Sleep is the Key

A friend of mine who writes books on bipolar said, “The main way to manage bipolar disorder is to manage your …. sleep.”

He’s totally right. I talk about this in my book Take Charge of Bipolar Disorder. It’s a huge component of a successful management plan.

Sleep is also an excellent mood indicator.

I know that I’m doing pretty well right now as I can sleep at night without Ativan. When I get sick, I have to use small amounts of Ativan to fall asleep. I monitor it carefully so that it doesn’t build up in my system and make me tired during the day.

Three questions:

It’s Thursday- how was your sleep on M T and W?  What does it tell you about your moods?”

Are your meds affecting your sleep? If so, what needs to change?

How many hours do you realistically need a night to wake up refreshed? What does it take to get those hours?

Julie

================================

Everyone I know with bipolar disorder has some sort of sleep problem- it’s normal. It’s a bother.

Sleep Tips

- Sleep in a cool room- this can make a huge difference. If you get too hot, you will wake up more.

- Turn off lights one hour before bed and listen to a book on tape by a really low watt light- not a daylight bulb!  I actually turned off the light last night and listened to a show on my IPOD.
- Have a noise machine such as a humidifier to block out sounds from outside.

- Keep your TV in the living room and definitely don’t watch TV right before going to bed. Not only is it overstimulating, it also emits a bright (blue spectrum) light that is stimulating.

Sometimes when I write these lists I think, this is just all so ridiculous. Why can’t I just be like my friends!
They can go out until 1AM and just sleep a few more hours the next day to make up for it.

Well, I can’t. So I make these lists and do things the best I can.

My friend Dr. Jay Carter- an expert on bipolar disorder treatment says- regulated sleep is the best and least expensive way to naturally reduce mood swings.

Julie

In honor of Mental Health Awareness month here in the United States, I thought a four part series of newsletters on how to create a comprehensive treatment plan would be timely.Part one of this series gave an overview of why a comprehensive treatment plan is essential for bipolar disorder management success.  The first newsletter is available on the bipolarhappens.com blog. I try to keep these newsletters short, but this is such important information I just have to keep getting the word out!  You may want to print this out for an easier read.
**

Four Tips to Successful Bipolar Disorder Treatment
The comprehensive treatment of bipolar disorder is a large subject, so in these newsletters I will give four effective and easy to implement tips on how to manage the illness more successfully. These can be added to any plan you already have. Here are the tips:1.      Find Helpful Medications with Limited Side Effects (available on the blog)
2.      Regulate Sleep (this issue)
3.      Improve Relationships
4.      Create a Written Treatment Plan

Regulate Your Sleep
To sleep, perchance to dream………….

Sleep is taken for granted by many people- but not for those of us with bipolar disorder!  If you’re the partner or parent of someone with bipolar disorder, you’ve certainly seen the problems we all have. The illness truly can cause TONS of sleep issues – some of these issues are caused  by the illness, while others are controlled by the person with the illness. It’s a pretty vicious cycle. The good news is that with just a few tips you can dramatically improve your sleep situation. It takes a lot of observation and sacrifice, but it can be done.  
The Chicken and the Egg- is it you or is it bipolar disorder?

One of the main obstacles a person with bipolar disorder faces is the chicken and egg nature of the illness. If you can’t sleep at night, is that because you’re manic, wired from medications or is it a reaction to a decision you made the day before that affected your brain chemicals? These are important questions. There are two steps you will need to take to stop the chicken from laying the egg that created the chicken that…..: You will have to manage the illness successfully so that the mood swings reduce and don’t affect your sleep as strongly and then  identify, monitor and ultimately stop your own behaviors that cause sleep problems. I have many tips on how to reduce mood swings in my books. This newsletter will cover personal behaviors that cause sleep issues as they are easier to change! And of course, as you do this, the bipolar gets better and you really are managing bipolar disorder more successfully which leads to regulated sleep! This is a sweet, non vicious cycle

What is Regulated Sleep?

When you go to sleep easily, sleep and dream deeply and wake up refreshed on a set schedule every night, you’re experiencing regulated sleep. (How often do you get to experience this!) This type of sleep lets the brain send out the chemicals that control emotions on a set schedule. To put it simply, regulated sleep stabilizes the brain chemicals that control emotions. So, it makes a lot of sense that the more regulated sleep you can get, the more stable you can be.
The Role of Your Circadian Rhythm

Our bodies work on a 24 hour biological clock called a circadian rhythm. If you have bipolar disorder, this is a process you need to understand very clearly. The circadian rhythm of your body determines when you need sleep and when you need to wake. It is through this rhythm that your body knows when to start and stop certain chemicals such as seratonin. This is a natural clock- the problem is that busy lives often make it difficult for people without bipolar disorder to sleep according to their circadian rhythm. When you add bipolar disorder to the problem, disruptions to the cycle can be VERY destabilizing.

You Can Control Your Rhythm
The more you upset this rhythm by working odd hours, staying out late and partying,  ignoring what you put in your body, cultivating stress, or watching upsetting tv before bed for example - the less likely you are to find stability. As you read this you may think, but I have to work these hours! I have to take care of my kids! I have to have coffee in the morning! Well, some of these behaviors may be exactly what you have to change in order to kick your circadian rhythm in gear so that you can sleep better and get your brain working more effectively.

Common Barriers to Regulated Sleep
-  Shift work or work that upsets your sleep patterns such as an ever changing schedule
-  Travel to different time zones
-   Drugs and alcohol
-  Medications
 -  Anything new- new baby, new job, loss of a job, new city, etc
-  Caffeine!
-  Stress
-  Bright light before bed

This list is pretty endless isn’t it!  I could write 100 more barriers and still not get to them all - and yet everything on the list would have one thing in common- an upset circadian rhythm.
This newsletter will focus on three off the list: caffeine, stressful situations and bright light at night. Just working on these areas can improve your sleep immediately.

Sleep Stressor #1  Caffeine

Ah, as many of you know, I had a little iced coffee habit this summer due to the amazing coffee at the restaurant where I sit and write. I knew it was bad for me, but I kept thinking- just one more time and then I’ll stop! I eventually had to stop when I realized the coffee that I drank in less than 15 minutes was literally affecting my sleep nightly. I often had to take Ativan just to get to sleep. It was not worth it in any way. I have enough bipolar disorder sleep problems as it is- adding caffeine to the mix is just stupid. I have a friend named Janea who is a very no nonsense person. When I tell her about one of my bad habits, she very kindly and humorously says- “Well Julie! That’s just stupid!”  In other words, why on earth would I do something to undermine the work I do daily to stay stable?
Limit Your Caffeine!
My coauthor Dr. John Preston is on a caffeine awareness crusade. He suggests that a person with bipolar disorder limit caffeine consumption to 250 mg or less a day.  Considering that a 12 oz Starbucks coffee has 260 mg- this can be a problem! (Decaf has about 10mg.) I started to drink iced tea when I went out. Then I realized that a few glasses of tea at 50mg a glass could cause problems as well.  Is there no justice! Lucking I like decaf and it doesn’t bother my sleep at all.
A New Caffeine Threat….
What is it? Energy drinks like Red Bull! People drink these sugary, caffeine drinks without thinking of their effect on mood swings. Red Bull has 80 mg of caffeine and lots of sugar. The combination is a brief high followed by a low. Just like a candy bar and a coffee. I’ve seen a lot of teenagers drinking energy drinks as they are considered cool. I like to be cool- but these days I prefer being stable.
It’s your choice. Only you know if caffeine is disrupting your circadian rhythm and causing mood swings. I know that decaf is my only option if I want to curb anxiety and sleep better at night.
Sleep Stressor #2  Stress!

Stress is an outcome of a behavior – either yours or that of someone else. This means that 50% of stress is in your control! Over the years, I’ve systematically removed the major stressors that cause sleep trouble. I really limit going out for late nights. I know that if I stay out at karaoke past midnight I simply will not get to sleep. I still do this once in a while- but know I will have to take sleep meds. Staying out every night like I used to is simply impossible. I also worked on the relationships in my life that used to cause stress to the point that I went over the problems in my head when I tried to sleep.  This was a process of course. Some of these people are family members. I can’t change them, but I learned not to set up or walk into stress traps. For example, my brother and I love each other greatly, but I can’t be in his life the way I would like to right now- it’s too stressful. Fighting with him upsets me for hours- so I don’t do it. It’s the same with my mother. There are things we discuss and things we don’t. She loves me and I love her, but there is no reason for us to cause each other stress. Our whole family dynamic is so much better now and I think we all sleep better.
Work Stress
I can’t work a 9-5 job. I realized this a long time ago. I can remember coming home from work after having trouble with a colleague and talking about it all evening and then not being able to sleep from worry. It’s as though the conversation continued even when I was asleep. I can’t do this anymore. It’s a loss as I really want to work with other people. Does your work cause you so much stress that it affects your sleep? If this is the case, you have to decide what you can and can’t change. You can make it a goal to sleep better at night no matter what it takes. For some it means changing jobs- especially if the hours are crazy. You have a lot more control over stress than you think. It’s ok not to be passive and let the world make it hard for you to sleep.
If I have trouble getting to sleep, wake up at night or wake up too early in the morning and then sit there and get worried about a stressor in my life, I am going to change that stressor. My sleep is too important.

Sleep Stressor #3 Blue Light at Night

I recently met with a psychiatrist friend who is very interested in the effects of blue light on people with bipolar disorder. Apparently, certain parts of the light spectrum affect people in different ways. For a long time, the idea was that light in general was the culprit when it came to mania and agitation, but new research suggests that it might be the blue light alone that causes the problem. What is the biggest source of blue light in most American households? The television. If this blue light is stimulating, it makes sense that watching TV, DVDs and playing video games at night can over stimulate the brain and make it very difficult for you to get regulated sleep. He suggests wearing special blue light blocking glasses at night to block the blue light so that your circadian rhythm can kick in on a more natural schedule.

What! No TV!

As most of us don’t have these glasses, the main solution to the problem is to stop exposure to blue light a few hours before bed. This means turning off the TV and reading, talking, doing crafts, family time, games, books on CD, writing or just relaxing as opposed to sitting in front of a television before going to bed. Hmm.. I’ve done it. I go to my room and read, write in my journal and listen to music. There is absolutely no question that this helps my sleep. The problem is that it feels a bit lonely and boring sometimes. It’s always a trade off isn’t it? Going out and meeting friends at karaoke versus going to bed early and waking up more refreshed. I’ve learned to compromise by going out, coming home earlier than I used to and then sitting in my room relaxing before I turn off the light. What will work for you?
Never Give Up!
There will always be situations where you can’t control your sleep situation. I went to visit friends in a city a few hours away last weekend and ended up sleeping in two different beds as I moved around town. I didn’t have my own pillow- it was too quiet- I was worried about being somewhere new, it was daylights saving time, etc. etc. I went into a down swing when I got home. I’ve decided that sleeping somewhere comfortable when I travel is the best way to insure that I have a good trip. This means a hotel room or planning ahead a bit more to find out my sleeping situation. It’s that serious for me. What a bother- I want to have fun, but my body wants regular sleep. I want make the right sleep choices for the rest of my life as I don’t want my life to be ruined by mood swings! I won’t give up on regulated sleep- the more I learn about my body, the better choices I can make. You can do the same.
A Simple Goal
 My goal is to help people throughout the world find a plan that works for them.  If every person on this newsletter mailing list learns to manage this illness more effectively, it’s a really great start. I use the Health Cards for Bipolar Disorder and the tips in my books to stay stable. All of my books have information for family and friends as well. Remember, educate yourself, take your meds, learn what works for you, teach others what you need and always know that bipolar disorder is a treatable illness.

**
Be sure and visit the new blog for more tips and information about bipolar disorder.  www.bipolarhappens.com/bhblog

You now have permission to reprint “Bipolar Happens” Newsletter articles on your web site, in your e-zine or share them with your support groups, forward to friends, or print copies for your health care providers.
Publishing Requirements:
Each article must be reprinted in its full form, with no changes. Please include the following byline at the end of each article:
=============================================
 ABOUT THE AUTHOR: Julie A. Fast best selling author of Take Charge of Bipolar Disorder and Loving Someone with Bipolar Disorder is a critically acclaimed six-time author, award winning bipolar disorder advice columnist, national speaker, and sought after expert in the fields of bipolar disorder and depression. Julie’s work specializes in helping people manage all aspects of their daily lives -despite the complications that bipolar disorder creates. To learn how to personalize a plan to help yourself or a loved one find and create stability that ensures the quality of life that we all deserve, visit: http://www.bipolarhappens.com 

Computers 

Yesterday, despite my hand problems, I wrote a wonderful newsletter on sleep. I was very proud of it. I always try to make the newsletters as interesting and informative as possible. Just as I was editing the final draft, my computer shut off due to low battery. I didn’t think much of it as I had saved regularly. Well, when the computer came back on, the file was not saved. I lost it all. One tries to be philosophical over these things,  but when you can’t write much and writing is your life- and then you lose what you wrote- bla! So, this is why part two of the comprehensive treatment of bipolar disorder newsletter has not be sent- I have to write it again. 

Julie

Bla.

I want to send out some encouragement today. If it’s tough for you right now, you’re not alone. It’s tough for many of us with bipolar disorder because it’s an illness. I always try to think of it as though I had serious diabetes. I would have to make a lot of changes in order to stay well. One day of cake and ice cream at a party could really make me ill if I had trouble regulating my insulin. I then think, one night of partying or staying up too late can make me ill in the same way. It’s physical. When it’s brighter outside, I do feel an increase in energy as well as a desire to go out more and have more fun – my friends often stay out past midnight and then have no trouble sleeping. I just can’t keep up that schedule for very long. If I stay up having fun at a karaoke bar or a dinner party, I will go home with a racing brain and will have to take some kind of sleep aid. This can then cause memory loss and tiredness the next day, so I often go home early. Another disappointment from bipolar disorder. I have made a decision that staying out really late is not worth it to me- nor is over drinking when I do go out. It’s a choice.

Are you in a similar situation?

Julie

Return to Bipolar Happens