Author: Melissa Howard
For people who live with bipolar disorder (bd), travelling internationally or across time zones, poses specific health risks that otherwise, do not affect individuals who do not live with a mental illness.
Travelling can be stressful for everyone. We are in unfamiliar surroundings, away from the comfort of our own bed, routines are often altered, our circadian rhythm is thrown off and days are usually long and eventful. All of these points can be exhilarating but also exhausting, stressful and sometimes anxiety provoking.
Just the act of packing and preparing for a vacation may trigger a mood episode. Bipolar disorder does not appreciate “change” and travelling is exactly that.
Travelling for leisure is an important part of my life but it has come with challenges that I have had to navigate through in order to enjoy my experience. My family plans for our longest vacation during the summer months. This process begins a year in advance. My husband takes the lead with the booking of our flights and accommodations. He manages all of the large details because he knows that it reduces my stress levels. Closer to our date of departure we look into daily excursions, places we would like to go sightseeing, and restaurants we are interested in trying. We plan ahead because this builds structure to our day and it helps me to keep a routine. This allows me to be part of the planning process without becoming anxious.
Tips and strategies I use when planning or on a vacation.
I begin organizing four weeks in advance of our trip. The process includes making a list in order of importance:
1 . Medication and supplements are always prepared first. I contact my pharmacy ahead of time to ensure all of my prescriptions are filled and ready to go. I put my medications and supplements into compartmentalized cases that I purchase at the Dollar Store. This keeps everything organized and easy to access while I’m away. I pack five days of extra medication in case of unforeseen issues like an illness, plane or weather delay. Additionally, I always have the email addresses of my support team in case of emergency.
2 . I ensure I create a proper sleep schedule. Lack of sleep is my main trigger for a mood shift. Travelling internationally is not kind when it comes to my sleep routine. My psychiatrist and I have implemented a plan, not just for international travel but for any time I am sleeping away from home. When travelling within the same time zone my evening medication is increased to ensure I am able to fall asleep quickly and remain asleep throughout the night. When travelling internationally, I am prescribed a stronger medication altogether to allow me to adjust to the new time zone with ease and with as little disruption as possible. This usually begins with the overnight flight. I take the stronger sleep aid to sleep through the flight. We usually arrive the next morning and I push myself to stay awake until the evening in the new time zone in order for me to wake the following morning well adjusted and refreshed. (Please contact your health care provider before altering or adding any medication to your routine)
3 . Meals are planned in advance, keeping in mind that I have dietary restrictions that I have to be mindful of. We attempt to eat at the same time throughout the day maintaining a consistent schedule. In hotter climates I tend to have a reduced appetite. It is imperative that I nourish myself even if it is with something small. I remain well hydrated because my medications cause me to overheat adding additional stress to my body and contributing to my loss of appetite.
With medication, a sleep plan and meal schedule organized I am able to begin packing.
- I am notorious for overpacking, sometimes even having to pay an additional fee because my luggage exceeds the acceptable weight for our flight. I worry if I do not pack something I may need and cannot find it at our destination something catastrophic might happen. To avoid this stress, I would pack everything. My family always teases me for this. In order to manage my uncomfortable emotions, I prepare my outfits and toiletries in advance, making sure I do not pack anything that is unnecessary. In doing this ahead of time it reduces my anxiety and gives me time to adjust my packing decisions if need be.
- I familiarize myself with the destinations immediate surroundings ahead of time. Making sure I know where there is a grocery, pharmacy or convenience store close by in case of an emergency or I have forgotten something.
- Music is important to me. I always pack my AirPods and portable speaker. Listening to my favourite playlist after a busy day helps me to unwind and relax.
- Exercise is part of my daily routine at home. When I travel my days are filled with walking which provides my body with the sufficient movement it needs. If I take a more sedentary vacation I tend to need some motivation to be active. I enjoy swimming and make use of the pool or ocean which does not feel forced.
- I take “me time.” I love to travel with my family but let’s be honest, spending every waking hour together, only to have our accommodations in smaller quarters than we’re used to can be a challenge. I appreciate and look forward to my quiet time alone even if it is for half an hour. I need it to recharge even when I’m on vacation. This is part of my self care that keeps me healthy.
- I try to remain flexible and live in the moment. I am able to plan our days ahead of time but sometimes life has other plans. Going with the flow is one of my best learned skills.
- Upon my arrival home, I practice self care and allow myself the space to adapt to my original time zone. For me, it takes about two weeks for my circadian rhythm to adjust back to normal when travelling internationally. I have to be patient with myself, unpack slowly and ease back into everyday life. If I try to speed up this process, I’m once again at risk of triggering a mood shift only this time it is likely to be a depressive one. With the excitement gone and return to normal life, I call this the “post vacation let down.” I mitigate these emotions by looking through pictures of the memories my family and I just created and look forward to when we can plan our next journey.
Looking back through my travel experiences during adolescence and the manic psychosis I experienced thirteen years ago, all had one thing in common, travel. I returned with a mood shift or vacationing aggravated my already existing symptoms. Prior to my diagnosis, I was unaware of how much travel could impact my mood. The three years that led up to my first hypomanic, manic and then psychotic episode, I had been travelling. Upon each return my symptoms became worse and at nineteen I was formally diagnosed with bipolar disorder.
Many may ask why I bother to travel with so many detrimental risks to my mood and all the provisions it takes to prepare for a vacation. My answer is, “I love it! It brings me joy and I love spending time with my family and friends while experiencing new adventures.” Bd has taken so much from my life, making lifestyle adjustments in order to experience what brings me happiness, supersedes any risks for me.
Travelling with bipolar disorder and maintaining a euthymic state takes effort. Now that I am more aware of my triggers, how to prevent them and the importance of creating a plan to reduce my anxiety and stress levels, I am able to travel with confidence and look forward to my new experiences.
