A Guide to Traveling with Bipolar Disorder
* Content Trigger Warning
Bipolar disorder affects individuals in different ways. Not everything that works for this person may work for that person as no two people have the exact same chemistry, patterns, and life experiences. There is no one-stop-shop with all the answers; no one person has it figured out -- including the individuals who are trained to.
And so, stringing together your own understandings and routines is the way to handle manic depression in various and unpredictable circumstances.
Travel can be difficult for an average person, feelings of homesickness, culture shock, exposed, being out of place, overwhelmed, confused, etc., and managing a chronic illness at home in a steady environment or routine can be a Herculean task, so an individual brave enough to juggle these two chaotic worlds must have an indomitable heart to say the least.
Nearly everything about travel can trigger someone with a personality disorder. For those who wish to better educate themselves, I’m beginning this article with a brief overview of Bipolar Disorder.
Those who already know the words, sing along.
What Is Bipolar Disorder?
Bipolar Disorder (BPD), also known as manic depression, is a chronic illness characterized by severe issues with energy, activity levels, and ability to carry out day-to-day tasks as well as extreme mood shifts- usually brought on by “triggers.”
Inside an individual suffering from BPD, chemicals in the brain, or neurotransmitters, can rise or fall far outside of the normal range of average humans resulting in the brain experiencing abnormal states of what are called manias, “highs,” depressions, “lows,” and hypomania, mania’s weird little cousin. (Further details in the “Symptoms”)
Most brains stop chemical production at a specific level so that you are not consumed with emotions too intense to function properly. Our brains work to push overwhelming things towards the back of the mind so that we aren't constantly fixated. Manic depressive brains, however, are not equipped with these repressive tricks; therefore, we feel everything all the time at intense levels. Sometimes the chemicals fluctuate so much that individuals begin to lose motor function control, e.g. not being able to sit up or stand, seeing things that are not there, having little control over speech, etc.
As mentioned above, BPD is categorized in three main classes according to the severity and length of symptoms:
BPD Type 1: mania and major depressive episodes
BPD Type 2: hypomanic episodes (not full-blown mania) and major depressive episodes; while not as extreme as BPD Type 1, Type 2 can be just as difficult as it is more likely to go misdiagnosed and untreated due to symptoms not being as severe.
Cyclothymia: hypomania and mild depressive episodes
There are also several potential "features" that can occur within these categories, like side dish symptoms:
Mixed episodes/ mixed features: when symptoms of depression occur during a manic episode; visa versa
Rapid-cycling: occurs when an individual has more than four episodes that last the minimum number of days within a 12 month period; untreated, BPD manic episodes can last up to 3-6 months and depressive episodes can last 6-12 months
Euphoric happiness; feeling extremely elevated
Increased energy, insomnia
Sudden, uncontrollable mood swings, agitation, irritability
Psychotic symptoms (similar to schizophrenia) i.e. hallucinations, delusions, etc.
Restlessness, easily distracted
Unhealthy high sex drive
Drastic change in appetite
Reckless judgement; pleasure activities with painful consequences (i.e. gambling, over-spending money on unnecessary things, self harming activities, risky/unsafe sexual engagement, etc.)
Constantly feeling extremely melancholy, hopeless, or worthlessness
Psychomotor retardation or agitation
Chronically out of energy
Chronic body pain
Myofascial Pain Syndrome
Poor concentration/ trouble making basic decisions
Lack of interest towards things you would usually enjoy
Decrease in appetite
Triggers are behaviors and/or outside events that can cause a symptom cycle. You’ll see that while you do have control over many of them, lots of triggers are a part of normal life. As everyone is different, people react to particular triggers differently. This is why it is important to know your own triggers and monitor them regularly.
Drug and alcohol abuse
Death of a loved one
Talking about daunting issues from the past (i.e. rape, suicidal thoughts/attempts, etc.) or reading/hearing/seeing similar accounts (Hence people adding "Trigger Warning" before information that might be sensitive to some.)
Problems in a relationship (i.e. romantic, friends, family, coworkers, difficult strangers, etc.)
Sleeping changes due to work or classes schedules
Being exposed to an excessive amount of media
Medication side effects
Not all triggers are bad though! There are plenty of positive events that can cause a BPD episodes. E.g.:
Graduating college, promotions, major accomplishments
Birth of a child
Time zone change
Adrenaline/excitement of exploring
Dissatisfaction with one’s own culture/ society/ life
Medications: mood stabilizers, atypical antipsychotics, sleep aids, antidepressants, anticonvulsants, microdosing nonprescription drugs
Therapies: Cognitive behavioral therapy (CBT), family-focused therapy, interpersonal and social rhythm therapy, psycho-education, meditations and mindful practices
Other: Electroconvulsive therapy (ECT), self tracking (i.e. bullet journal, life chart, etc.), lifestyle changes
Tips for Managing BPD and Traveling
Before Your Adventures
Learn yourself and know your triggers. Prepare for them accordingly. Make a plan.
Talk to a doctor. Don't be afraid to ask questions! Get a letter from your doctor explaining your diagnosis and medication list, etc. in case it is needed for reference.
Start new hobby to take with you on trip.
Pack your carry-on like a emergency box. Assemble objects that help you cope with mood/anxiety while also taking care of your essential travel needs.
Really think about your destination. Some locations and activities are filled with many more triggers than others. Be sure to research the destination's view on mental health and know your emergency treatment options.
Start getting on your destination’s sleep schedule now. A week before you leave start slightly shifting your sleep hours to match your new destination's.
Get that flight and medical travel insurance. Avoid unnecessary stresses if you can afford it.
Eat right. Food is our medicine. Staying healthy makes travel much easier for numerous reasons but also helps with BPD in general.
Tell someone traveling with you. If you're comfortable with it having someone to help if the situation calls for it is always nice.
Meditate through the worst case scenario. It may seem strange, but acknowledging and getting control of the worse case scenario in your mind can emotionally prepare you if the occasion arises in real life. Envision having an episode and picture yourself taking the appropriate steps to getting it under control. Don’t dwell, just practice this a few times to help feel confident going forward. With this method you are trying to working with your mind-- not against it.
Prime yourself to have an amazing time. Now that you have prepared the best you can, turn your focus to the adventures ahead. Think positively! Have fun!
Not preparing for episodes or having “That won’t happen to me.” syndrome
Not telling someone when, where, and with whom you are traveling
Find a routine that works for you while on the road. Write down your plan and check in with yourself. Journal, habit trackers, jotting down thoughts, doodling, etc. can be beneficial for calming you down and pinpointing where you are mentally.
Less screens. You're on an adventure! You should be exploring your heart out instead of being on social media or talking to people back home the entire time. Loads of screen time isn’t great for BPD in general.
PRIORITIZE SLEEP. Sleep is usually the most frustrating factor to control while on the move, but it is also one of the most intense triggers for BPD. If you don't get a good night's sleep, try to get a nap in and rest where you can.
Take your meds. If you are prescribed a medication for your diagnosis, take them on time- even if you feel great.
Hydrate! This is one of the first steps to staying on track, drink water! Don't be curious as to why your body doesn't feel right if you are neglecting this aspect of your self care.
Exercise whenever possible.
Go outside! Sunshine is an outstanding antidepressant and your friend when it comes to keeping your cycles in check.
Hygiene. Getting sick, especially while on the road, can be a major setback. Be proactive by washing your hands and avoiding touching your face.
Show up early. Make things as painless as possible by showing up to airport or train station well before your intended travel.
Be flexible. Don't panic if things don't go according to plan. Mishaps are a natural part of travel, and if you’re feeling worse than bad, be okay with slowing down for a bit.
Do your big moving items as early in the day as possible. Obviously, somethings can’t be helped, but getting the big ticket activities items scheduled earlier in the day helps ensure you won’t burn out or bail as quickly.
Try taking it easy the same day as big travel legs. Scheduling activities for the day you arrive to your destination may seem like a way to optimize your experience, but major travel days are taxing in and of themselves. Instead take the rest of the day to settle in, plan, get lost in the new city, etc. If something spontaneous comes up, fantastic! Either way, you'll be relaxed and ready.
Keep the party binging to a minimum.
Meditate. It’s okay to chat with yourself when you’re struggling. Remind yourself that episodes will pass- like all the others have before.
Remind yourself: you are a badass for getting out to experience this world carrying twice the weight of an average person.
Too much caffeine and/or alcohol
Letting irritation take over
After Your Adventures
Prepare for your return. Often in the the excitement of going somewhere new, people forget to consider the conditions of their return. Having a post-travel depression plan prepared/ scheduled for when you come home is often very helpful. Doing little things for yourself before you leave can make all the difference: clean your dwelling, have frozen snacks and meals ready so you don't have to cook right away, leaving yourself a return gift, etc.
Journal everything you're feeling. Venting creatively or even planning your next adventure can help keep your mind up and moving.