Bipolar disorder causes big shifts in mood, from mania to depression. Both ends of this spectrum can interrupt your life. Self-care is an important part of the treatment plan for bipolar disorder.

In fact, in a 2017 study, researchers found that people with bipolar disorder who used self-care strategies had a better quality of life. They also had lower scores for depression, stress, and anxiety, and reported that bipolar disorder had less of an impact on their day to day.

But self-care can only help if you practice it with some consistency. In the middle of a manic episode, you may be too busy to think about taking care of yourself. During a depressive episode, it can be hard to find the motivation to do anything.

Self-care goes beyond getting a massage or haircut. Here are a few tips to get you started.

Routines are often an important part of bipolar disorder treatment.

This is based on the theory that structure can have a beneficial effect, and disruptions to taking your medication and social routines can lead to mood episodes.

Your routine might include:

  • taking your medication at the same time every day
  • eating and going to bed at the same times each day
  • carving out time during the day to relax or hang out with friends and family

Accountability is key for sticking with routines. Consider setting up a buddy system for daily or weekly check-ins. That way, a trusted friend or family member can help you stay accountable.

Both mania and depression affect sleep, but they do so in different ways.

During manic episodes, you may sleep little, if at all. During depressive episodes, you may feel like you can sleep all day.

Poor sleep can put you at risk of having more manic or depressive episodes, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

Getting into a regular sleep routine will help even out your sleep cycles. When your mind is racing before bed, take a few minutes to wind down with a warm bath, a good book, or another calming activity.

Following your treatment plan for bipolar disorder can also help reduce the impact that manic and depressive episodes have on your sleep.

Stress wears on everyone, but people with bipolar disorder are even more sensitive to its effects. Life stresses like relationship problems, an illness in the family, or financial strain can trigger symptom relapses, according to research findings.

Reduce stress by not taking on more than you can handle. This is easier said than done, of course, but it’s an important step to take to maintain self-care.

If you’re feeling stressed, schedule small breaks throughout the day. Be honest with your colleagues, friends, and support network about how you’re feeling and how it can affect your condition management, especially when major stressful events happen in your life.

You can also consider trying relaxation techniques like:

  • deep breathing
  • tai chi
  • meditation

Unpredictability can be one of the most frustrating parts of living with bipolar disorder. Keeping a diary of your highs and lows might help you gain more insight into your condition.

Once you’ve tracked your activities and symptoms for a while, you may start to see patterns. You may also notice warning signs of a manic or depressive episode, such as changes in your:

  • sleep
  • energy level
  • behavior patterns

Eventually, you may be able to predict when you’re about to shift from mania to depression or vice versa.

A paper diary is one way to track your moods. You can also try an app like Moodfit, eMoods, or MoodPanda.

A simple walk outdoors might buffer the effects of stress and improve resilience, according to a 2019 study.

Yet it can be hard to get up and go outside to take that first step. This may contribute to a finding that up to two out of three people with bipolar disorder have generally inactive lifestyles.

Exercise is a great mood booster and has known benefits for bipolar disorder: It can help relieve depression symptoms and improve quality of life in people with the condition.

Try to incorporate some activity into almost every day, even if it’s taking a short walk around the block. Choose a type of exercise you like to help keep you motivated. You can lean on others to help you stick with your plan and add a social element to your exercise, too.

Substance use can make bipolar disorder more complicated to treat. It’s likely to affect how well a person sticks with or responds to their treatment plan. It can put them at higher risk of hospitalization and suicide, according to SAMHSA.

Between 30 and 50 percent of people with bipolar disorder will develop substance use disorder at some point.

Understanding the connection between the two conditions — and knowing one can’t improve without treating the other — is very important.

If you feel that substance use is complicating your management of bipolar disorder and you need guidance on how to reduce or stop your substance use, speak with your primary doctor.

Building a circle of close friends and family who you can lean on during difficult times is part of self-care.

Keeping your support network informed and up to date can provide a safety net during crisis situations. The National Alliance on Mental Illness (NAMI) suggests creating an action plan and giving copies to everyone who may be involved.

The plan can include:

  • your warning signs and episode triggers
  • updated addresses and phone numbers
  • things that have helped in the past
  • local crisis line contact information and the National Suicide Prevention Lifeline: 800-273-TALK (8255)

You can also have your doctor and a mental health professional on standby for when an episode starts.

Support doesn’t always have to come in human form. Pets can also be comforting companions during stressful times. The benefits of pets for people with chronic mental health conditions are even backed by research.

As you incorporate these general tips into your routine, you can also try these specific self-care strategies to manage manic and depressive symptoms.

When you’re in a manic episode:

  • Press pause. Take 5-minute breaks during the day to breathe deeply. This may help with impulsivity and decision making.
  • Avoid added stimulation. Try to stay away from foods containing caffeine, as well as environments with loud noises, bright lights, or both. Caffeine can be especially disruptive to sleep routines.
  • Set limits. Even if you feel like you can do 10 things at once, try to stick to one at a time. Finish one project before you start the next one.
  • Schedule time to relax. Practice deep breathing or meditation to help slow a racing mind. If you’re new to mindfulness, start with just 5 to 10 minutes each day.
  • Call a friend. Reach out to someone you trust when you need help.

When you’re in a depressive episode:

  • Change your environment. Sometimes the first step — like getting out of bed — is the hardest, but just the simple act of moving can give you momentum.
  • Talk with a real person. Try turning off your computer or closing social media and call a friend. Better yet, meet them in person if you are able.
  • Tidy up. It’s easy to let things pile up during a depressive episode, but clutter can have a negative effect on your mental state, according to a 2016 study. Try clearing up just one space at a time.

Self-care doesn’t have to be complicated, but it’s important to practice when you live with bipolar disorder. Self-care can improve your quality of life and help lessen the everyday impact of the condition.

To avoid getting overwhelmed, pick one or two self-care strategies to start. Ask a friend to help keep you accountable. Once you make these practices part of your routine, try adding something else.

Involve your care team in your routine, too. Check in with your doctor and therapist regularly to let them know how you’re doing, and ask for help when you need more support.