March 23, 2020

Bipolar & Managing Stress from COVID-19

A special article written by our director, Melvin McInnis, M.D., for BP Magazine

This article first appeared on BP Magazine's website

The outbreak of Coronavirus Disease 2019 (COVID-19) is stressful for everyone. Managing your bipolar disorder symptoms during these chaotic times is vital to your stability and well-being.

We know that bipolar disorder can cause people to have a more reactive response to stress when compared to those without the diagnosis. This means that you may respond more intensely and with passion, which can be either a benefit when times are good or a problem when the news is not so good.

We are in a time when the news is not so good. So how do you manage bipolar in the face of uncertainty? Are there additional concerns to address in the context of this pandemic when you have bipolar? Are there further actions that we should be taking to manage symptoms in the COVID-19 pandemic?

Bipolar, Sleep & Mania

We know that when you have bipolar, you are at risk for unstable moods whenever there are excess stressors, such as now. In addition to the health and hygiene recommendations from the public health service, such as regular handwashing and social distancing, maintaining a healthy and consistent sleep pattern is essential to sustaining a stable mood.

Loss of sleep is one of the first signs of mania. It is very important to contact your care provider if you find that you are not sleeping, and it’s a good idea to discuss a plan to manage your sleep (for example, having additional medication on hand to take on an “as needed” basis). The risk of developing a manic episode after even one night of missed sleep is high, and the consequences of a manic episode may be greater in our current stressful times.

Depression & Worry

People with bipolar often note that, for them, the depressed phase is more common and is what they live with daily and on a chronic basis. The stream of worrisome news may serve to exacerbate worry and anxiety and cause a preoccupation with the worst-case scenario. It is important that you, and your family, know that that you will benefit from a strategy to manage anxiety and fixations on catastrophic outcomes that could lead to panic and confusion.

Be Prepared

Planning is everything.

Clinics are evaluating how best to serve everyone and are dedicated to the health and safety of all—staff and patients. For your next appointment, check the website of the clinic to find out if a policy for visits is in place. If you call by telephone, expect a wait time. Send an email to the clinic or a message through the patient portal. Find out if your provider offers the option of a telephone or online interaction.

Be sure that you have refills of your medications. Talk with your family or a close friend about your plan. Ask them to be a part of the strategy to stay well and healthy. The current challenging times may be with us for a while.

If you become manic or depressed: contact your provider immediately and, if possible, include your family or close friend. Ask about additional medication to treat your symptoms, and also ask about options such as urgent or emergency services, as well as the risks of attending the local emergency room.

Social Distancing & Social Media

The recommendation for social distancing—meaning staying away from places where people gather—may be a problem for many. It can mean that there are fewer people to help you monitor how you are doing. It is best to identify a “check-in” buddy, someone you know well and whom you can talk with once or twice a day by phone or chat.

Be wary of overdoing it on social media and minimize your exposure to news feeds that tend toward the sensational. Allow yourself a limited amount of news and talk with your care provider if you are concerned. Get updates from the Centers for Disease Control and Prevention.

Be calm, follow guidelines, get plenty of rest, wash your hands frequently, be aware, and—most of all—be well.




Melvin G. McInnis, MD, FRCPsych, is Thomas B. and Nancy Upjohn Woodworth Professor of Bipolar Disorder and Depression and professor of psychiatry in the Department of Psychiatry, University of Michigan School of Medicine. He is also principal investigator of the Heinz C. Prechter Bipolar Research Program and associate director of the University of Michigan Frances and Kenneth Eisenberg and Family Depression Center.