Katie Way

If you have bipolar I, you’re probably familiar with the emotional peaks and valleys that the condition is characterized by. “With bipolar disorder type I, the person either gets very, very depressed or they get very, very high on what we call a manic state,” Ludmilla De Faria, MD, a psychiatrist specializing in bipolar disorder and an associate professor of psychiatry at the University of Florida, tells SELF.According to Dr. De Faria, mania is pretty unmistakable. Manic episodes, which sometimes include psychosis symptoms like hallucinations and delusions, can become so intense that they lead to hospitalization. A person experiencing a manic episode might be “talking very fast, they don’t need to sleep, they’re doing 500 things at the same time, they’re very grandiose,” Dr. De Faria says.She adds that the triggers that can lead to a manic or depressive episode in people with bipolar I are often more difficult to identify than the symptoms themselves. One trigger, in particular, is especially elusive because it’s such a normal part of life. That trigger is sleep disruption: a period when someone gets less sleep than usual, or has poor sleep hygiene that affects the quality of their rest.1“It is very well-documented that not sleeping enough hours by itself can trigger an episode, without any other issues,” Dr. De Faria says.1 For someone with bipolar I, even a short stretch of disrupted sleep can be enough to trigger mania. “Lack of sleep is not a good thing, in general,” she says. “Sleep is a period when the brain resets and reorganizes, and I like to say it files away important information that you came across during the day. The inability to engage in that on a regular basis can eventually be very problematic.”Research supports the link between sleep disruption and bipolar I episodes—and, more specifically, manic periods. A 2019 study found an overall connection between problems with sleep, daytime sleepiness, and bipolar disorder2, and a 2017 study found that people with bipolar I, and especially women, were more susceptible to sleep loss as a trigger for manic episodes.3According to Dr. De Faria, what makes issues with getting rest so tough to identify as a trigger is that, socially, we’re conditioned to think that missing out on sleep in certain situations is normal—like, if you’re a student working hard in the lead-up to finals, or if you’re partying on a fabulous vacation in Mykonos, or you’re staying up late and waking up early to show a manager you deserve a promotion at work.On top of that, poor sleep can also pair up with other factors that may trigger a bipolar I episode, like stressful life events or changes in medication. For example, what looks like overachieving behavior, or even maintaining a strong “work-life balance” as a person raising children and trying to advance their career, can potentially signal the beginning of a bipolar I episode. “People think, ‘Well, look at her—she’s having it all, and she’s really successful, so why would I interfere?’” Dr. De Faria says. But the symptoms of full-blown mania that disrupt someone’s life—say, they’re having extreme delusions, or they’re staying up all night, every night—might not be apparent until months later, when more intensive treatment and hospitalization could become necessary in order for a person to recover.

10. If you’re traveling with a mobility device like a manual wheelchair or power chair, things can get extra complicated. This is a great multi-part guide to traveling with a wheelchair, and this is a really helpful Reddit thread about taking your manual wheelchair on a plane—or, if absolutely necessary, checking it at the gate. One user suggested bookmarking this page, which outlines the federal regulation that states airlines have to at least try and store your collapsible wheelchair in the plane’s cabin.11. As unfair as it is, flying comfortably while fat requires some extra preparation. Some airlines have gotten with the times and established specific policies for “customers of size,” which is the terminology carriers typically use. Southwest, for example, offers complimentary additional seats if a passenger can’t fit into a single one, including by reimbursing extra seats bought in advance.12. When you can’t book ahead of time but think you’ll need more space, you should ask the staff at the gate whether it’s possible for you to switch to a part of the plane with an extra empty seat, or even to an entire free row if your flight isn’t full, Katie, a Delta Airlines flight attendant, tells SELF. (Katie requested that SELF omit her last name for professional reasons.) “Try just going to the gate agent and saying, ‘Hey, if there’s anywhere with a middle seat open, I’d love to be there,’” she says.13. Request a seatbelt extender as you board the plane—according to Katie, that’s the easiest time for flight attendants to accommodate your request. “We have all different planes, the seats are made differently sometimes,” she says, so even if you don’t always need an extender, it’s worth asking if you think there’s any chance you could be uncomfortable. (You can check SeatGuru to find the width of the seats on your plane.) Also, it might seem like a timesaver to bring your own extender from home, but you’ll need to ask the flight attendants in order to ensure the one you’re using is Federal Aviation Administration (FAA)–compliant, because not every at-home model conforms to the aviation safety administration’s safety regulations.14. Mask up. The Centers for Disease Control and Prevention (CDC) still recommends that you wear high-quality masks or respirators while traveling, especially in “crowded or tight spaces with poor ventilation like airport jetways,” on planes where the ventilation system is switched off, and on trains and buses—a.k.a. the way many airports require travelers to hop from terminal to terminal. For the best protection, grab a pack of disposable N95, KN95, or KF94 masks. Keep a few on you at all times so you can put on a new one if long-term wear is making the one you came to the airport with feel stale.15. While you don’t need to use a Clorox wipe on every inch of your seat to protect yourself from germs, it’s good to be cautious about touching shared surfaces on the plane, especially if you’re immunocompromised or traveling to visit someone who is. One thing you do need to thoroughly sanitize: your hands! Make sure you wash them after using the bathroom, and don’t be afraid to get liberal with the hand sanitizer, too. “Hand sanitizer is going to be a better investment than bringing a whole tub of wipes,” Dr. Chin-Hong says. “And washing [or disinfecting] your hands before touching your face—that’s probably the most important thing.” Dr. Chin-Hong also says that because bathroom door handles tend to be particularly germy, it’s worth finding an alternate way to open the door after you’re done, like with a napkin or your elbow.

Back to topWhen is an irregular period a potential warning sign of a bigger health issue?There is one pretty glaring medical issue that can interrupt your period: pregnancy. If you’ve had unprotected sex, or PIV intercourse in general, and your period is late or missing, you should take a pregnancy test to rule that out completely. If you can’t tie your irregular period to pregnancy or any recent life events, medication changes, or lifestyle habits, something else could be at play, health-wise.AnnaMaria Maples, MD, an ob-gyn at Emory University School of Medicine inAtlanta, tells SELF that three or more months of irregular menstrual bleeding is a red flag that could indicate a bigger health issue, like a hormonal imbalance. “It’s important to have regular exposure to progesterone and estrogen,” Dr. Maples says. Ordinarily, that exposure would come from your own body’s production of those hormones. “Naturally, ovaries make these hormones and, together, they impact the menstrual cycle.” The specific way that your period is irregular can also tell you something about what the potential cause could be. “If you’re skipping many months between periods, that can sometimes be a sign of PCOS, or polycystic ovary syndrome,” says Dr. Kossl. “For those patients, sometimes when they’re skipping months, when their periods actually do come, they can be heavy or prolonged.” Dr. Kossl also notes that PCOS can be tough to diagnose, and that people with the condition often experience other symptoms outside of irregular periods. If you’re experiencing frequent ovarian cysts, hair growth that feels outside of your norm, acne, rapid weight fluctuations, prediabetes, or difficulty getting pregnant on top of an irregular period, consider talking to a doctor about getting tested for PCOS, which could mean undergoing a pelvic exam, some blood tests, and/or an ultrasound, per the Mayo Clinic.Dr. Cron says that debilitating menstrual pain also often indicates a bigger issue. She points to endometriosis—a condition that Lena Dunham, Halsey, and Padma Lakshmi have all spoken about living with—as a particularly excruciating cause of menstrual irregularity, as well as other symptoms, like pain during sex, fertility issues, stomach problems, and persistent fatigue, among others.Back to topWhen should I see a doctor about my irregular periods, and what should I say during the appointment? According to Dr. Kossl, if your period is causing you significant discomfort of any kind—or you just feel like something is off—you should discuss that with a medical professional. “If anybody’s experiencing changes to their periods that are resulting in bothersome symptoms, that’s always worth addressing,” she says. “That doesn’t necessarily mean that there’s something wrong or abnormal, but that’s what we’re here for as providers. People shouldn’t have quality of life issues secondary to menstrual periods.”If a visit to the doctor is an emergencies-only situation for you, the symptoms that can come with issues like PCOS and endometriosis are big signs that it’s time to talk to a health care provider. That means if you’re experiencing lots of pain (especially during sex), persistent fatigue, fertility issues, adult acne, or hair growth that feels abnormal for you, and irregular periods, that’s your signal to make an appointment if you can.So is nonstop bleeding—according to the Centers for Disease Control and Prevention, you should see a doctor if you are passing period blood clots that are the size of a quarter or larger, or bleeding through a pad or tampon in less than two hours. “In that case, we would do evaluations to see if there’s anything structural in the uterus, such as fibroids or polyps,” Dr. Kossl says. “For [people] who might be a little bit closer to menopausal range, we’d also be looking at some safety checks to make sure that we’re not seeing any precancerous or cancerous tissue that is presenting with abnormal bleeding.”