It’s been 3 years since my diagnosis of Bipolar 2 disorder, and while I’ve learned much through therapy and self-help, there’s still a lot left to discover in managing this sea of turbulent cycles.

With Bipolar 2 there's a lot of see-sawing between depression and hypomania. There's more to it of course and it’s different for each individual, but at least for me this is what it means to have bipolar 2: long periods of depression and a brief brush of elation, and back down again.

The Case of Intense Mood Swings and Things

Moods naturally change but what it takes for you to have this mood disorder is having an imbalance in your brain chemicals (neurotransmitters and hormones) where you don't produce enough, and then too much, hormones that make you feel happy or rewarded. This renders you depressive and then hypomanic for long periods of time (cycles) affecting your daily function, of course.

Because the emotions are intense and the imbalance is happening in your brain, it’s normal to feel helpless and sense that you have no control. Your energy levels and your motivation change along with the state of your thoughts and emotions, or because of it. This makes it difficult to keep yourself committed to something, like a hobby, or work, but it doesn't mean it's not possible to. It's very difficult to believe it but you can manage through Bipolar 2. While you can’t once-and-for-all “cure” it, there are ways to keep in control and come through whether it's a hypomanic or depressive episode. Here are some of the ways that you can manage yourself, despite having Bipolar 2:

Trigger Me This, Trigger Me That

Do you know what your triggers are? What pulls you into a depression, and what launches you into hypomania? Knowing your triggers are a good way of preventing yourself from falling deeper into either state and lessen the duration.

Does your hypomania intensify when  you don’t get enough sleep? Are your depressed longer when you isolate for a period of time? Ask yourselves questions that help you identify what things make you feel certain ways, like agitated or anxious, that add to the severity of the cycle. Keep a mental note, or even a physical one, of what puts you out of balance so you can find ways to either avoid them or address them in a healthier way. The idea is to reduce those triggers, obviously we can't avoid everything, but at least the lesser there are the more manageable it is to bounce back.

Mood Tracking

Besides identifying your triggers, tracking your moods through a diary or app will help you become more prepared for when your highs and lows take place. There’s a lot of power in knowledge, and knowing the pattern of your moods gives you opportunities to adjust your activities.

For example, when you're feeling like your hypomania is coming, it's a good opportunity to hide credit cards, schedule an exercise routine, or use the opportunity to finish backlogs. When you anticipate depression coming on, it helps you to simplify your activities so you don't get overwhelmed and/or disappointed with not being able to have the capacity to do all of them.

Routine for a Sense of Stability

The feeling of instability is inevitable when you have Bipolar disorder. Having a routine is a direct counter to that, it brings structure to your day-to-day life.. When you’re following a routine there’s a general expectation on how things will turn out and what you will do, putting you into a kind of goal-oriented mindset.

Daily routines also set healthy barriers over the activities you do that sometimes affect your cycles. For example; the tendency to sleep too much or not at all, overwork or procrastinate and skip meals or overindulge, they can trigger or prolong your cycle. Following a routine kind of keeps your actions in check so that you don't overstep into these types of triggers.

Good Sleeping and Eating Habits

Whether we like it or not, our eating and sleeping habits play a significant role in the production of hormones in our body, affecting our moods. There’s still a lot of research needed to verify how sleep and food correlates with our mental health but one thing is for sure: diet and sleep affects our physical health. And our physical health affects our mental health. When we’re not feeling well due to lack of sleep or food, we function poorly, think negatively and therefore are prone to triggers.

Exercise, Exercise, Exercise!

Just like with our diet and sleeping habits, having exercise helps you to naturally produce happy hormones and pump up your feel-good neurotransmitters. It's not the permanent, magic solution to all of your problems, but movement, whether it be sports or as simple as taking walks, will help alleviate the symptoms of your "low" episodes in the long term.

It's also a good action plan for when you're in hypomania and have more energy than you know what to do with. Sports and exercise are good additions to your routine, whether it's daily or weekly, it might not cure your disorder but it definitely brings about a sense of accomplishment and you can use a lot of that positive feeling.

Disaster Management Action Plans

We do a lot of prevention methods for these mood cycles, but it doesn’t mean it will keep your worst symptoms at bay forever. There will be times when the episodes hit their hardest anyway and you end up where you don’t want to, which is why it’s important to have a disaster plan for these situations. An example of a disaster plan is setting a go-to activity for particular situations. For example: you have depression and rumination, to combat this episode you can set up activities like listening to music, taking walks or binge-watching to disrupt the rumination and prevent it from deepening your depression. For hypomanic states when you have the tendency to do risky behavior on impulse you can set yourself up to exercise instead or play a type of sport to expend that excessive energy instead of on something riskier.

You can come up with the ideal go-to activity for each situation, completely customizable, but for the worst case scenarios like self-harm and suicide ideation and/or attempt, it’s important to have an emergency contact AND hotline numbers for hospital emergencies or emotional support/suicide hotlines. Safety is a priority, don't ever downplay your depression and never think it's a bother to ask help from someone dear to you, you wouldn't turn them away if it was the other way around.

Build Your Emotional Support System

It doesn’t take away the pain or discomfort of the turbulent emotions, but having someone to talk to, vent to, or simply sit by really provides a lot of comfort and hope. It’s human to need company in times of distress and during your weakest, most challenging moments, a lifeline might just be one person offering their time and attention.

There must be people in your life, if not one person, that you can turn to for emotional support. Nourish these bonds and keep yourself from being completely isolated, because even loneliness can affect your physical and mental well-being.

Therapy and/or Medication

It’s not for everybody but it’s an ideal support system for anyone with any mental disorder. Through therapy, you can navigate the internal factors that affect and prolong your moods like intrusive thoughts, negative thinking and other cognitive distortions. It’s also a great way to get psychoeducation and learn the roots of certain behaviors you may want to change. Medication, on the other hand, is a direct intervention for addressing the chemical imbalances in your brain. This means trying to encourage your system to produce more of certain hormones to increase your happiness levels or level out your fight-or-flight response (which is often haywack during hypomania).

You can be given antipsychotics, antidepressants and/or mood stabilizers depending on what your most prominent symptoms are. There’s a lot to be shared about the differences of each psychiatric drug and how they work but I honestly have not found anything that satisfies my curiosity yet to expound further on this. I’ll update when I’ve found enough resource material. Ultimately, psychiatric medication is designed to assist your body to function a little better in the hopes that it will give you that small push to instill healthy habits that will then naturally encourage a balanced production of your hormones.

Things that Swing and All that’s In-between

None of this fool proof, it takes a level of commitment and understanding of how important it is to instill healthy coping habits in order to manage Bipolar 2. It’s a lifetime thing, but it shouldn’t discourage you but rather inspire you to lead a healthier lifestyle altogether. Some days you will be keeping yourself above water while some days you’ll get caught in the undertow. But you have to believe that just as things can go bad, they also have to eventually go well. And, no matter what, you are in control. You have a say in everything, this is your life and your choices!

Bipolar 2 is a biological illness that does not depend solely on your environmental experiences or triggers, it's not your fault. But despite it being biological, your choices make a big difference in how you experience each cycle. Not everything is out of your control, it takes a little more attention and effort, true, but you are capable of more than the makings of your disorder. I hope this lengthy article helps in some way, please be safe and have the best of luck wherever you are!

Sources:

• Reed Cappleman, Ian Smith, Fiona Lobban (2014). Managing bipolar moods without medication: A qualitative investigation. https://www.sciencedirect.com/science/article/pii/S0165032714007794
• Lex C, et al. (2017). Does stress play a significant role in bipolar disorder? A meta-analysis. sciencedirect.com/science/article/pii/S0165032716308369
• Dr. Tracey Marks (2020). Managing Bipolar Disorder - 6 Strategies https://youtu.be/awPP5YrVGyY
• Mia Nacamulli - TED-Ed (2016) The Surprisingly Dramatic Role of Nutrition in Mental Health https://ed.ted.com/lessons/how-the-food-you-eat-affects-your-brain-mia-nacamulli / https://youtu.be/xyQY8a-ng6g
• Srini Pillay, MD - Harvard Health Publishing (2016) How Simply Moving Benefits your Mental Health https://www.health.harvard.edu/blog/how-simply-moving-benefits-your-mental-health-201603289350
• Elizabeth Pratt, medically reviewed by Nicole Washington, DO, MPH (2022) How Does Bipolar Affect the Brain https://www.medicalnewstoday.com/articles/bipolar-disorder-and-the-brain
• Alpana and Murari Chaudhuri - The Biochemists (2018) Hormones and Neurotransmitters: The Differences and Curious Similarities https://medium.com/the-biochemists/hormones-and-neurotransmitters-the-differences-and-curious-similarities-46c6095b825
• Emma Bryce, TED-Ed (2019) How Do Your Hormones Work? https://youtu.be/-SPRPkLoKp8
• E.V. Cauter,PhD; K.Knutson, PhD; R.Leproult, PhD; K.Spiegel, PhD - Medscape Neurology (2005) https://www.medscape.org/viewarticle/502825
• Amy Novotny - American Psychology Association (2019) The Risks of Social Isolation https://www.apa.org/monitor/2019/05/ce-corner-isolation