Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
For patients with bipolar disorder, several lifestyle interventions can be recommended to assist in managing their condition and preventing relapse:
- Routine and Self-Monitoring: Encourage compliance with treatment and establishing a regular morning routine NICE CKS. Patients should structure their day with some activity and social contact NICE CKS. Advise self-monitoring of symptoms, including identifying triggers and early warning signs, and developing coping strategies NICE CKS.
- Sleep Management: Emphasise maintaining an adequate amount of sleep NICE CKS. Patients should avoid, if possible, shift work, night flying, flying across time zones, or routinely working excessively long hours NICE CKS.
- Substance Avoidance: Advise avoiding alcohol and drug misuse NICE CKS. Patients who smoke should be advised to stop or cut down, as nicotine is a stimulant NICE CKS. Additionally, recommend avoiding caffeinated drinks such as tea, coffee, or cola NICE CKS.
- Physical Health and Diet: Encourage discussions about diet and level of physical activity, and monitor the patient's weight and waist circumference NICE CKS. Identify and manage conditions such as hypertension, abnormal lipid levels, obesity, or diabetes, or those at risk of these conditions, at the earliest opportunity NICE CKS,NICE CG185.
- Psychological Interventions: Psychological interventions, often offered by secondary care, can provide information about bipolar disorder, help patients consider the impact of thoughts and behaviour on moods and relapse, and include self-monitoring of mood, thoughts, and behaviour NICE CG185. These interventions also address relapse risk, distress, and how to improve functioning, and help develop plans for relapse management and staying well NICE CG185. Problem-solving to address communication patterns and managing functional difficulties may also be included NICE CG185.
- Environmental and Social Support: During episodes of mania or hypomania, advise patients to access calming environments and reduced stimulation NICE CG185. Patients should be advised not to make important decisions until they have recovered from mania or hypomania NICE CG185. Encourage them to maintain their relationships with their carers if possible NICE CG185. Consider offering assistance with education, financial, and employment problems that may arise from the behaviour associated with bipolar disorder NICE CG185.