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When bipolar hypomania changes your drive to rest, try these unconventional body-based techniques to find calm.
We hear it from our therapists like a broken record: For successful mood management with bipolar disorder, consistent and adequate sleep is essential. The usual tips are to maintain a consistent sleep schedule, get a full 7 to 9 hours, and take naps thoughtfully and carefully when you need to.
Yet, standard routines often fall short when an elevated mood completely changes your biological drive to rest. Unlike traditional advice, these body-based techniques are specifically intended for acute manic or hypomanic states to help quiet an overactive nervous system in the moment.
Best Practices and Roadblocks to Routine Sleep
Best practices for a good sleep environment have become well known, too: Reserve the bed for sleep and sex only, skip screens and caffeine before bedtime, and keep the room temperature cool.
RELATED: Ask the Doctor: Sleep Strategies to Help Your Bipolar Symptoms
But the road to a sleepless night is often paved with good intentions — and circumstances can make it difficult or impossible to follow the guidelines we know like the back of our hands.
What if you’re working shifts?
Or caring for someone who needs help during the night?
What if you don’t have an air conditioner or space for a sofa?
What if naps don’t fit into your schedule?
Plus, it’s not that easy to be screen-free for a few hours at the end of the day, in case you hadn’t noticed.
When Mania or Hypomania Interferes With Healthy Sleep Hygiene
On top of these common environmental obstacles to sleep, those of us with bipolar disorder have the difficult task of taming hypomanic or manic energy. The involuntary surge of energy and physical activity often makes us feel that sleep is a waste of time. Setting up a cozy atmosphere, keeping a consistent nighttime routine, and planning for at least 7 hours of sleep per night can definitely help — but they don’t always quiet manic or hypomanic energy.
There are a few body-based and mental steps I take when trying to settle my manic or hypomanic energy enough for a night of sleep. These aren’t your usual sleep hygiene tips — just a handful of things that have stuck with me through the years. I wish you sweet dreams!
A safety note: If you still can’t sleep, or if mania or hypomania keeps getting worse despite trying these strategies, reach out to your doctor, therapist, or another member of your care team. These tools may help in the moment, but they don’t replace medical support.
1. Fix Your Face… With Muscle Relaxation
Picture this: You lie down in your own bed after a long, exhausting day. You just remembered the thing you were supposed to do tonight, but you try to sear a mental note into your brain to do it in the morning. You notice that your toenail is chipped and getting snagged on the sheets. You remember a conversation from earlier and think of some other way you should have said something.
Your neck is stiff from the activities of the day. Now look at your face. It’s grimacing! Stop the grimace, and literally relax your face. You can begin with eyebrows and eyes, then release your jaw and neck. Doing this can feel like turning down the volume on a noisy speaker; there’s relief in the absence of overstimulation.
2. Lie on the Left and Roll to the Right
I automatically lie on my left side, and then roll to my right side once I feel closer to sleep mode. It’s like I’m putting all the remnants of the day to bed, fixing my face, and then turning my back on all of it. Plus, since the heart is on the left side of the body, I think it feels a bit easier to breathe when lying on your right side.
Also, if you have tummy troubles like acid reflux, sleeping on your left side can help. Did you know that your anatomy is not symmetrical on the inside? Your liver, heart, and digestive tract are off-center. According to an older study, gravity can help reduce reflux if you’re lying on your left side.
3. Straighten Your Spine for Restful Sleep
Regardless of whether you like to sleep in the fetal position, face down, or belly up, think of your spine as a rope that you can pull at the ends to straighten. It’s totally normal to just flop into bed in a twisted, non-ergonomic pile of exhaustion. But once you’re in your space, use your hips and your head to pull your spine as straight as an arrow.
If you’re lying on your side, rotate your shoulders and hips back, as though you’re stacking them on top of each other. This position can make it easier to breathe, and it may reduce your likelihood of waking up with a stiff neck, back, shoulders, or all of the above.
4. Gather Your Thoughts and Recite Poetry or Pray
“Look upon my works, ye mighty, and despair!”
~ Percy Bysshe Shelley, “Ozymandias”
Remember your grade-school days, when you had to memorize and recite poetry? Reaching back into those memories can be a comfortable path to calm. One of my favorites is a sonnet by Percy Bysshe Shelley, called “Ozymandias.” Spend time remembering and recalling the words and how they sound best when recited. No getting up or grabbing your smartphone to check for your accuracy, though!
Pro tip: This strategy also works well during turbulence on airplanes! Some people say the Hail Mary; I say the prologue to The Canterbury Tales — in its native Middle English.
5. Be Still, My Hands
If eyes are a window to the soul, then hands are a window to the brain. If you find yourself picking at your nails, twirling your hair, or clenching your fists when you’re trying to fall asleep, you’re distracted from the job at hand (pun intended!).
It’s hard to rest your mind completely if you’re absentmindedly tapping out a song with your fingertips. Stop that unintentional flow of brain activity by focusing on keeping your hands still. Imagine becoming a statue or sitting for a portrait. This approach works well when combined with “Sit Through the Itch,” below.
6. Sit Through the Itch
One of the core values a parent must have is tenacity. I feel I deserve a “Tenacity Award” for ignoring an itch on my leg because I was too scared that if I moved, my child wouldn’t fall asleep. To my surprise, with a little time, the itch just went away, and I fell asleep myself.
With this in mind, try to do the same when having trouble sleeping during mania or hypomania — ignore a sudden itch that pops up:
- Think about mind over matter.
- Think about keeping still during a game of hide-and-seek.
- Think about dipping your hands in cool, gummy plaster to have them bronzed.
- Think about anything that helps you ignore the itch.
Sometimes I imagine I’m in a scene where staying still really matters. That way, I have much bigger problems to think about than some silly little itch. Give it a try — maybe you’ll win a Tenacity Award, too.
Editorial Sources and Fact-Checking
UPDATED: Originally published September 25, 2019.
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