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7 Ways to Treat the Depressive Episodes of Bipolar Disorder

Medically reviewed by Timothy J. Legg, PhD, CRNP on May 18, 2017Written by Erica Cirino

Bipolar disorder is a chronic mental illness that causes severe mood swings. These moods alternate between joyful, energetic highs (mania) and sad, weary lows (depression).

Coping with a depressive episode can be difficult. The symptoms of depression can make you lose interest in activities you usually enjoy and make it challenging to get through the day. But there are things you can do to fight the negative effects of depression.

Here are seven ways to boost your mood during a depressive episode:

1. Stick to a healthy routine

When you feel depressed, it’s easy to get into bad habits. You may not feel like eating even when you’re hungry, or you may continue eating even when you’re full. The same goes for sleeping. When you’re depressed, you’re more likely to sleep too little or too much.

Unhealthy eating and sleeping habits can make your depression symptoms worse. So a healthy daily routine can make it easier to maintain good habits. Consider working in these healthier habits:

  • Eat meals and snacks at set times throughout the day.
  • Increase your intake of vegetables, lean proteins, and whole grains.
  • Get seven to nine hours of sleep each night.
  • Wake up and go to bed at the same times every day.

2. Structure your day

Just as scheduling your eating and sleeping can help ward off depressive symptoms, so can structuring the other activities in your day. It can be helpful to create a list of daily tasks to check off as you complete them. It’s also useful to keep a calendar and sticky notes to help you stay on track.

When scheduling your daily tasks, be sure set aside enough time for resting and relaxing. Being too busy can exacerbate depressive symptoms and cause frustration. It’s best to prioritize your time, taking extra care to make sure you attend medical appointments.

3. Don’t be afraid

When you’re not in a depressive mood, you may find pleasure in certain activities, such as reading or baking. When you’re feeling depressed, however, you may not have enough motivation to do anything. Despite your lack of energy, it’s important to push yourself to partake in activities you usually enjoy. Doing the things that make you happy can alleviate your depressive symptoms.

Don’t be afraid to do the activities that usually boost your mood. While you may fear that you won’t enjoy them as much when you’re depressed, that doesn’t mean you should avoid them. Once you start doing these activities again, you’re likely to feel much better.

4. Stay active

Researchers believe certain types of exercise can help alleviate the symptoms of depression. This includes low to moderate intensity walking, jogging, or biking. For best results, experts say you should exercise at least 3 to 4 days per week for 30 to 40 minutes at a time.

5. Don’t isolate yourself

When you’re depressed, social situations can seem overwhelming. You might feel like being alone, but it’s important not to isolate yourself. Being alone can increase the symptoms of depression.

Get involved in social activities, such as local book clubs or athletic teams. Spend time with friends and family or chat with them regularly on the phone. Having the support of friends and loved ones can help you feel more comfortable and confident.

6. Find new ways to relieve stress

Trying new things may be one of the last things you want to do when you’re in a depressive episode. However, doing so can help alleviate your symptoms.

For example, if you’ve never gotten a massage before, consider scheduling an appointment at a local spa. Similarly, yoga or meditation may be new to you, but they can be beneficial during depressive episodes. These activities are known for being relaxing. They can make it easier for you to cope with the stress or irritability you may be experiencing.

7. Join a support group

It can be helpful to join a support group for people with bipolar disorder. A group gives you the opportunity to meet other people with the same condition and to share your experiences during depressive episodes.

Ask your mental healthcare provider about support groups in your area. You can also find different bipolar disorder and depression support groups by searching online. Visit the Depression and Bipolar Support Alliance website for a list of online support groups.

Understanding bipolar disorder

There are several different types of bipolar disorder. These include:

Bipolar I disorder: People with bipolar I experience at least one manic episode before or after a depressive episode or mild manic episode (called hypomania).

Bipolar II disorder: People with bipolar II have at least one major depressive episode that lasts two weeks or longer. They also have at least one mild hypomanic episode that lasts more than four days. In hypomanic episodes, people are still excitable, energetic, and impulsive. However, the symptoms are milder than those associated with full-fledged manic episodes.

Cyclothymic disorder: People with cyclothymic disorder experience at least two years of hypomanic and depressive episodes. The mood swings tend to be less severe in this form of bipolar disorder.

DSM diagnostic criteria

In addition to the manic or hypomanic episode, a person with bipolar I or bipolar II disorder must have a major depressive episode. In order to be diagnosed with a major depressive episode, the person must exhibit 5 or more of the following symptoms during the same 2-week period. These symptoms must represent a change from the person’s previous level of functioning, and at least one of the symptoms has to be either a depressed mood or loss of interest or pleasure, and must not be attributed to another medical condition.

These symptoms include:

  1. depressed mood (or irritability in children) most of the day, nearly every day, as indicated by either subjective report or observation made by others
  2. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day, as indicated by either subjective account or observation
  3. a change of more than 5% of body weight in a month when not dieting, or a decrease or increase in appetite nearly every day
  4. insomnia or hypersomnia nearly every day
  5. psychomotor agitation or retardation nearly every day, observable by others
  6. fatigue or loss of energy nearly every day
  7. feelings of worthlessness or excessive or inappropriate guilt, which may be delusional and which is not merely self-reproach or guilt about being sick, nearly every day
  8. indecisiveness or diminished ability to think or concentrate nearly every day, by subjective account or as observed by others
  9. recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

What’s more, the symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The episode also can’t be due to physiological effects of a substance or another medical condition.

Symptoms of bipolar disorder

While there are various types of bipolar disorder, the symptoms of depression, mania, and hypomania are similar in most people.

Common symptoms of depression include:

  • deep feelings of sadness or hopelessness for a long period of time
  • having little to no interest in activities that were once enjoyable
  • difficulty focusing, remembering things, and making decisions
  • restlessness or irritability
  • eating too much or too little
  • sleeping too much or too little
  • thinking or talking about death or suicide
  • attempting suicide

Common symptoms of mania include:

  • an overly joyful or outgoing mood for an extended period of time
  • intense irritability
  • talking quickly or rapidly transitioning between different ideas during a conversation
  • racing thoughts
  • being easily distracted
  • picking up many new activities or projects
  • restlessness
  • difficulty sleeping due to high energy levels
  • impulsive or risky behavior

The symptoms of hypomania are the same as mania, except for two key differences. With hypomania, mood swings usually aren’t severe enough to interfere significantly with a person’s daily activities. Also, no psychotic symptoms occur during a hypomanic episode. During a manic episode, psychotic symptoms may include delusions, hallucinations, and paranoia.

The bottom line

There’s no cure for bipolar disorder, but you can manage your mood by following a treatment plan and making lifestyle modifications. In severe cases of depression, temporary hospitalization may be required. Most of the time, however, you’ll be able to manage your bipolar disorder symptoms with a combination of medication and psychotherapy. There are also some easy lifestyle changes you can make to help yourself feel better during depressive episodes.

Getting through a depressive episode can be challenging, but it’s possible. Remember that there are many ways to boost your mood and relieve symptoms. Don’t hesitate to call your doctor or mental healthcare provider if you need help. If you find yourself having thoughts of suicide during a depressive episode, call the National Suicide Prevention Lifeline at 1-800-273-8255. There are counselors available 24 hours a day, seven days a week. All calls are anonymous.

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