As I’ve talked about before, I was diagnosed with Bipolar II Disorder when I was 14. It has taken me decades to come to grips with what that means, and to be in a place where I am comfortable being open about it. On Wednesday nights (assuming I am in town), I help facilitate a support group for others dealing with mood disorders (depression, bipolar, anxiety, PTSD, and others) as a volunteer with the Depression and Bipolar Support Alliance (DBSA). One of the questions I get asked often is how I manage my illness while traveling.
For many of us, myself included, it can be hard to even get out of bed some days. The depression comes crashing down, and the thought of even moving becomes overwhelming. So the idea of journeying to the other side of the world can seem downright impossible. However, travel can be one of the most incredible experiences for those of us who struggle to keep our emotions above water. I’ve found that waking up in a new place can be very effective in breaking my “spiral” downward into an extended depression. It takes me out of my daily routine, and my brain is too preoccupied with learning about a new place to focus as much on my mood.
That said, traveling with a mood disorder has its perils. So here are some tips and lessons I’ve learned the hard way. May they help you!
Before You Go
1. Make sure you have enough of a medication supply
Most of us go month to month on our meds. That can be a challenge for an extended trip that overlaps with your refill period. I worked with my doctor to get my supply two months at a time to help mitigate that issue, and my pharmacy is aware that I travel often and has worked with me to push up refill dates if needed.
2. If traveling with companions, brief them on your needs
Solo travel is easier for me in many ways because I don’t have to justify my emotional needs to anyone else. However, when traveling with companions – even close friends and family – I try to discuss with them what I am likely to need (downtime, alone time, etc…) before we go and it becomes an issue. We can work out systems to allow me to get what I need within the framework of our trip.
I love to take driving trips with my father, and have been doing so since I was a little kid. One of the systems we have in place is that on nights that I need some alone time, we stay at a hotel that has one bedroom suites (Embassy Suites or an equivalent). He will have the bedroom and I will sleep on the couch in the living room, but feel that I have more personal space.
For many people with mood disorders, our anxiety gets worse with the unknown. Having a plan can help with that. This doesn’t mean I always have every day planned out, but I go into a trip with at least a rough itinerary. Things that need reservations have them. I also try to alternate packed days and lighter days to build in some downtime for myself.
4. Prioritize self-care
Just because I travel doesn’t mean my self-care can be neglected. For me, emotional balance begins with a good night’s sleep (at least 8 hours, and preferably more). I have accepted that this means I will rarely enjoy the nightlife in a new place, and have become ok with that.
If your self-care involves exercise, or meditation, or anything else, structure that into your daily plan. Stay at hotels with fitness centers, bring your meditation materials, etc…
5. Know your triggers
Again, our illnesses do not disappear just because we are on vacation. Our triggers are still there, and we need to pay attention to situations that can activate them. Knowing what those are ahead of time can help avoid things that might set them off, but sometimes it still happens. So then what?
I was recently in Japan, and visited the Fushimi Inari shrine in Kyoto. It was crowded, extremely crowded (see the image below), and at one point people were all around me and it felt like I was trapped. I had a panic attack and decided that, rather than push through, I would take care of my needs and leave. I told my companion that I would meet him back at our hotel, and I left.
Because I recognized my trigger and had thought about it ahead of time, I was able to get through that situation.
6. Practice self-compassion
This one is still hard for me. After a situation like I described above, my natural inclination is to be upset with myself. My illness and my needed response to it prevented me from seeing a place I wanted to see!
While that might be our natural feeling, it is important to be compassionate with ourselves. Doing what is necessary to maintain balance is hard, and doing it at the expense of something we were looking forward to is even harder. We make tough choices like that every day, and prioritizing our emotional needs is never a bad thing.
Others may give us a hard time about things like that. Even in my day to day life, it is tough to get questions from people around me about why I make the choices I do. Just as I would prefer them to understand, I also have to understand and be gentle with myself. If I had a physical illness with a flare-up, nobody (myself included) would think twice about excusing a choice to take it easy. It is no different with mood disorders, and while others may not yet see that, we need to understand it within the context of our own illnesses.
7. Keep your support structure engaged
For some people, this means doctors or therapists. For others like me, it means certain friends and family members. My friend Ana is one of my first calls when I have panic attacks or depression spirals at home. So even when in Japan, she was my first call when I got back to the hotel and had wifi. Keeping that routine, even while on the other side of the world, is very important to my balance, and to the feeling of not being helpless and isolated just because I am gone.
I try to make sure my support structure is aware of what is going on with me while I’m gone, and I have emergency procedures in place with my therapist and psychiatrist, just in case.
Keep notes, written or mental, about what works and what doesn’t. There is no solution that is 100% effective for everyone. We learn much by trial and error.
After You Return
9. Update your doctor and therapist
I find it key to do a “debrief” with both my psychiatrist and my therapist when I return from a trip. What were the situations I handled well? What do I wish I had handled differently? How did my meds work in a completely different environment? Again, we learn by doing, and keeping the professionals we trust in the loop is important.
10. Congratulate yourself
Regardless of whether or not you handled every situation in a way you’d consider perfect, you were able to travel with a mood disorder, and lived to tell the tale. That is an accomplishment that needs to be celebrated! Look back through your photos, tell stories to your friends, and know that if you could do this, you can do anything.
Travel has been one of the greatest gifts to me in my ability to deal with my mood disorder. I hope it will be the same for all of you!