Overview Bipolar disorder is a chronic mental illness that causes severe changes in mood. 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 adopting 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 experiencing a depressive episode, 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 continue 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 three to four 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 changes in mood 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. To be diagnosed with a major depressive episode, the person must exhibit five or more of the following symptoms during the same two-week period: depressed mood (or irritability in children) most of the day, nearly every day, as indicated by either subjective report or observation made by others 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 a change of more than 5 percent of body weight in a month when not dieting, or a decrease or increase in appetite nearly every day insomnia or hypersomnia nearly every day psychomotor agitation or impairment nearly every day, observable by others fatigue or loss of energy nearly every day feelings of worthlessness or excessive or inappropriate guilt, which may be delusional and which isn’t merely self-reproach or guilt about being sick, nearly every day indecisiveness or diminished ability to think or concentrate nearly every day, by subjective account or as observed by others 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 These symptoms must represent a change from the person’s previous level of functioning. At least one of the symptoms has to be either a depressed mood or loss of interest or pleasure, and mustn’t be attributed to another medical condition. 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 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

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 Common symptoms of mania The symptoms of hypomania are the same as mania, except for two key differences. With hypomania, changes in mood 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.