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I estimate that, once optimal bipolar medications and therapy are implemented, changing lifestyle and health patterns is the best thing you can do to improve your health. I believe that lifestyle changes can reduce residual bipolar symptoms by 10 to 30 percent. Best of all, lifestyle changes are easy to make, safe, and completely, free of cost.

Overall, I have found that drinking alcohol, staying up all night, missing meals, and working too much are the most common behaviors that destabilize bipolar disorder.

Stress Drives Bipolar Disorder
Bipolar disorder is a stress-related disease. That is, the symptoms of bipolar disorder become worse as stress increases. Therefore, the most important thing that you can do is to purge the sources of stress from your life and make a commitment to keep new stressors under control. Effective stress treatment can be a godsend for bipolar sufferers: It is an effective means of helping to control bipolar illness that is both safe and free.

Unfortunately, stress reduction is often the most difficult treatment to convince patients to follow. When I tell patients to lower their stress levels they usually come up with excuses explaining why it is impossible. They say, "I couldn't possibly cut my workday by two hour," or, "I have to stay up until 3:00 am every night," or, "I have to take on this extra work. I don't have a choice." The most common thing I hear is, "Don't worry, doctor, I'll be free from stress as soon as I finish this big project." Unfortunately, as each stressful project is finnished, another one seems to take its place. It is important to remember that you can always find reasons why reducing stress seems difficult or impossible. Nevertheless, you must make your health a priority in your life in order to beat bipolar disorder.

What is stress anyway?
Stress refers to a physiological reaction of the body that overstimulates the adrenal glands, resulting in the overproduction of body stress steroid hormones such as cortisol and stress neurochemicals such as adrenaline. Among other things, these body stress biochemicals increase blood pressure and change blood flow, heart reactivity, urinary and bowel function, breathing rate, body temperature, perspiration, tremor, memory, and attention. Stress hormones are meant to be released only briefly in times of stress. However, modern life stresses are often constant. When stress steroids are present continuously in high concentrations, they produce permanent, unhealthy changes in the body and brain. Some studies have even shown that steroid hormones can kill brain cells when present at high level for a prolonged period of time.

What are some examples of stress that can affect the body?
Examples of stress include working too many hours, not getting enough sleep, going to sleep too late, working under pressure or at the last moment, having or nearly having an accident, and so forth. Stress may also come from intense, pleasant experiences such as getting married, having a birthday, taking a trip, or having a child.

How much stress do I have to cut out of my life to be healthy again?
I recommend you start by spending 25 percent less time in activities that cause you stress. For example, if work is the main source of your stress and you work seven days a week, cut back to five. If you are working fifty-five hours per week, cut back to forty. Believe me, you can do it.

What is the connection between stress, bipolar disorder, and the immune system?
The exact connection is not clear, although the immune, hormonal, and neurotransmitter systems are very closely interconnected. For example, an injection of naturally occurring immune system compounds (Called inflamatory cytokines) can trigger depression. So can the administration of stress hormones involved in the immune response.

How can I be under stress? I like working all night long with no sleep.
Stress refers to things that overstimulate our bodies. The secretion of stress steroids makes our hearts beat faster, our blood pressure rise, our hands shake, our body sweat, and our stomach acid churn. It really does not matter whether you like something or not; it can still cause damage to your body and health.

Try going to a bipolar support group or online forum and notice how much outside stressors increase other people's bipolar symptoms and severity.

If I reduce the stress in my life, will I be able to cut back on my medication?
You probably would not have to take much medication if you moved to Siberia and lived alone in a Quonset hut, eating bonbons and watching MTV all day. However, most people with bipolar disorder choose to live a more complex life with higher levels of stress. If you choose to live a life with typical amounts of stress, you will probably have to take medications and manage your life stresses to keep yourself healthy.