October 15, 2018


By Rachel K., a Prechter research participant

Decisions. We make them every day. Some are so simple or habitual that they can feel mindless, such as what we put in our tea or coffee in the morning or what we watch on TV in the evening. Some are more complex and periodic and feel much more mindful, such as how much to save for retirement or where to go on vacation. Some are so intricate and intense that they take over our minds, such as whether to buy a home or have a baby.

Decisions can be challenging for a number of reasons, and they can be all the more challenging for people with certain personality profiles or temperaments. For people with bipolar disorder, they can be downright daunting because every decision—even a small one like the coffee example above—creates a ripple in the water of a person’s life. For people living with bipolar, the little ripples come together to create waves that can potentially lead to episodes.

For example, I watch how much caffeine, sugar, or alcohol I consume, so the second cup of coffee midday or the second glass of wine when I’m out with friends is a much more careful decision for me than it may be for my peers. I’m not just worried about long-term health effects or a headache the next day; I’m worried about the wrong decision triggering an episode that could last days or weeks, so I have to review all of my other recent “little” decisions to decide if my brain can handle it.

The big decisions are all the more difficult. For example, I am trying to decide about a potential job offer right now that would further my career and give my family more income. It seems like a “no-brainer” in some ways. However, I am currently off in the summer months and stay home with my kids, and the new job would be year-round. On the one hand, these free summer months offer me a chance to slow down, recharge, and put things in order for a very stable life during my “working months.” Would preserving that be better for me? On the other hand, the transitions out of work in the summer and then back to work in the fall both predictably trigger episodes because my routine changes dramatically and new anxieties are presented. Would having a stable routine all year be better for me?

On top of that, we all know that the big decisions have a complicated structure of considerations, and some of them are very particular to living with a chronic mental illness: Which job has better health insurance for mental health care?  Would starting a new position add too much stress to my life or would it increase feelings of competency and excitement at work? Is it more important to have a very routine schedule to help prevent episodes, or the flexibility I might need if I experience an episode?

All of this might seem like an extra burden that people with bipolar have to deal with, and in some ways it is. But I consciously choose to look at the positive influence bipolar has on my life, and this is an exemplary area for that. In general, I think most people could benefit from being as mindful about their decisions as people with bipolar have to be. “Am I getting the right amount of sleep?” or “Did I drink too much?” or “Which of these commitments could I let go of to reduce my stress?” are commonplace questions for people living with bipolar, but really should be commonplace for anyone who wants to live his or her best life. Moreover, the reflective habits that a life with bipolar demands are habits that anyone who wants to be truly awake to life needs to cultivate. The fact that our brains are all different and set within different contexts means there is no list of hard-fast rules for every person, so we have to routinely reflect on our lives in order to know ourselves and determine whether or not we are thriving.

Since my diagnosis, my family and I have developed and maintained habits to keep me healthy. Routine, routine, routine is the cornerstone, and when we choose to break routine, we do it for reasons that are worth it and prepare as much as we can. We get lazy about it sometimes and I usually pay the consequences and am reminded why I watch what I eat, how much I sleep, how much I get to exercise, how much I am meditating, and how much stress I’m under. And because we do this, I am pretty darn healthy, physically, mentally, and spiritually. Since my diagnosis over a decade ago, I have had so many people (who know nothing of my illness) comment on how “together” or “at peace” I seem to them. Funnily enough, I think that is thanks to bipolar. The comparative fragility of health that comes with the condition has given me an impetus for being mindful and reflective when it comes to my decisions.  

I remind myself of this commitment to my health with a fortune cookie message taped to my computer: “Doing the best at this moment puts you in the best place for the next moment.” That’s not just true for people with bipolar, but for everyone.


Read more on Rachel’s blog: