours?

Preventing/Easing/Cutting short Hypo/Mania:
- "Laying low". Avoiding stimulating places/things/activities sometimes prevents stoking the fire of my mania, so to speak.

- "As needed medications". My long-time pdoc prescribed meds to use for this. He gave me directions on what and how much to use, "when needed" and when it was time to call him for emergency appointments.

- "Stress reduction/avoidance". A biggie for me!

- "Good sleep and not deliberately avoiding it".

- Healthy diet and low/no alcohol or street drugs".

- "Knowing my danger months/triggers". Springtime has been when my hypomanias/manias often start. Light/longer days. Self checks. Also my loved ones will be more vigilant.

Depression/Anxiety:
- "Stress reduction/avoidance", as above.

- "Avoiding hypomania/mania". If I can avoid the "up", I can often avoid a "down" that often follows.

- "Healthy diet and low/no alcohol/drugs."

- "Quick intervention". Nip it by the bud by seeing my pdoc before it gets bad.

- "Certain Cognitive Behavioral Therapy (CBT) coping tools". These have served me well, especially for anxiety and sometimes curbing that prevents/eases depression. Mindfulness exercises can also help to varying degrees.

- "Knowing danger months/triggers". Same as above.

Having a regular routine. Waking up, eating, bathing, and going to bed at about the same time every day.

Not falling into the trap of hypomanic seduction. Look out for early warning signs and take immediate action (lay low, take PRNs, get extra sleep, tell pdoc).

Cut down on caffeine

Regular exercise. Nothing feels better than coming back from a 10km run and hanging your legs against the wall, stretching out, taking a hot shower, and just enjoying the endorphins running through your body.

I’m a huge believer of therapy. It was mostly Cbt but over the years a bit of this and a bit of that. But for that to work I had to be somewhat stable on meds. And that took a lot of trial and error.

Having a stable safe place to live is important too.

For me I. Need a general schedule especially around sleep.

You both have mentioned really good measures! I think it's important to realize that both that while manic, mixed, and depressive episodes are all distinct and have their own challenges to keep in mind -- there are core things that help with all of them like was already mentioned-- routine, diet, avoiding alcohol/drugs, etc. One that I would add that I personally used for a while was a journal and mood tracking. By itself it won't prevent anything, but knowing is half the battle -- if you're reflecting and noticing symptoms, you can better prepare yourself. My go-to strategies now are actually DBT based skills. I've heard some negative talk about the therapy because of its origins and its design but it's components are very solid for mood regulation, which is what we deal with -- a mood disorder! There are some really good skills to help combat depression and even (hypo)mania.

Talking preventative measures, one that I think stands strong for me is knowing not just avoiding triggers, but proactively preparing for the possibility. Much like soupe said about nipping it in the bud, I like the DBT skill of "accumulating positive emotions". It's a pre-emptive strike to knowing a stressful/sad/uncomfortable moment it gonna happen. You do things you enjoy and relish in that for a while, you build up a positive feeling, to curb the anxiety/sadness/irritability of the inevitable one. I use this a lot for depression. For hypomania? Easiest tip for me is to keep my debit/credit card in my wallet and no shopping online or dating apps when i'm feeling too revved. Mixed states are hell -- just remember it will pass. Meds really are the best help there.

I know i didn't add much to what was already said, but I wanted to contribute the little I could. Good post!

I don't like preventing hypomania. It feels good! So I eat a bunch of candy and drink coffee and energy beverages and purposely stay up all night and getting 2 - 4 hours of sleep.

I don't like depression. Depression feels bad. I often lack energy and feel overly drained. I don't know how to prevent it though. It just kind of happens out of nowhere.

I'm starting a DBT group soon that my therapist recommended. I'm hoping it helps me!

Generally I try to go to bed at the same time every evening and get up at a fixed time every morning. I use good time on my breakfast while reading the news. After that I do physical exercises for my body and then repeating (reading) my coping strategies every morning. I end my morning routine by doing relaxation exercises.

I have used a lot of time years ago to make a schedule that is appropriate for every day, but different each day. The plan repeats itself every week. It takes care of my different needs, work (part time), rest/relax, my prayer-life, meals, cleaning, social contacts, and more.

Especially, I am satisfied with a set time each evening for worrying. I allow myself to worry or think things through from clock so and so and end it at clock so and so. Such an arrangement allows me to be in the here and now most of the day. I tell myself in a friendly way that these distracting thoughts are not allowed now. They have to wait until the "worry time".

Since my bipolar is unspecific, it "works" different than those with bipolar I or II. I suffer most from depression, but to me the worst is to have too much fun. That can trigger a couple of days where I feel high. I don't like that, because it steals time from other important topics in my life.

The most important preventing tools are my structured mornings and my weekly schedule. This also prevent highs. If I have to go to a party, I decide to set a time for when to prepare for that. Then I make an extraordinary plan from that point and am very specific on what to do when coming home from the party. That involves deep relaxation exercises and something calming for the stomach.

I have found my tools partly from former therapy, but have used much time on making my own tools according to how I know myself. CBT is a valued part of it, especially the more modern forms that have come into use the last years, like the STOPP tools (Stop - Take a breath - Observe (what are you thinking) - Pull back (How would others see this) - Practice what works).

STOPP - CBT in a Nutshell - YouTube

Using my WRAP plan and dbt skills

I like having someone (can be a therapist, family member, partner) I trust who knows me at my baseline who can sound off if I'm too far up or down. Since loss of insight can definitely happen with mental illness, it's nice to have a perspective outside yourself.

That said, knowing how it feels when I'm on my way up or down helps me to act to address the mania or depression head on. Talk to my PsychNP, change meds or go to the hospital if it comes to that.

Thanks for sharing all of these great tips!

Yes. It does help having someone close to you who can tell if you're going up (or down), and can tell you, or warn you. My husband has been nagging me for days that I'm going hypo and he can tell because he knows me. It's annoying, but he's probably right lol.

This is so true. That was one of the functions of my t as I got better. To tell me if I was becoming untethered. Insight is often the first then lost.

Great tip Aurelius!