OK, let’s get down to it. I am badass disciplined about my self-care. I believe it is absolutely essential to preventing my next bipolar flare. The prospect of that is so terrifying that I am uber dedicated to practices for a healthy brain. When people ask me, “How are you so disciplined?” I usually respond, “I have a very healthy respect for my bipolar brain!” A friend who just visited from Minnesota said, “You are my number one model for self-care. You need to tell readers about that in your book.”
So here are some of my PECS practices — Physical, Emotional, Creative and Spiritual — that I offer as a guideline for you. Please don’t feel overwhelmed if you can’t do all of these. Make them your own. Start with one and work up.
Physical: As you can see by now, I’m fond of acronyms as a memory tool. In the Physical domain it’s ERN: Exercise, Renewal, and Nutrition.
Exercise: Moving the body as you’ve likely heard in a thousand places is absolutely essential to brain health. I won’t give you all the scientific data here, as I’m not an expert in that domain, but you know the research is out there correlating aerobics and endorphins. You simply feel and look better after a workout.
For me this is an every day thing seven out of seven. Like I said, work your way up if that’s overwhelming. My go to sports are walking and swimming because they are easy. I live in the woods so on a good day in the winter I’ll go cross-country skiing. You don’t have to be an avid athlete. Just move.
If you’re feeling down it is hard to motivate on your own. I’m always better with a buddy. Make dates in advance. It is especially helpful in the winter (if you live in icy territory) to have an appointment with a friend to get you out the door.
I also do yoga on a daily basis and have for decades. I missed several months when pregnant and nursing twins, but otherwise I’ve been consistent with this. I find it extremely nourishing to my otherwise buzz-tending brain to calm down and center. Some would describe this as engaging the parasympathetic nervous system. (Again, I’m not an expert, but there’s tons of research connecting yoga and other mindfulness practices to supporting the parasympathetic.) If you don’t have a yoga practice yet, there are hundreds of free classes on YouTube. Or find an instructor near you that folks recommend. Start with 10 minutes.
Renewal: The afternoon power nap has become an essential part of my practice. I get in a hammock, read for ten minutes then set my alarm for twenty, close my eyes and I’m out. Turns out there is research to support the idea that naps of under thirty minutes are super healthy for the brain. Like a mini vacuum cleaner that sucks out metabolic wastes. I go deep and wake up feeling like I’ve been on vacation. Just half an hour later!
According to an article in the New York Times several years back, there’s an island in Greece that is home to the highest concentration of folks over 100 years old in the world. Among other secrets to their success is their required daily nap! (Of course it helps that the whole island goes to sleep at the same time.)
Growing up my siblings and I were trained by our Dad with one of his common mantras, “Work, work, work, think later!” This also applied to “rest later.” I took me years to give myself permission to take a break. Now having trained myself to nap, I can sense and feel when I’m pushing my brain too hard. It takes a while to build that muscle. But once I gave myself permission to respect my brain and take a break when needed, my commitment to doing that strengthened.
Quality rest includes steady sleep of course. As I’ve written in previous chapters, I learned the hard way that sleep deprivation is a recipe for disaster for a bipolar brain. Dr James Phelps in the interview below and in his website pscycheducation.org also describes the importance of quality darkness during sleep. This means making sure that there is no light — including the pervasive little lights on all our electronics like phones and alarm clocks, etc. My black silk eye mask is an essential part of my sleep hygiene and I never leave home without one!
And speaking of little blue lights, it is also imperative to limit screen time at night before bed. The blue light that screens emit is bad for the bipolar brain (probably any brain) as we are winding down to sleep. I’ve heard and read different recommendations, but most say stop screen time 2-3 hours before bed. If that’s too hard, given the ubiquitous nature of screens in our lives, do what you can. You can also pick up inexpensive amber glasses that filter out the dangerous blue light. Note: if you wake up in the middle of the night do not turn on your phone. Keep a book by your bed. Better yet, since it doesn’t involve light, cue relaxing music on headphones before you fall asleep. I find this works beautifully for me. There’s a lot more on sleep hygiene on Dr Phelps website, link below in Appendix III.
Nutrition: Again you’ve probably heard all this before, but a healthy diet is key. I may be a bit more religious about this than necessary. I go mostly organic. This is influenced by my career in sustainability where I learned too much about the toxic nature of chemical additives, and because I live in a place surrounded by organic farms which makes it easy to support my health and my neighbors at the same time. You don’t have to be exclusively organic, but try to avoid processed foods. Here are the things I minimize: processed sugar (I use maple syrup), dairy (I go with goat cheese when needed), wheat (except for Friday nights) alcohol (one or two nights a week I have a glass of wine or a beer.) I say “minimize” instead of eliminate because for my brain and personality, being too rigid about anyone path is not useful. That said, I do find that eating a local, mostly organic, low wheat, sugar and dairy diet is super calming for my nervous system.
Emotional: An emotional support system is essential. As I’ve written elsewhere, find friends who will listen to you without blame or judgement and who will show up for you in a crisis. (You’ll do that for them another time.) A therapist as also an essential part of your emotional support system. I also think it’s super helpful to have a “Brain Buddy.” This is someone you trust fully and loves you no matter what. Contract with your Brain Buddy that when you are in crisis you will text them “Code Red.” This means that they’ll call you immediately (and vice versa).
Before you are in a crisis, create an affirmation for yourself with your Brain Buddy that you will repeat on a regular basis. The affirmation is stated in the first person, present tense, and with feeling. For example, “I am safe, free, and loved.” Or “I am loving, strong and innocent.” You get the point. The important thing is that the affirmation rings true for you and gives you a sense of calm and joy.
Here’s a five-step process for working with your brain buddy in a time when you are under stress.
Step 1: Notice what’s happening in your body/emotions and give it a name that you state out loud. For example, “Self-judgement is arising.” “Comparing-mind is arising.” “Fear is arising.” The key point here is that by stating the uncomfortable feeling as “arising” we separate it from ourselves and see it for what it is, a temporary state of mind. It does not own or define us. This three-word formula,
“____(negative emotion or sensation) is arising” works because it is simple and accessible in a moment of crisis. (Shout out to MBCT, Mindfulness Based Cognitive Therapy out of UMass Worcester for this approach.)
Step 2: When you state, “Fear (or other) is arising” that’s your trigger to text your Brain Buddy, “Code Red.”
Step 3: Brain Buddy calls you and states your affirmation with you out loud, slowly, several times. This calms your nervous system and lets you know, in the moment that you are not alone.
Step 4: Make a plan with your Brain Buddy for immediate next steps to get through the crisis.
Step 5: Exhale and celebrate yourself for implementing the triage plan.
Creative: It is helpful for our brains to have creative outlets to minimize perseveration and to maximize a sense of productive engagement, purpose, meaning. Everyone has their own creative “go to” practices. For me these are writing (working that one now!), cooking, singing. For others it might be painting, performing, gardening. It may be political activism or volunteer engagement. Work of the heart like this — some service to others — is particularly therapeutic. It’s ideal if some of these activities take place in community as that supports the emotional side of PECS. For example I often write in a writer’s group which provides both creative engagement and social connection. There’s no specific recipe here (unless you are cooking) here. Just find something that has meaning for you.
Spiritual: I could write a whole other book here. (Indeed I have and it’s called Secrets of the Seventh Day about the power of unplugging for a day every week. Check it out!) You may or may not have a religious practice or belief in what AA calls a “Higher Power.” If you do that’s great. Practicing with a spiritual community is powerful because it supports both the Emotional and Spiritual side of PECS. Find a trustworthy (not Guru) spiritual teacher. You may engage in mindfulness meditation (see Mindfulness Based Cognitive Therapy in the Brain Buddy section above), walking unplugged in nature, a series of prayers or any other spiritual discipline that expands the mind. Choose what works for you.
One spiritual discipline I do recommend to everyone irrespective of religion or background is daily gratitude practice. I do that every morning on waking (aided by my teacher Shefa Gold’s app!) and most nights before falling asleep when I remember! One year I did an experiment and wrote one thank you letter a day for sixty days. This generated all kinds of positive energy that I did not anticipate until I did it. Here’s what I learned:
1) Offering gratitude is a big gift to those on the receiving end. They are reminded of their beauty. Who couldn’t use that?
2) This blessing is contagious. They see their glory and tend to “pay it forward” to the next person.
3) Giving thanks shifts our consciousness from scarcity, pain and victimhood, to abundance, joy, and possibility.
Try it. It’s liberating.
Yes, these PECS practices for a healthy brain are a lifelong commitment. The good news is that no matter who you are, you will be healthier and happier for it. Yes, if you have a bipolar brain, I believe being disciplined in your commitment to self-care is a required part of your prevention program. Taking the time to do this is not selfish. It is essential to your wellbeing.
If you are just beginning on the PECS path, start small and celebrate every step. You are putting you and your unique and powerful brain first. Good job.