Combatting Bipolar Disorder-Related Fatigue

Medically reviewed by Timothy J. Legg, PhD, PsyD, CRNP, ACRN, CPH on January 18, 2018Written by Brian Krans on January 12, 2012

Bipolar disorder and fatigue

Bipolar disorder is known for causing severe mood swings that can include bouts of depression and mania. During episodes of mania, or emotional highs, you may feel extremely happy and energetic. However, your mood can shift to a depressive episode very suddenly. You may feel hopeless or sad and be less interested in doing activities you normally enjoy.

During these fluctuations in mood and behavior, it’s not uncommon to have excessive fatigue. Fatigue causes an overall feeling of extreme tiredness and a lack of energy. Although it’s often accompanied by a desire to sleep more than usual, fatigue isn’t the same as feeling drowsy or sleepy. When you feel fatigued, you don’t have the motivation to do anything. Even getting out of bed in the morning can seem like an impossible task.

Fatigue often occurs during times of depression, but it can also be a problem during manic phases, as mania often causes insomnia and restlessness.

Fatigue can be one of the most debilitating symptoms of bipolar disorder. It may impact your ability to perform daily activities, as well as your overall well-being. However, making certain lifestyle changes may help prevent the negative effects of fatigue.

Here are seven adjustments you can make to help fight the fatigue caused by bipolar disorder.

Make over your sleep routine

Unfortunately, fatigue is often a vicious cycle in bipolar disorder. High energy levels and restlessness during mania can make it hard to sleep at night, causing you to feel very tired during the day. During a depressed state, however, you may feel fatigued all the time. You may not have the motivation or energy to do daily tasks, such as getting the mail or making meals.

One of the best ways to break this cycle is to establish a sleep routine. You should try to:

  • go to bed at the same time every night
  • wake up at a similar time each morning
  • eliminate daytime naps
  • avoid using electronics within an hour before bed
  • take a warm bath prior to bedtime
  • practice meditation or deep breathing exercises at night

It might be difficult to establish a sleep routine at first. You may need assistance from a loved one to help you stay on track. But it’s important to stick to it as much as possible. Once you establish new sleeping habits, you should feel less tired during the day.

Exercise for a boost of energy

When you feel fatigued, exercise is probably the last thing you want to do. However, once you get motivated to start exercising, it can provide many benefits. Aside from improving your physical health, exercise can help ease your fatigue and make you feel better overall.

Physical activity stimulates the production of various brain chemicals that make you feel happier and more relaxed, too. This can help make you feel more energetic and less tired during episodes of depression. Exercise can even help you sleep better at night, which will help reduce your daytime fatigue.

Although exercise can help prevent the fatigue associated with bipolar disorder, it’s important to keep in mind that it will only work as long as you do it. You may need to exercise at least 3-5 times per week for 30 minutes to see an improvement in symptoms. People with extreme fatigue should start off slow and work their way up to a longer workout as they gain more energy.

And for those days when you may not even feel like getting out of bed, remember that walking is exercise too. Take a short walk to get your body moving. The exercise, paired with fresh air if possible, will likely help perk you up.

Limit caffeine consumption

Caffeine provides a sudden boost in energy and mental function, which is why many people rely on coffee or energy drinks to get through the day. However, the “crash” that happens afterward may make you feel more tired than you did before. Drinking caffeinated drinks later in the day can also make it difficult to sleep at night, causing you to feel tired the following day.

According to the Mayo Clinic, of caffeine is the maximum amount of caffeine that should be consumed by adults per day. This equates to about 4 cups of coffee or two “energy shot” drinks.

If you need to reduce your intake of caffeine, consider doing so gradually. Sharp decreases in caffeine consumption can cause headaches and make fatigue worse.

Stay hydrated

Another problem with caffeine is that it has diuretic effects. This means that caffeinated drinks increase your body’s production of urine, which can cause you to become dehydrated. Dehydration can also lead to low energy levels.

Staying hydrated can help fight fatigue and increase energy, so it’s important to drink water throughout the day. The recommended amount of water to drink is about 15.5 cups (3.7 liters) per day for men, and about 11.5 cups (2.7 liters) for women. However, you’ll need to drink more water if you exercise.

You can also keep your body hydrated by:

Increase your intake of vitamin B-12

Vitamin B-12 is an essential nutrient that’s mostly found in red meat, poultry, and other animal products. In addition to keeping the body’s nerves and blood cells healthy, vitamin B-12 helps with brain function. Deficiencies in this vitamin can cause low energy levels and fatigue.

The recommends a daily vitamin B-12 intake of 2.4 micrograms for adults. Vitamin B-12 can also be found naturally in the following foods:

  • red meat
  • chicken
  • liver
  • fish
  • fortified cereals
  • eggs
  • milk

If you aren’t getting enough B-12 from foods, talk to your doctor about taking supplements.

Choose your medications wisely

Many of us rely on over-the-counter (OTC) medications for relief from common aches and pains, as well as illnesses. However, many of these drugs can cause drowsiness, which can make fatigue much worse. Common culprits include:

When buying these medications, look for versions that are labeled “non-drowsy.” You should also ask your doctor if any OTC drugs you’re taking could interfere with the effectiveness of your other medications.

Catch a few rays

Increasing your exposure to sunlight can help improve your mood and give you a boost of energy when you’re feeling fatigued. This may be because sunlight makes it easier for your body to absorb vitamin D, which is an essential nutrient for brain function. A also found that frequent exposure to sunlight might help prevent the onset of bipolar symptoms, including fatigue.

When you do go outside to catch a few rays, be sure to apply sunscreen to prevent sunburns and skin damage.

The takeaway

Trying one or all of these tips can help take the edge off your bipolar-related fatigue. However, it’s important to note that you may still experience fatigue even after you make these lifestyle changes.

If your fatigue persists, talk to your doctor about the medications you’re taking. Certain drugs, such as mood stabilizers, can increase drowsiness and make fatigue worse. Your doctor may be able to prescribe another medication if your current medication is contributing to your fatigue. However, you should never change medication dosages or stop taking a medication without first checking with your doctor.

And whether your fatigue is caused by your bipolar disorder, your medications, or something else, be sure to communicate with your doctor. In addition to providing guidance on your medications, they can make suggestions for other ways to cope with your fatigue.

CMS Id: 14398