Bipolar disorder is characterized by mood swings from very high (mania) to very low (depression). Medication is an important part of management, but research has shown that behavioral techniques are equally essential for long-term mood stabilization.

In this article I discuss daily routines and schedules, record-keeping of moods and medication, inspiration and motivation, affirmations, and cognitive distortions.

1. Daily routines and schedules – Because the mood swings of bipolar disorder can lead to unpredictable behavior, it is important to set up daily routines (at the minimum, a morning routine and a before-bed routine) and to have a schedule or agenda for each day. This will help during manic period to keep the person focused, and during depressed periods to encourage and motivate action.

2. Records of moods and medications – It is a good idea to keep records of the major behavioral factors that relate to mood stabilization. These include nutrition, exercise, medication, sleep, assigned therapeutic activities, and social contact. You should record your mood as well, at least once a day but preferably three times during the day. This is important because some individuals have mood swings related to circadian rhythms. For example, my worst moods generally occur in the late afternoon and early evening.
Records like this keep you focused on self-help behaviors and maintain awareness and insight.

Keeping records of medication is critical for anyone who has bipolar disorder. You may have heard before that it is common for persons with bipolar to stop taking their medication, especially during manic periods. The results of this can be very damaging. Make sure you keep track of your medications every day, and use the affirmation “I take my prescribed medication even when I don’t feel like it.”

3. Inspiration and motivation – Keep a list of inspirational quotes handy and read it at least once a day. You can even make signs or posters with your favorite quotes and put them around your house or workplace where you will see them often.

4. Using affirmations – Choose 5 affirmations that target your most pressing needs. Affirmations have the greatest impact when you repeat them while looking yourself in the eye in a mirror. The 5 affirmations should be repeated 5 times, twice a day, for 21 days in a row. If a day is skipped, start the sequence over. This can be a difficult process but it is very effective. By the end of 21 consecutive days there will be noticeable integration of the affirmations into your thought patterns.

5. Cognitive distortions – This is a fancy way to say “false beliefs.” A belief is false if it doesn’t match reality. For example, you may have the belief that anyone who needs daily medication is weak and incompetent. It is understandable that you might believe this, but it does not match the facts. Many people do take daily medication for a variety of different problems, including leaders in all areas of life. One of the best ways to refute one of these cognitive distortions is with affirmations. However, that alone will not do the trick. You also need to “act as if” the belief is false; that is, think about how you would act if you did not have the false belief. You might be more diligent about taking your meds. Behaving that way, even if you still have the belief, will help to get rid of it.